91-579 e CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
This is to certify that work requested to be done as shown by Permit No. 91-579
has been completed.
This structure may be occupied as a Septic alteration
Location Cleverdale Rd
Owner Albert & Jane Frei hoffr
By Order Town Board
T OF QUEENSBURY
Director of Bldg. 6c Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY X
No. 91-579
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Albert & Jane Freihoffer , w
Cl dl evera a Road Street,Road or Ave. ,I
OWNER of property located at
owl
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. fD
0
1. OWNER'S Address is -
Same fD
Y
a
2. CONTRACTOR or BUILDER'S Name C
Condon's Septic Service r+
ae
3. CONTRACTOR or BUILDER'S Address
fD
f7
4. ARCHITECT'S Name CD
fD
a
a
Emol
fD
5. ARCHITECT'S Address
Gt.
Vf
6. TYPE of Construction—(Please indicate by X) fD
e*
( )Wood Frame ( ) Masonry ( 1 Steel ( ) n
7. PLANS and Specifications ff
No. Septic Alteration to include: 2 holding tanks, 2000 gal. each �,
0
8. Proposed Use
Septic ALteration
$ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES August 19, 19 93
(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 th3 19th y of August 19 91
SIGNED BY �' for the Town of Queensbury
Building and Zo Inspector
Oat
Arc TOWN OF QUEENSBUEIVED
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # 7
AUG 141991 Fee Paid
Date: g -f �� ` "LOG. & CODE DEPT. Reviewed By
ii
LOCATION OF PROPERTY FOR INSTALLATION: , DA* /cc C1,/-(/6. ,M" )41
Owner' s Name:\ iik *' �f/E 1 H O
Owner' s Mailing Address: C.Iev aDA-i PcI ( c ?j0
Installer' s Name: CCC ic ' S S Phone #: 7 7 - s- /2-
Number of bedrooms (if residential ) :
Total daily flow (residential-compute @ 150 gal . per bedroom) :
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: Not Required Required/Rate Min. 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
PROPOSED SYSTEM: Septic Tank gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length 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 REQUIRED
No. of Tanks - Size of Each Acco 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. ,p
SIGNATURE OF RESPONSIBLE PERSON: - re v DATE: lit 7/
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:
_C own o/ Queensury >47/21
.1 BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPPECTION
NAME & / f :1',Q _ <.-- ..LC ''�
LOCATION e,.� '.e(4, , / '
DATE ,/,_,/f/ �/ PERMIT NO. g/j 79
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each trench
Depth of trenches
Size of gravel
SEEPAGE PITS{Number of) _ A;
Size- ft. X ft.
Gravel size
PIPING: Size: Type
Bldg. to tank
Tank to dist. box
Dist. box_ to- field/pit
Openings sealed? YE0 ,t NO Partial
LOCATION/SEPARATIONS:f
Foundation to tank ft.
Foundation to absorp on ft.
Absorption to lot 1; ft.
Separation of pits ft.
LOCATION OF SYSTEM'ON ROPERTY(circle one)
Front - Rear - Left si4e - Right side -
COMMENTS:
.9- zed° "I Aed-(ek/Pf` ‘- jel<1.
j Nr,K5 (A) PC�te -_l5' u-C- Ps P& (�t1� 7� orti„f
1 Al lic..0�12-f .A.vk.J 1`u"1' c6-/1 C1-26
A1 1 16-enz, CJ1� Cto n-I L 1 il)T/i A ics /-
I-1 u - , -,t/v-t-ri -fQut�ZG19 i2-L f?. c 4-
SYSTEM USE APPROVED Y S N ) -
Bu lding nsp ctor
01/86 and vl
,
,-WAGE '11 ,, BE EJP7,1) TO DRAIN INU ) !fi—. TANK
•
n7nrift: H) TANK YNLY TF1 TANI: '2:
SBLIh 6" GPAVEL LEL
ALE L; AiCUD TANK TO DTVET CUIFPCh AWAY
TAFK ACC (- CfwER.
