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95-103 CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date 19 • This i s to certify that work requested to be done as shown by Permit No. • 95103 has been, completed. • This structure may be used as a , SEPTIC ALTERATION Location ROCF11URST RD. Owner F OENIG, ANTHONY & By Order of Town Board TAX NAP NO. 15. -1-3 ' TOWN OF QUEENSBURY Di rectorof Building, & Code Enforcement BUILDING PERMIT VALUE $ 0 TOWN OF QUEENSBURY 95103 TAX MAP NO. 15. -1-3 No. WARREN COUNTY, NEW YORK KOENIG, ANTHONY & PERMISSION is hereby granted to ROCKHURST OWNER of property located at Street,Road or Ave. SEPTIC ALTERATION 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 89 CEDAR COURT QUEENSBURY, NY 12804 2. CONTRACTOR or BUILDER'S Name ROULIER, CHARLES 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) SEPTIC ( 1 Wood Frame ( ) Masonry ( 1 Steel ( ) 7. PLANS and Specifications No. SEPTIC ALTERATION TO INCLUDE: 2 HOLDING TANKS EACH 1500 GAL. AS PER PLOT PLAN 8. Proposed Use SEPTIC ALTERATION $ 25 97 PERMIT FEE PAID —THIS PERMIT EXPIRES March 11 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.) Dated at the Town of Queensbury this 23 Day of March 19 95 SIGNED BY for the Town of Queensbury Building and Zoning I cto Aplica .ion for [SEPTIC DISPOSAL PERMIT STAMP RECEIVED ,.•-....;..,c-,/....,.,-; ---z7.../ Location of property for installation:-- 4/ ,/ PERMIT NUMI3ER Owner's Name: ,-,-".%C.� e e".rs Address: Ve .0e.e- •-,-;---- ,...ee...S67., AA/A goy 9 s- /03 • Installer's Name: e �• -- �` •v L,c FEE PAID p25, 00 Phone #: (c4) ez-e- _3.$)-W Number of bedrooms (if residential): 02 Total daily flow (residential -compute @ 150 gal. per bedroom): -3 Topography: I Yl Flat F-1 Rolling [ J Steep Slope % of Slope Soil Nature: Sand I >/1 Loam r Clay r Other /Depth: Ground Water: at what depth? feet Bedrock or Impervious Material: at what depth? feet Percolation Test: 1)1 Not Required r1 Required/Rate min. per inch Domestic Water Supply: Municipal r1 Well I-1 Other ../.o/1" t<6 f e.. If domestic water supply is a WELL: water supply from any septic absorption is feet PROPOSED SYS'IEM: 0,.� .,,� • Septic tank:..�J©e gal. (minimum size: 1.000 gal.) I - /s o• 7'°' . 1---''''''''' 0�®�9 .i2file Field: each trench feet. / total system length feet. \� MAR 1995 A '. • Seepage Pit(s): number of / , size each: ft. x f{1 M R�Ceive I 1 �\ c �\ Queensbu Size of stone to be used: # • / depth or thickness feet. \, tto \�Bld&pep�� fgi '' HOLDING 'TANK SYSTEM: (if required) 8 ,` r Number of tanks: Size of each:/JOo gal. ~` -•-. -^ ' . 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 o f an applicant, shall be void. • 1 have read the regulations with respect to this application and agree to abide by these and all requirements of the 7'own of Queensbury Sanitary Sewage Disposal Ordinance. ' Si enature o f responsible person: — Date: 3' .t f' J TOWN OF QUEENSBURY BUILDING" & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 • (518)761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name r Location ���,��� Date Permit # 9K:103 SOIL TV)-1-f(e3-7 : Sand-Loam-Clay- Results of Percol . .'on Test- (if applicable) 'ate- inute/Inch TYPE OF SYSTEM: ABSORPTION FIELD Tota ' Length Length of :. • — Depth of trenche- Size of stone SEEPAGE PITS: Nu ber- Size - f►. 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: SYSTEM USE APPROVED: 41:151NO Arrived: Departed: Building Inspe r f 0441/6' • TOXIN OF QUEENSBURY BUILDING A CODE ENFORCEMENT O 531 Bay Road 1] Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name ke \ t I IVY‘Akrvv..., , , Location ( 0-z,4_IAA Re Date -4713-12 Permit #9 j'10 3 SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF S M: ABSORPTION FI • ! • ota Length Length of each try h Depth of trenche Size of stone SEEPAGE PITS: N mber- Size - . 't. 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: ✓�sJ/f sithwari SYSTEM USE APPROVED: YES ()NO Arrived: 3)/ Departed: Building Inspector TOWN OF QUEENSBURY BUILDING A CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location 447;4/ Date fL 441' Permit # 7.5-1.Av> SOIL TYPE: Sand-Loam-clay- Resul is of Percol ati ori.. 