99-734 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date December 30 19 99
99734
This is to certify that work requested to be done as shown by Permit No.
has been completed.
SEPTIC SYSTEM
.This structure may be used as a
3 Z NACY RD. ---
location
ENZ INriA, ROBERT Zc CAROL
Owner
TAX MAP NO. 44 . -1-19 By Order of Town Board
TOWN OF QUEENSBURY
am( fj
� _____ _ __
Director of Building & Code Enforcement
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 0 Building Permit No. 9 9 7 3 4
TAX MAP NO. 44 . -1-19
Permission is hereby granted to ENZ INNA, ROBERT & CAROL
Owner of property located at 3 2 NACY RD.
in the Town of Queensbury,to construct or place a SEPTIC SYSTEM
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
Owner's Address:
200 LAUREL LANE
LYNCHBURG, VA 24502
Contractor or Builder's Name:
IBS SEPTIC
Contractor or Builder's Address:
IVAN BELL 2 LOWER WARREN STREET
QUEENSBURY, NEW YORK 12804
Electrical Inspection Agency:
Type of Construction:
SEPTIC
Plans and Specifications:
SEPTIC SYSTEM FOR 3 BEDROOM HOUSE AS PER PLOT PLAN
AND SPECIFICATIONS
Proposed Use:
SEPTIC SYSTEM
$ 2 5PERMIT FEE PAID—THIS PERMIT EXPIRES December 1 2001
(If a longer period is required,an application for an extension must be made to the Code Enforcement
Officer of the Town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 1 Day of December 19 9 9
SIGNED B a C C for the Town of Queensbury
Code Enforcement Officer
4 Application for SEPTIC DISPOSAL PERMIT
1
Town of Queensbury 9 9 7 3 4 4 4 . —1-19 Dept. of Community r ENZ INNA, ROBERT & CAROL Permit No. W.-7:9/
Building &Codes Ofic 3 2 NACY RD. r
742 Bay Road SEPTIC SYSTEM 'f
Fee Paid S ��_►
Qu~ensbury, NY 1280kt._
Location of property for installation: 3 /UG ey i J
Property Owner's Name: 6.V r'A,"A, ` , <f I 1 Z' ''t c__
Property Owner's Mailing Address: - /V+
Installer's Name: J. •13, 5. S7 /\r G Phone # 79l-, /9 4
Number of bedrooms (if residential): 3 Total daily flow:
(residential -compute @ 150 gal./bdrm.)
Topography: flat, rolling, steep slope % of slope
Soil Nature: sand, loam, clay, other /depth:_
Ground water: at what depth?/ feet / Bedrock or Impervious Material: at what depth? — feet
Percolation test: not required, K/recuire� (rite min. per inch]
Domestic water supply: municipal, 'weir, other
If domestic water supply is a NWT, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tan1,-/b00 gallon (minimum size: 1,CCO gal.)
Tile field: each tench feet / Total system length: feet
Seepage pit(s): number of / size each: . ft.by ft.
Size of stone to be used: # / death or tbiclmess feet
HOLDING TANK SYSTEM: (if rewired) .
Number of tanks: : Size of each: o fons
(Alarm system and associated electrical work to be inspected by a certified a y.
J
For your protection, please note that purstaat to Section 136-29 of the Code of the Town of Qoeeasbury, may permit or
approval wed which is based ton or is granted in reliance t x�c air material a=isreprese ca or fulure to.make a
material fact or circumstance known by or on behAlf of an applicant, erg!' be void.
I have read the regulations with respect to this application and a.,--ee to abide by these and all rec remeuty of the Town of
Quee sbt..-y Sanitary Sewage Disposal Ordinance.
Sim ar e of responsible person: C../e".....,_
Date: //".). �-'
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INCF
Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL ''?
9
anel Board No.
� Cert. N2 /'64336 Cut-in Card No
Iwner ;/<�,1..�e't . /=.n. 2..L.tz..n..A
,ocation e4- C/ A- 0
astallation Consisting of SekA,1 e.r-LA,
lstalled By...... 3.3 ,$c /./..G...Y..L2 .nz..l.LL Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
ancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
rtroduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making inspections at any time, and if its
Iles are violated,the Company shall have the right to revoke this certificate.
)ate...l..22.i./R.9 INSPECTOR4d/.......
Member N.F.P.A.,I.A E.I.
tA- frJT•\1:1 \
D 0 11
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT Se
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 77T, r\rap,-c‘ f 1
Location - (\)c c . cl
Date cT Perini t # \ C1-73
1.1
SOIL TYPE: Sand-Loam-Clay-
Results of Percolati . Test-
(if applicable) Ratw Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: To al ttength
Length of each trenc
Depth of trenches
Size of stone
SEEPAGE PITS: N1e -
Size - ft. x ft.
Stone size
PIPING: Size ype
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Ye No Parti a
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Ye No
LOCATION OF SYSTEM ON PROPER .
(circle off. /.i . s€.4.
Front -Kllear2 Left Side - Right Side
Middle 5ron1 - Middle Rear
COMMENTS:
Ae, c-;I L
j �/yTArt.
/$•
0/( 7cs (A)/11,a- (if c_
SYSTEM USE APPROVED: C Ej. NO
Arrived:
Departed:
! '/1
Building Inspector
x V r
TOWN OF QUEENSBURY % i_
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
/ lfeoil UL� 1.J� i
Name .--;:-/)2-M-A-ei
Location ;�(,� 0Cc; _31/
Date /1, 5 Permit # %�� I
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:
/'"',� s44- Ca' �. 1S
,Vfj44d„e,i) ag Strk 'CD,/4r/
/),vtt �I✓7 .f44%
SYSTEM USE APPROVED:/ YES NO
Arrived: /if&
Departed:
ceit
Building Inspector
_ t r c,_ C-G, - - ivr
-...
99734 44 . -1-19 65 o5
ENZINNA, ROBERT & CAROL 1 4
32 NACY RD.
SEPTIC SYSTEM
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!"1 h;we seer nr observed, or bieve I pw evidence of,
3uct-, as rio', ,, ,-- IF ',..,,,-,ts, teqcos, etc.,
.rilePt ,;,y -:''D' SJ,-.'HI th6t
-73ft. measured the .ista ices -:i44 lotth oh the di "
gram.
SIGN U DATE
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TOWN 0 .••.•41
F Clq,JEENSBURY— 9 )(1 I '‘. 5c()( 4 i
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. cx CODES p-r. 1
,,_ •
REVIEWED BY
,7.1.1.61.....o,
DATE
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