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95-422 -_— .- CER,TIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date 19 August 21 95 This is to certify that work requested to be done as shown by Permit No. 9 422 has been completed. This structure may be used as a is i-'r1 x'k:'1'u1=1 Location 11 ,24 WO' kr, , Owner `:ltiriar1,13i.t1 '` tl )l i1:1 By Order of Town Board Z „> ti.'- l• TOWN OF QUEENSBURY Director of Building & Code Enforcement BUILDING PERMIT VALUE $ 0 TOWN OF QUEENSBURY 95422 TAX HAP NO. 60. -7-5. 1 No. WARREN COUNTY, NEW YORK CANTERBURY WOODS PERMISSION is hereby granted to 1124 BAY RD. OWNER of property located at Street,Road or Ave. SEPTIC SYSTEM in the Town of Queensbury,To Construct or place a 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 1124 BAY ROAD QUEENSBURY, NY 12804 2. CONTRACTOR or BUILDER'S Name 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) SEPTIC ( )Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications SEPTICo.SYSTEM AS PER PLOT PLAN SPECIFICATIONS 8. Proposed Use SEPTIC SYSTEM $ 26 PERMIT FEE PAID —THIS PERMIT EXPIRES July 27 97 19 (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.) 2 August 19 95 Dated at the Town of Queensbury this Day of SIGNED BY for the Town of Queensbury Building and Zoning Inspector l --- '- -3 ' Application for SEPTIC DISPOSAL P1�;IRM11' O STAMP Rl:('I?IVIA) Z Location of properly for installation: r /,nl T7/3 i/L y Ga;i #± O 10 Owner's Name; _ /`-•'62vX"C' wNG, /11- PERMIT NUMBER Owner's Mailing Addiess: _ 4 ,�� 9 5 490 eev6... eUs134/l / tTi MI'. �5 I'. '.'AII) Installer's Name: _ Phone #: tDO 1C1�.. Number of bedrooms (if residential): / 2 c /vi Total daily now (residential - compute (li) 150 gal. per bedroom): �a GG p•� Topography: LA Flat I___ Itullinl: I- I Steep Slope of Slop Soil Nature: I i Sand I___J Io:un I i ,'lay I_I Oilier _ /DREG ED Ground Water: at what depth? _--,f24/ 26a •• feet JUL2 C 1995 U C' t J Bedrock or Impervious Material: at what depth'! Ni-/4-7,feet TOWN OF C JEENS IJRY s BUILDING AND CODE Percolation Test: I i Not Required I I Required/Rate i/ min. per met Domestic Water Supply: LA Mctnicipal i I Well Li Other If domestic wale, supply is a WF.I.I.: water supply hunt any septic ahsotptio„ is feet PROPOSED SYS'TFM: Septic tank: 3r-S gal. (minimum size: 1,000 gal.) Tile Field: each trench &c-') feet. / total system length / ��D_feet. Seepage I'it(s): number of — / size each: ft. x _ ft. Size ul'stone It, he used: II / depth or thickness feet. I101.DiN(1 'TANK SYSI FM: (if,equired) i Number of tanks: Size of each: gal. I.1� 7 A/anti system and associated electrical work to be inspected l,r a certified agency. 1 For your protection, pleci.se note that pursuant to ,Section 136-29 ()fare Code of the 7'onvt of Queensbnry, any permit or a ppro, tl granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf o f an. applicant, .shall be void. 1 have read the regulations with respect to this a )plica(ion and agree to abide by these and all requirements o f the Town o f Quee itsbtiry Saiti e y S aiU•.sp/l Ordinance. /0 i;i /t UIr1/' s>;:- i 15 Signature of re.sponsib'e person: - j Unlc.: 17 G"L� c--\CS PN\ TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location L Date qj- 1--Ck Permit # 5 SOIL TYPE: Sand- oam-Clay- Results of Percol , tion Test- (if applicable) R.te-Minute/I h TYPE OF SYSTEM: ABSORPTION FIELD: •tal Len. h Length of each tren•h Depth of trenches Size of stone SEEPAGE PITS: Number Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Fieli/Pit Openings Sealed Yes No Partial LOCATION/SEPA' •TIONS: Foundation Tank feet Foundatio to Absorption feet Separation o(= Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPER . : (circle one) Front - Rear - Left Side - Ri. t Side Middle Front - Middle Rear COMMENTS: 1/0/77//9 ,f1X4 44/f a- err- arAi 3122,ec- ,, SYSTEM USE APPROVED: YES ` Arrived: g1,61 Departed: 7. Building Inspector TOiNV OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name /2V,174 .e- 61 S l Location Date )41.ermit # S SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/I ch TYPE OF SYST l.: ABSORPTION FI D: Total Length Length of each , rench Depth of trench- Size of stone SEEPAGE PITS: Nu ber- Size - ft. x ft. Stone size PIPING: S ze Type Bldg. to Tank Tank to Dist. Box Dist. Box to Field/Pit Openings Sealed? Yes No Partial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption feet Separation off= Pits feet Conforms as per Plot Pla Yes No LOCATION OF SYSTEM ON PRIP 'TY: (circle one) Front - Rear - Left Sid - R ght Side Middle Front - Middle R: ar COMMENTS: T/A47 F/74;� ( � 7---;-(1/4/ 3 41 ( j/r. SYSTEM USE APPROVED: NO Arrived: (? A Departed: fS Building Inspector COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 357 Elwyn Terrace — Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL 45270 ^ r Panel Board No. r, Cert. t.