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2008-584 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Pernut Number. P20080584 Date Issued: Friday, November 07, 2008 This is to certify that work requested to be done as shown by Permit Number P20080584 has been completed. Tax Map Number. 523400-279-018-0001-008-000-0000 Location: 1169 RIDGE Rd Owner. LEON & THERESA SPATH Applicant: LEON & THERESA SPATH This structure maybe occupied as a: Septic Alteration Residential By Oder of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the /f property owner of the responsibility for compliance with Site Plan, �d Variance, or other issues and conditions as a result of approvals by the Director of Building&Co e E nf&tement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20080584 Application Number. A20080584 Tax Map No: 523400-279-018-0001-008-000-0000 Permission is hereby granted to: LEON &THERESA SPATH For property located at: 1169 RIDGE 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: LEON &THERESA SPATH 1169 RIDGE Rd Septic Alteration Residential QUEENSBURY,NY 12804 Total value Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2008-584 septic alteration residential $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,November 04, 2009 (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.) Dated at the Tov�Fn of Q*ensb00-, ; rt;iesday,November 04, 2008 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Irrrrr♦rrrrrrrr...rrrr.rrrrrr.rrrrrr.r.r.r..r.♦........r.r.rrr.r.r.r . �rrrrr..r..r..r........� of OFFICE USE ONLY ' TAX MAP NO. PERMIT NO. 1% ' 0 PERMIT FEE 4 r , 0 , 0 APPROVALS: ZONING TOWN CLERK i:.............r....r.. ..............! ..r...rr.....r........ APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT A PERMIT MUST BE OBTAINED BEFORE RK BEGINS.APPLICATION IS SUBJECT TOR IEW BEFORE ISSUANCE OF A VALID PERMIT. i OWNER: e a�� INSTALLER: OU S G ADDRESS: ` 1 c '` _ ADDRESS: PHONE NOS. PHONE NOS. �� G/✓ �� LOCATION OF INSTALLATION: NO.O x..... _...._............ -.................................................................. RESIDENCE INFORMATI -• ON: YEAR BUILT - --X COMPUTAT10Na _" TOTAL GAILY FLOW I ... ........................... .BEDROOMS.. .. .. ....................................,............... ........:............................................................I GARBAGE GRINDER 1980 or older -X 160 gallon per bedroom i = j INSTALLED? -1981 -1991 »..x... .X .130 gallon per bedroom ; -....._.........•.......i SPA OR HOT TUB .1992-present -- .X 110 gallon per bedroom I INSTALLED? w.... »..-...„-.--,-.......................�........................................................................................... ....•....J,..................•...••,..,,..,.........................................� PARCEL INFORMATION: / ✓ TOPOGRAPHY: FLAT OLLiNG STEEP SLOPE %SLOPE _ SOIL NATURE: SAND J/ LOAM CLAY OTHER ✓ GE QUNDWATER AT WHAT DEPTH? BEDROCKAM PERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (IF WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS � FT. ) ✓ PERCOLATION TEST: P.^;TE iS PER MiINUTE PER IN0'H (TEST TO BE COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT) 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: 10 GOB GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH FT. ✓ TOTAL SYSTEM LENGTH: ` 210 FT. SEEPAGE PIT(S): HOW MANY? ✓ SIZE OF EACH FT. X FT. ✓ SIZE OF STONE TO BE USED: # /DEPTH OR THICKNESS FT. ✓ BED SYSTEM SIZE: X ✓ ALTERNATIVE SYSTEM: :t r LENGTH AND/OR SIZE ✓ HOLDING TANK SYSTEM:(if required) NO.OF TANKS: /SIZE OF EACH ✓ GALLONS./TOTAL CAPACITY. GAL. It•1.IV•xI.NN.4•..1•x.•1.x.4.MVxVNxxt•1.xx:.:•:•i•xxl•1•t•xx:•xx.•1.1•.•1•xx1.1.1.1.I.x1•xxx.•xl.1.1.1•1y.1.xl•l.:rl.1.t.xl�:.:.xl.1.1.1.1.:•1•x�•:•1•.•1.I.xxl.xxxl.l.��i.....x.....�..i.:•��••1.:�x;..:•:µ...•..•y:•t•:•t•t•t•,•x..1.1.t•.•xx:.IV•xxx..,.yxxxl•i.1.1•..xl•y.•1•.•1•xl.l.l•..1.1•:•1..•� NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN Ii I APPROVED ELECTRICAL INSPECTION AGENCY, PLEASE REVIEW LIST PROVIDED. l l: .................I.1•NLIvxl•1•xNV V x:yi•xl•1•t•.•xl•xyx Vx1•xt9•V Nt•Irt•xlvo•x:•1•;q•NN W9W P4.1•.•PNP:•14q V•N:V•1q.x:••i :•:•1•Ignq.l•Ivly.l4•NY•1•xxxxl•1•xxln•PI V.1•xiV4.1.:.:•�•xNxxxl•1•:•14•la•.•.•t44•NNN:•INMMM•1.1.1.1•N:•:•1•xl•xI V4.1.1•Iq.