1993-157 •
CE ° ®.ti:.! !, 1 CIMPLIA CE
TOWN OF QUEENSOURY
WARRE i COUNTY, NEW YORK
Date May 4 19 93
This is to certify that work requested to be done as shown by Permit No. 93-137
has been completed. .
This structure may be used as a septic system
Location 5 Prospect Drive
Owner Nicholas Caimano
91-3-5
By Order of Town Board
TOWN OF QUEENSBURY
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E F
• Director of Building & Code Enforcement
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•
BUILDING PERMIT
TOWN OF QUEENSBURY
No. Q3-/5'1
WARREN COUNTY, NEW YOR.K ' .p
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PERMISSION is hereby granted to /v 1('holl Oa;Ma.r)D
OWNER of property located at .5 racpecf- -i've Street, Road or Ave.
in the Town of Queensbury,To Construct or place a SPpiic. A I fern d-i'on
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
II H lnrick CIrCie..
(QLLeensbu.ryt, N1 1280L)
Z
2. CONTRACTOR or BUILDER'S Name
53on ct Yy Sewe{r 5v-ce.
3. CONTRACTOR or BUILDER'S Address
PO Bx 224
Glens ' uls ay i 9oI-azzy
4. ARCHITECT'S Name
5. ARCHITECT'S Address
V
6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
No. 663T-, cafe c.0- oy-i `fD inclu e, 1000 Cgc..0 54)t1c +ctrn k and
,2 i()($' SeePQ,9 i+s a5 Per Plo+. loran w-)d appL CCi songs.
8. Proposed Use
S fil c s1/5-1-em
$ 2,5,U0 PERMIT FEE PAID —THIS PERMIT EXPIRES APRIL 2R 19 q4 0\
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
i7
Dated at the Town of Queensbury this . I-41 Day of " 19 q-3
((
SIGNED BY • C/ �1j / for the Town of Queensbury I'i'1
Building and Zoni nspector
,�► , 9'- 3 - 5 .
TOWNQUEENSB QUEENSbL
� � APPLICATION FOR SEPTIC DISPOSAL 11MIT Permit # 73-157
Fee Paid , ;cc
AP R'11 1993
Date: f__ 09q� . ._- CODE DEp`Reviewed By �f i
LOCATION OF PROPERTY FOR INSTALLATION: � P4ocj a?
Owner' s Name: /V /a._ C9-/,1,4-A)o
Owner' s Mailing Address• ', 6z,„v,2„Aq�!,cG-
Instal ler' s Name: JA/0 7 /k .2a---' Phone #: 792 -72_5
Number of bedrooms (if residential ) : J
Total daily flow (residential-compute-@ 150--gal-. per bedrecm) : 4
Topography-Circle One: Flat Rolling Steep Slope % of Slope
r
Soil Nature-Circle One: San. Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Cunicipal ell Other
If domestic water supply is ar_
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank i0� gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length p, feet
Seepage Pit(s) : Number of /�I / Size each: A'" ft. x- _" ft.
Size of Stone to be used: # / Depth or Thickness 2/feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size\of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
I have read the regulation on the reverse side of this sheet and agree to abide
by these and all requirements of e wn of Quee s Ty Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON DATE: �.v"y,
•
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
1) the proposed location of the system
2) location and distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution boxes, tile fields
and/or _drywells
B. No system shall be covered before inspection and approval by the Building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
cc�� / `(1' •
• _locun o/ Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 .Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME OPt- ( 11/V/1-U 6 --
LOCAT I ON S NOD D e6€f \
DATES/ (/ 9 PERMIT NO. 93'I -
SOIL TYPE - Sand) Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: •
Absorption field, total length
Length of each trench '
Depth of trenche -
Size of grave
SEEPAGE PITS{Number of) -/' --,,_
Size- Kft. X g ft.� ,-'
Gravel size .
PIPING: Size Type
Bldg. to tank 4 Gf �,De j
Tank to dist. box 1 t\ i" LI
Dist. box to field/ V.‘ °%
Openings sealed? YES l(NO Partial
LOCATION/SEPARATIONS-I" }i
Foundation to tank( '\ ft.�+L`
Foundation to absorption \ ft..r . ,- i
Absorption to lot line \ ft. :
Separation of pits ft.
LOCATION-,- YSTEM ON PROPERTY(circle one)
Front41:110 Left side - Right side -
COMMENT .
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SYSTEM USE APPROVED ES NO
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i\i OF QUEENSb
RECEIVED
.411PR e.i 1993
. - & CODE DEPT
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