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2015-352 � ` TOWN OF QUEENSBURY 0-0,0742 Bay Road,Queensbury, (518)NY 12804-5902761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20150352 Date Issued: Monday, August 17, 2015 This is to certify that work requested to be done as shown by Permit Number P20150352 has been completed. Tax Map Number: 523400-301-008-0002-055-000-0000 Location: 15 PROSPECT Dr Owner: PATRICIA BYRNES Applicant: PATRICIA BYRNES This structure may be occupied as a: Septic Alteration Residential By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the (-- J 4 property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Director of Building&Code nforcement 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: P20150352 Application Number: A20150352 Tax Map No: 523400-301-008-0002-055-000-0000 Permission is hereby granted to: PATRICIA BYRNES For property located at: 15 PROSPECT Dr 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: PATRICIA BYRNES Septic Alteration Residential P.O. BOX 4372 Total Value QUEENSBURY,NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency MORNING STAR SEPTIC 793-2290 744-8139 107 JEWELL Rd GANSEVOORT NY 12831-0000 Plans&Specifications BP 2015-352 Residential Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, August 12,2016 (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 To o eensb ; ,� d,f• s . ,August 12,2015 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement SEPTIC DISPOSAL APPLICATION Office Use Only Received DATE: Tax Map ID TAX MAP ID: Permit No. 'LC 1'7 Permit Fee ZONE: APPLICANT � c>� _ PHONE/E-MAIL 9 Y fr 8 13 ADDRESS INSTALLER/ PHONE/E-MAIL BUILDER A%y� 5 OWNER �Q,'_ n'�- /� tutex..4o ?r1 Z SS'.4) ADDRESS q�^ "' / CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: PHONE/E-MAIL RESIDENCE INFORMATION Year Built #of bedrooms X gallons per bedroom =total Daily flow 1980 or older 3 l5-� 5--0 Garbage grinder installed Yes & No 1981-1991 Spa or Hot Tub installed Yes &No 1992-Present PARCEL INFORMATION Topography j(... Flat rolling Steep slope %Slope Soil Nature Sand Loam Clay Other Groundwater At what depth: Bedrock/Impervious material At what depth: Domestic Water Supply X. Municipal Well(if well,water supply from any septic system absorption is ft.) Percolation Test Rate: per minute per inch(test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION Tank size pa) gallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub System Absorption field with#2 stone Total length lie s ft.;Each Trench 415- ,Q, -e.*aP-+ 14' Seepage Pit with#3 stone How many: ;Size Alternative System Bed or other type: 4'Z. Holding Tank System Total required capacity? Tank size #of tanks Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will no longer allow systems to be covered until such time as an As-Built plan is received&approved. The installed system must match the septic system layout on file-no exceptions. Declaration: Any permit or approval granted which is based upon or is granted in reliance upon any material representation 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 and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME: /%lr'4Ad 1c L i C . S/4)A DATE: -s. /z., ../5 SIGNATURE: ..� DATE: Town of Queensbury Building&Codes Principal Structure Application Revised September 2014 Town of Queensbury Building &Code Enforcement Office No. (5:8) 761-8256 Septic Inspection Report Inspection request received: LL Name: f____ Inspected on: —_A Iiitio Location: k 5 Q� Ci , Arrive: Affro .m. Permit No.: 16 — jSZ.. Inspector's Initials: 'j,/ Ems- FLC) Mkap cArts and/or dia•ram Soil Type.leilk oam/Clay 0 Type of Wat- • Municipal , ell Water V-�iYc-- `-4,, 7 2_5( V-E-'‘ot,\ Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N N/A [150'to well required if NO] Absorption Field: Total length Lc-6 ft. t. •. Length of each trench I-10145-1 4u ft. Eta, L..DOPEZ' ‘- ' v-4,,,s p., , , IT r ,,, .,....i, . Depth of trenches ..�- P z..- 3 ft. Size of Stone E.-c-_FLD Nn £1-t c Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank y.' ‘ yp Tank to Distribution Box �" hiV-2)5- Distribution Box to Field/Pit N k, �jQQ,.-z7� rO Z ., -c j Opening Sealed: End Cap ✓�/ N Inlet/Outlet Pipes&Baffles ✓Y N Manholes 12"or less below grade [provide extension collar if Yes] N Location/Separations Foundation to tank n ft. Foundation to absorption 1 O ft. Separation of Pits ft. Conforms as per Plot Plan Y 1 Engineer Report and As-Built N F't b-(7lj‘‘.1- (4_c_EAN)G> ETU Maintenance Contract provided Y N Location of System on Property: Front Rea Left Side Right Side Middle Fro f'idle Rear System Use Stat : Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Septic Inspection Report4 Town of Queensbury Building &Code Enforcement Office No. (518) 761-8256 Septic Inspection Report Inspection request received: Name: pp�� Inspected on: i— �� . Location: \5 PK,Lb?c"\-- V)?\ Arrive: 1 7-'0 .m. Permit No.: Inspector's Initials: Lir #ts and/or dia•ram Soil Type: Sand/Loam/Clay ! Type of Water: Municipal I Well Water Waterline separation distance ft. Well separation distance ft. 1vv Other wells: ft. b —'— c3R Well Casing Length 50'+/- Y N N/A �� e [150'to well required if NO] \� Absorption Field: Total length ft. L3 ‘` Length of each trench ft. o 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 N End Cap Y N Inlet/Outlet Pipes&Baffles Y N Manholes 12"or less below grade Y N [provide extension collar if Yes] 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 ETU Maintenance Contract provided Y N Location of System on Property: Front Rear Left Side Right Side Middle Fro Middle Rear System Use Statu • Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved Septic Inspection Report 518-793-2290 Fax#518-793-2115 t 6 + . E-mail: morningstarseptic@hotmail.com " www.morningstarseptic.com ... PT1C *■RVIC$ Date: C1-4,— > .._r 107 Jewel Road,Gansevoort, NY 12831 TO: ,, .....-6------1' P / 5--- /-9,7,„-,-t- 5 -- M A P 6---__„,......„4„). _ __________ _________ ____________ __ ,,_____ 1 EWIT , 0 v- y _________________Ia . ...:7_ ), 5:.... ___________. oil ._ _____________ .73, _ 1 ,,, .\ ,O , r -- ., i7 � i � A - i a441: A 0O f - %,..),..\,ZCI.X. i I / 518-793-2290 MAW Fax#518-793-2115 r 3 6 0 , 3 4 g E-mail: morningstarseptic@hotmail.com www.morningstarseptic.com sera te aill iii V10:R Date: (S. - i'ir 107 Jewel Road,Gansevoort, NY 12831 TO: Fe it- 1�7 u ttyv i sFes. itg, MAP (R-LAL.1.44) SEPTIC PLOT PLAN I HAVE SEEN OR OBSERVED ALL OBJECTS \/ SUCH AS HOUSES, WELLS, TREES, FENCES, ETC FILE COPi MEASURED DTH THIS DOCUMENT.I HAVE PERSONALLY �, SET Fi,,�. N THIS DIAGRAM. __ /5^ SIGNATURE � pA \--------____ _--....._N________, LL S-- ,D./0 4'� lob; 1 Yr /dr tt.pe' Pi . T°') 2,...--t200 3 — `\ *iS- N9 3 .' e /