94-137 CERTIFICATE 0141 COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 3chrr , S 19 6
This is to certify that work requested to be done as shown by Permit No. 94-137
has been completed.
This structure may be used as a commercial septic system
Location Corner Ridge Road and Hicks Road
Owner Peter J. Holmes
55-1-15
By Order of Town Board
TOWN OF QUEENSBURY
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Director of Building & Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY ro
94-137
No.
WARREN COUNTY, NEW YORK 0
PERMISSION is hereby granted to PETER J. HOLMES uLrii
OWNER of property located at Cor. Hicks & Ridge Road Street,Road or Ave. �.
in the Town of Queensbury,To Construct or place a Commercial 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.
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1. OWNER'S Address is
Box 62 Ridge Road
Queensbury NY 12804 °'
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2. CONTRACTOR or BUILDER'S Name rD
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Chris Crandell •
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address Ii
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( I Steel ( ) id
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7. PLANS and Specifications
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Septic alteration to include one 1000 gallon pump
No. tank as per plot plan and application. ¢,
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8. Proposed Use
Commercial Septic System
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35. 00 April 22 6
$ PERMIT FEE PAID—THIS PERMIT EXPIRES 19
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the W
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this ay of 19 9 4 't7
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SIGNED BY for the Town of Queensbury n
Building and Zoning In r
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TOWN OF QUEEY
APPLICATION FOR SEPTIC DISP "' L PER4TD\ Permit # / V/3 7
pQR�99Q ,.� i Fee Paid
Pa i d — `—.
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Date: j Z�:�>���
To
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c‘ A,Idg pep Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: 6c f �� er ft" C
Owner' s Name: T j-t�.L✓r�r=S
Owner' s Mailing Address: g X (. IZA D c eD CsC /f-Y f2ta
Installer' s Name: CI-tVi.S C 'L/ i D & LL_ Phone #:
Number of bedrooms (if residential ):
Total daily flow (residential-compute @ 150 gal . per bedroom): 20 _ GP, a L ,/
Topography-Circle One: Flamm: Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam C Other Ceihr /Depth:
Ground Water-At What Depth? 1f- C 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 CP 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 ivc,,.rG.- feet//Total System Length ,(/civ(' feet
Seepage Pit(s) : Number of AqW / Size each: G ft. x ft.
Size of Stone to be used: # 4/0xrc-/ Depth or Thickness /it- e- feet
**************
HOLDING TANK SYSTEM IF REQUIRE
No. of Tanks A, Size of Each i COO Gal .
Alarm system and associated electrical work to be inspectediby 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.
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SIGNATURE OF RESPONSIBLE PERSON: DATE: r l jl-7
,L.vr1r1v111 WV Gtu.111 11VJ1-G1.11V1V J6RV1l,r,,
Main Office 357 Elwyn Terrace — Manheim,PA 17545
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MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL �4/
Panel Board No. Cert.N° 3 3 2 9 9 Cut-in Card No.
Owner...X' y'A 77V T e 64-i7 ? I o£ Mue,1�/�
Occupant 6' /?//,,.6 /�
Location !`rr l�./ C,"�' ��� r
Installation Consisting of.... ' P/!v C FC ,. S'ec-zzre , lc/1--keZr
Installed By .t.. L! Lic. #
The conditions following governed the issuance of this certificate,and any certificate previously
issued is cancelled:—
This certificate only covers the electrical equipment and installation conditions as of date. Upon
the introduction of additional equipment or alterations, application shall be promptly made for
inspection.
Inspectors of this Company shall have the privilege of making ins tions at any time, and if its
rules are violated,the Company shall have the right to revo ���t certi icistte �J
Date Cr �3.._ `/ INSPECTO.. `
ember N.F.P.A.,I.A.E.I.
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name (2[1.l J y 4-611.Ao
Location 6mt, x, , w 6 dpi&
Date 5/J1lj4/ Permit # 9 -/37
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
`'' (if appl able) Rate-Minute/Inch
1 TYPE OF S ,TEM: �,,,
ABSORPTION IELD: Total Length -°
Length of ea h trench
Depth of tren hes
Size of stone
c p SEEPAGE PITS: umber-
Size - t. x ft.
Stone size
PIPING: Ipplir Size Type
-p, Bldg. to Tank
Tank to Dist. Box
Dist. Box to Fi: d/Rit
Openings Seal -•? es Partial
';y LOCATION/SEP ' 'TIONS:
- Foundation `o Tank feet
Foundati. to Absorpti feet
Separat'on of Pits feet
C Confo, s as per Plot Plan Yes No
.—_ Li . ION OF SYSTEM Off PRO RTY:
0 (c. cle one)
Front - Rear - Left Side - 'ght Side
Middle Front - Middle Rear
COMMENTS:
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1 1— )Affr. UJQ -7O. f
C'la-it- c 0 l5 c i 6'if e'=
1TE ivi S -
SYSTEM USE APPROVED: YES GiT)
Arrived:
Departed: ,,
Building In ecto
TOWN OF QUEENSBURY
= 531 Bay Rd. , Queensbury NY 12804
518-745-4447
Building & Code Enforcement - \
INSPECTOR'S REPORT
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RO ( &
Property Location
1463
Owner or Tenant
Building Sewage Sign Other
Remarks:
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CONTACT THIS OFFICE Quit
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