� p _ Cut-in Card No.~.�. . •-M pa Owner effort �`ac�R`� Occupant f� Location sly) ! J 6- y Installation Consisting of... . rGt fit frf 4t,( S � Installed By4` Clf 5K Lic. # The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:— This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations, application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of making inspect" s at any time, and if its rules are yr lated,the Com any shall have the right to revoke th' erti Date INSPECTOR , Member N.F.P.A.,I.A.E.1. TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name ir , fr deiacg Location (s, xy7 Date f' Permit # 9�- 'I 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 Tank to Dist. Box Dist. Box to Field/Pit Openings Sealed? Yes No Partial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption feet Separation of Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: A.,(4 /1 Ede, .3 v‘ /4 J-1-4 .e Ycrlc° SYSTEM USE APPROVED: YES Arrived: l(,� Departed: 47 a) :?1- Building nspector Vt-lx`rI34sctiA:6Y-\ TOWN OF QUEENSBURY BUILDING b CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION NameMa4-eAA. ,.., , i)...)60� Location (li (),-)( -32,, Date /9 -1 c Permit #01 5' Ll SOIL TYPE: Sand-Loam-Clay- Resul s of Percolation Te 7t- (if ap•licable) Rate-Min to/Inch TYPE OF YSTEM: ABSORPTII FIELD: Tota Length Length of -ach trench Depth of t -nches Size of sto e SEEPAGE PITS Numrier- Size ft. x ft. Stone size PIPING: IF Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Fie' d/Pit Openings S-.led? Yes No Partial LOCATION/ PARATIe S: Foundati. to Tank feet Foundat'.n to Absora ti on feet Separa ''on of Pits feet Confo .s as per Plot 1 an Yes No LOCAT ON OF SYSTEM ON 'ROPERTY: (cirile one) Fron - Rear - Left Sid. - Right Side Middle Front - Middle Rear COMMENTS: D te.,P f y ell 1 / 7 SYSTEM USE APPROVED: YES NO Arrived: /;;jz Departed: 42,et / /-7 Building Inspector 7(. 116)-677) TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 124 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name N;vA , L kk.)6d() S Location 610' OG,\A Date q ft-C1 Permit # 5-4Q;L SOIL TYPE: Sand-Loam-Clay- £ Results of Percola ion Test- (if applicable) Ra ►--Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Ti al Length Length of each trenc'/ Depth of trenches Size of stone ,fir SEEPAGE PITS: Numbkr- Size ft. x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Bohr Dist. Box to Fierld/Pit Openings Sealed/ Yes No Partial LOCATION/SEPARA IONS: \, Foundation to T nk feet Foundation to sorption feet Separation of its feet Conforms as pe Plot P1 an ; Yes No LOCATION OF S TEM ON PROPER: (circle one) Front - Rear Left Side - Right Side Middle Front Middle Rear COMMENTS: Ar44-10(11 SYSTEM USE APPROVED: YES Arrived: Departed: !i • 3 Building Inspector Y TOWN OF QUEENSBURY BUILDING b CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name C ,v9 /Q /6/ Location , 41/ A . Date 1//i/fr Permit # q e—/22 SOIL TYPE: 4 .-Lo m-Clay- �/ Results of Pe colation Tes (if applicabl Rate-Minn a/Inch TYPE OF SYSTEM # ABSORPTION FIEL' : Total Length, I2 '' Length of each trench (A0 Depth of trenche ' Size of stone a ;/— SEEPAGE PITS: Nu - Size ft. T ft. Stone size /' PIPING: / Size Type Bldg. to Tank Tank to Dist. Bo* -`' 'SzDe 24 Dist. Box to Fi e,�d/Pith° 56k 3� Openings Sealed Yes No Partial LOCATION/SEPA IONS: Foundation to ank feet Foundation to bsorption /5''O feet Separation oj- its feet Conforms as p r Plot P1 an C No LOCATION OF SYSTEM ON PRO'ERT . (circle ....:' Front - Re.. Left Side Right Side Middle Front/ - Middle Rear COMMENTS: ,P R 014 L 7 -- 1 wCe5 iu o`T `?Er \it -,r/(1-ilAe SYSTEM USE APPROVED: YES ND Arri ed: / ' 30 Depar ed: /j . Ol-L CL...u6f O4)& Building Inspector YGY"& TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Namec:ip\AAL) N)1,),( 1.)e)( 1)._S Location cet..,1,-,eq--\.3 Date I D ` 9S Permit # `14 a, SOIL TYPE: S:n•-Loan Clay- Results of 'ercolation Test- (if applicaile) Rate-Minute/Inch TYPE OF SYS 0 : ABSORPTION F LD: Total Length Length of each trench Depth of trenc -s Size of stone SEEPAGE PITS: N ber- Size ft x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box 560 Dist. Box to Field/ Openings Sealed? ( ` No Partial LOCATION/SEPARATIs Foundation to Ta 40 feet Foundation to Ab .orption feet Separation o+ Pi s feet Conforms as per Plot Plan No LOCATION OF SY EM ON PROPE. (circle Front e Left Side - Rig ,t Side Middle r ont - Middle Rear COMMENTS: \: V\ /us ' °° PO4 C CAAt4.1-70e, vit,5Tki t‘' SYSTEM USE APP OVED: YES N ) Arrived: / Departed: / % 0 L CLL,657--01,/ Building Inspector