1991-671 CERTIFICATE OF ' COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date. 3-7"."}aril. T 19 /
- , This is to certify that work requested to be done as show by Permit No. 91-671
n
has been completed.
This structure may be occupied as a Septic Al tp.r ti rm
Location. Sunnyside North
Owner Joseph L kas
By Order Town Board
TOWN OF QUEENSBURY
(:----/--/ A17
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-671
WARREN COUNTY, NEW YORK •, c
PERMISSION is hereby granted to Joseph Lukas nWi
OWNER of property located at Sunnyside North Street, Road or Ave. r-
c
in the Town of Queensbury,To Construct or place a Septic Alteration H
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. O
N
CD
1. OWNER'S Address is
Same
N
2. CONTRACTOR or BUILDER'S Name
Glenn Batease CD
0
3. CONTRACTOR or BUILDER'S Address -1
12
V1
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4. ARCHITECT'S Name
c+
CD
5. ARCHITECT'S Address
c+
0
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
No. Septic Alteration to include: 2 seepage pits each 6' x 8' using
12 Stone as per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25 00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 20 19 93
(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 Day f , September 19 91
SIGNED BY for the Town of Queensbury
Building and Zoning In* ctor
et y
`� j TOWN OF QUEENSBURY l �/
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # / /�
Fee Paid05`x'
Date: / Reviewed' By®
LOCATION OF PROPERTY FOR INSTALLATION: SC.V.), �S (/��' /V'j'.
S E P 19 1991
Owner' s Name: dra'.;t23/24 Z I-) 4$
Owner' s Mailing Address: cU/z-tiS' /OZ Amer-, QUA/ f.3 C'�`t C EQTo
Installer's Name: c//,;A/W Phone #: 79277577
Number of bedrooms (if residential ) :
Total daily flow (residential-compute @ 150 gal . per bedroom) : j C's°'
Topography-Circle One: 0111110 Rolling Steep Slope % of Slope
Soil Nature-Circle One: 40 Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: Not Required Required/Rate S-f"Min. Per Inch
Domestic Water Supply-Circle One: Municipal Well ifigbe w4V
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 feet//Total System Length feet
Seepage Pit(s) : Number of / Size each: _ ft. x 0 ft.
Size of Stone to be used: # / Depth or Thickness feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size of Each Gal .
Alarm system and associated electrical work to be inspected by 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.
SIGNATURE OF RESPONSIBLE PERSON: DATE: � / /
'-r
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the -Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at. least 24 hours , before start
of construction and shall include a plot plan showing:
1) the 'proposed 'location of the system
2) location and distance to lot lines
3) 'location and distance to structures - -
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution boxes, tile fields.
and/or drywells B. No system shall be covered before inspection and approval by the Building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00..
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may 'result
in an immediate work: stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
•
Town of Queensbury -
Building & Code Enforcement
Department - -
531 Bay Road -
Queensbury NY 12804
Remarks:
•
46 EL(REV.1/90) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
THE NEW YORK BOARD OF FIRE UNDERWRITERS
,CERTIFICATE NO.
•DO NOT WRITE HERE:FOR OFFICE USE ONLY
•
BUILDING PERMIT NO.
TEMP.I! DATE •
CITY OR VILLAGE • TOWNSHIPj 7j
k--,,r5/S r- { 6„,,,7 %. t/STREET ANDIJO.OR ROAD POLE NUMBER
i0r1.1/e-ii`'5,1)/ 4/c3'CT
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT
OCCUPAIQT ME BUILDING OCCUPANCY ,
- � / /r�� •
-
OWNER'S NAME AND ADDRESS 'J z�.�L�HOME
``7^^��J HOME LEPHONE NUMBER
CURRENT SUPPLtBb BY `s7/ FROM THEIR OFFICE • WORK TELEPHONE NUMBER
BUILDING IS •
NEW 0 OLD❑ WORK IS NEW❑, ADDITIONAL 0 DEFECTS REMOVED 0
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
Loca- NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Lamp Receptacles CIRCUITS ONLY
lion Side Attach't
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Ea h No. Each No Gauge INSPECTION
OUT-
SIDE
SUB-
BASE
—
BASE-
MENT
-( -
1st
FL.
2nd _
FL.
3rd '
FL.
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE. - "
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT.
SIZE OF MAINS FEEDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS
CHARACTER OF WORK •
❑� EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
U CONCEALED
DATE WORK W BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN
_ ❑ OVERHEAD ❑ UNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANTS
IDENTIFICATION NUMBER I I I I I I I `
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF APPLICANT 13/A3E 0 APPLIC ION SIGN E P. ••
STREET ADDRESS • � •
G�'!'—
TELEPHONE NO.
