93-728 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date /P eeart,�.t.�if. RI 19 93
This is to certify that work requested to be done as shown by Permit No. 93-728
has been completed.
This structure may be used as a septic system
Location Reardon Road
Owner Margaret Wallace
By Order of Town Board
44-2-27 TOWN OF QUE SBURY
Director of Building & Code Enforcement
BUILDING PERMIT
ro
TOWN OF QUEENSBURY No. 93-728
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to MARGARET WALLACE N
OWNER of property located at Reardon 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.
r
1. OWNER'S Address is
same
2. CONTRACTOR or BUILDER'S Name Fl
Queensbury Sewer Svce `c
n
m
rt
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
;CJ
(D
6. TYPE of Construction—(Please indicate by X) O
( 1 Wood Frame ( ►Masonry ( )Steel ( ) 'd
O
SZ
7. PLANS and Specifications
Septic alteration to include 1000 gallon septic tank
No. with one 8 ' x8 ' seepage pit with stone as per plot plan,
and application and in accordance with Town Board
8. Proposed Use Resolution # 60 , 93 .
Septic system
rt
$ 25 . 00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 14 19 95
(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.) N
rt
(D
11
Dated at the Town of Queensbury this thDay of December 1993
rt
SIGNED BY ,j for the Town of Queensbury
Building and Zoning spector
`�lip
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # i 3 `lz k
Fee Paid a 5
Reviewed B �" 2 3
Date: 0�c c q 7 �� 1.r
�
LOCATION OF PROPERTY FOR INSTALLATION: A,, z ,1 4 `. �Y
<—�� DEC 1993
Owner' s Name: AJ Chi L�� I,,' c ((c c_ Rey^
Owner' s Mailing Address: l<>_<--40 .c/ ?_ =J-> - � Y �0,Posbury wA)
Installer' s Name: ', ,� S ��u , N � �� �� Phone #: i 3� , �'
Number of bedrooms (if residential ):
Total daily flow (residential-compute @ 150 gal . per bedroom): 3 cs
Topography-Circle One: Flat ci oll Steep Slope % of Slope
Soil Nature-Circle One: .iT1 Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One. ui Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal el Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank/ e'17-) gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of ! / Size each: ' ft. x P- ft.
Size of Stone to be used: # / Depth or Thickness feet
**************
HOLDING TANK SYSTEM IF REQUIRE
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.
DATE:SIGNATURE OF RESPONSIBLE PERSON: e .7/�€%_e__A =�
Septic System Inspections:
A. All apphications 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:
TOWN OF QUEENSBURY /0 a/41
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name `7214Vti a
Location ___,2atizd
Date / 41/{ Permit # 9,�- ZeS
SOIL TYPE •,t oam-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- 1
Size - 9 ft. x 1,() ft.
Stone size 3
PIPING: Size Type
Bldg. to Tank
Tank to Dfist---Bjx-
o 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 e No
LOCATION OF SYSTEM ON PR RT :
(circle one)
ro - Rear - Si - '\Right Side
MTdale—Front - iddle Rear `
COMMENTS:
0
SYSTEM USE APPROVED: AD O
Arrived: 1c=W
Departed:
ui1 ing fg/p ctor