92-587 - .
041
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date ?4?19 .Z._
This is to certify that work requested to be done as shown by Permit No. 92_587
has been completed.
This structure may be used as a septic system
Location 5432Bay Road
Owner Robert Hillis
By Order of Town Board
TOWN OF QUEENSBURY
Director of Building & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 92-587
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to ROBERT HILLIS
OWNER of property located at 543 Bay Road 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. r-
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1. OWNER'S Address is N
same
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2. CONTRACTOR or BUILDER'S Name �+
Sanitary Sewer
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address Poi
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6. TYPE of Construction—(Please indicate by XI
1 1 Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. Septic alteration to include 100 gallon septic tank and 200 feet of
tile field with 5 treaches at 40 foot each with #2 stone at 1 foot. f
8. Proposed Use CD
rD
septic system
(--
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$ PERMIT FEE PAID —THIS PERMIT EXPIRES
25.00 Setpember 25 ,19 94 sti.
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the O
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 25th Day of September 19 92
SIGNED BY e- for the Town of Queensbury
Building and Zoning In; ctor
TOWN OF QUEENSBURY
APPLICATIO1 FOR SEPTIC DISPOSAL PERMIT
DATE: " I 24 l 9 P L 46:11 '/ / ,` .a CIF UPPf)"_
LOCATION OF PROPERTY FOR INSTALLATION
Owner' s Name: R o1 e>LT ' ;///„."'
Address: y1 A I� / a e
Installers Name: C4-,v/ I,�At,�_. Telephone: '�92- s
Number of bedrooms (residential' only)
o y)
Total daily flow (compute @ 150 gal per bedroom) 1/5-0
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle on:.. Sand 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: Municipal Wei Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption /'0 o feet.
PROPOSED SYSTEM: Septic Tank / (l gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench 4}0 feet/Total system length 2 0 o feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used # 2.- /Depth or Thickness 1 feet
*****************************
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 the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: /�(�(,c,t DATE: "9Z
L
scat* SYstes Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be subsicced co the Building Department at least 24 hours before start
of construction and shall include a plot plan shoving:
1.) the proposed location of the system
2.) location and distance to lot lines
3.) location and distance to structures
4.) location and distance co any water supply
5.) size and dimensions of all conks, distribution boxes,
gild fields and/or drywalls
B. No system shall be covered before inspection and approval by the
uuilding Inspuctor. Failure to comply with this requirement say
re:ault in the uncovering of the system by the installer and a fine
of up co $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
rusulc 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 co the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, Nero_York_ 12804
k4m4rks: :.
1 '1`' 4-A4-L-UI --VI'. "
5/ ,3J� 1'_._- 51-'�I o-41-
Jown o1 Quee iburj
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
f Queensbury, New York 12801 /f"T7_j
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME eAe4sr 4 OW di,
21- .�
LOCATIONB � �
SATE Li /(7- PERMIT NO. %�,� )� /
SOIL TYPE - Sand -( oa - Clay -
Percolation Test Required? YES -ea
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length Q-)O
Length of each trench ly()
Depth of trenches ' .7 f-7--
Size of gravel
SEEPAGE PITS{NumbeI. of) '
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank \ i -/ S 4 li
Tank to dist. box y S D z. 3.— L-
Dist. box to field/A: S- _le.:-S" J _
Openings sealed? l NO Partial
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LOCATION/SEPARATIONS: ;
Foundation to tAnk ft./ j&,.&Z
Foundation to absorption \. ft. „T--
Absorption toot line ft. .40V
Separation o pits AY/4-ft.
LOCATION 0 .YSTEM ON PROPERTY(circle one)
Front - - Left side - Right side -
CC COMMENTS:
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SYSTEM USE APPROVED E . NO
Bui ding Inspe tor
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