96-125 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date July 3 19 9:
9612
This is to certify that work requested to be done as shown by Permit No.
has been completed. •
• This structure may be used as a SEPTIC ALTERATION
Location LAKE PARKWAY
Owner BIRNEY, ARTHUR .& ALLISON
By Order of Town Board
TAX HAP NO . 9 . -1-14 TOWN OF QUEENSBURY
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No 96125
TAX MAP NO. 9 . -1-14
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to BIRNEY, ARTHUR & ALLISON
LAKE PARKWAY
OWNER of property located at Street, Road or Ave.
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.
1. OWNER'S Address is
4846 VAN NESS , N.W.
WASHINGTON, DC 20016
2. CONTRACTOR or BUILDER'S Name
GRANT, DAVE
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction— (Please indicate by X)
SEPTIC
( I Wood Frame ( I Masonry ( I Steel ( )
7. PLANS and Specifications
SEPTII°oALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATIONv� �
Cal+,)
$ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES April 16 19 98
(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 16 Day of April 19 96
f
1
SIGNED BY 1 for the Town of Queensbury
uilding and Zoning Inspector
t .
-- -------------- --
H
Application fOl• ,SYLI'TIC 1)IS1'OSrAL PERMIT o
S IAM!' ItECEI VIA)
(q. - 1 - 04 ) o
I.ocatinn oLake. Parkway, �scmh!yPi, '-z-i
f pt opct iy for installation: __--
Owner's Nan,,. A i"hur 8%rnG7_ 'ItltMl'1'NUk11tl:It110
_--
y89G VG." N'cs 5 S4• M '.i r ✓ Fri
Owncr•s Moiling Address: Wszs/ r►3'fo A t D.C. .1001(0 ((1tli
cJ ,�
. ' 8
1:1W. PAIDAPAID . ,Si
Installer's Name: _ Gran+ — I'honc #: 4 La- " e - - (..)w
Number of bedtonuts (if residential):
'fol81 daily !low (residential -compute Git 151)gal. per bedroom); 4o0
Topography: -_ a:1:il I-_ I Rolling I-1 Steep Slope If, of Slope --
Soil Nature: I I Sand ''1 I.o:on 1-1 Ctfty 1 1 Other /l cl,lli:
Uround Water: at what depth'? A,A%'r k6le feel
lietlrock or Impervious Material: at what depth? (.hLv6tap* feet
I'crcolat' Test: t-Not Rcquioell I _1 Re,luited/Itlllc win pt intIi
Domestic Water Supply: LJ Municipal I ] Well Oilier /G. k�
If domestic water supply is a 1VF.1.1: water supply ftotn any septic absorption is Icet
EmJ) kc-1?u -
Ac t-1�1
/�
l'foros t.l) sysl I M: +air k r4ast,Frl
r>«�f oh ly ( K-Ev1 0
Septic tank:ia56 gal. (minimum size: 1.11011 gal.)
'lite Field: each trench -55- feet. / total system length Z-SI feet.
Seepage I'il(s): number of / size each: ft. x ft.
Size of stone to lie used: ft Z- / depth or thickness feet.
I101.1)INO TANK SYS'l l:M: (if required) ,
Number of tanks: • Size of emit: gal.
11:W I Alarm .system anddLassociated electrical!cork to be inspected by a certified agency.
For your p►•orection, please tune that pursuant to Section 136-29 of the Code of the Thorn of
Queensbury, any permit or a p prowil granted which is based upon or is granted in reliance upon
any material misrepresentation or.ftihue to make a material fact or circumstance known by or on
behalf of an a p plicant, shall he void.
