92-696 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date i /a..sx6eA. /f 19 �1.t
This is to certify that work requested to be done as shown by Permit No. 92-696
has been completed.
This structure may be used as a septic system
Location Box 1272 Bay Parkway
Owner Kenneth Ruffing
By Order of Town Board .
OF QUEENSBURY
// /7/
Director of Building & Code Enforcement
n
BUILDING PERMIT
TOWN OF QUEENSBURY o
No. 92-696
WARREN COUNTY, NEW YORKqk
PERMISSION is hereby granted to KENNETH RUFFING
OWNER of property located at Box 1272 Bay Parkway 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
RD#1 Box 1272
Lake George NY 12845 -n
T1
2. CONTRACTOR or BUILDER'S Name GZ')
m
3. CONTRACTOR or BUILDER'S Address m
4. ARCHITECT'S Name
5. ARCHITECT'S Address
I-+
CO
N
N
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. Septic alteration to include 105 feet of tile field with 35 ft trenches N
as per plot plan, specifications and application.
8. Proposed Use
c+
Septic system
25.00 November 10 94 N
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(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 Da of ovember 19 92
cu
SIGNED BY
for the Town of Queensbury
Building and Zoni ctor
/,'�� ►�< TOWN OF QUEENSBURY
$.1 4 APPLICATIOt1 FOR SEPTIC DISPOSAL PEfd t4OF OLIEENSB1
RECEIVED r
DATE: /'0/2' )9 _.
/�SS Pi/VT"'
1��OV 2 1992
LOCATION OF PROPERTY FOR INSTALLATION /4E�e°-(
DU. & CODE
Owner's Name: /� /jJ,+C��' •()p-1Gc,,t' DEPT
Address: / 2-7 Rei-V PAir.R.,(4),19(../ &116e-Sor
Installer's Name: Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) 1 s Pi) (Jo c/// t1
/ . J
CE
Topography: Circle one: Flat ling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam 41DOthers Hk. /Depth: 18 ti
Ground Water: At what depth? (F311 -Feet—
/
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: not required required
Rate - 4515-7tMin. Per Inch
• Domestic water supply: Circle one: Municipal Well Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption feet.
n )377A `4'
PROPOSED SYSTEM: Septic Tank gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench 3-S feet/Total system length /OS feet
SEEPAGE PIT(S): Number of N`/q' /Size each feet
by feet U
/Size of stone to be used #. `2% /Depth or ThicknessMeet---
*****************************
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.
SIGNATURE OF RESPONSIBLE PERSON: J ��-i. DATE: /c ./2 /9
r
r
4111 Seeptic 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 proposed location of the system
2.) location and distance co lot lines
.) location-and distance co structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields and/or drywalls
B. Nu 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 in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installs—
cion, 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
•
Kt:marks:
•
• •
awn oQ Q . ,.
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC�, DISPOSAL SYSTEM INSPECTION
NAME !T f/�4'/ ---
LOCATION el,a7.2 l/ c
DATE 41/ PERMIT NO. 9a- 9�
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch -y:.
TYPE of SYSTEM:
Absorption field, total leqlth
Length of each trench
Depth of trenches •
Size of gravel
SEEPAGE PITS{Number of)
Size- ft. X ft. I
Gravel size
PIPING: SFze Type
Bldg. to tank T
Tank to dist. box
Dist. box to field/pit
Openings sealed? YF NO Partial
LOCATION/SEFARATION81:
Foundation to tank I ft.
Foundation to abso*pt on ft.
Absorption to lot 41ine ft.
Separation of pitd ft.
LOCATION OF SYSTE1 ONROPERTY(circle one)
Front - Rear - Left si e - Right side -
COMMENTS:
3 A d- C) /,SYSTEM USE APPROVED YES NO
Bui d ng Inspector
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MOWN." OF QUEENSBURY
/O • — 48" TANIB,eo v)N srL r) soMf s TOWN OF QUEENSBURY BUILDING DEPARTMENT
C'L Ay J'OME s'A�VD g U I L.D I Ni G & �O D DEPT.
Based on our limited examination,
G�eo vrvD wAT£,e AT FILE COPY compliance with our comments shall
REVIEWED BY not be construed as indicating the
Plans and spec cations are in full
BATE `/ ld Z compliance with the code.
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