91-179 I
Ipt
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date t /...� 19
This is to certify that work requested to be done as shown by Permit No. 91-4179
has been completed.
This structure may be occupied as a Septic Alteration
Location 389 Ridge Road
Owner Jonathan Hague
By Order Town Board
TOWN OF QUEENSBURY
(-7)/
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY 0
No. 91-179 x
WARREN COUNTY, NEW YORK a
0
PERMISSION is hereby granted to Jonathan Hague
OWNER of property located at 389 Ridge 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.
1. OWNER'S Address is
Same
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2. CONTRACTOR or BUILDER'S Name
Glen Batease `*
3. CONTRACTOR or BUILDER'S Address Oi
CO
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W
CO
4. ARCHITECT'S Name 1.0
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) y
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( )Wood Frame ( 1 Masonry ( )Steel ( ) e+r.
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7. PLANS and Specifications
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No. Replacing a 1000 gal. Septic Tank as per plot plan specifications a
and application
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8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES April 11, 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 11th Day of April 19 91
SIGNED BY // for the Town of Queensbury
Building and Zontr(g Inspector
\?J n TOWN OF QUEENSBURY ) 7
APPLICATION FOR SEPTIC DISP;mii PERMIT /
411.4 . 'V/fr
DATE:
LOCATION OF PROPERTY FOR INSTALLATION y tA:1L7c57 ! 1
Owner's Name: 6/-',/ /1/"V ,/4 &' "
Address: _5 /i 1_
Installer's Name: '%r_"Jjl/y 7 /�r97 =' Telephone: '7? ;2 77 c �"
Number of bedrooms (residential only)
Total daily flow (compute @ 15 gal per bedroom) — (- CD
Topography: Circle one: " Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: and Loam Clay Other /Depth:
Ground Water: At what depth? ,n iy "feet
Bedrock or Impervious Material : At what depth? TOWN OF U ENS6UH"
VIZ ill
Percolation test: Circle one: ` not required_- required 103
Rate - Min. Per Inc h APR 19
1 i9 1 dof9
Domestic water supply: Circle one: , Munici Oth4UILOING & CODE DEPT.
If domestic water supply is a we ,,/.
Separation: Water supply from any septic absorption feet.
\..fTh PROPOSED SYSTEM: Septic Tank ./C2 C gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #. /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 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.
r
SIGNATURE OF RESPONSIBLE PERSON: < � `'" DATE: 4216//
Jown o f Queen t u r i
6
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME QYJ/Z(lLJ !r � i
LOCAT I ,-)--"1 V ,£f 7171 /ed
,.,
DATE 4// 9/ PERMIT{NO. 7/7, , ,,,
�/
SOIL TYPE - San ; Lo 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- /0 ft. X G( ft. Win-,,,
Gravel size .:;,
's
PIPING: Size Type
Bldg. to tank + l!/=-
Tank to dist. box }/( Jr
1 t
Dist, box to field/pit` r
Openings sealed? YF NO Partial
LOCATION/SEPARATIONS ,
Foundation to tank / ft.
Foundation to absorption 01-5ft.
Absorption to lot line ft.
Separation of pits 1 ft.
LOCATION , ___SYSTEM ON PRbPERTY(circle one)
Front .'Rear '- left side( - Right side -
COMMENTS. i
,It: ,
a"
(5
1i
SYSTEM USE APPROVED ( YES
a
i1 ing Inspector
01/86 and vl
(Avo(a:U 'o
_town o/ Queeniiury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME _ (`? n c C't.M \_\CC*LQ .
LOCATION -iS 1 (;:p1 C\
DATE Li /4 PERMIT NO. 9/ / C7
SOIL TYPE - Sand`',- Loam - Clay - '
Percolation Test Required? YES /' NO
Percolation rate -,Min/Inch fr.
TYPE of SYSTEM:
Absorption field, tot 1 length
Length of each trench
Depth of trenches
Size of gravel _
SEEPAGE PITS{Number of) I
Size- ft. X ft.
Gravel size
PIPING: SizO Type
Bldg. to tank
Tank to dist. box /
Dist. box to field/pit /
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank ft
Foundation to absor ion
Absorption to lot lne
Separation of pits.' ft.
LOCATION OF SYSTEll ON PROPERTY(circle one)
Front - Rear - Lt side - Right side -
COMMENTS:
SYSTEM USE APPROVED YES
i1 ng Inspector
01/86 and vl
P H
1
1
1
TOWN OF GUEENSBURY
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APR 111991 Li
BUILDING & CODE DEPT.
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