98-291 CLRTIFICKrE OF COMPLIANCE
TOWN OF QUEENSOURY
WARREN COUNTY , NEW YORK
Da to June 1 19 98
31
98291
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
Location 436 LUZERNE RD .
Owner CHENEY , LELAND , JR , &
TAX MAP NG] . 121 . - 3 - 7 , 3 BY Order of Town Board
TOWN OF iQ
Director of Building 6 Code Enforcement
BUILDING PERMIT
ITAT.t,rM fi TOWN OF QUEENSBURY No-
TAX MAP NO . 121 . - 3 - 7 . 3 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CHENEY r LELAND r JR . &
OWNER of property located at 436 LUZ'ERNE RD , Street, Road or Ave.
I
n the Town of Queertsbury, To Construct or place a SEPTIC ALTERATION
at the above location in accordance to application together with ptot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
t' 0w�4i36 LUZERNE RD ,
QUEENSBURY , NY 12804
2. CONTRACTOR or BUt LDE R S Name
SMITH , FRED q
3. [X�ITR$ I LOE p desx
QUEENSBURY , NY 12804
12804
_4. ARCHITECT'S Name
5, ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by Xl SEPTIC
{ } Wood Frame [ 1 Masonry I 1 Steel [ 1
7. PLANS and Specifications
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
No.
a, Proposed Use
SEPTIC ALTERATION
25 June 1 2000
S PERMIT FEE PAID - TIHIS PERMIT EXPIRES 19
(If a longer period is required an appti coo lon for an extension must be made to the 8ulWing and Zoning inspector of the
town of Ousensbury before the expiration dera.l
1 June 19
Dated at the Town of Queensbury this Day of 19
SIGNED BY for the Town of Queensbury
SwildkV and 2oni
4&%PPucation star ZiEk 11C..: DjILSFOS.A,L PERMIT
Town of Queensbury.
Buflding &� Codes CIF= J U N - 6 1 Ig Permit N01
742 Say Road / r�
Qutawbury, ,NY 12W4 _ Fee Pai $ Gay
Location of property for instal ation: It
Property Owner's Nam4 • �-
_ Property Owner's Maili cg Address:
Installer's Name Phoce
Number of bedrooms (if reside :tial): Total daliv now: 7 J�
(residcadai - compute 150 gaUbdrm.)
TQFhY- ant, trolling, steep siorre 56 of
slope
Soil NaoareI sand, loam, clay, otl:c I depth:
Ground water: at what dq :h? =
fee: / Bedrock or Imper-r_cus Matwial: at what depth?
feet
Pe=olaaoa test: oe mot requunxlr required eq C rant,. twin. per inch ]
Domestic ware` supply: _L! murticzval, well r
If domestic water supply is . WELL, water supply from any sewx absorption is f ,
PROPOSED SYS'IF.M
septic tarl3c%C,O(!99 ttlots (mil2imu sz size: l ,aQQ gal.)
Tile fold: each =enc feet f Torn). sysrcm - � feet
Seepage pit($): numbe r of I size each; & by & .
Size of stone to be use l: d� f depth or t#:d3ex: feet
HOLDING '`TANK SYSTEM (if required)
Number of tani3: _ Size of each: gauons
Alarm system and assoc need electricaal, work to be istapected br a eert$Sad agency.
For your prct.r-don
'w ovA1 �++d I ca breed po P � to n Seen va 3 nc u of the Cade ram a�r Town of +�aamabW70 any PW=jt or
material fact or upon or a gss d is reti�ce upper nap l or haw* to =aloe a
'n`m ce known by c - on behalf of an appUcam, 1120el3 be void...
I have Hers! the regulacic co wi& reovp or thin &FIALiaatiOn BMW asgrme to abide b. assae +tad an
Q berry Saasitary Sewage 03 of tha Town of
Signature of responsible person:
_.,__ Date: a'/
�-- TOWN OF QUEENSSURY
BUILDING B CODE ENFORCEMENT
742 Bay Road
Queensbury NY 22804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name �,
Location
Date Permit #
SOIL TYP San Lo -Clay-
Results f Percolati Test-
( if appl cable ) Rate- mute/Inch
TYPE OF YSTEM:
ABSORPTI FIELD : Total Len t�
Length o each trench �
Depth of trenches
Size of s one
SEEPAGE P TS : umber-
Size - ft . x ft .
Stone size
PIPING : 7ze ype
Bldg . to Ta k /05-7/.c�59:�
Tank to Dis Box
Dist . Box to Field/P ' µ
Openings Sea d ? s o Pa gal
LOCATION/SEPA TIONS
Foundation to ank feet
Foundation to so tion feet
Separation of P ' ts _ et
Conforms as per t Plan es No
LOCATION OF SYS ON PROPERTY :
( circle o
Front - Rear - of Side - Right Side
Middle r Rear
COMMENTS :
SYSTEM SE APPROVED : ES NO
Arri►r t � 515
Departed :
-j pew
Building inspector
asva
AId
San mis
. :. i r
w ,ram m ,/l, of
�M�'l�ai ywy vow" +rr wwoe�t
iL
x
110 Nnr
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