1990-78 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
3 0 CI 0--
This is to certify that work requested to be done as shown by Permit No. 9 6 - 78
has been completed.
This structure may be occupied as a sewage alteration
Location Luzerne Road
Owner VFW Post 6196 Inc.
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No 90 - 78
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to VFW POST 6196 INC. _
Luzerne Road
OWNER of property located at Street, Road or Ave. •
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
0-3
Same I.
2. CONTRACTOR or BUILDER'S Name
•
Queensbury Sewer
3. CONTRACTOR or BUILDER'S Address
RD#1 Bay Road ti
Queensbury NY 12804
4. ARCHITECT'S Name
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Cl.
5. ARCHITECT'S Address
6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( ) Masonry ( I Steel ( ) — - --
7. PLANS and Specifications CD
No. Seepage pits (2) 8' x 8' with #3 stone at 2' depth as per plot plan, specifications
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and application.
8. Proposed Use
ro
Seage application I
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$ PERMIT FEE PAID —THIS PERMIT EXPIRES March 28 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 2Rth Day of March 1990
SIGNED BY / for the Town of Queensbury
Building and Zoning I spector
a))'' ,o
Jocun otQueen.sburcy Ain
• BUILDING and ZONING DEPARTMENT /J
Bay and Haviland Road, R.D. 1 Box 98 .
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME '.v F W 577. Co I q(o
LOCATION ' i✓tyrz z, . P .
DATE 7//3 /cy)\ PERMIT NO. ; 0 76()/
l
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 k,
SEEPAGE PITS{Number f�) ' /�
Size- 7 ��0��
ft. X ar..
Gravel size -/ •j
PIPING: /Size Type
Bld to tank &' •—
Tank to dist. box i,,C 6"
Dist. box to field/ .3� j" PVC,
Openings sealed? YES/° NO Partial
LOCATION/SEPARATIONS:
Foundation to tank e�K-5r J ft.
Foundation to absorption j ft.
line.to lot /0 ft.
Separation of pits { /(,., ft.
LOCATION OF SYSTEM ON?,PROPERTY(circle one)
Front -(Rea�- Left side - Right side -
COMMENTS a_`.
.
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SYSTEM USE APPROVED ( YES? I NO / j
01
�: /,/
! Bui`lding"inspector
/
01/86 and y/1 .
TOWN OF QUEENSEURY
(OWN OF QU A NSBU
APPLICATION FOR RECEIVED'
v_ > SEPTIC DISPOSAL PERMIT titkR 2 3 1990
alb
BLDG. & CODE DEPT.
DATU1\ (x r 7C — / 99
LOCATION OF PROPERTY FOR INSTALLATION Co.�
,,Lci ET: � 7
,
Owner's Name: ( W Telephone:
Address: /---tt �i� „i-e i�U '
Installer's Name: r r� ��
cue . Cr r% irw Telephone: /7123;4 y I
Number of bedrooms (residential only)
Total daily flow (compute la 150 gal per bedroom) S Z
Topography: Circle one:41M Rolling Steep Slope % of Slope
Soil Nature: Circle one : i. Loam clay Other /Depth: Feet
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth? Feet
Percolation test: Circle on . not re_c uire required rate min. inch.
Domestic water supply: circle one: 'Iun cii pal Well Other
If domestic water supply is a well:
Separation: Water supply from 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 8- feet by g' feet
Size of stone to be used # 5 /Depth or Thickness 2_ C feet
•
*************************
I have read the regulation on the reverse sid f this sheet and agree to abide by these
and all requirements of the Town of Queensbi Sanitary Se-wage Di posal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: e --
DATE: . .
�(liv✓ 22 ' 7%,,/ U (
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 112804
Remarks:
01_,I.c.20 -/ey-c frip p
. _
TOWN OF QUEENSBUR\'
RECEIVED
MAR 2 3 1990
eLDG. & CODE DEPT.
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