1999-723 Certificateof • Compliance
Town of Queensbury
Warren County,New York
Date November 20, 99
309 ,
dp99723
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be used as a _
SEPTIC ALTERATION
18 LUZERNE RD.
Location
Owner WILLIAMS, NATHANIEL &
TAX MAP NO. 13® . -3-5 By Order Town Board
TOWNOF QUEENSB,U!R •
Director. of Building& Code'Enforcement
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 0 Building Permit No. 99723
TAX MAP NO. 130 . -3-8
Permission is hereby granted to WILLIAMS, NATHANIEL &
Owner of property located at 18 LU Z ERNE RD.
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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
Owner's Address:
KATHILYN 18 LUZERNE RD.
QUEENSBURY, NY 12804
Contractor or Builder's Name:
SANITARY SEWER
Contractor or Builder's Address:
DAN DRELLOS PO BOX 224
GLENS FALLS NY 12801
Electrical Inspection Agency:
Type of Construction:
SEPTIC
Plans and Specifications:
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
' Proposed Use:
SEPTIC ALTERATION
November 23 2001
$ 5 PERMIT FEE PAID—THIS PERMIT EXPIRES
(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.)
November 1999
Dated at the To of Queensbury this 2 3 Day of
SIGNED BY for the Town of Queensbury
Code Enforcement Officer
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Y;:; 1 ;' I` !'i r•1Applicatron for SEPTIC•:DISPOSAL PERMIT /�
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r 1 1 :I' i Dept.,oP Com *tX. Davolo�ment 44.F C 'I\I F Permit No.. . -�t: i . .
-7 `i 3 Bmlrlmg'&Codes Offico ;'
}r. 742$a Road'i oo •
,, ,y , ..:NOV 2 3 1999 Pee Paid $ �S;
1119 Queensbury;l NY 12804''
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'f'1�I ! L'ocation��of r for installation � (�
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! ' ' '1i II!11 Property Owner's Name: . / 14/v / ✓� (/v !// /t'l.,f
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y,'11 l i Property Owner' Ma111I1g Address. d` w e P /(L lPC)/A) •
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1 Tom -A-- Phone # 7 5
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`( : � e rooms (if residential) Total daily flow:1 lle I II 1
C ; ,, I I • (rec1 'n;al -compute 150 gal./bdrm.)II I 1lII 1 IIjI II 1 I
I I I l 'ti 1 al, 1 I h1 '' 1,,1 ; : fl Topography: flat, rolling, steep slope % of slope •
1.• I1.I+I !,lll 1 laI
r { F c- r 11 So:l•Nature: _;sand, loam clay
! € lb 13 �, I.. , y, other/depth•
,11,11:
` 1,,°1, i` ) Grolindiwater: at what depth?:• feet / Bedrock or Impervious
1; ,0 ( ,•1 ;I pe Material: at what depth? feet
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•
! + I Percolatwa,test. ,
I not required' • required [rate min, per inch i it i ; 1 ' 1
I ,.' ,d- li � 117+ 1
;Jo::''%' •I ,,:,,I I ;. ' •, , Domestic water supply:-• , ,
I :I 1 ! , I I . .b�—mun�apal well, other
it ,1 `' !wl If'domestic lmestic water supply is a WELL,;water supply from any septic absorption is___ feet..„
, 1 j I PROPOSED SYSTEM �,) •
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'I Ilj Septic tanic:l• . gallon`(mintn„nm.size: 1,000 gal.) Cr.() F' L7TZA-ToP-s)
;i 1,Ill ! i Tile field. each trench _ feet / Total system length: ��D ' feet
r
I ;Il 101 11 q 'I�, ', 1 Seepage pit(s): number of it)/IA- / size each: ft. • •
II ; l ,',1 Size'of stone to •
be used. '#' A' / depth or thickne'c` feet
1 j1, HOLDING.TANK SYSTEM:. (if required) •
III I; .,, :;',Y;i,,1 i • • ..
1, INumber of tanks: Size of each: g� •
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•
;: �� , :• • ,,,,;•:;.-...,,,,..Atry�aad'aaaocaated'r'alec�cal vcvrlc to be inspected by a certified agency. ) •
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;:::::;.-:'.::::A: r .'�+ '.:,: 4D1'° i 41 P O that p�aaat to'3ecbon.136-29 of the Coda of the Town of Queecabary,any permit or
, 8c�mted which v based or as m=diaace
` � ,4�inr nl'fact`;pr, ,� FPS � �any mateual natation or to make a
arc anitaace lmown by or odbebalf of an applicant;aball be Void.
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II .rl , •I,' ;1 I have''read`tlie'rogidatioaa wath respect and agree to abidethese and all
l l byOf the Town of
Qnaeaa::;:; :' '
e : Date: /r/ Z2•
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TOWN OF QUEENSBURY6
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAM, INSPECTION
\\Name
Location I g LUi ZeiL Rc)
Date\\-aW-9.9 Permit � (- /
! i
SOIL TYPE: Viand- oam-Clay
Results of Jer.colation Test-
(if applicabile) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total LepgYh �5
Length of each trench �5L?
Depth of trenches -20
Size of stone ,, 1 ,fq-i141-49R
SEEPAGE PITS: jNumber=
Size - ft. x I ft.
Stone size \,
PIPING: \ / ize Type
Bldg. to Tank '., X/hj/' '
Tank to Dist. Box ';; *4 Sa. 35—
Dist. Box to Field/P\ _ N u
Openings Sealed? / 'es` No Partial
LOCATION/SEPARATION . •
Foundation to Tank \ �eet
Foundation to Abgorption }- feet
Separation of Pijts eet
Conforms as per: Plot Plan \ es No
LOCATION OF SY EM ON PROPERT •
(circle
Front - Rear ] Left Side - Righ\t Side
Middle • . Middle Rear .\
COMMENTS: .7 t 316&:\ rot? A P"5\•"
SYSTEM USE APPROVED: YES NO
Arrived: r.
Departed:
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Building Inspector
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NOV 2 3 1999
, r ), L ENSBUR-Y
BUILDING ArD CODE
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"I have seen or obs or and. believe I saw evidence of,
all objects such as houses,wells,trees,fences, etc.,
sh on this , . ,.0,,, l also epresent that I have
Pe A moose i'i l ': dtii . set forth on the diagram.
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OWN OF Qt tE oe s Ry s)t�tu� 'r: - DOTE
BUILDING & CODE D EPT.
ii-
REVIEWED BY - .ill
DATE fiat -