2004-539 � TOWN OF QUEENSBURY
f742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
OTO
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040539 Application Number: A20040539
Tax Map No: 523400-239-007-0001-014-000-0000
Permission is hereby granted to: KATHRYN& CHRIS FOWLER
For property located at: 67 KNOX Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: CHRISTOPHER&KATHRYN FOW
14 ELIZABETH Ln oic Alteration Residential
Total Value
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-539
SEPTIC ALTERATION
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, July 14, 2005
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
I
Dated at the To ueensb , W dnesday, July 14, 2004
SIGNED BY for the Town of Queensbury.
Director of Building ode forcement
kierm_e
Application for Permit=Septic Disposal S stem I 0 7 5
Town of Queensbuty 742 Bay Road Queensbury,NY 1280 (518 761- 2
1. OWNER INFORMATION: ri 3 l Q
goo
Office Use ?
Location of installation: Cam V_N,OX RcaAi) ('
i File Permit No. d�`- "S.39
Tax Map No.1. :7/ I / 14
' Fee Paid 'a�, d
O�er s Name:IKAl Q(� r FQ �R, i
ddress: vy e_y z."5�TH LAME (.., "c\ e)::)„Q d
-1LA--
Qc�tc.crtsr Y , K1' 1Z -i r
2. INSTALLER'S N�ME : PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply#of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: No. of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdrm =
1980— 1991 j x' 130 gal/bdrm = in
1991 —present x 110 gal/bdrm =
Garbage Grinder Installed yes_ / no
Spa or Hot Tub Installed yes / no V
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
Topography Soil Nature Ground Water Bedrock or Impervious Material . Domestic Water Supply
Flat i •and at what depth at what depth municipal
•• ' _ loam — feet > feet well
•, o.• clay if well; water supply
1I J%slope other : from any septic-system
depth: absorption is ft.
other L..4ic G -,:,tzcE
Percolation Test: . (To be completed by licensed professional engineer or architect)
Rate: 3t/Z minute per inch C.O Mpt_..E .> j1( "DErLK%
-PE- 077 cc7
- 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed
professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size
of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank: 1 c OOgallon (min. size 1,000 gal)
Tile Field: each trench ft. Total System Length: ft.
Seepage Pit(s): number of size of each: ft. by ft.
Size�f Stone to be used: # / depth or thickness feet
Bed System Size: IC) x "50 l.,J/ oZ— -a8 L F 1�x z Ot
ELJ art. Ulm\T--
Alternative.System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
•
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
Commercial Final Inspection Report
Office No.: (518)761-8256 Date Inspection req es rec 've
Queensbury Building&Code Enforcement Arrive: p Depart: 2;'_ 11 a pm
742 Bay Road Queens ury,NY 12 4 Inspector's lnitia s• -
NAME: ) 3 0� PERMIT • l O 3- J
LOCATION: DATE: ,
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish Grade Complete 6"in 10' or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks 6,NwN �S
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in./Step Risers 7"/Treads 11" -\6\—
Vestibules For Exit doors>3000 sq. ft.
All Doors 36 in.w/Lever Handles/Panic Hardware, if required
Exits At Grade Or Platform 36 (w)x 44" (1)/Canopy or Equiv. % J
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight/Other Floors Okay
Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum
' Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stocicroom/Storage/Receiving/Shipping Room(2 hr.), 1 '/2 doors
> 10%> 1000 sq. ft.
3/4 Hour Corridor Doors&Closers •
Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 sq. ft.Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan,if required
Elevator Operation and Signage/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36" //
Handicapped Ramp/Handrails Continuous/12 in.Beyond I
2
Active Listening System and Signage Assembly Space
Final Electrical
Site Plan/Variance required
Final Survey,New Structure/Flood Plain certification,if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway
Water Fountain or Cooler /
Building Access All Sides by 20' /Driveable Surface 20'wide /'"
Okay To Issue Temp. or Permanent CIO
Okay To Issue C/C
Last printed 6/3/2003 9:27 AML:\PamW\Building&Codes\Commercial Final inspection Report.doc
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