92-460 CERTIFICATE OFCOMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date d9r,,g,141 19P4
This is to certify that work requested to be done as shown by Permit No. 92-460
has been completed.
This structure may be used as a Septic Alteration
Location Ridge Road
Owner Warren Schmidt
By Order of Town Board
TOW QUEENSBURY
Director of Building & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY •
o
No. 92-460
WARREN COUNTY, NEW YORK1-1
v I
PERMISSION is hereby granted to Warren Schmidt c~n
OWNER of property located at Ridge Road Street,Road or Ave. H
t't
in the Town of Queensbury,To Construct or place a Septic Alteration I
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 .�
SAme t�
2. CONTRACTOR or BUILDER'S Name
Queensbury Sewer
3. CONTRACTOR or BUILDER'S Address eD
70
4. ARCHITECT'S Name
N
tD
e+
5. ARCHITECT'S Address
r
fD
6. TYPE of Construction—(Please indicate by X) e+
O
( )Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
Septic Alteration to include:
No. 1250 gal. tank with 250' of Tile Field using #2 stone, 10"
thickness as per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 31, 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 this 31st Da July 19 92
SIGNED BY f__ for the Town of Queensbury
Building and ing Inspector
_.ram
i J
44111
� � TOWN ' k
APPLICATION FOR S DISPO L P. ' IT Permit # 6
il N� Fee Paid
R �9 ! IRal
Date: y- I. Z TA °w,�oCen, co Reviewed By
VA 8.4.s ' st'f_/‘ -e
LOCATION OF PROPERTY FOR INSTALLA .
Owner' s Name A T 4 L i,
��n va
Owner' s Mailing Addres : 7,-Al L ,,, p, 1) _ C/, 0c - ç ( ) S —
Installer's Name: 1 tee) cis' u,a--7 Sew J2-„--- Phone #:
Number of bedrooms (if residential ): 2.7_
Total daily flow (residential-compute @ 150 gal . per bedroom): __,--z)
Topography-Circle One: lat ) Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sa Loam Clay Other /Depth:
—
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: of Requires Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal Wel ' Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption f S—t) feet
PROPOSED SYSTEM: Septic Tank / b gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench S--6 feet//Total System Length a0) feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # / Depth or Thickness Zee r feet
********r:*****
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: c k„,/e DATE: 7- .,I I'-7 z___
_loran o/ Queen Jhur,BUILDING and ZONING DEPARTMEN/-47',"
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION /&d -. i'd
DATE i�7 / C/02 PERMIT NO. 41 67
SOIL TYPE - Sand pia - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
/
TYPE of SYSTEM:
Absorption field, total lenth o2 5o
Length of each trend ire, /
Depth of trenches .
Size of gravel t� _
.
SEEPAGE PITS4Number of) v
Size- ft. X fib.;'
Gravel size
PIPING: Size Type
Bldg. to tank
Tank to dist. box 0 3$
Dist. box to field/pit y ,
Openings sealed? YES , NO Partial
LOCATION/SEPARATIONS:
Foundation to tank kit, ft.
Foundation to absorption $Oft.
Absorption to lot line ".---,-----ft:
Separation of pits -- ft.
LOCATION OF SYSTEM ON PR ERTY(circle one)
Front -ar7- Lef i el Right side -
COMMENTS:
cli
SYSTEM USE APPROVE,1111
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