90-380 V` � Y y ._ n..l"7r . - .. - '". - •�rru a _ -y J'.. r .- - y.,-t-...Y.. .. �..i
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y CERTIFICATE OF ,COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
June 28 90
Date 19 _
This is to certify that work requested to be dotie.as shown by Permit No. on-3 9Q
has been completed.
This structure may be occupied as a sewage alteration
Dunham's Bay
Location
Elizabeth S. Williams
Owner
By Order Town Board
TOWN OF QUEENSBURY
r
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No 90-380 x
WARREN COUNTY, NEW YORK
b
PERMISSION is hereby granted to ELIZABETH S. WILLIAMS z
C
B'hams a
OWNER of property located at Dun Y Street, Road or Ave. I
I
in the Town of Queensbury,To Construct or place a Sewage 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
Route 9L
Lake George NY 12845 t"
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2. CONTRACTOR or BUI LDER'S Name
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3. CONTRACTOR or BUILDER'S Address sT
4. ARCHITECT'S Name
CJ
5. ARCHITECT'S Address
td
6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No. Sewage alteration to include 1000 gallon tank with 200 feet of Tile field ,raq
as per plot plan and application.
B. Proposed Use r+
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Sewage alteration
0
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 15 19 92
(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 15th Day of June 19 90
� n i
SIGNED BY C }J u� for the Town of Queensbury
Building and Zoning Inspector /
I UWN U!= QUEENSEURY
APPLICATION. FOR
SEPTIC DISPOSAL PERMIT
J N 141990
DATE
LOCATION OF PROPERTY FOR INSTALLATION �OIJ�i ✓J�J�S ,� �J L � � �v`�GF
Owner's Name:aiz;;3h�,T s /,_Telephone:
Address: 6 e&
no cof-,2� 1 url.�LC_�l
Installer's Name: P l'.hPP. Telephone:
Number of bedrooms (residential only)
Total daily flow (compute (d 150 gal per bedroom) �l
Topography: Circle one: Flat Rolling Steep Slope % of Slope ,G' Tad
Soil Nature: Circle one: Sand Loam Clay Other /Depth: Feet 1
Ground Water: At what depth? I � % Feet
Bedrock or Impervious Material: At what depth? / Feet
Percolation test: Circle one• not required required rate min. inch.
Domestic water supply: circle one: Municipal Wel Othe Ld(o
If domestic water supply is a well: If
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM: Septic Tank (�o-U gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench � feet/Total system length feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # /Depth or Thickness feet
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 Rueensbury Sanitary
/Sewage Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: �j/2� 9�•lit�iLL�%I�����
DATE:
OVER
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 installa—
tion, 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
F:�marks:
c� P
Jown of Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 ox 98
Q eensbury, New York 12 01
SEPTIC ISPOSAL SYSTEM I PECTION
NAME
LOCATION —
DATE / PERMIT NO.�� 30
SOIL TYPE - Sand Loam lay -
Percolation st Required YES - NO
Percolation to - Min/I h
TYPE of SYST
Absorption fi ld, total ength ,,-2p�
Length of eac trench zJ
Depth of tren hes
Size of grave _
SEEPAGE PIT54 er of.
Size- ft. _ f
Gravel size
PIPING: Size Type ;
Bldg. to tank
Tank to dist. b x
Dist. box to fi ld/ it
Openings sealed E NO Partial
LOCATION/SEPARA S:
Foundation to to ft.
Foundation to ab orption
Absorption to 1 line Z�3e? ft.
Separation of p s ft.
LOCATION OF SY ON PROPERTY(circle one)
Front - Rear - L t side - Right side -
COMMENTS:
SYST USE APPROVED ES )N .
Btii1(kill
g Inspector
01/86 and vl
JUN 141990
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JUN 14 1990
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