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 t. Stone size PIPING: Si . : Type Bldg. to Tank Tank to Dist. Box Dist. Box to Field/Pit Openings Sealed? Yes +o Partial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption feet Separation of Pits feet Conforms as per Plot P1 an Yes No LOCATION OF SYSTEM ON PRO'ERT (circle one) Front - Rear - Left Side Rig t Side Middle Front - Middle Re. r COMMENTS: n E Gtfr X / d. e v1/�� c',, -6 OI " eeipak s � ' 44/71 5p4"4 SYSTEM USE APPROVED: YES Cn F Arrived: 2713o Departed: (,;!),4 Building Inspector TOM OF QUEENSBURY (O�O 3jW BUILDING Si CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name Pti - He k Y KF i.->1G Location c,1 \0MT Date Permit # e15-1C 2 f SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: To al Length Length of each trenc Depth of trenches Size of stone SEEPAGE PITS: Numb:r- Size - ft. , ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Field/Pi : Openings Sealed? Y . No Partial LOCATION/SEPARATIONS Foundation to Tank feet Foundation to Absor+tion feet Separation of Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - L:ft Side - Right Side Middle Front - Middle Rear COMMENTS: F\IJRL E.L.CCTRIC` L <'t e c" / 4 /y .2 . €8,6 J� � SYSTEM USE APPROVED: YES 41111 Arrived: /1i(AJ 1 Departed: OfBuilding Intor TOM OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518--745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION &isl/ionq- Name 4145/— Location Date _ V5/1 Permit # f,5 103 SOIL TYPE: Sand-Loam-Clay- Results of Percola ion Test- (if applicable) Ra e-Minute/ nch TYPE OF SYSTEM: ABSORPTION FIELD: Total Le •th Length of each trenc 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/Pi Openings Sealed? es No Partial LOCATION/SEPARATI ON ,: Foundation to Tank feet Foundation to Absorption feet Separation of Pits feet Conforms as per P. ot Plan Yes No LOCATION OF SYST"g' O1 PROP',RTY: (circle one) Front - Rear - eft Side - "ight Side Middle Front - Middle Rear COMMENTS: f fdr. A Z(e- • il I er45. Li- e ems' e eclrtc '' '/ SYSTEM USE APPROVED: YES Arrived: c:›21/0 Departed: ,9.f21 Building In ector d—a-cr — G ' 3 " 4,. • o� l.T F Sc r ----------------- 11111111111 �I I hereby certify that this map was prepared from a: actual field survey. This certification shall run onl} Q to the persons for whom the survey was prepared, and of 1¢' / his behalf to the Title Company, Governmental Agency an( `,D/A�tJP` Lending Institution listed hereon. Certifications ar, not transferable to additional institutions o: ! s•"J9.O . Kw subsequent owners. • sa+ ° E ceo,,c H_ / Anthony J. & Jacqueline A. Koenig ,7„cam tvcC 4 h Certified To: L„T G9 7Z, `H x, / Old Republic National Title Instuance C kas ila a,e rs� �` I. f !'� C �„ ' Certified Hy: UJ o.0 9,' _ 0 / Leon M..,,St:avesj,.LL$iNYS 35.617 r h 111 - 1 o Dated: June 21.,' 4" Lvi��` C�• / i. MP t I \ er A , �—"�v_ "UNAUTHORIZED ALTERATION OR ADDITIC S.c'+ ' ' :• i W I 3 ! �,4,�ep y TO A SURVEY HAP HEARING A LICENSE o1. (�.(6" ,'"'�e:� t Wr f,f �r� _L/a g4'S SECTIONLAND RVEYORS SEAL IS A 7209 SUB-DIVISIONVIOLATION 11/ TF ��II FE'ucc3:7. -` w 4 Pw� �� NEW YORK STATE EDUCATION LAW." 4 ,V' '9 Ob La �•a• p0� ��\ C�� "ONLY COPIES FROM THE ORIGINAL OF THJ I T� • ^ SURVEY MARKED WITH AN ORIGINAL OF Tt �o� , aR 1995 I:'\ �� E` LAND SURVEYORS SEAL SHALL F Cu is A ( . f � I CONSIDERED TO BE VALID TRUE COPIES. �e�V :• ` `OWN ®� . . - . . . 3 ; n b ri QUEENS BURY . / • DCEp fZ ErEtz 6t,�cS 9 /.., • _.. WED BY }i0,-)-MAc V -" LaP MEN't'S, it.1 c. I Q[ • -7 ( ®ATE 3 7; Lo-r 14C i''4 • JoSEPtl J. i Awa 2_.+1Aw•+.•1 • MA2crl ( (SSL 352-I . HAP OF• A SURVEY MADE FOR gow_MAc 17CJEl...Peke4TS, /r'#-• ' .+ 4 1.1A(+ 2E�=�cJl-EN cE AiTrAe"11'4 i. 4 s3AC c?uE��nE t( T a • nn TOVN OF QuEENS3v,Lv V I AiLQFN JcaSE" J . i. A-ma Q �A,iUA..) !�'A!-' f�ac.. u• '"L ot-1 LAKE. 4eclat,I ! Sit SDALE I 1 _ Zo ' DATE. JQN AfL 74,(1S, - j.penes* b ' Vadusen & -Steve / 11114IL o`c C- 1-4)" •1' SC �Ev,SiO BAN It. ItS(, /� # "" / ...� ^ 3 a3 S LAND SURVEYORS,GLENS FALLS,NEU . t T - N.Y. STATE LIC. NO. 35617 .p1.? . ,e..+ ¢., F.P.F. P.P. /..5:/- 3