1993-629 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 93-629 2
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to ALICE M . CORRIGAN
OWNER of property located at Chestnut Road Street,Road or Ave.
o`
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
RD1 Box 356 a
Lake George NY 12845 z
2. CONTRACTOR or BUILDER'S Name
Cook' s Septic Service
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( ) Masonry ( )Steel
7. PLANS and Specifications
No. Septic alteration including 1000 gallon septic tank—
pump up system as per plot plan, specifications and
application ancd in aernrdancP with Town Board
8. Proposed Use Resolution #4 8 ,9 3 .
Septic system
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$ 25 .00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 18 1995
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rt
town of Queensbury before the expiration date.) 1-1
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Dated at the Town of Queensbury thi 18 th Da pf November 1993
SIGNED BY l for the Town of Queensbury
Building and Zo ing Inspector
ssirarTOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid )
Date: /O-b-83agobw.170) Reviewed B it„ 40
LOCATION OF PROPERTY FOR INSTALLATION: £ rr- 4i 6/' iLeidia 1993
Received
Owner's Name: l j l Ce /4. !'-ruc M Town of ��-
R i Ne.44.55k geensbury
Owner's MailingAddress: " �`� 'V
Installer s Name: 2O7,k$ �lC_ Phone #:
Number of bedrooms (if residential ):
Total daily flow (residential-compute Cr 1bu gal . per bedroom): 45CA
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand 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 Min. Per Inch
Domestic Water Supply-Circle One: Municipal Other _
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
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PROPOSED SYSTEM: Septic Tank 000 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench , 4 2 feet//Total System Length , feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
1
Size of Stone to be used: 3 / Depth or Thickness / fe€t -
**************
HOLDING TANK SYSTEM IF REQUIREp
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:
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R INDEPENDENT ELECTRICAL INSPECTION93- ` CERTIFICATE NO.
R a 4� AGENCY, INC. 41 t7118ff
,ill 626 Bleecker Street Utica, New York 13501 ATTACHMENT NO.
1.5
E.R / INSPECTOR CODE:, TO rff
R
R APPLICATION REF.NO. DATE
• THIS CERTIFIES THAT THE ELECTRICAL EQUIPMENT LISTED BELOW WAS EXAMINED BY REQUEST OF THE ABOVE APPLI- '
1 CATION REFERENCE IN THE RESIDENTIAL( )AND/OR COMMERCIAL(X )PREMISES OFE.
Owner's Name f4L ICE CORR 1 GAN Location-( )Base ( ) 1st Fl ( )2nd Fl
R Address of Installation CHESTNUT RI) OUTSIDE A
1 t( )City ( X)Town ( )Village UEENS8URY, NY ( X ) A
AND FOUND TO COMPLY WITH THE REQUIREMENTS OF THIS AGENCY AND SECTIONS OF THE NATIONAL ELECTRICAL CODE APPLIED BY THIS AGENCY. U
E. SERVICE DISCONNECT METER TYPE OF SERVICE NO.OF SERVICE CONDUCTORS PER PHASE EXHAUST FANS FUTURE APPLIANCE FEEDERS U
1 W
• AMT AMP TYPE AMT 102W 303W CC. A.W.G. NEUT A.W.G. AMT HP AMT A.W.G. APPLIANCE ,
L.D 1 f U
a 1 20 CB 1 103W 304W 4t 1 2/0 A,
E. X W
R W
FURNACES BELL R.W.O. RECEPT. SW. FIXTURES COOKING DECKS OVENS U
ARR TRANS 13
AMT HP INC. FL HID AMT KW AMT KW
OIL U
R U
Lill Ii
E GAS A
E U
I DISHWASHERS RANGES DETECTORS DIMMERS SPEC.RECEPT. TRANSFORMERS SUB-PANELS TIME CLOCKS UNIT HEATERS U
Ig.Ig. AMT KW AMT KW HEAT SMOKE AMT WATTS AMT AMP AMT KVA AMT AMP AMT AMP AMT RATING A
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U !MUM VIM A S.PUMP IN PRIG REMEILE. PER OWNER W
*• FOR ADDITIONAL APPARATUS REFER TO ATTACHMENT. U
R• APPLICANT'S NAME r
U• ADDRESS ED W HBURN A
q GAGE HILL ROAD iJ 's?►:: U
R LUZERNE, NY 12846 J. .VwlOhO$CO U
R PRESIDENT A
PAGE. U
515'�HI�GI CERTIFICATE AND ATTACHMENTS SHALL NOT BE ALTERED IN ANY MANNER. CONDITIONS ON REVERSE SIDE OF GG� GAG G GAG G�
L E L IM EI I .0 Gr i i � EI I sl0_1 _al �_ IEl
APP./REF.--90 FORM#16 1st&2nd Copy-Applicant;Canary-Office;4th Copy-Bldg.Dept;5th Copy-Record
•
1. This certificate expresses the personal opinions of inspectors of this Agency based on his visual
examination of the items and components listed on this certificate. The inspection was limited primarily to
visual impressions of readily accessible areas - no disassembly of equipment, opening of walls, moving of
furniture, walking on roofs (unless readily accessible) or excavation was performed.
