90-135 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date June 1 19 92
This is to certify that work requested to be done as shown by Permit No.90-135
has been completed.
This structure may be used as a sewage alteration
Location 31 Fitzgerald Road
Owner Donald A. Milne
By Order of Town Board
TOWN OF QUEENSBURY
Director of Building & Code Enforcement
BUILDING PERMIT 1-3
TOWN OF QUEENSBURY No. 90-135 ro
WARREN COUNTY, NEW YORK
O
PERMISSION is hereby granted to DONALD A. MILNE i`
OWNER of property located at 31 Fitzgerald Road
p p ty g 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. 4
1. OWNER'S Address is cD
764 Pease Lane
W. Islip NY 11795 z
2. CONTRACTOR or BUILDER'S Name
Bill Threw
3. CONTRACTOR or BUILDER'S Address
rj
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4. ARCHITECT'S Name
(J4
•s
Sv
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( 1 Masonry ( )Steel ( 1
7. PLANS and Specifications
No. Sewage alteration as per plot plan, specifications and application. sr
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(I)
8. Proposed Use
I
Sewage alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Apr- 47 19 9`2
(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 th)5 17th Day of April 1990
SIGNED BY for the Town of Queensbury
Building and Z ing Inspector
•14:1 -. APPLICATION FOR
--� � SEPTIC DISPOSAL PERMIT
gab
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DATE 3 /l/fo APR 0 6 1990
LLJ . & CODE DEPT.
LOCATION OF PROPERTY FOR INSTALLATION 3/ 'A'reiPlkp J.
Owner's Name: �/ .� A. /yJ/y1/( Telephone: (s/6) ‘B 7-41,267
Address: 74 9 447.2E_s e. LA/.. 1Jesr lam[.%i° /v(f //7 9Y
Installer's Name: O/'// -iea) Telephone: 773—37 8/
Number of bedrooms (residential only)
Total daily flow (compute 0. 150 gal per bedroom) c°
?AwK # A' ' pe r ied-0 pA)
Topography: Circle one. Rolling Steep Slope of Slope.3O f Le,e�.. Pu,K P yps�•o�,
ntivK r„ r,e.
Soil Nature: Circle one: Sand Loam Clay Other 4" '�4��epth: SO Feet '"0
Ground Water: At what depth? ./110/ 00 Feet
Bedrock or Impervious Material: At what depth? Feet 4, 4A
Percolation test: Circle one: not required required rate min. inch.
Domestic water supply: circle one: Municipal Well Other f'7vARtp cieeM .e44 - .e
If domestic water supply is a well:
Separation: Water supply from septic absorption /30 feet
PROPOSED SYSTEM: Septic Tank /O0-40 gal. (minimum size: 1.00n gal.)
TILE FIELD: Each Trench feet/Total system length • feet
SEEPAGE PIT(S): Number of p
/ Size each O feet by ? feet
Size of stone to be used #3 /Depth or Thickness feet
*************************
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 Sanitar ewage Dispos rdinance.
SIGNATURE OF RESPONSIBLE PERSON:
DATE: 54ichJ S'I 9 O
OVER
awn of Queen Jurf/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTICkf
AL SYSTEM INSPECTION
NAME e
LOCATION f //r e / . /-`1
DATE AIV 0 PERMIT N(�,. C 13
SOIL TYPE -Sand - Loam ' Clay -_
Percolation Best Require,? YES - NO
Percolation ate - Min/ r ch
TYPE of SYST
Absorption fie.d, total length
Length of each rench
Depth of trench s
Size of gravel_ 1 _
SEEPAGE PIT -{N - .- r of
Size- t. X _ f
Gravel size
PIPING: Si -, T,vpe
Bldg. to tank r /' t
Tank to dist. box r
Dist. box to field/pi " `L, '.
Openings sealed? YES 0 artial
LOCATION/SEPARATIONS: �,jj
Foundation to tank 1/7ft.
Foundation to absorption ft.
Absorption to lot line �ft.
Separation of pits _IpIt.
LOCATIO S ST.M ON PROPERTY(circle one)
Front -(tear .,- *ft side - Right side -,
COMMENT , 7 /
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