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97-054 CERTIFICNrE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date July 2 19 97 97054 This is to certify that work requested to be done as shown by Permit No. has been completed. SEPTIC ALTERATION This structure may be used as a LAKE PARKWAY Location Owner TOBIN, BEVERLY C . By Order of Town Board TAX MAP No. 8 . -J-5 TOWN OF QUEENSBURY Director of Building & Code Enforcement BUILDING PERMIT VALUE $ 0 TOWN OF QUEENSBURY No 97054 TAX MAP NO. 8. -1-5 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to TOBIN, BEVERLY C. OWNER of property located at LAKE PARKWAY 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 37 SOUTH MANNING BLVD. ALBANY, NY 12203 2. CONTRACTOR or BUILDER'S Name CONDON SEPTIC & DRAIN SERVICE 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 ( 1 Masonry ( )Steel ( 1 7. PLANS and Specifications EPTICNALTERATION AS PER PLOT PLAN SPECIFICATIONS B. Proposed Use EPTIC ALTERATION $ 25- PERMIT FEE PAID —THIS PERMIT EXPIRES March 10 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 10 Day, f March 19 97 SIGNED BY for the Town of Queensbury Building and Zoni nspector Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Permit No. �J Dept. of Community Development Building &Codes Office 742 Bay Road Fee Paid Queensbury, NY 12804 Location of property for installation: �� p/�/Q �/�`�-/ �/ �/► : ;7�: " j Property Owner's Name: F.-I'x0l9a ;?IN � FEB 2 5 1997 Property Owner's Mailing Address: 4 i TO"`,`;: .` Installer's Name: `r S' Phone # � ��/�—��/Z Number of bedrooms (if residential): Total daily flow: �y (residential - compute @ 150 gal./bdrm.) Topography: flat, rolling, steep slope % of slope Soil Nature: sand, loam, clay, other /depth: yw Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? _ feet Percolation test: not required, _4 required [rate min. per inch ] Domestic water supply: municipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tank: JQ6) gallon (minimum size: 1,000 gal.) Tile field: each trench_YO feet / Total system length: apt feet Seepage pit(s): number of / size each: ft. by ft. Size of stone to be used: # / depth or thickness _� 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 the 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 known by or on behalf of an applicant;shall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person: -� t0&ndA=n= Date: TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 518-761-8201 March 25, 1997 Mrs. Beverly C. Tobin 37 South Manning Boulevard Albany, NY 12203 RE: Permit No. 97-054 Dear Mrs . Tobin: The following items were brought to our attention regarding your new septic system to be installed this spring. 1 : Mr. McGillen who lives to the east of the property where your leach field is to be installed has a well and it may or may not meet the required 100 foot setback. 2 . The leach field must also meet. 100 foot setback from your pond. The items in question were not shown on the plan submitted. Mr. Ray Buckley will need to verify these setbacks and revise the plans accordingly, whatever the findings . Until the items in question have been verified and remedied if necessary, your septic permit will be temporarily on hold. If you have any questions, please feel free to call at your convenience. S cerel ' f John O'Br' n Building Inspector JOB/mg "HOME OF NATURAL BEAUTY. . .A GOOD PLACE TO LIVE" SETTLED 1763' COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. C 7 Main Office 357 Elwyn Terrace — Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL J Panel Board No................... Cert. 45841 Cut-in Card No......�/.e._,....... Owner............. .........%S?..h.J.13............................................................. Occupant............................... -............................................................................ Location .... ....... ......�� Installation Consisting of.......... u!..c— .��j..4r....... .................... .................................................. ..........�.. .!. .m,-............................... ............................................................................................................................................ Installed By..Co11.0o.71. .....5 ...... 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 inspections at any time,and if its rules are violated,the Company shall have the right to revoke this certificate. Date........ ......... INSPECTOR ............ ember N.F.P.A.,I.A.E.I. r T0VM QUEENSBU Y BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name , Location , DateG _JP`` Permi t # SOIL TYP �d-Loam- ay- Results of P' rc0lation Test- (if app)each 4Rat in ute/Inch TYPE OF ABSORPTa1 Length h Length Depth oo Size ofSEEPAGEumer- Size -�� _ ft. � ft. Stone size PIPING: Size Ty Re Bldg. to Tank t p "A" Tank to Dist. Box Dist. Box to Field/Pit � (�� Openings Sealed? es No Partial LOCATION/SEPARATIONS: Foundation to Tank Pq&J. t feet Foundation to AbsorptionA eet Separation of Pits feet Conforms as per Plot Plan —�No LOCATION! OF SYSTEM ON PROPERTY: (circle o Front Rear Left Side - Right Side Middle Front - Middle Rear COMMENTS: P16 115' �P.�ocy ZJ��► ��L_� SYSTEM USE APPROVED: YES NO Arrived: Depart ' Build ng n p c or TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 Bay. Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Date Permit SOIL TYPE: Sand-yRa -Minu - Results of Perco Te t- (if applicable) a/Inch TYPE OF SYSTEM: ABSORPTION FIELD ength Length of each t Depth of trenches/ Size of stone SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank --- Tank -to D-i sf. 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 - Lef t.Side - Right Side Middle Front - Middle Rear COMMENTS: DF ?0Pi D SYSTEM USE PPRO a YES NO G Arrived: i�-; Depart B fiding Insp c or J C� TOUN OF QUEENSBURY BUILDING A CODE ENFORCE14ENT 742 Bay Road ck� �ueensbuwy NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name J Location. Date( Permit # SOIL TYPE: Sand-Loam-Clay- Results of Perco 'on Test- (if applicable) Rate- inute/Inch TYPE OF SYSTEM: ABSORPTION F ELD: T al Length Length of eac re ch Depth of trenches Size of stone SEEPAGE PITS: Number- Size - _ ft. x ft. Stone size _ PIPING: Size Type Bldg. to T � `66 s Tank to '�� c3c\ D to Field/Pit _ k C—C]�k�, � Openings Sealed? Yes No Partial LOCATION/SEPARATIONS: Foundation to Tank tom` feet Foundation to Absorption feet Separation of Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front ea Side - Right Side Middle Front - Middle Rear COMMENTS: 1 lL � SYSTEM USE APPROVED: YES NO Arrive Depar ed: Building 7 ctor TOWN OF QUEENSBURY BUILDING A CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name FACIA--Q— -2 N Location LP,1�E- -('r�IfL�A Date Z ZLa Permit # -- rL SOIL TYPE: San -Lo m-Clay- Results of Perco ation Test- (if applicable te-Minute/I ch TYPE OF SYSTEM: ABSORPTION FIELD: Total L gth Length of each trench Depth of trenches Size of stone SEEPAGE PITS: Numbe - Size - ft. ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. ox Dist. Box to ield/Pit Openings Sea ed? Yes No Partial LOCATION/SE ARATIONS: Foundation to Tank feet FoundatioV to Absorption feet Separati n of Pits _ feet Conform as per Plot Plan Yes No LOCATIQA OF SYSTEM ON PROPERTY: (circl one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: l- Co A 13�F �� -4yc- SYSTEM USE APPROVED: YES NO Arri De rted. Building In -p ct r TOWN OF QUEENSBURY BUILDING b CODE ENFORCEMENT 531 Bay Road Queensbury NY 12864 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION NameB/�/ Location Date > Permit # 7— SOIL TYPE: Sand-41ati ay- Results of Per 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:-- S.ize 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: SYSTEM USE APPROVED: YES N0, Arrived: Departed: Building Inspector