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1990-802 CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date January 16_ 101 19 — This is to certify that work requested to be done as shown by Permit No. 90 802 has been completed. This structure may be occupied as a Septic Alteration Location Reardon Rd, Glen Lake Owner Irene Olson By Order Town Board TOWN OF QUEENSBURY Director of Bldg. & Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No 9Q_802 WARREN COUNTY, NEW YORK 0 (xi PERMISSION is hereby granted to Irene Olson ca OWNER of property located at Reardon Rd, Gl enLake Street,Road or Ave. in the Town of Queensbury,To Construct or place a Septi c Alteration 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 r., SameCD • ro 2. CONTRACTOR or BUILDER'S Name to 0 Sanitary Sewer 3. CONTRACTOR or BUILDER'S Address CD -S Ct. 0 4. ARCHITECT'S Name s 5. ARCHITECT'S Address rD CD 6. TYPE of Construction—(Please indicate by X) ( )Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications No. Septic Alteration as per plot plan specifications and application including: Pump Replacement & Tank Only 8. Proposed Use CD Septic Alteration CD $ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES January 15, 19 93 (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.) Dated at the Town of Queensbury this 15t.11 Day of January 19 91 u � SIGNED BY for the Town of Queensbury Building and Zoning Inspector 11!#�� IVWLV titL2UttVJIiUKY 1 1 APPLICATION FOR SEPTIC DISPOSAL PERMIT b52/2,%7( DATE: //a- 'gi OWN OF QUEENSBURY LOCATION OF PROPERTY FOR INSTALLATION RECEIVED Owner's Name: "'€ 0 NOV 2 3 1990 � F Address: A .101 4r, c- BLDG_ & cons Installer' s Name s/ A f r Telephone: 7 2 ) Number of bedrooms (residential only) oet14 Total daily flow (compute @ 150 gal per bedroom) Topography: Circle one: Flat Rolling Steep Slope % of Slope Soil Nature: Circle one: Sand Loam Clay Other ,, 'J /Depth: Ground Water: At what depth? 1 Feet Bedrock or Impervious Material : At what depth? Feet Percolation test: Circle one: ( not re uir required Rate - Min. Per Inch Domestic water supply: Circle one: Municipal Well Other If domestic water supply is a well : Separation: Water supply from any septic absorption feet. PROPOSED SYSTEM: Septic Tank 6n :077,„/"0(0, gal . (minimum size: 1,000 gal ) TILE FIELD: Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of /Size each feet by feet Size of stone to be used #. /Depth or Thickness feet fp u RA - Air ***************************** ';*ori HOLDING TANK SYSTEM IF REQUIRED NO. of Tanks Size of Each Gal . *Alarm system and associated electrical work to be inspected by an approved agency. I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of t Town of Queensbury Sanitary Sewage Disposal Ordinance. c' SIGNATURE OF RESPONSIBLE PERSON: DATE: . "' 4 • pie System InsEections: A. All applications for septic system installation, alteration or repair, as required ,by the Town of Queensbury Sanitary Sewage Ordinance, shall be: submitted Co 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 co structures 4.) location and distance co any water supply 5.) size and dimensions of all tanks, distribution boxes, tile fields and/or drywalls 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 co produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installa— tion, alteration or repair of an approved system, a new proposal must bu submitted to the Queensbury Building Department before further • construction. • Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York 12804 • Rgmar}Cs: a • TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280i TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME 4*e$41 LOCATION /f a* �}Ars' /ems DATE (( PERMIT # APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS. WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE & RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER(S) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION _FINAL APPROVAL OF CONSTRUCTION OK TO ISSUE C/O OR O/C A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: iaae pV 4/ ,j ARRIVE DEPART T_MCDLY!T!_]D-_ -- _ _- __ I ..... N11 OF QUEENS-BURY RECE -' /.`/„/ 1'¢.iec JAN 8 1991 9L©Go & CODE DEPT. ;. siA F;k£ kr- -..�. , i , t) ,tsr pi"pc, lito^.1 tr44c4 res- vU t10i i F 7 J . ifriR,,:c„-?.: a , :, ppA RY GATE /o lir j • R 1 r ill L_____frip__________-----0------------f yef-inL- TIN v f i A ,���.+�Tie„r dr- . �a'rie-'. pu 6p Tt94"4 Lz>4•glt44 e. els—if