93-235 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 514 /1/ 1991
This is to certify that work requested to be done as shown by Permit No. 93-235
has been completed.
This structure may be used as a septic system
Location Nacy Road
Owner. John and Anne C. Dowd
44-1-13
By Order of Town Board
TOWN OF QUEENSBURY
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Director of Building & Code Enforcement
BUILDING PERMIT
TOWN OF PO No. 93-235
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WARREN COUNTY, NEW YORK r' o
PERMISSION is hereby granted to JOHN AND ANNE C. DOWD
OWNER of property located at Nacy 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. C7
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1. OWNER'S Address is
RD1 Box 1646
Lake George NY 12845 ca
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2. CONTRACTOR or BUILDER'S Name
George Savale
3. CONTRACTOR or BUILDER'S Address
Dream Lake
Queensbury NY 12804
4. ARCHITECT'S Name
5. ARCHITECT'S Address ()
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6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( ) Masonry ( )Steel (
7. PLANS and Specifications
Septic alteration to include 1000 galbn septic tank with
No. 2-8 'x8 ' seepage pits with #3 stone at 6 ' , as per plot plan
specifications and application.
8. Proposed Use to
Septic system
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$ 25 .00 PERMIT FEE PAID —THIS PERMIT EXPIRES MAY 28 1995 rt
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the fi
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this t Day of May 1993
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SIGNED BY : for the Town of Queensbury
Build' and Zoning In .-ctor
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APPLICATION FOR SEPTIC DISPO PE'Mat nil mit #
� ye Paid � '.
Date: 3121//93 <abOeSZbZtt eviewed By
LOCATION OF PROPERTY FOR INSTALLATION: L - riV 2 II
N/3CY ROAD (Neer Sovey OF A CRaANNA>
Owner's Name: .ro/{,V AND ANN VGidD
Owner's Mailing Address: RR °i, ,Qex /014 LAKE GEORc / Ny /2v/5—
Installer's Name: GAN9G47 Sav44f- Phone #: >92-211132
Number of bedrooms (if residential ): 3
Total daily flow (residential-compute @ 150 gal . per-bedroom): y fa
Topography-Circle One: Flat Rolling Steep Slope12
) % of Slope yQ - . O
Soil Nature-Circle One: Sand Loam Clay Other Gag/F-L /Depth: yp '
Ground Water-At What Depth? yS/ Feet
Bedrock or Impervious Material-At What Depth? EST; i510' Feet
Percolation Test-Circle One: Not Required) Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal 01111 Other SPRING fle usE ,
If domestic water supply is a well -
Separation: Water supply from any septic absorption //p feet (471er3,s'4,0rt)
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PROPOSED SYSTEM: Septic Tank 10.0-117 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench'------ '- feet//Total System Length - 2- -- feet
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Seepage Pit(s) : Number of 1‘. / Size each: -,( ..._ft. x 'Q ft.
Size of Stone to be used: # ,3 / Depth or Thickness d feet
**************
HOLDING TANK .SYSTEM IF REQUIREp
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: / s DATE: .572 y093
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TOWN OF QUEENSBURY
BUILDING 8 CODE ENFORCEMENT J/yC.
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 9fita /d/pj, iGte•V
Location — �/�
Date 2� 4'.3 Permit #
SOIL TYPE anLoam-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: Numb c
Size - 6 ft. ft.�a
Stone size ,
PIPING: $`ize Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/P�'t
Openings Sealed? No Partial
LOCATION/SEPARATIONS: ':.
Foundation to Tank 6 ' feet
Foundation to Absor. i otl feet
Separation of Pits a S feet
Conforms as per Plat Plan Yes No
LOCATION OF SYSTE- ON PROPERTY:
(circle one)
Front - Rear - L:ft Side - Right Side
Middle Front - ddle Rear
COMMENTS:
/1/ (z(014/14
c tLes.4 tW( `I
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SYSTEM USE APPROVED: e!!/)S NO-
Arrived: 1 , 3r)
Departed: yv z
iy
Building Inspector
TOWN OF QUEENSBURY a ,�
BUILDING & CODE ENFORCEMENT"' �
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location 1*( / '
Date e/s/ey. Permit # 9 ' - 7jj
SOIL TYPE: Sand-Loam-Clay-
Results of Percoation 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-
Size - ft. x ft.
Stone size
PIPING: ASize Type
Bldg. to Tank
Tank to Dist. Box °
Dist. Box to Field/Pit..
Openings Sealed? Yes, No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan ` Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Mi udl e Rear
COMMENTS:
1 k. /92,0pst 6 sz i4
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SYSTEM USE APPROVED: YES NO
Arrived: 0 - /5
Departed: a s
Building pector
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NACY ROAD , T01✓N OF (�t1E�NS(JURY
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