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93-438 wet - CERTIFICATE OF CO:MPLIANCI+a TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date taefadi 4 19 ig This is to certify that work requested to be done as shown by Permit No. 93-4.38 has been completed. This structure may be used as a septic system Location Gunn Lane Owner William Wells 12-3-9 By Order of Town Board TOWN OF QUEENSBURY Director of Building & Code Enforcement '-3 BUILDING PERMIT ro TOWN OF QUEENSBURY No. 93-438 • WARREN COUNTY, NEW YORK N PERMISSION is hereby granted to WILLIAM W. WELLS ` I' OWNER of property located at Gunn Lane Street, Road or Ave. in the Town of Queensbury,To Construct or place a Septic Alteration tli at the above location in accordance to application together with plot plans and other information hereto filed and r' approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. cn 1. OWNER'S Address is 842 AvosiV Crest Blvd ~" Schenectady NY 122301 Iv 2. CONTRACTOR or BUILDER'S Name Signorelli & Son Inc. 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name t a 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) ( 1 Wood Frame ( )Masonry ( )Steel ( ) 7. PLANS and Specifications Septic alteration to include 200 feet of leach field at 40 No.foot lengths as per plot plan, and application. 8. Proposed Use ID Septic system 0 H 25 .00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 2 1911) 95 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rt town of Queensbury before the expiration date.) F,• Dated at the Town of Queensbury this Day of August 19 93 i SIGNED BY :'` for the Town of Queensbury Building and Zoning In-'ctor TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # Fed aid Date: O '�" ` 3 ;tq ReLOCATION OF PROPERTY FOR INSTALLATION: r Idg.Dept w Owner's Name: �� S W 5, Owner's Mailing Address: �Ya '��dou� ��s/ A�0 �5�wA<-�42y Installer's Name: , /4 (/G/���1 / J� /� Phone v Number of bedrooms (if residential ): 3 Total daily flow (residential-compute @ 150 gal . per bedroom): Topography-Circle One: Flat Rolling Steep Slope % of Slope Soil Nature-Circle One: and Loam Clay Other /Depth: Ground Water-At What Depth? SY 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-/ Other If domestic water supply is a well - Separation: Water supply from any septic absorption /ad feet PROPOSED SYSTEM: Septic Tank gal . (Minimum size: 1,000 gal . ) i Tile Field: Each Trench feet//Total System Length o90 0 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 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. DATE: 2 F5 SIGNATURE OF RESPONSIBLE PERSON: j 2 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 $250.00. C. An approved copy of the plot plan shall be available on the construction site. Failure to produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installation, alteration or repair of an approved system, a new proposal must be submitted to the Queensbury Building Department before further construction. Town of Queensbury Building & Code Enforcement Department 531 Bay Road Queensbury NY 12804 Remarks: fir,, TOWN OF QUEENSBURY BUILDING b CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name �,616 Location Date 2/ Permit # " 93f SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length ,Lap Length of each trench , 410 Depth of trenches 3 Size of stone 40. SEEPAGE PITS: Number- Size - ft. x ft. Stone size — PIPING: Size Type Bldg. to Tank Via✓`, Tank to Dist. Box Dist. Box to Field/Pi Openings Sealed? LOCATION/SEPARATIONS: No Partial Foundation to Tank'{ dlo feet Foundation to Absorption feet Separation elk-44 s r Lx. tc /0.3 feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM PROPERTY: (circle one) J- Rear - Left Si - Right Side Middle Front - Middle ear COMMENTS: L_ SYSTEM USE APPROVED: Cam.' NO Arrived: { it , 50 a Departed: —__ Building I s ector TOE OF QUEENSBURY BU$LDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Date Permit # SOIL TYPE: Sand-Loam-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- Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Field/Pit Openings Sealed? Yes PO /+Parti a1 LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption 7— feet Separation of Pits I \\ feet Conforms as per Plot Plan' Yes No LOCATION OF SYSTEM ON PRpERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle .Bear COMMENTS: SYSTEM USE APPROVED: YES NO Arrived: _�,A4'tg Departed: • 3' I , f Building in-p ctor 1/31/j=-411 OF QUEENSBURY BUIL 3NG & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name S Location1 Date Permit # 93-/,3f SOIL TYPE: Sand-Loam-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- Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box `- -- -- Dist. Box to Field/Pi Openings Sealed? Ye 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 - Middle Rear COMMENTS: w.,?tee 1-/- 0,,,,,i di& 5 6e("'° to'dhe- SYSTEM USE APPROVED/ YES NO Arrived: y., ' Departed: 0 Building Ins ctor -own o/ Queeniur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME Gf/il/(Gvn 6(4'A' 41. LOCATION GvvJ h DATE g/R /9, PERMIT NO. j 6,2 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{N ,ser of) Size- ft. X ft. Gravel size PIPING: 111prze Type Bldg. to tank Tank to dist. box Dist. box to field/p Openings sealed? Y NO Partial LOCATION/SEPARATIO:S: Foundation to tan ft. Foundation to absorption ft. Absorption to lot line ft. Separation of pits ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front - Rear - Left side - Right side - COMMENTS o,6„, /km.", 4,47 Ys 4,4)1. /� SYSTEM USE APPROVED YES NO Buildi g Inspector 01/86 and vl TOWN OF QUEENSBURY BUILDING b CODE ENFORCEMENT /u4 531 Bay Road Queensbury NY 12804 518-745-4447 y/% SEPTIC DISPOSAL SYSTEM INSPECTION Name Location ��pp Date L `— Permit # SOIL TYPE: Sand-Loam-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- Size - ft. x ' ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Feld/Pit Openings Sealed? Yet o Partial LOCATION/SEPARATIONS: �. Foundation to Tank / 4 feet Foundation to Absor ion feet Separation of Pits _ '- feet Conforms as per P1 t Plan Yes No LOCATION OF SYSTE ON PROPERTY: (circle one) Front - Rear - L ft Side - Right Side Middle Front - iddle Rear COMMENTS: tit _ 0 A ,4 SYSTEM USE APPROVED: YES NO Arrived: Departed: _ ;` Buildi Inspect r �1234ee' . �N AU61993 o A Received N Town of l �ueensbury Idg. Dept. i a' � I V S I � \ i