Loading...
98-437 CLRTIF'ICKrE OF CCJIV PLIANCEI TOWN Or QUEENSBURY WARREN COUNTY . NEW YORK II Da t e-�7 y 24 19 98 . (" j 98437 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 �— Loc PiYn LAKE PARKWAY Owner SELKOW , RICHARD By Order of Town Board TAX MAP NO * � . - � - 5 _ TOWN OF QUEENSBURY Director of Building & Code Enforcement BUILDING PERMIT VALUE $ g TOWN OF QUEENSBURY No. 98437 TAX. MAP NO . 9 . — 1 - 5 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to SELKOWr RICHARD OWNER of property located at 1291 LAKE PARKWAY 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. 4wNER'S Address is 1291 LAKE PARTWAY LAKE GEORGEr NY 12845 2. CONTRACTOR or BUI LI Ft OS Name CRANDALLr CHRIS 3. CONTRACTOR or BUILDER'S Address RaD . # 1r BOX 1376 LAKE GEORGEr, NEW YORK 1284E A. ARCHITECT`S Name 5, ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by X) SEPTIC I l Wood Frame I ! Masonry I } Steel I I 7. PLANS and Specifications SEP71W ALTERATION AS PER PLOT PLAN SPECIFICATIONS 8. Proposed Use SEPTIC ALTERATION 25 July 17 2000 g PERMIT FEE PAID — THIS PERMIT EXPIRES 19 (If a longer period is required an application for an extension must b . made to the Building and Zoning inspector of the town of Queensbury before the expiration date-1 1998 17 July Dated at the Town of Queensbury this Day of 15 for the Town of Queensbury SIGNED BY irtg and 20 erg nspactor y Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Permit No. V . Dept. of Community Development Building & +Codes office _., Fee Paid $ —.-- 742 Bay Road Queensbury, NY 12804 Location of property for installation: /`7 gxcH, b ,! ie „��3 ►'`� /� 1 J 44A4e:e Property Owner's Name: Vi, % G ry L4AW c! L yJ Property Owner's Mailing Address: ,� Installer's Name: X W o 0wq// r"k C i4 V,pq T: Phone # Number of bedrooms (if residential): 3 Total daily flow: / (residential - compute a 150 gal.Ibdrm.) Topography: flat, #'rolling„ steep slope A of slope Soil Nature: sand, 49;00�10am, clay, other I depth: Ground water: at what depth? J. feet I Bedrock or Impervious Material.: at what depth? /� feet Percolation test: C�0not required, required [ rate min. per inch , ] Domestic water supply: municipal„ well, o er If domestic water supply is a WELL, water supply from any septic absorption is _ D � �et1 7 PROPOSED SYSTEM Septic tank: �ZSUgallon (minimum size: l ,(]QQ Dal .} Tile field: each trench .15�0 feet / Total system length: S O feet Seepage pit(s): number of / size each: ft. by ft• Size of stone to be used. # _ � f depth or thickness _ feet- HOLDING TANK SYSTEM: (if required) Number of tanks: Size of each: gallons Alarm stem and associated electrical work to be inspected by a certified agency. For your protection, please note that p rsuant to Section 136-29 of the Code of the Town of Qtu*nsbury, any permit or approval granted which is based upon or is grained m reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal e�� Signature of responsible person: Date: r •, "Ihsoo saw orA , wWrfmv � at aH objeda seems U A k time; 419* " shown on this docona t 1 do sep-eellt OW t #loft p+ersonaft na�od *A diebnn set 60 so tho dievaWO =GNATURE am PPEOT PI AN SEPTIC SYSTEM Notice : The following statement must be " stamped" on your plot plane This sheet of paper MAY be used for purposes of drawing your plot plan . After drawing such plot plan , please read the statement and sign it . If you chooser to use other paper for your plot plan , the office will stamp those plans for your signature . COMMONWEALTH ELECTRICAL INSPECTION SERVICE, 1Nt� Main office 357 Elwyn Serrate — Manheim, PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPRCIVAL 513180 Cut-in Card No Panel Board No. ..._.,.....,_.. . Cest- �CZXvo�. . . . ..� c Owner • .... Pik. . .... . .. ... ... ..+.....--..--.,--..- ....-. ... . . . . . . . . . L[)L'atl{)n ..-... y-- /'±. . ....~. ... . . ..._u1 L`% �-. . . .1 . . .` 't^� .5•°'' .-'[-'Q- AJ . . I!r... ... -.-_S. . . . .. Instaffatiun Consisting of ... . . • i " S . ..... ..... .. ............ Installed $ crx[ficate previ ,usl The conditions following governed the issuance of this certificate. and any 'i issued iscancelled: - made for This certificate only covers the electrical equipment and in;14aki�nnshall be promptly ate. Pc>n the introduction of add'stional equipment nr alterations, app ' Minns at any time- and if its inspection. shalt have the Privilege of making - Inspectors of this Company xi Wate- rules are violated, the C m any shall have the right to revoke x -.M'C - Date . ..--..'. .L". -.. . .-. .- Member N.F.P.A-, LA-E-I. i TOWN OF QUEENSBURY BUILDING A CODE ENFORCEIWMT 742 Bay Road Queensberry NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location, L Date - gPermit # 4 SOIL S am- Clay- Results of Percolation Test- ( if applicable ) Rate-Minute/ Inch TYPE OF SYSTEM: ABSORPTION FIELD : Total Length Length of each trench Depth of trenches ► r ■ Size of stone SEEPAGE PITS : er- Size ft . Stone size PIPIXG : - Size Type Bldg . to Tank Tank to Dist Box � ` "` t�it ►�,�3 � Dist . Box to Fi el d/Pit Openings Sealed ? e o Partial LOCATIONISEPARATION Foundation to Tank �eet Foundation to Absorption �� feet Separation o� Pits Conforms as per Plot Plan o LOCATION OF SYSTEM ON PROPERTY: ( circle one ) Front - Rear - Left Side Ri ht Side Middle Front 4i ear COMMENTS : SYSTEM USE APPROVED: Arrived : Departed: ` cling n for W �.172+T37 47N (10 FACE .� � DOCK LLJ IF e 0 a a a u —p v�i ca w N o © V) x U o (� \ a a Q t a FORCE I OEM, Li ItiF ( GARAGE c� v $ 4 15 N72*23 55 w 53 , w I K ' � (L GARAGE u (� ' +Five .kiFit Vil kit rX y