90-485 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date July 26 19 90
This is to certify that work requested to be done as shown by Permit No. 90-485
has been completed.
This structure may be occupied as a sewage alteration
194 Shermanativenue
Location
EDWARD KERR
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enfo
rcement
BUILDING PERMIT ,.
1-3
TOWN OF QUEENSBURY
No. 90-485
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to EDWARD KERR
OWNER of property located at 194 Sherman Av Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage 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
t17
47 Garrison Rd
Queensbury
to
2. CONTRACTOR or BUILDER'S Name
-s
Queensbury Sewer
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
I
cc
5. ARCHITECT'S Address N
Pp
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( 1 Masonry ( 1 Steel ( )
7. PLANS and Specifications
No. Sewage alteration to include 1000 gallon tank, 200 feet of tile field with
#2 stone at 1 ft. depth. U'
8. Proposed Use c
Sewage alteration (I)
n
$ 25_n0 PERMIT FEE PAID —THIS PERMIT EXPIRES July 24 19 92
(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 24th Day of July 19 90
� 1 f`
SIGNED BY `— ' ✓ for the Town of Queensbury
Building and Zoning I ctor
TOWN OF QUEENSBURY ,Q
*ArmAPPLICATIOr1 FOR SEPTIC DISPOSAL PERMIT (r
DATE:
LOCATION OF PROPERTY FOR INSTALLATION,
Owner' s Name: Ji
Address:
Installer' s Name: . �� °,; ,. -� Telephone: / -, (/
r
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) /_1
Topography: Circle one: (Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: ,- 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: c-Municipal. Well Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption - feet.
PROPOSED SYSTEM: Septic Tanks,, gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench 4`_ - 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 Mork 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.
a
SIGNATURE OF RESPONSIBLE PERSON: I { DATE: \ fir'
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 co the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
1.) the proposad 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 anal/or drywalls
B. Nu system shall be covered before inspection and approval by the
Building Inspuctor. 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 co produce said plot plan at time of inspection may
result 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
be submitted to the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
kwniarks: :,
.Town o f Queenilur, /!ila
B ILDING and ZONING nEPARTMENT
Ba and Haviland Road R.D. 1 Box 98 /O
Queensbury, New ork 12801
SEPT DISPOSAL SYSTEM INSPECTION
NAME � /Lt E�� 15/1%
LOCATION 494/1},A/ -' z/
DATE 7/21 (1.9 PERMIT 0. 9r-1693
SOIL TYPE s and Lo- - Clay -
Percolation lest Requi ed? YES - NO
Percolation ate - Mi Inch
TYPE of SYST y, :
Absorption f i-ld, to•=1 lengtp /90
Length of eac trenc 3- 6a /. /a
Depth of trend es /
Size of gravel it —
SEEPAGE PITS-EN •er of)
Size- ft. _ ft.
Gravel size
PIPING: Size Type
Bldg. to tank „ f/c �xt
Tank to dist. box p"C.
Dist. box to field ,;•it `/~ Pi .—
Openings sealed? dap NO Partial
LOCATION/SEPARATI• •
Foundation to tan• (02, ft.
Foundation to abs• rp'ion o2O ft.
Absorption to lot lin- /0 ft.
Separation of pi ft.
LOCATION OF SYST: ON •ROPERTY(circle one)
Front -dr, L. ft site - Right side -
COMMENTS:
SYSTEM USE AP 'ROVED drble
rid::
Build''g ' nspe•tor
01/86 and vl
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