1992-439 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSOURY
WARREN COUNTY, NEW YORK
Date (74 4 .2z 19
This is to certify that work requested to be done as shown by Permit No. 92-439
has been completed.
This structure may be used as a Septic Alteration
Location 3 Orchard DRive
Owner Stephen Tucker
By Order of Town Board
TOWN OF QUEENSBURY
(7) ,
Director of Building & Code Enforcement
BUILDING PERMIT x
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TOWN OF QUEENSBURY
No. 92-439
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Stephen Tucker
OWNER of property located at 3 Orchard Drive Street, Road or Ave.
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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
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2. CONTRACTOR or BUILDER'S Name
Queensbury Sewer
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction— (Please indicate by X) C
( I Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No. Septic Alteration to include: 2 seepage pits each 8' x 8'
using #3 stone, 2' Thickness as per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 21, 19 94
(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 tls ` Day o July 19 92
SIGNED BY / ) for the Town of Queensbury
uilding and Zo i/ Inspector
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TOWN OF QUEENAMNIDNSBUII
APPLICATION FOR SEPTIC DISPOSAL PEIRVICFEIVED Permit # 6i" ��g
Fee Paid „ ��
JUL 20 1992
Date: 5411 (20 Z Reviewed By
91LDG.LOCATION OF PROPERTY FOR INSTALLATION: _ ) &( V DEDEFT r G r- y�
Owner' s Name: 371-erh,e it) /Gt� 2 r
Owner' s Mailing Address p7 Gh e v--j 7) r .
Installer' s Name: /,L,o P0 � �- �Q , Phone #:1/9 - 3C V
Number of bedrooms (if residential ) :
Total daily flow (residential-compute @ 150 gal . per bedroom): `7ZS C)
Topography-Circle One Rolling Steep Slope % of Slope
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 of Required)Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: 4611111100111Well Other _
If domestic water supply is a we -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank /7 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of :2 / Size each: ft. x g' 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 th Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE: 1/41-07 --- ?
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:
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Bay and ha. _- _E_ _ = ' Boxes.
Queensbury, New Yc-,‘ _-
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION ozI" tt.. 166,i
DATE i/i11^/ q PERMIT NO. ;/;- LI. cj
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SOIL TYPE: latzw..- Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length /
Length of each trench
Depth of trenches --
Size of gravel
SEEPAGE PITS{Number of)
Size- 8 ft. X _ g ft. -- s,eu.... .„
Gravel size
PIPING: Size Type
Bldg. to tank Pc,154-,
Tank to dist. box - y
Dist. box to field/pit << < <
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank Ecc34'. ft.
Foundation to absorption 343 ft.
Absorption to ]bt line 30 ft.
Separation of pits A0 ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
ron - Rear r Left side - Right side -
C ENTS: J
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SYSTEM USE APPROVED YES 0
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