92-691 -1 -____
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Q c29 194,E
This is to certify that work requested to be done as shown by Permit No. 92-691
has been completed.
This structure may be used as a septic system
Location 379 Ridge Road
Owner Howard Be&teon
By Order of Town Board .
TOWN OF QUEENSBURY
Director of Building & Code Enforcement
BUILDING PERMIT
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TOWN OF QUEENSBURY
No. 92-691
WARREN COUNTY, NEW YORK oz
PERMISSION is hereby granted to HOWARD DENISON
OWNER of property located at 379 Ridge Road 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
RD1 10 Brookfield Run
Queensbury NY 12804
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2. CONTRACTOR or BUILDER'S Name
Battease Excavating
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3. CONTRACTOR or BUILDER'S Address a
4. ARCHITECT'S Name
5. ARCHITECT'S Address
CL
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6. TYPE of Construction—(Please indicate by X) cQ
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( )Wood Frame ( ) Masonry ( )Steel ( ) 0
7. PLANS and Specifications
No. Septic alteration to include two 8')(8' seepage pits with #3 stone
at 2 ft.
8. Proposed Use
Septic system
to
25.00 OCTOBER 27 94 -
$ 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.) p�
CD
Dated at the Town of Queensbury this 27th Day of October 19 92 -.
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SIGNED BY ,,� Xteiti � for the Town of Queensbury
Buil oning Inspector
MIIL
`` w TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #1, —
Fee Paid
.JWN OE QUEEM56Ur
Date: �cA � t ���(� Reviewed F�E�vED
LOCATION OF PROPERTY FOR INSTALLATION: 3 / RAckcifF T 2 6 1992
Owner' s Name: -Hoc-On-RA 1Thr3or-f. - 1 -pals
ii rrIscoplioorr
Owner' s Mailing Address: . j. IO 39oo k
Installer' s Name: ( \ wt �= 'G c i,�r�}�irc� Phone #: (9ica-175 7
Number of bedrooms (if residential ): J
Total daily flow (residential-compute @ 150 gal . per bedroom): `1 Sv
Topography-Circle One: 6-a-i) Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loamy Clay Other /Depth:
Ground Water-At What Depth? /L`//� Feet
Bedrock or Impervious Material-At What Depth? /1 4- Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: (1;unicipal Well Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
=xi.S?w(,
PROPOSED SYSTEM: Septic Tank /0 c)o gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench------------feet//Total System Length -------feet
Seepage Pit(s) : Number of / Size each: n" ft. x 6 ft.
Size of Stone to be used: # 73 / Depth or Thickness—, Z-- feet
**************
K SYSTEM IF REQUIRED
No. of Tanks Size` Gal .
Alarm and associated electric o 6e inspected r ified
cy. ___------ **************
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: DATE: /643 c/2
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:
TOWR OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
4 I -�
Name c j w.c4td, ,01242.4 1-,c_
Locatiog7 f' „P/„lr_,
Date Permit #
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number- 62-
Size - 6 ft. x ft.02(5 .,
Stone size 3
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box. / 4" ,q/t-
Dist. Box to Field/Pit ( G-c
Openings Sealed? No Partial
LOCATION/SEPARAT! S:
Foundation to Tank 2s.;G feet
Foundation to Absorption p feet
Separation of Pits 02/ fee
Conforms as per Plot Plan Yes
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
�toi9d _ riddle Rear
COMMENTS:Cc�iQcL `V� SGb�,,.,/
SYSTEM USE APPROVED: CYE. NO
Arrived: 1�r2 o
Departed: /7.7f
(T)
Building nspector
� � TOWN OF QUEENSBURY
Bay at Haviland Road, Queensbury,NY 12804-9725-518-792-5832
Building & Codes Department
INSPECTOR'S REPORT
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DAiici
PROPERTY LOCATIO
3 ?9 Dry
OWNER OR TENANT
BUILDING SEWAGE SIGN OTHER
REMARKS:
The water supply line that has been
temporarily connected, must be relocated so as
to have a minimum separation from the septic
system of 10 f ett. As per discussion with the
excavation contrActor, this office will require
that it be inspected before covering.
It may require inspection from the Water Dept.
as well; their interest being that type "K"
copper is installed at the proper depth.
CONTACT THIS OFFICE ylati with questions.
VIC LEFEBVRE .O.
INSPECTOR
/;'))P/
r0/ 01—
"HOME OF NATURAL BEAUTY. . .A GOOD PLACE TO LIVE"
SETTLED 1763
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BUILDING & Cii S. DEPT'
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