1991-864 ,t.., jlfi7,•y�.-,,,,� 1 �.. r..j { -a� - -- - _ - . ,�.
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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 26//72, 2 4" 19 2
This is to certify that work requested to be done as shown by Permit No. 01-864
has been completed.
This structure may be occupied as a SepticAlteration
Location Surnyside North
Owner Eric Sage
By Order Town Board
TOWN OF QUEENSBURY
V
Director of Bldg. do Code Enforcement
i
BUILDING PERMIT
a
TOWN OF QUEENSBURY .x
No. 91-864 a
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Eric Sage
OWNER of property located at Sunnyside North 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. OWNER'S Address is
Same �*
C!
2. CONTRACTOR or BUILDER'S Name Q+
Glenn Batease
V
3. CONTRACTOR or BUILDER'S Address =
to
G
Cg
4. ARCHITECT'S Name
O
ci
5. ARCHITECT'S Address
ei
1
C)
r_
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
Septic Alteration to include:
No. 1000 gal septic tank with 1 seepage pit 8' x 10' using 02 stone, •.
2' x 8 thickness as per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT•FEE PAID—THIS PERMIT EXPIRES December 30, 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 30 Di7 f . December 19 91
SIGNED BY c_I4v01/ for the Town of Queensbury
Building and Zoning isctor
- c)
TOWN OF QUEENSBURY _�/ �/
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit V`�
Fee Pa'
Date: cT/ Reviewed By Sy %C, ,6i. ece
LOCATION OF' PROPERTY. FOR INSTALLATION: 6t5,- 'f , WO(
O(
Owner's Name: 4/'(_.
Owner' s Mailing Address: <uiu//-) .-, S/'e /Y6:2�"/,�
Installer' s Name: / i /%/j S Phone #: '7 ,>757
Number of bedrooms (if residential ) :
Total daily flow (residential-compute @ 150 gal . per bedroom):
Topography-Circle One: Flat Rolling Steep Slope % of Slope 2O
Soil Nature-Circle One. Sand Loam Clay Other /Depth:
Ground Water-At What Depth? S U Feet
Bedrock or Impervious Material-At What--De th? ;! Feet
Percolation Test-Circle On Not Required quired/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipa6e) Other f,,M
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank /c Cc gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of ( / Size each: q ft. x /0 ft.
Size of Stone to be used: # 2 / Depth or Thickness X y 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 Dispos 1
Ordinance. = __
SIGNATURE OF RESPONSIBLE PERSON: � .;�� DATE:/
- f
FORMS THE NEW YORK BOARD OF FIRE UNDERWRITERS
ELECTRICAL DEPARTMENT
A.J. REED, GENERAL MANAGER
RESPOND TO:
0 85 John Street D'41 State Street 0 584 Delaware Avenue 0 217 Lake Avenue C 202 Arterial Road
NEW YORK,NY 10038 ALBANY, NY 12207 BUFFALO, NY 14202 ROCHESTER, NY 14608 SYRACUSE, NY 13206
THIS IS A REPORT OF (SEE BOX CHECKED HEREUNDER)
El NON-INSPECTION {7-ff1SPECTION El ELECTRICAL SURVEY
Os
JOB LOCATION: ;'.t �� r t v� t 1
APPLICATION NO.: PERMIT NO.:
TO: OWNER/
r' TENANT
` ,- - ADDRESS
NON-INSPECTION: We have received your application for an inspection of the electrical installation made by you at the
premises named herein but we have been unable to make the inspection for the following reason:
CI Floor location and name of tenant not furnished El Premises locked, no entry possible.
Floor location of building not furnished ❑ Other__.__
Inspector's Signature Date
Please provide the necessary information or suggest arrangements for our access to the premises on the green form
attached and return it to this office.
Applicant's Signature Date
INSPECTION OR ELECTRICAL SURVEY: We have attended at the premises named herein to inspect the electrical
installation and regret that we can not issue a certificate of compliance for the reason(s) listed hereunder;
D Concealed work not exposed sufficiently ❑ Additional electrical work found for which no application
for inspection. for inspection has been received.
Cl Installation not completed sufficiently l - ectrical installation does not comply with National
for inspection. Electrical Code for reasons listed hereunder.
(see reverse side for explanation of coding)
KEY TO FORM: Code number printed under BLACK column listed below combined with code number printed under RED column listed below
indicates condition. EXAMPLE: BLACK RED = Service Conductor not of proper capacity.
76 45
BLACK RED FLOOR BLACK RED FLOOR BLACK RED FLOOR BLACK RED FLOOR
td
1 Inspector's Signature Date r
NOTICE TO APPLICANT: Please sign, date and return green copy, of this
form to request re-inspection when modifications have been made..,' APPLICANT'S SIGNATURE DATE
NOTE: IF THIS IS A REPORT OF ELECTRICAL SURVEY, A NEW APPLICATION MUST BE MADE FOR RE-INSPECTION.
