97-464 BUILDING PERMIT
TOWN OF QUEENSBURY No.
VALUE $ 0 97464
TAX MAP NO. 36 . —1-12 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to LAKE GEO-RCE R. . PA1tK,
OWNER of property located at 74 STATE ROUTE 1-4-9 Street, Road or Ave.
in the Town of Queensbury,To Construct or place a SEPTIC ALT RA ION
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
INC. 74 STATE ROUTE 149
LAKE GEORGE , NY 12845
2. CONTRACTOR or BUILDERS Name
KING, VICTOR
3. CONTRACTOR or BUILDERS Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( )Wood Frame ( I Masonry ( ) Steel ( )
7. PLANS and Specifications
SEPT1e• ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES August 18 19 99
(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 18 Day of ugust 19 97
SIGNED BY for the Town of Queensbury
Building and Z ning I ctor
Application for SEPTIC DISPOSAL PERMIT
/41
Town of Queensbury I rl I 97
Dept. of Community Development 1 Permit No.
4
Building &Codes Office "
742 Bay Road 1 1997
Fee Paid .'
Queensbury, NY 12804
Location of property for installation: 7 f STp t E g o u T 4 l 4
Property Owner's Name: A! 6-6 0 GE. R. 1/, fA RK /h/G
_ Property Owner's Mailing Address: 7 1-1- S7ATE /5 0 UT' I`f9
LAliE GEoR GE !Z. V. t'ARK
Installer's Name: V/ic-r n/G Phone # 793 'f9 0
Number of bedrooms (if residential): Total daily flow:
(residential - compute Q 150 gal./bdrm.)
Topography: X flat,' rolling, steep slope 7 of slope
Soil Nature: )( sand, loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Imperv_cus Material: at what depth? feet
Percolation test: not required, required [rate min. per inch.]
Domestic water supply: municipal, X well, c r
If domestic water supply is a WELL, water supply from any se tic absorption is /70 feet.
PROPOSED SYSTEM (PUvn 001- S �n 7gr
( 2) Septic tank: /000 gallon (minimum size: 1,000 gal.)
Tile field: each tench feet / Total system ieiggth: feet
Seepage pit(s): number of 2 • / size each: If- ft by r ft.
•
Size of stone to be used: # 3 / depth or tbictr feet
•
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each. gallons
Alarm system and associated electrical work to be inspected by a certified agency.
For your protection, please note that pursuant to Section 136-29 of the Code of Town of Queensbury, any permit or
approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a
material fact or circumstance]mown by or on behalf of an applicant, shall be wid.
I have read the regulations with respect to this application a od agree to abide by these and all requirements of the Town of
Queensbury canitary Sewage Disposal • • : . 1
Signature of responsible person: Date: F//S'/ 9 7
� � rr
BLDG. PERMIT NO. 97-564
APPLICATION FOR A TEMPORARY CERTIFICATE OF OCCUPANCY
A TEMPORARY CERTIFICATE OF OCCUPANCY is hereby requested for the property
located at; 911 Route 9 TRAVELERS INSURANCE
for the following uses: Addition and Alterati on
December 1B, 1997 , 11
DATE SI`o NATJY IE °/APPLICANT
TEMPORARY CERTIFICATE OF OCCUPANCY
-The-TEMPORARY CERTIFICATE OF OCCUPANCY is hereby- k)APPROVED - - -
( )DISAPPROVED
with the following conditions: Certifi€zate of Occupancy to he i squad
upon completion of project.
TEMPORARY CERTIFICATE OF OCCUPANCY FEE: $10.0 D POSIT: (i$100.00
received on December 16, 1997
Date of Issuance Director of thidg..u& Code Enforcement
THIS TEMPORARY CERTIFICATE OF OCCUPANCY EXPIRES 90 DAYS
FROM THE DATE OF ISSUANCE.
NOTE: This Certificate is NOT VALID unless signed by the Director of Bldg. & Code
Enforcement or his designee.
-- - -`. TOWN OF QUEENSBURY 4-1 .G— --BUILDING & CODE ENFORCEMENT 742 Bay Road ,
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 01/ f c(J.
Location - 7011 Lk a A, 9
.Date 4 yi 637 Permit # 9)-7-_,/-&-e-/
SOIL TY l .T LA-Cl ay- .
Results of P,•rco ation Test
(if applicabl -) ''ate-Minute/Inch
TYPE OF SYSTE -
ABSORPTION FIELI • 'otal Length
Length of each t.. --4ch
Depth of trenche
Size of s•'.• -
SEEPAGE PITS: Number- 7 3E E SYc
Size - 4 ft. x . ft.
Stone size .fit
PIPING: Size. Type
B . to Ink -- --..
a i st. Box ' a •ial HO
i st. Boxo Fie <<
ings ealed? Yes No Partia
LOCAT ON/SEPARATIONS:
Foundati Tank -- f_e'et
Foundation to Abs ' � feet
Sepa • o Pit l, a � - --t
Conforms as per PlotPlan e No
LOCATION OF SYSTEM ON PROPERTY:
circle one)
, Fron Rear - Left Side - Right Side
i . e Front - Middle Rear
COMMENTS:
1zJ111DE- . : t0
kk\1 BT6VALE_ ►Nf--FA b IW____
V---' v \
SYSTEM USE APPROVED: ,..—'NO
ll
Arrives. II: ' ii,
Depa -ed _k '
i. ' c.
2 r 1. /./
/Build g `` .pe for
i
3 I
"t hmIm or observed,or believe I saw evidetroeo.
170' �! all objeP sub as hr ,es,wells,trees,fences,etc
shownceftdocumtru 1 also represent that i hM
PeISDA*Mftsured the distances set forth os thediainm,"
Iw' / 97
S�fL:GoDATE
1005 GA SFPTic ' gNJV
}_ I000 GA SrPTIG. I PPP'
, I
LICEq
'y gijG i5, 1997
1 � l
Ly- t
Iao ,
I
WELL
I
75'
4-0'
I I
1 Lake George R.V.Park,Inc.
1 ( U J3 L� I�0 A p 74 State Route 249
Lake George,New York 12845.3501
Ex�sirNs EXIT Rare
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AUG 15 1997
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TOWN
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BUILM ;
REVIEWED u`i X__/sT/N G . F>=NGE_____-DATE
17
5ca'LF l =9-0'
t Lake George RV Park,In
3 t)' (I U[3�3 LE 1�0 Rip c.
74 State Route 149
Lake George,New York 12845.350,
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