1996-681 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date t etA roll A, 19 0.6
96681
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be used as a SEPTIC ALTERATION
Location 58 REARDON RD.
Owner GLARY, ¶HOIIAS L.
By Order of Town Board
TAX MAP NO. 45. —3-14 TOWN OF QUEENSBURY
Director of Building & Code Enforcement
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BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 96681
" TAN MAP NO. 45. -3-14 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to GLARY, THOMAS L.
- OWNER of property located at 193 REARDON RD' Street,Road or Ave.
in the Town of Queensbury,To Construct or place a SEPTIC 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
193 REARDON ROAD
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
KRUGER CONCRETE, INC.
3. CONTRACTOR or BUILDER'S Address
8 HAROLD HARRIS RD
QUEENSBURY, NY 12804
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
1 1 Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 November 1 98
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(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 1` Day of November 19 96
SIGNED BY — f J1N'V'\ c j for the Town of Queensbury
Buil.ing and Zoning I ns6ector
._l . , Application fin' SEPTIC DISPOSAL PERMIT 0
• Si'AMP RECEIVED
VED
Location of property fur installation: R.Ati ot4 A O D 0
Owner's Nan ; I �o s L. • C L.A ky PERMIT NUMBER
Owner's Mailing Address: CR1Sl Y ,-1-.1
FEE PAIL O v `1,
• Installer's Name: kR 14 GEn CONCie64_ Phone #: 793 -S'907 e)
td
Number of bedrooms (if residential): �2
Total daily flow (residential in-compute 150 gal. per bedroom): `���
Total
Topography: ( I Flat . f1 Rolling Steep Slope % of Slope
Soil Nature: ( ✓I Sand r Loam • r Clay Other /Depth:
Ground Water: at what depth? :NOW Al.# Ccct I _ _s {
Bedrock or Impervious Material: at what depth? 70 feet OCT 3 •
1996 1
pi t
Percolation Test: [V i ^Nut Required I I Required/Rate T' min. per-inch ' -`o 1
Domestic Water Supply: I I Municipal I ( I Well r-1 Other
If domestic water supply is a WELI. water supply from any septic absorption is 15U feet
PROI'OSEI) SYSTEM:
Septic tank: rcto0 gal, (minimum size: 1,000 gal.) -
Tile Field: each trench feet. / total system length feet.
Seepage Pit(s): number of i 1 size each: V ft.x /0 ft.
Size of stone to be used: # 3 / depth or thickness d feet.
HOLDING TANK SYSTEM: (if required) - •-
Number of tanks: • Size of each: gal. . -• -
tAlarm system and associated electrical work to he inspected by a certified agency.
For your protection, please note that pursttant to Section 136-29 of the Code (lithe Town of
Queensbury, any permit or approval granted which is based upon or is granted in reliance upon
any material misrepresentation or failure to make a material fact or circumstance known by or on
behalf of an applicant, shall be void.
.
•
1 have read the regulations with respect to this application and agree to abide by these and all
requirements of the Town o f Queensbury Sanitary Sewage
Disposal Ordinance. - .
Signature of responsib'e person: /74"4'f af -tl Date: /0/30 Jg
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OCT 311 1996 __. ,
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DATE
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50 FT. FROM ; SEPTIC
1200 �\
WELLS
I TANK
HUMP. STAT.
, -DIST. BOX
150 FEET
FRONVINELLS
200 FT. 8X10 ) L. PIT
FROM LAKE �_ i`
;4 Page No. of Pages €.._
KRUGER CONCRETE, INC.
8 HAROLD HARRIS ROAD
QUEENSBURY NY 12804-1244
PH. 518-793-5707 c.
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M1 PROPOSAL 0.UBM\Ta Tn (Q t fp PHONi - E. DATE oc �q 1 )qq 9 "
STREET Y JOB NAME I
S
,,CITY,STATE AND ZIP CODE JOB LOCATION
Reax-d n Rd- > ,
s:ARCHITECT DATE OF PLANS JOB PHONE `t-'`.
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.We hereby submit specifications and estimates for.
