2001-509 Ala TOWN OF QUEENSBURY
2 Ba Roa ueensb NY 12804-5902 518 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20010509 Date Issued: Wednesday, July .18, 2001
This is to certify that work requested to be done as shown by Permit Number P20010509
has been completed.
Tax Map Number: 523400-308-010-0002-013-000-0000
Location: 547 LUZERNE Rd
Owner: GEORGE RANNEY
Applicant: GEORGE RANNEY
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
Director of Building& Code Enforcement
TOWN OF QUEENSBURY
41"
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010509 Application Number: A20010509
Tax Map No: 523400-308-010-0002-013-000-0000
Permission is hereby granted to: GEORGE RANNEY
For property located at: 547 LUZERNE Rd
in the Town of Queensbury, to construct or place
at the above location in accordance with 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. Type of Construction Value
Owner Address: GEORGE RANNEY Septic Alteration Residential
547 LUZERNE Rd Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans &Specifications
2001-509
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
$25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday,July 18,2002
(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 T n Quee b ;Alf ` • s/•sd. ,July 18,2001
SIGNED BY `' for the Town of Queensbury.
Director of Building&Code Enforcement
_ Application for Permit—Septic Disposal System
Town of Qieensbii,y 712 Boy 11uad Qi/eensbmy, NY 12804 (518) 761-8256
I. OWNER INFORMATION:
Location of installation: 7 e.-•�V 2.pJl _ f� Office Use
Tax Map No, / /
Owner's Nn Filo Permit No. :1��� / /
r .�
ute: CFO,r?� ��t�/�y,Y
Addross: c �+',1` ��
JUL1 0 2001
Y� Lc/ ����� (dam
2. INSTALLER'S NAME : (Alt/z7 ,r AA-144_-
3, RESIDENCE INFO �U LD1N�(J ..'�RY
� ���RMfl PION: (circle yea, or dwe ling, indicate II bedroom(s) mid multiply it of
bedrooms with applicable gallons per bedroom to equal total daily/low)
Year of House; No. of Bedrooms x Computation_ _ 'Total Daily Flow
1980 or outer v2- x , 150 gal/Willi = ,7 0 0 •
1980— 1991 x 130 gal/burnt =
• 1991 —present x 110 gal/burin =
Garbage Grinder Installed yes / no K
Spa or Whirlpool Installed yes / no p(,_
4. PARCEL INFORMATION: (circle applicable information & indicate measurements)
To !rap So auto .Ground Water _ Bedrock or lii,perviuus Material __Doitcstic Water Supply
at u•hrtl depth al;ohms Elc/tllt
oiling owe: • fL'ei t
/`'el tt't'/
Steep slope clay
slope other if•well; realer supply
• depth; from any septic-syslent
abswjllion is fi,
•
Percolation Test: (To be completed by licensed prdJessional engineer or architect) other_
hale; minute per inch
5, PROPOSED SYSTEM: For New Cwi tnrclion: All individual sewage disposal systems must be designed by a licensed
professional engineer or architect(unless installed in a Planning Board annoyed subdivision), Add 250 gallons to the size
• of the septic tank and leach lield for each Garbage(;tinder, Spa or WhitIpool Tub.
Septic Tank: 19®0 gallon (min. size 1,000 gal)
Tile Field: each trench Lill—.71. Total System Length:_ALL. fr.
Seepage Pit(s): number of171L. size of each: fl, by fl.
' Sizo of Stone to bo used: Il_11. 01 / depth or thickness..________fret
I3ed System Size: x
•
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /'I'0'I'AL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON (please read)
For your protection, please note that pursuant to Section 136-29 of the Code of the Town
of Queensbury, any permit or approval granted which is based upon or is granted in
• reliance upon tiny material mistcpresenlation or Failure In make a rttate'ial tact or
circumstance known by or on behalf of an applicant, shall be void.
. I have read tho regulations wilts respect to this application and agree to abide by these and all
requiroruo�te-of�4lto'1'own of Queen ry Sanitary Sewage Disposal Ordinance.