1 hare read the regulations with respect to this a pplieation and agree to abide by these and all
requirements o f the Town o f Que'ensbur•y Sanitary Sewage Disposal Ordinance. /
Signature o f t,'slrrrn.cib'e• person: �_ - /`� -,u-¢� Date: 4//15/ 94
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name A1/4".1.16; f1
Location 11'
Date Permit #
SOIL TYPE: Sand Loamy Clay-
Results of Percolation Test-
(if applicable) Rate-Mi ' ute/Inch
TYPE OF SYSTEM:
ABSORPTION FIEL : Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Numier-
Size - ft. ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Fiel :/Pit
Openings Sealed?! Yes No Partial
LOCATION/SEPARJtIONS:
Foundation to tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPER :
(circle one)
Front - Rear - Left Side - Righ . Side
Middle Front - Middle Rear
COMMENTS:
�vl ' /-120 ,4i10,ec zl C r� P-66x
/d 1` `r %O
y5rU. LcAcl& - ci<
SYSTEM USE APPROVED: NO
Arrived: 4 u
Departed: 0
Building Inspector
/o : 30
t TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name fr/q Nv_iktA
Location "4ke 4\ALl Ct
Date 37-3-9 Permit #9(p - j025
SOIL TYPE: Sand-E oa Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM: 1
ABSORPTION FIELD: Total Length 1- 1
Length of each tren h
Depth of trenches 1--
Size of stone
SEEPAGE PITS: Num?,er-
Size - ft x ft.
Stone size
PIPING: Size Type
Bldg. to Tank p `—
Tank to Dist. : ,x 0
Dist. Box to , i -ld/P . ' �-xio 00
Openings Se. ed. o Partial
LOCATION/S', A'- i Ir' •
41461'
Foundatio to Tank 01 \ feet
Foundatido to A sorption - .L feet
Separa on of Pi s _ Meet
Confo s as per P of Plan WE, No
LOCA ON OF SYSTr Or PROPERT-
(cir le one) ab
Fro t - Rear - L� - Right Side
Middle Front - Mi. 'ear
IMMENTS:
SYSTEM USE APPROVED: dell°
NO
Arrived: 47 .Z5
Departed: '
J�
Building Inspector
TOWN Y OF QUEEPISBUR,
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location
DateG21a2gPermit #
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applica.le) Rate-Minute/Inch
TYPE OF SYS EM:
ABSORPTION ' IELD: Total Length
Length of ea h trench
Depth of tre ches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank 41tA fo
Tank to Dist. Box _a
Dist. Box to Fiel .
Openings Sealed? 4110 No 'arti 1
LOCATION/SEPA I
Foundation t. ank /6- feet
Foundation to Absorption feet
Separation of Pits % feet
Conforms as per Plot Plan 4100
No
LOCATION OF SYSTEM OPT PROPER
(circle one)
Front - Rear - Le t Sid- - Right Side
Middle Front - - 'ear
COMMENTS:
RTI/1- I .20is,j\ 400-56
- 0
A) lc —re) D --Gc33L — °K
SYSTEM USE APPROVED: YES (j)
Arrived:
Departed:
2c-
Building Inspector
TOWN OF QUEENSBURY
BUILDING b CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Qj 1
Location 2\1,: RHRi<t),)al'
Date (c`Zt_i )cl Permit # qfr u zs-
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 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:
t) LE_PCAA F‘ELD t- bT Pig
1 �ERLLEXj fn 6M
SYSTEM USE APPROVED: YES NO
Arriv •d. ;�
Dep .rt- . • j 7
ailed_._ 41
Building p•ctor
V�
4 TOWN OF QUEENSBURY yQ
r BUILDING A CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name (tom, .-
.1AVA,
Location AEO:e ':? ).1i.Aili-21-4
Date —Z-9(ppermit #CI(p--l-42
SOIL TYPE: Sand Loa' Clay-
Results of Percolation Test-
(if applicable) Rate-Mi ute/Inch
TYPE OF SYSTEM: i
ABSORPTION FIELD: Tota Length Z5�
2. --ength of each .trench1 '35 1"
Depth of trenc es
Size of stone
SEEPAGE PITS: umbe
Size - f, . x ft.
Stone size
PIPING: ` Size Type
Bldg. to Tank
Tank to Dist. Box e_ __70
Dist. Box to Fiel ./PitlIlir
Openings Sealed? Yes No Partial
LOCATION/SEPARA. IONS:
Foundation to 'ank feet
Foundation to/Absorption feet
Separation of Pits _ feet
Conforms a "per Plot Plan Yes No
LOCATION SYSTEM O6' PROPERTY:
(circle ne)
Front - Rear - eft Side Right Side
Middle Front - a','. - . .r
COMMEN :
(k)N, Ck.).K
�� ov T
SYSTEM USE APPROVED: YES (i
Arrived: I /'?)
Departed: 7767
,f2C_-
Building Inspector
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