nl III nIttZr t1 rf-r
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED a /
441
TEMP.N DATE -1 f ^-
-
CITY OR VILLAGE"-, j, TOWNSHIP COUNTY
i 3)t.-/irgii9 ,)6,r4 --
k..._/„,2,44-7,-7,J.---
STREET AND NO. ROAD 4 t • POLE NUMBER
BETWEEN WHAT TWO CROSS REEj LOCATED? -SST TS IS PREMISESSECTION BLOCK LOT
F ( _... gj /`A BUILDING OCCUPANCY OCCUPANTS NAME / 7
OWNER'S NAME AND ADDRESS� "- HOME TELEPHONE NUMBER
C nJ� Ur /12 e A/E� �
CURRENT SUPPLIED B V FROM THEIR OFFICE WORK TELEPHONE NUMBER
BUILDING IS
NEW El OLD - WORK IS NEW❑ ADDITIONAL❑ DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MUIURS HEATERS BRANCH OFFICE USE
Inca- Lamp Receptacles CIRCUITS ONLY
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each 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
❑ CONCEALED
DATE WORK TO 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
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS _
NAME APPLICANT , DATE F A PLIC TI N SIGNATU T FAPAICAN ,. c'" —
STR ADDRESS, t / TELET10NE7Np,1�-r,`"
�:/1--//t/r -/i,%(e' //3 ice• ;f. 1j`!�;
CIT*Yr-OR,POST OFFICE ZIP CODE LICENSE NO.WHEN APPLICABLE
❑ 85 John treet (I
0 41 State Street 570 Delaware Avenue <TIsEli Lke( enue 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
T1_1 AIC\A/ \/r1In1/ IDf\Ainr r1C c I in c I in I rt=En A/Mr=ID C
!,\!,\.lam?.-0 !:.\.'\1.\ A-,‘I,../..\/.,\/\tl,�/._.!-'!. ! /' i\, .1 , a l:�.l;\1,fit,,lt/ t/ \/:1./.,1.',..k/-1 J.,'t.�\/tea/..\tti)t��t/.1t!1�/.. �1ti, t/�tl.,\t/, /1./ 1 '.•f !. 1.!„.!..A,,1ti,.\ I !..'
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE I
8023201 BUREAU OF ELECTRICITY
1; 41 STATE STREET.ALBA EW YORK.12207 .
Date JULY 10,1992 Applicatio o.on file C 861519x/92 U 418019
THIS CERTIFIES THAT PERMIT .i 91_864
only the electrical equipment as described below and introducJe-db b • t named on the above application number in the premises of
ti
ERIC SAGE, SUNNYSIDE NORTH. QUEE SfUP i, N.Y. o
o
in the following location; ❑ Basement El1st Fl. El2nd Fl. OUT Section Block Lot
was •examined on '�1fNi' �1"1 `' and found to be in compliance with the requirements of this Board.
J
FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
g
-L
1
- DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
-% AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. • AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS
NO.OF FEET AMT. WATTS
a
-c
,., SERVICE DISCONNECT NO. S E R V I C E
AMT. AMP. TYPE EMOEU�P 1,B'2W I,B'3W 3 if 3W 3,9 AW NO.OAR CirCOND. OF C COND.. NO.OF HI-LEG o •HI-LEG NO.OF NEUTRALS OF NEUGRAL
4 OTHER APPARATUS: •
j
MO
SIsP'TIC ALARM SYSTEM-1
.
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1
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,. %Jltt�l'l SaS.1.. DE NORTHUw'C
-4 PDT 1 (1,( g13O�XX'�p.J;A Cary BRANCH MANAGER
k QUIJ1.J�VNBUR y N y 12�:04 239 •
-4 Per
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..` 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. '`:
f• .irc Mat 1ic11.(W.1Mir1WI).S1 Astau vat lilt Mt.rrvIMtMN/ all1 L I%t'I I1 IIrcIffi Ulu1WI Illi LUAU"vat vitt vat vat Ala Iva larva via Ssr1*tII&In fumarintlairvlLt Ala1st .'.. ,
COPY FOR RUILDING DEPARTMENT_ THIS COPY OF CERTIFICATE MIST NOT RF Al TERM IN AMY UAMAIFR
Jotun o f Queeniur,
BUILDING and ZONING DEPARTMENT
, Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
•
NAME K'c 3- 4 /
LOCAT I O�N/ -TcAw 4., `c
DATE 94.7 2/ PERMIT NO. 9/ 5617/
SOIL TYPE -cliZqa 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 '
Size of gravel_
SEEPAGE PITS{Numbe l .' ) /'
.
Size- ft. X ! ft...f SVer,-..e
Gravel size , r � A
PIPING: Size Type
Bldg. to tank , J'
Tank to dist. .ox 2�� 1504
t
Dist. box t. field/.
Openings s-aled? 40
NO Partial
LOCATIO /SEPARATIONS: ,�
Founda ion to tank g Ic:3T ft.
Foundation to absorp 'on _ 'tom: ,, '
Absorption to lot line ft v -
Separation of pits / ft. /2„,,l'4
,
FTION OF SYSTEM ON PROPERTY(circle one)
ron, - Rear - Left side - Right side COMMENTS:
Ti -E/ •
S
Qrf
SYSTEM USE APPROVED YES • /]k /
/V 1?�(''lkla I
Bui ing nspector
•
01/86 and vl •
.awn of Queenaturcy
•
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME . , A-GG
LOCATION Sip A/4 \D4
1
DATE �121 PERMIT NO. \ LOLJ\
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
Depth of trenches
Size of gravel
SEEPAGE PITS4Numb:r of)
Size- ft. X _ ft. 7
Gravel size
PIPING: jze Type
Bldg. to tank
Tank to dist. box
Dist. box to field/.. t
Openings sealed? .ES NO Partial
LOCATION/SEPARATI'iNS:
Foundation to ta. k / ft.
Foundation to . .sorpi 'on ft.
Absorption to of lin- ft.
' Separation o pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS:
f r e 12_0 v -
�o (Alto Ce)c)
I'
po5rtiD
SYSTEM USE APPROVED ES N
Building In pector
01/86 and vl
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