W
SI nalture of responsl I person ate
ei -��65 i l /l rrA-Cst .
uf- 6130
TOWN OF QUEENSBURY 0 AM -j
531 Bay Rd., Queensbury, NY 12804
RESIDENTIAL SOLID FUEL BURNING APPLIANCE CERTIFICATE OF COMPLIANCE
In conformity with the New York State Uniform Fire Prevention and Building Code
Note - Appliances and factory-built chimneys must be listed by nationally-recognized testing agency.
cjojoz
Only one appliance permitted per flue. j�
NAME �L"Cf}U /7( iC ADDRESS U L)4(/( to i 2-rrt PHONE 35/`''.6`C-
APPLIANCE: FACTURER l�z ,f of MODEL Ash Lf
(circl S�T'OVE FURNACE FIREPLACE Wood Coal Pellet FIREPLACE INSET
WALL PROTE TION ❑Existingej(e,e,g cl 5 , 0_4:ea Ca.60-g-,
XClearances per listing 1)
❑ Masonry wall aply 111 17 `J UQ,J� TO GOO 1 t / 15/> r&4j ` f .' l( Corn' e C
❑ Clearances red lcedby properly spaced-out material (Describe)
FLOOR PROTECTION ❑ Existing
❑ Masonry floor 1 i 1 A 1 1 q L}
X Per listing'(Describe) '' 1, jQ \ DO - [OKrot:Q.4,0A �G' tit rQ F'e,� /aM z, ,IQ.�.�Tt�14 -Fh EXT 6XYeitd, t' T'o pop e
CHIMNEY CONNE i TOR ❑ Existing
❑ Proper blued or hla k steel stovepipe, min. 24 ga. Listed factory-built chimney material
❑ Minimum interior lingth 10 ft., max. two elbows / or eng neered system /'
Crimped ends of pip. point toward appliance /min. 3 sheet metal screws per joint and at appliance 0 f.3f ,-----A f l( I
Clearance min. 18 i hes or per listing ptd.i 'uA 1.i5 I 1 5-" 41 l ;ttr e t . C',,►r-2t,�t� .kr
❑ Clearance reduced h properly spaced-out material (Describe) ei c-I 30 td .t'
111
WALL PENETRATIO /THIMBLE ❑ Existing
❑ Tile /masonry thimble per recognized standard
"g] Factory-built thimble per listing
MASONRY CHI EY 0 Existing
❑ Footing inspected
❑ Height 2 ft. above ge or 3 ft. through roof; 2 ft. above any part of roof within 10 ft.
❑ Air space hetwe n cla tile and inner wall of masonry enclosure, refractory cemented joints
Cl Clearance to omhustihl (1" exterior, 2" interior)
FACTORY BUILT CHIMNEY ❑ Existing
Clearance to combustibles per listing
Firestops installed (if required) i' -Al ct< M4011 1;,0-54'70 �45 0(44
Storm collar at roof
Height 2 ft. above ridge or 3 ft. through roof; 2 ft. above any part of roof within 10 ft. o+ ie6 4 (,_.1 1 F
FIREPLAC 4 I ERT � � lf� ``7
❑ Installed pe listing /directly connected into flue
❑ Flue gase• pr% ented from mixing with room air
FACTORY-BU L FIREPLACE
❑ Appliance cle ances, floor protection, hearth per listing
❑ Combustion rovided, Dam ers for combustion air and flue operating
DATE OF ISSUANCE �° D� .4,4-ekt, :�,ww 1
�I FIRE MARSHAL
ram- 1®4E5
SOLFPERM-11/93
"%/11:
TOWN OF EE QU WSBURY
.BUILDING b CODE ENFORCEMENT ,
742 Bay Road /04BO
. Queensbury NY 12804 ('»�
(518) 761-8256 dL
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Locati on 5/ / C1-L4 /
Date ,;_ 1 Permit # O f � 5-611
SOIL TYIE: Lam-Clay-
Results of P:rcola ion Test-
(if applicably) Ra' e-Minute/Inch
TYPE OF SYSTE
ABSORPTION FIELI• Totgl Le gti )21-0
Length of each french
Depth of tr- . he '
Size of s one F)L:64;.fo1
SEEPAGE PITS: N meeer-
Size - ft. ( . ft.
Stone size -
PIPING: Si .c Type
Bldg. to Tank 'v7
Tank to Dist. Box
Dist. Box to Field/Pi �� IV
Openings Sealed? - , No . .Partial
LOCATION/SEPARATION,
Foundation to Tank /D feet •
Foundation to Absorption . 2`j<feet
Separation of Pits ovet
Conforms as per Plot Plan No
LOCATION OF SYSTEM ON PROPERT .
(circle one)
Front - Rear - eft Side Right Side
Middle Front - - 'ear
COMMENTS:
•
•
SYSTEM.USE APPROVED: YES NO
Arrived:
Departed: _ Y7
/C-)J/d (V,e/
Building Inspector
REC 1-5.°7
EIVED
JV i 1 0 200i
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^f C:t�iFE�1u`„u�; ;��::f�1G DEFARTCJiE�!
�, 6„ e ' rte eased.on our limited examination,
�� °j ' 0 1i E�` 'i� compliance with our comments shall
not be construed our
indicating ment t
he
BUILDING EP plans and specifications are in full
7.
corn,�•.`�nce with the code
REVIEWED B
DATE D '