2. This Agency does not adopt the warranty of the manufacturer of any component inspected, or the
warranty of the builder or seller of the structure.
3. This certificate is not intended to imply that every possible defect was discovered.Latent and concealed
defects and deficiencies are excluded from the inspection. This certificate expresses compliance to the
best of the inspector's knowledge and ability.
4. Issuance of this certificate is the result of a request by the applicant on the standard Agency "Application
for Electrical Inspection" form identified by reference on the cover page of this certificate,
5. This certificate is intended only to assist the enforcement authority and/or the applicant, owner, builder
or seller,in evaluating the overall condition of the structure. Acceptance and use of this certificate is entirely
at the discretion of the receiver.
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name l
Location
Date /2 = 1 Permit # f' 44t'
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: F, Size Type
Bldg. to Tank 1
Tank to Dist. Box
Dist. Box to Fiel Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATI S: ,
Foundation to Tank : feet
Foundation to Absorption feet
Separation of Pits: _ feet
Conforms as per P tot\Plan Yes No
LOCATION OF SYS JN * PROPERTY:
(circle one) ,
Front - Rear Left Side - Right Side
Middle Front, Middle Rear
COMMENTS: /
Flu. //1.0 dux.
en
J -,,
f�.r
a
Ai / A;frf/ J /
lG
SYSTEM USE APPROVED: YES
Arrived: -7?2-0,
Departed: ' 2)
Building In ector
TOWN OF QUEENSBURY
BUILDING b CODE ENFORCEMENT
531 Bay Road
Queensbury NY 1280 it API
518-745-4447 ea1etbL uu
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ( q-CRr..4,----'
Locationak411-u-
Date I I 3 Permit # kj . 6,4c/r
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size c
PIPING: 4. Size Type
Bldg. to Ta•k
Tank to Dist Box
Dist. Box to ield/ it
Openings Sealei? Yes No Partial
LOCATION/SEPA' 0IE S:
Foundation to Tar feet
Foundation to Ab, a rpti on feet
Separation of Pit feet
Conforms as per Pict t Plan ! Yes No
LOCATION OF SYSTEM PROPERTY:
(circle one)
Front - Rear ,� Left S de - Right Side
Middle Front - Middle 'ear
COMMENTS:
'-7 C 1
SYSTEM USE APPROVED: YES NO
Arrived: . ,e 3
:)
Departed: fo
Bui1'VI Inspector
Aid
TOM OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ,,,ce A...
Location f',id
Date - Permit # 13 -4;2
SOIL TYPE: ,an oam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inchjt
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench 5 /`10-
Depth of trenches
Size of stone ._3
SEEPAGE PITS: Number-
Size - ft. x __7/1„4/. 4.
Stone size
PIPING: Size T e
Bldg. to Tank 9"
Tank to Dist. Box -2' Ac-
Di st. Box to Field/P'im, 0'4L-
Openings Sealed? 6440. No Partial
LOCATION/SEPARATIONS:
Foundation to Tank I/0' feet
Foundation to Absorption e ; feet
Separation of Pits . I., ......eet
Conforms as per Plot Pla o
LOCATION OF SYSTEM ON P' s ERT :
(circle o„.i.,- /t.
Front - �.( - Left Sfele - Si
Middle Front - Middle' Rear
COMMENTS: \
kivAdL ,
1:2c Crx-4,,L-
SYSTEM USE APPROVED: ES NO
Arrived: / ,
Departed: /'j`
Building ns tor
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name e 6-7,7?Location
Date Permit #
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. k ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box ;
Dist. Box to Field/Pit
Openings Sealed? `des No Partial
LOCATION/SEPARATIOHS: ',,.
Foundation to Tan feet
Foundation to Abrp ti Q,n feet
Separation of Pi s y. _ feet
Conforms as per/Plot P1 0 Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one) y
Front - Rear - Left Side - Right Side
Middle Front Middle Rear
COMMENTS: I
464-
1.44-,e1
SYSTEM USE APPROVED: YES NO
Arrived: / /v/
Departed: /i 4
(7V--Building Inspector
TOWN OF QUEENSBURY jD//7
2 deed66t BUILDING b CODE ENFORCEMENT
'erve 531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name _ t &frivtirAt,
Location OhJ f/t uiJ ied
Date / ,/�//0t? Permit # 9,4-4,2W!/
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank s`
Tank to Dist. Bo
Dist. Box toy Fi- d/Pit
Openings Sea ,e,4? Yes No Partial
LOCATION/SEP, + ,TIONS:
Foundation o\Tank feet
Foundation to Ribsorption feet
SeP arati n of Rits feet
Conform as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
4/ :A• /7.
r r,r/t
SYSTEM USE APPROVED: YES (NO
Arrived: % "/
Departed: /c,'
/)//4/1
Building Inspector