CITY OR POST OFFICE ZIP CODE LICENSE NO.WHEN APPLICABLE
Ii 85 John Street ❑ 41 State.Street ❑ 570 Delaware Avenue ❑ 217 Lake Avenue D. 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206
(212)227-3700 `(518)463-2122 (716)884-1155 (716)254-0141
(315)463-8552
THE NEW YORK BOARD OF FIRE UNDERWRITERS
al
E S{..,...i,.\..tia�.J./Jt���i,at,,,,,p... ...{a"i„1,9,!�...!„ .J.,,„1t.1 19,1,..i,),/„1"i.)",/,".19/j1P/.Al t,„1,ti.,19), „1,9)..\"1.!1P),a,Ca,•t.,.1P),?,.lah.),"1 1t1„1"i,a."1„M, t..k11/i.M,,f,.,,11).fib.sh.1"i. 11i.1.4,VIPi.41p„ , ��SIP!- ;,
r.7. re, THE NEW YORK BOARD. OF FIRE UNDERWRITERS PAGE 1
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1; $0�1223 f~ BUREAU OF ELECTRICITY.
.,: I j 41 STATE STREET.ALB NY NEW YORK 12207
•. n C A licatio No.on L e
-4; Date OG`iOBEP, �3,1�91 pp J79.B9191/91" li 413973
�1 THIS CERTIFIES THAT PERMIT NO. 91-671 j
only the electrical equipment as described below and introduced by applic named on the above application number in the premises of
a ;JC)E LUKAS, SUNNYSIDE NORTH, QUEENSBURY, N.Y. '
in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot
s- to►: was examined on OCTOBER 16,1991 and found to be in compliance with the requirements of this Board. ii
r. :, • ,ii .:
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;`.-
OUTLETS ECEPTACLES SWITCHES INCANDESCENT-FLUORESCENT OTHER AMT. K.W. MAT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
'c'
�
la
•!:.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
k SYSTEMS it
AMT. K.W. OIL H.P. GAS H.P. - MAT. NO. A.W.G. MAT. AMP. AMT. - AMPS. TRANS. MAT. H.P. NO.OF FEET AMT. WATTS
1
i; i
SERVICE DISCONNECT NO.OF S . E R V I C E
METER
!p AMT:,. AMP. TYPE EQUIR 1,B'YW 1�'3W 3 3W 3,4 IW NO.OFF C$COND. OF CG COND.. NO.OF HI-LEG OF•HIdEG NO.OF NEUTRALS Of NEUGRAL %�£
- _ t
•1, OTHER APPARATUS:
SEPTIC ALARM-1 -
ty
1,
Z. 1,
, JOE LU1 AS
j' SUNNI SIDE NORTH
ii1,
. RD 1 32�5 • BRANCH MANAGER 6
T. s' r •
QUEENSBURY, NY, 12804 .. - 239 .14 7
Per
; This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Rill
_Down of Queenibur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME a (] o,_, j. Z/�
LOCATION SV\(d)()U\1 e. NOY01
DATE 10 / c) PERMIT NO. ) 1 ^(9 71
q�e",
SOIL TYPE - 'and Loam Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each trench '
Depth of trenches A
Size of gravel_ !
SEEPAGE PITS{Number of) _ ,A.��
Size- ft. X _ f Ar
Gravel size • Or;r
PIPING: ,'I1P7. ^ Type
Bldg. to tank Iv; /
Tank to dist. bo
Dist. box to f'e ••it
Openings seale . YES /' NO Partial
i
LOCATIO , S�• ' ••TIONS:/ .
Founda t.s o tank / \ ft. •
Foundat'. to absor"ption eft.
Absorp .on to lot/line fit.
Separation of pi ys '. ft.
LOCATION OF SYSTEM ON PROPERTY(crcle one)
Front - Rear - Deft side -. Right. side -
COMMENTS: .
SYSTEM USE APPROVED (NO
A
B ' ding I" pector
01/86 and vl
J ,
_awn of Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
•
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ,20 V.9 7
LOCATION of\rx. e- I Vo-1/‘
DATE /e9 3 PERMIT NO. 91 --(p 7l
SOIL TYPE -(Sand)- Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE. of SYSTEM:
Absorption field, total length
Length of each trench lY,•
Depth of trenches "
Size of gravel_
SEEPAGE PITS{Numb of),
Size- t. X -(ft"`
Gravel size . %;3
PIPING: .,;".Size Type
Bldg. to tank
Tank to dist. box v` •
Dist. box to field pit '
Openings sealed? j' YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank ft.
Foundation to absorption ti'I. ft.
Absorption to „lot line ; ft.
Separation of Ipits i; ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rears - Left side - `Might side COMMENTS:
7A44eiX/60
.
.7a4/241,e,.47,--‘f-?
e� Old
SYSTEM USE APPROVED YES NO
i
B ding Insp tor
01/86 and vl
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.. . iii-xi )14 4 p co _ ' a (...:E!
CODE DEPT..
'•. . . . SEP 1 lj 1991
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