{I 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 abid se and all r quirements of the Town of QUESTIONS? CALL 761-8256 OR EMAIL codes ueensburv,net Queensbu anit y Sew s Or ' nce. VISIT OUR WEBSITE FOR MORE INFORMATION www.ctuewisbury.net Slgrh&r6of Person es risible Date ta Town of Queensbury - Community Development Office • 742 Bay Road, Queensbury, NY 12804 06— Brian S Fear P.E. 71 0 Consulting Engineer C�� 12 Pine Ledge Terrace 361 - �j 0�i ilt/on,NY 12831 lG- r October 22, 2008 Cook's Septic Service 194 Hall Hill Road Lake Luzerne,NY 12846 Re: Septic System Percolation Tests Lands of Spath- 1169 Ridge Road Queensbury(T)' Gentlemen:: Om October 22,2008,I performed percolation tests to the rear of the home and in the area of the proposed replacement system. The tests were performed to verify the lot's suitability for a sewage disposal system. The tests were done at depths of 25 and 26 inches and had stabilized rates of 2 minute 00 seconds and 1 minute 40 seconds. The first test was run roughly 20 behind the south rear corner of the home and the second was run 40 feet south of the north rear corner and 47 feet from the back of the house. The results indicate establish that the lot is satisfactory for a conventional subsurface sewage disposal system Sincerely, ----e,D� 11� Brian S. Fear,P.E. Consulting Engineer Septic Inspection Report Office No. (518) 761-8256 Date In q o request received: Queensbury Building &Code Enforcement Arrive: am/prra,� pepart: am/pm 742 Bay Rd., Queensbury, NY 12804 Ins or's Initials: V��(/ NAME: k PERMIT NO.: ,- LOCATION: INSPECT ON: l RECHECK: Comments and/or diagram Soil Type: Sand Loam Clay Ty of Water: Municipal/ Well Water fick(z— Waterline separation distance tft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + - Y N _N/A Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: N End Ca Y N Inlet/Outlet Pipes&Baffles Y N Location Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N Engineer Report and As-Built Y N Location of Syste/onP perty: Front Left Side Right Side Middle Front Middle Rear S m se t Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc Septic Inspection Report Office No. (518) 761-8256 Date Ins ion Wiest received: Queensbury Building &Code Enforcement Arrive: f S anr�WDepart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials. �Q NAME: 'i�f PERMIT NO.: LOCATION: t t.1nf- O INSPECT ON: RECHECK: Comments and/or diagram Soil T : San J la T of Water: Municipal Well Wa Waterline se ratio nce ft. Well separation distance ft. Other wells: ft. /'o Well Casin Len th 50' + - Y N N/A U 4 b U� �C�r1dA)� ® r Absorption Field: Total length ft. o i- V'o -rd /0%0 ll� /Oz� , Length of each trench ft. G Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field / Pit Opening Sealed: Y End Cap Y VN Inlet/Outlet Pipes&Baffles Y N Location Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N Engineer Report and As-Built Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: proved artial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc C Septic Inspection Report Office No. (518) 761-8256 Date In ctio request received: r✓1 3 d� Queensbury Building &Code Enforcement Arrive: -d` am/ m Depart: am/pm 742 Bay Ri ., Quee sbury, NY 12804 Inspectors Initials: i NAME: r� PERMIT NO.: C� LOCATION: INSPECT ON: c RECHECK: v omm ents and /or Soil Type: Sand Loa � Type of Water: Municipal ell W Waterline se ration istance ft. cw (7,- Well separation distance ft. Other wells: ft. Well Casing Length 50' +/ - Y N—NIA Absorption Field. Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone _- -0 . g- Seepage Pits: Number Size: x Stone Size: Pipinq Size Type Building to tank "30-4 /, Tank to Distribution Box Distribution Box to Field Pit 2_.." Opening Sealed: N End Cap 4y— Inlet/Outlet Pipes&Baffles Y N JwJ/ Location Separations YYY Foundation to tank ft. , Foundation to absorption - ft. p` � C �c- Separation of Pits ft. L ' /-VI 10 A) Conforms as per Plot Plan Y N Engineer Report and As-Built Y N t Location of Syst o Property: Front d Rear Left Side Right Side Middle Front Middle Rear em Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-011)\Building&Codes\Inspection Forms\Septic Inspection Report.doc Go TOWN Oil— QUEE SBURY evieel —Fla iv b4 FILE el i lied