91-493 ;moo
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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
_ . Date _ ), ,494 9J
This is to certify that work requested to be done as shown by Permit No. _ 91-493
has been completed.
This structure may be occupied as a Septic Al terati on
Location 15 Lynnf i el d Drive
Owner Mike Hevenor
By Order Town Board
TOWN OF QUEENSBURY -
Director of Bldg. do Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-493
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Mike Hevenor 3
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OWNER of property located at 15 Lynnfield Drive 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.
F-
1. OWNER'S Address is
Same
2. CONTRACTOR or BUILDER'S Name
Steven Sanders
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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)
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( I Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No.Septic alteration to include: 330' of Tile field using #2 stone, 1' thickness as
per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 10, 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 1 Day of July 19 91
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SIGNED BY / G;' L, for the Town of Queensbury
Building and Zoning I,spector
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TOWN iF ,� E�IS�gU�t1 QSF QUEENSSUR, VED ,
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APPLICATION FOR SEP/� A' SPOSAL P: IY Permit #
�1/ JUL 10 1991 Fee Paid
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Date: d Cal BLDG. & CODE DETviewed By
LOCATION OF PROPERTY FOR INSTALLATION: /5 2 /n ieb/
Owner' s Name: Mi he Pifvekrd"-
Owner' s Mailing Address: lynrp-,4/ Or' (S ue frx
Installer' s Name: Phone #:
Number of bedrooms (if residential ): dr
Total daily flow (residential-compute @ 150 gal . per bedroom) : 7,50
Topography-Circle One: lat Rolling Steep Slope % of Slope
Soil Nature-Circle One: g-p---4) Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? --- Feet
Percolation Test-Circle One: No Resuired Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: ZILn.icipa> Well Other _
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank /D00 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 50 feet//Total System Length 3:3D ' feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # 2 / Depth or Thickness / 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 the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: �� JaAiliO DATE: / 9/
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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OWN OF QUEENSBU
REC ;DIED
JUL 10 1991
BLDG. & CODE DEPT.
66-Oird�'In�
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_Torun o f Quenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
C)ueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 14Q,V Pccx` 11);ke_
LOCATION J' joyi n7 i c4C)
DATE 7 //7/ PERMIT NO. 99
SOIL TYPE - Sand`'- Loam - Clay -
Percolation Test Required? YES -
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, tota] len th j?C:) -f- --
Length of each trench O. `!o c i
Depth of trenches -L 0--T-
Size of gravel •: _
SEEPAGE PITS{Num o )
Size- . X
Grave siz-
PIPING: •ize Type
Bldg. to tank /�CCST-j•(/(�i�
Tank to dist. box Lf f�
Dist. box to field/p L./
Openings sealed? :S NO Partial
LOCATION/SEPARATIO, S4t �.
Foundation to tan) bXcS :l�
Foundation to abs rption cift:f-
Absorption to to line /0 ft.-t—
Separation of pi s A/.,q_-ft.
LOCATION OF SYS EM ON PROPE TY(circle one)
Front - Rear - eft side - Right side -
COMMENTS: /
P6-eXICT CiAni
SYSTEM USE APPROVED YES NO
Buil ing IAsp or
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gown of Queen Jhurcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME Qfr41Lti 41/
LOCAT I 616 i'ite-rou 9‘iii /6(
DATE 1 '1/9/ PERMIT NO. 9/ '7(9.
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 trenches
Size of gravel
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank 1! C'�L Pt'(
Tank to dist. box
Dist. box to field/pit
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS: _
Foundation to tank J ft.f`-L. '
Foundation to absorption ft.
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS: i
i
/oo61 01 0An-y
SYSTEM USE APPROVED Y 0
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B i din I Spector
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