COATED INTERNALLY MD
`TFTITO 1T :1(71
Jj TANK !1.1,,TRATIOUS WILL BE SEALED WITH A NUIININK
EPT. N-Y, TANKS TO Fr. LEAK TESTED BY FILLING WITH POTABLE WATER FOE 24
1-r.1.TS 7)7i-,;CTAT:ILF LEAKAGE WILL BE AILOWED 4
• ,'`
9. A TWO STi,r, A'.aRli SYSTEM WILL BE INSTALLED
LIGHTS DESIGNED TO FUNCTION AS FOLLOWS:
A YELLOW EIGHT WILL BF ACTIVATED ON THE AL;.P1,1 PAIFT, WHEN T.IF ;
SEWAGE LLVLL IlEAOHES 2000 GALLONS (OR ii7L V'.1j..,1,1L OF akir, _
TRUCK) =
A FLASHING REP LIGHT AND BUZZER WILL ACTIVATE WHEN THE I -
SECOND TANK IS WITHIN 100 GALLONS OF FULL. AT THIS LEVEL
THE TANKS WILL STILL HAVE SPACE TO CONTAIN THE WATER
REMAINING IN THE HYDBOPNEUMATIC TANK AND PLUMBING FIXTURES.
THE BUZZER WILL ACTIVATE AND THE WATER SUPPLY PUMP WILL
AUTOMATICALLY BE DISABLED. AT THIS STAGE THE BUZZER CAN
ONLY BE SILENCED BY SHUTTING OFF THE WATER SUPPLY CIRCUIT
BREAKER.
10. A REMOTE :MADING c;ATY-1" WILL BE ;,-,OUNTED NEAR THE ALI-_RM LI(HfL 1 ,
TO INDICA].L THE SSWA:':E LEVEL IN EACH TANK (OPTIONAL).
11. THE TOP OF THE TANKS SHALL BE COVERED WITH 2" OF RIGID
1fl5ULAT101 EXTENDING 12" BEYOND TOP.
12. TEE GENET,AL LOCATIO.7: OF THE TANKS IS IJLICATED ON TIE
DRAWING. THE TAr:rs MAY BE MOVED TO AVOID UNDERGROUND
OHSTACLE (r'iCTRICAL LINES, STORM DRAIN, 1:TG. ) DURING
Tf, ras? !T AT LEAr'T PROPYRI
LINE AND HI
4114Ak M '
.'
00 • I 00,
t vi
V,' '446 4,1.3.'
72177i: •
"`.** e NS'es z 7" elov - 11
0 e iv 7—.4
f1/
/7 7-
e /;tritl" ‹.
APPROVED BY
SCALE DRAWN BY /c
DATE e;,;/-e,A7 REVISED
‘,1
,4 e _5-TA FL A
• ••
DRAWING NUMBER
•
sea ear"...evo, '**
•- ' ' -- ,, A'...6e.E
. .._.„.4 -' •
•
,
Ma Pik
i OWN OF QUEI
RECEIVE
AUG 14 '
BLDG. & CODI
TOWN OF QUEENSBuRy
3 8,1: . REV1EWE BY
—
g E51 DE IJCE DATE • ,
1 ----
_........._\v,....._
17 ,,..„ ,
r
, LO__10 i
_ 1
I
,
. 1!
a .4
4.,
1 i
d
w :
,..
4 .
I 1-4' '' ' '` .44,4—A44,444,..;'44-.•.':::'' ''S+•.Vg;:s.
Z •. I --- .
F-A • '1 ,' ;':-. . 1 1 \Z i i 6 A 66 i ,
E ...,
I... — I
u 1
SI I
2 0 0 r`" 21A, ;. i.,el tj
;....* 1
% 1
;1/-..1: 1 .1 /' fl. '1< ..y.W,
•
... 11
...
I.. ........_ ..., , ,. .
......
ST0(P.-Dn.AF I ING ropm No f ni-f 1