94-493 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date , giber- 29 19 9
This is to certify that work requested to be done as shown by Permit No. 9449
has been completed.
This structure may be used as a SEPTIC SYSTEM
Location HILLMAN ROAD
Owner MASON, MR AND MRS. JAMES H.
By Order of Town Board
TAX MAP NO. 11-1-1. 20 TOWN OF QUEENSBURY
Director of Building & Code Enforcement
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BUILDING PERMIT +
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TOWN OF QUEENSBURY
No. 94-493
WARREN COUNTY, NEW YORK z
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PERMISSION is hereby granted to Mr. and Mrs. James H. Mason I
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OWNER of property located at 18 Takundewide Cottages, Cleverdale Street, Road or Ave. o
in the Town of Queensbury,To Construct or place a septic system
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
Mr. and Mrs. James H. Mason
R.R. 1, Box 1198
Lake George, New York 12845
2. CONTRACTOR or BUILDER'S Name
James H. Mason
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3. CONTRACTOR or BUILDER'S Address
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d/b/a Sunsoval, Inc. Rte. 9L, P.O. Box 86
Cleverdale, New York 12820 9
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel 0 68FUG #
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7. PLANS and Specifications H
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No.
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8. Proposed Use
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septic system o
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 9 19 95 In
(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.) (D
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Dated at the Town of Queensbury this Day September 19 94 R'
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SIGNED BY for the Town of Queensbury
Building and ZonI Inspector
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # �y-y
Fee Paid
Date: —August 30, 1994 Reviewed By
19
LOCATION OF PROPERTY FOR INSTALLATION: Takundewide Cottages, Cleyv,erd,'ple
Owner's Name: Mr. and Mrs. James H. Mason
Owner's Mailing Address: R.R. 1 , Box 1198 , Lake George, NY 1 845 "
Installer's Name: Sunsoval, Inc. Phone #: 656-A956
Number of bedrooms (if residential ): 2
Total daily flow (residential-compute @ 150 gal . per bedroom): 300 gal.
Topography-Circle One: Fla t- Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand% Loam 1 Other /Depth:
Ground Water-At What Depth? over 4 Feet
Bedrock or Impervious Material-At What Depth? over 4 Feet
Percolation Test-Circle One: Not Required Required/Rate 8 Min. Per Inch
Domestic Water Supply-Circle One: Municipal 4efl Other Lake
If domestic water supply is a well -
Separation: Water supply from any septic absorption +2 0 0 feet
(existing)
PROPOSED SYSTEM: Septic Tank 1 000 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench , 60 feet//Total System Length 180 feet
Seepage Pit(s): Number of / Size each: ft. x ft.
Size of Stone to be used: # / Depth or Thickness feet
**************
HOLDING TANK SYSTEM IF REQUIREpp
No. of Tanks Sizeiof 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: L --- -- DATE: 8/30/94
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 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 � I "
' BUILDING b CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DI OSAL SYSTEM INSPECTION
Name rd UY�t
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Date Permit # qq-,
SOIL TYPE: Sand-Loa Clay-
Results of Percolation Test-
(if applicable) Rate=Minute/Inch
TYPE OF SYSTEM: CIA
ABSORPTION FIELD: Total+, Length
Length of each trench
Depth of trenches _2
Size of stone
SEEPAGE PITS: Num er—T
Size - ft. x t.
Stone size
PIPING: Siz Type
Bldg. to Tank ,r�-,
Tank to Dist. Box _
Dist. Box to Fiel /Pit
Openings Sealed? No Partial
LOCATION/SEPARATI S:
Foundation to Ta k k111- feet
Foundation to Ab orption feet
Separation of Pi s eet
Conforms as per lot Plan Ye No
LOCATION OF SYS EM ON PROPER :
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - :Middle Rear
COMMENTS:
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SYSTEM USE APkOVED: ES NO
Arrived: 3Y
Departed:
Building Inspe for
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Lands o 1000 gallon concrete septic tank (existing)
I Lucas
I � 1010" setback
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Lands of
^ Mason '\
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Eckenfelder �� 4" PVC solid (new)
distribution box (new)
Takundewide Homeowners
Association, Inc .
10 ' 0" setback ,%/ �',� / �
200 '+ to lake
drainfield (new)
�r (see blowup)
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200 '+ to lake
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STOCKDRAFTING FORM NO.101.61
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTORS REPORT
REQUEST FOR INSPECTION RECEIVED
NAME I /i�,a/y, o •M
LOCATION
DATE - PERMIT #
TYPE OF STRUCTURE
RECHECK APPROVED
N/A IYES1 NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN ACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING v
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
lei/ w rar for
ARRIVE �Ge
DEPART�D
INS LCTOR
MAC
LAKE GEORGE = '
0 - - PARKING
PARKING
0 PARKING
BEACH �---'
PARKING i PARKING
TENNIS ! ,
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PLAY AREA
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LAUNDRY i
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---------------------------------------
RArTOIyROAD
TMUNDEWIDE
COTTAGES
CLEVERDALE,NY 12820 0 PHONE:518-656-9573 TO ROUTE 9L
SUNSOILA
P.O.BOX 86,CLEVERDALE,NY 12820
(518) 656-9986•656-9956
September 6, 1994
Town of Queensbury
Building and Code Enforcement Department
Bay at Haviland Road
Queensbury, New York 12804
ATTN: David Hatin
Dear David:
Enclosed please find the electrical inspection form filled out by our office for#94-492, Mr.
and Mrs. Robert Sherry, as requested by Linda to be a part of the Sherry septic permit
application.
I have also enclosed two copies of the amended plot plan for#94-493, Mr. and Mrs.
James H. Mason, as requested by you to be a part of the Mason septic permit application. As you
can see by the enclosed, we have kept the drainage field 10'0" from the neighboring cottage's
property line. We have also stated that the domestic water is supplied from the lake.
If you should have any additional questions, please call our office. Please call as soon as
these permits are approved and ready to be picked up.
Sincerely,
4
LLL
John A. Mason
JAM:pah
Enclosures
Lands o 1000 gallon concrete septic tank (existing)
I Lucas
10 ' 0" setback
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Lands of
\ Mason '\
ands o ` Y'
Eckenfelder 4" PVC solid (new)
- distribution box (new)
\ /,% Lands of
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/ Takundewide Homeowners
Association, Inc.
10 ' 0" setback,%
.;� 200 '+ to lake
drainfield (new)
(see blowup)
a .
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a 200 '+ to lake
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STOCKDRAFTING FORM NO.101-61