98-532 •
'• CERTIFICATE; OF COMPLIANCE '' ,
:TOWN. or .0 UEENSBURY::
WARREN CO.UN1'Y NEW Y,ORK . .
Date September 1 • 19. 9•8 -
•
98532.
• This i s to-,certify that work requested to, be done as shown by Permit '•No.. ; -.
has been` completed... •
SEPTIC ALTERATION -
Thiis 'structure may,be' used as a' ' - • , • ', . '
• '110 LAKE PARKWAY . ; -- • .
Locat;fon.
Owner LESTER, '•MILFORD
TAX MAP NO. 9 . -1-15, ' By Order,. of Town Board . .
TOWN OF QUEENSBURY
Director Of Building & Code Enforcement ,
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No.
98532
TAX MAP NO. . 9. —1-15 WARREN`COUNTY,NEW YORK
PERMISSION is hereby granted to. LESTER, MILFORD
OWNER of property located at 110" LAKE PARKwhy Street,Road or Ave.
in the Town of Oueensbury,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
LESTER, NANCY TRUSTEE 41 EUREKA AVE
SARATOGA SPRINGS, NY 12866
2. CONTRACTOR or BUILDER'S Name
QUEENSBURY SEWER
3."CONTRACTOR or BUILDER'S Address
JAY SWEET-
0
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by XI
SEPTIC.:,.
( 1 Wood Frame ( 1 Masonry ( I Steel. l 1
7. PLANS and.Specifications
SEPTgC ALTERATION AS PER .PLOT. PLAN SPECIFICATIONS
B. Proposed Use
SEPTIC' ALTERATION
25- August 28 2000
$ PERMIT FEE PAID -THIS PERMIT, EXPIRES, 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 Oueensbury before the expiration dated_
28 August 1998
Dated at the Town of Oueensbury this. Day of 19`
SIGNED BY ""t" 2 P111/ — for the Town of Queensbury
Building and;Zoning Inspector,
Application for SEPTIC DISPOSAL PERMIT
Town of Qi ePnsbury
Dept. of Community Development Permit No. Q 0 -53 a
Building &Codes Office _
742 Bay Road 1 Fee Paid $L 00
Queensbury, NY 12804
Location of property for installation: Lq (,g,Jr/d
Property Owner's Name: 01 I t — c vj k.,2 to AUK
da- 1998
Property Owner's Mailing Address: S cc Puri- 1:,:}trlJN
OF
`."""^.-=.. tea.-•. r/
Installer's Name: a Eyiyar c�r- SP *jay-. Phone # 36' T J\X�` _"�
. ./
. Number of bedrooms (if residential): ' Total daily flow: 4s---0
(residential - compute @ 150 gal./bdrm.)
Topography: flat, rolling, steep slope % of slope
• Soil Nature: ) sand, X loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? _ feet
Percolation test: ' not required, 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 ken feet t •
PROPOSED SYSTEM
Septic tanky/ !) gallon (minimum size: 1,000 gal.)
Tile field: each trench feet / Total system length: 4Z trZ) feet
Seepage pit(s): number of, / size each: ft. by ft.
Size of stone to be used: # / depth or thickness `2/r 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 •
Signature of responsible person: C41 ae_o_d: Date: 4 �,��� 9
FILIAL IlilEPEC1f°I®iN IRtM taimir
MOBILE I MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 '
ARRIVE: DEPART: 3 l/�(-INSP:
DATE INSPECTION REQUEST RECEIVED: `E^:.
NAME: ✓►3 / ��i% -_
LOCATION: /27 W et/t --;r7/-'El'.. ,4 c.._.
l �r / 'DATE: / / a- 1/98./ PERMIT#/6—6
MOBILE HOME ill MODULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING
N/A YES NO
-1. foundation support, pier spacing
per manuf. — — —
2. anchoring per manuf. .. — — —
3. water line shut,off — —4. sewer line support a 4 feet — — —
lopi eating crossover (dblewi.<-) off grd _ _ _
dryer vented outside .. — — —
skirting ventilated — — —
1 'hot water r lief valve p`.ing outsi'- — —
. deck, pore es, steps, r; ling .... .. — — —
10. furnace/hot ater ope acing — — —
11. garage fire pr 11 :.. — — —
12. door closers — — —
13. plumbing fixture — — —
14. foundation insulati'in (if appl.) — — —
15. smoke detectors . °
16. final electrical . — —
17. variance requir= _ — —
18. data plate oka — — —
19. mobile HUD seal okay — — —
Model # Serial# 4
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments: `• Pe VA.,(1- O(/{-5 'UT
R6-G nV CCc-}S-,b f A)0 '%
1, ()et) ` ft r_�- conei-cr
• k5 0r F1cC I bA6Dllt--;c-C.,y
Ek&)Pil— j Ai St err NO
-- TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742. Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 4/ 7-4/1?
Location _4 5! vi , 6-.
Date / ej8 Permit # W----5732.---
SOIL TY E: S nd-Loam �l ay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM: go,/
ABSORPTION FIELD: T-.ta Len tli, /r
Lengt ' of each tre c ( 0 -
Depth •. trenche ,
Size of tone j 2-
SEEPAGE P ' umber
Size - . x ft.
Stone size
PIPING: i e TYP e
g
Bldg. to Tank `�D 3S
Tank to D t. Box T
Dist. Box to Field/Fr, u
Openings Sealed? / Y s No Partial
LOCATION/SEPARATI S / r
Foundation to Tank.' /1 feet
Foundation to Absorption -2feet
Separation of Pits _ eet
Conforms as per Plot P1 an No
LOCATION OF SYSTEM ON PROPERTY:.les
(cir, ones) _ ,r _
Fro Rear L' ft Sided Right Side
Middle Front a Rear
COMMENTS:
-->" ..-.._ -- /4-5 -g 0 te-T---
L 4-t<<- `,'-,--1-64-Cg — C"
SYSTEM USE APPROVED: OYES NO
Arrived: . ,
Departed: ,�
`312(L7
Building Inspector
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7� REVIEW NEEDED
K O/V' AssF/k46LY PoinKT
A/ZT.�U2 /a . cQ /�L/SC,�/ L3 �'�//�/l/E}J - - - - - - - - - -
- - - - - - - - - - �0 ,- -13_ - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - i Tvwn/ r/= QUEEA/SC3Ut2Y , vJA2_2r.� COUWTV 1VEW vO-QkL
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SCALE : / /O SEPTEMr3EtZ I /�C 4j
APP 'N s '
Application
- _ SU2VE $, MAh 8Y
jM
I
r ,��ENSBIIRJeffrey G. Martin, PLS ���5 �o D. � cl
90Y �-p
SURVEYOR - GEOLOGIST MODELE
m oe
VA.*' 99 LOWER DtE •vENVE
— ]UEENSBURY, N.Y 12801 % +^• i s