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64ed( V66 cc of l o 4 .Se �c�
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; 6 .41 ICU.)` — a o_0frn 1po m1O - -A r
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sA-a,�\ ^c2 " . 1 C--'e. �na�'�n v Q.-o g X \ o ' cl \Cie '
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INe Propose se hereby to furnish material and labor — complete in accordance with above specifications, for the sum of:
ti'dollars(S 766, 66 ).
,- Payment to be made as follows:
:tie,`
1
'44 All material is guaranteed to be as specified.All work to be completer)in a substantial workmanlike 'c�,.t _... •
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manner according to specifications submitted per standard practices.Any alteration or deviation from Authorized
above specifications involving extra costs will be executed only upon written orders,and wilt become Signature 74-W7 —an extra charge over and above the estimate.All agreements contingent upon strikes,accidents ordelays beyond our control Owner to carry fire,tornado and other necessary insurance.Our workers Note` This propos be t
are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days.
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AC C ; ;r:;.o-r .:`' ':. . .. -The above prices,specifications
and conditions are satisfactory and are hereby accepted. You are authorized to do
the work as specified. Payment will be made as outlined above. Signature
Date of Acceptance: Signature
TOWN OF QUEENSBURY ,
BUILDING & CODE ENFORCEMENT .
531.'Bay Road:
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name C4440'
Location 1eG—Aie00n) 2) ,
Date 14/G jt Permit # �� 6'g/.
SOIL TYPE: and Lo.m-Cly-
Results of Percolati Test
(if applicable) Rat.- +inute/Inch
TYPE OF SYSTEM:
ABSORPTI IELD: Total Length
Length each t ench
Dep of trench s \
S' e of stone ` \ 1
SEEPAGE PITS: Number- [ \
Size - g ft. x A) ft.
Stone size
PIPING: Size Type
Bldg. to Tank 4k /3.Ye,
Taprk'to Dist, Box
Dist, Box to Field/P'Aiiim • " 5 b/2o 24
Openings Sealed? OP ' No Partial _
LOCATION/SEPARATIONS:
Foundation to Tank .`JrCD feet
Foundation to Absorption /2 feet
Separation of Pits feet
Conforms as per Plot Plan Aial No
LOCATION OF SYSTEM ON PROPERT' .
(circle o eh
Front - z. < .- Left Side- Right Side
Middle Front - Middle Rear
COMMENTS:
/4„ 5er6 cci&5 -lla' ( C�u.5 C � T
SYSTEM USE APPROVED: ' NO
Arrived:
Departed: inr
Building Inspector
TO OF QUEENSBURY
BUILDING CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name a.9r2f'
Location , gj2 a') J
Date ///f-A10 Permit # Z--6e(
SOIL TYPE: S nd-LoamTClay-
Resul is of Percol ion Test-
(if applicable) Rate inute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: T,tal ength
Length of each tre ch
Depth of trenches
Size of stone -
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot P1 an Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
1�- &Jo 4h7 Reet v t te.6'D
rn- .. C-ice I A.► PoC)T 14J5/1 c
SYSTEM USE APPROVED: YES N
Arrived:
Departed: //
Building Inspector
e arJL
®€ f OF QUEEf SBURY
UILDING & CODE ENFORCEMENT
531 Bay .Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ---\CO- 1 / TA_Cfna S
Location q lEpy;)(j`0
Date 11 -- 16 Permit #%
r�9_Loan1. Clay-
Results SOIL TYPE: a of Percolation Test-
(if applicable) .R 'e-Minute/Inch
TYPE OF SYS EM:
ABSORPTItx D. Total Length
Length of ach ench
Depth trench
Siz/f stone
SEEPAGE PITS: Number ,
Size - ft. xft.
Stone size
PIPING: f Size Type
Bldg. to-"Cank 1/'
Tank to' Dist. Box
Dist. Box to Fie1d/P -t
Openings Sealed? No arti al'
LOCATION/SEPA F ,,TIONS: —
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan es, No
LOCATIC OF SYSTEM ON PROPERT
(circleOe.
Front - R Left Side - Right Side
Middle ront - Middle Rear •
COMMENTS: "� L eat+ g.s 6)0 4
L6n)- cArK 2 -\pu6
.0K "ra Cooe2 L I n16 ON
SYSTEM USE APPROVED: YES ` NO '
Arrived: W
Departed:
-WC"'
Building Inspector