2015-446 TOWN OF QUEENSBURY
vto742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150446 Date Issued: Wednesday, September 23, 2015
This is to certify that work requested to be done as shown by Permit Number P20150446
has been completed.
Tax Map Number: 523400-288-008-0001-011-002-0000
Location: 1602 STATE ROUTE 9
Owner: RASHEED BHATTI
Applicant: RASHEED BHATTI
This structure may be occupied as a:
Septic Alteration Commercial
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the /
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the ANG1 '
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
FON
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150446 Application Number: A20150446
Tax Map No: 523400-288-008-0001-011-002-0000
Permission is hereby granted to: RASHEED BHATTI
For property located at: 1602 STATE ROUTE 9
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: RASHEED BHATTI Septic Alteration Commercial
932 STATE ROUTE 9 MOTEL Total Value
QUEENSBURY NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2015-446
The King Hendrick Motel
Commericial Septic Alterations
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, September 22,2016
(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 T n o ueen u l d. September 22,2015
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL APPLICATION Office Use Only
Received
DATE: 1 r/t_c-- Tax Map ID
TAX MAP ID: 2-8b.i5 -1 -1A..2- Permit No. '24:2‘5—,.
Permit Fee .4 —6 -ff,/
ZONE: IV
APPLICANT % -e- 7 ( )
/ rc/ (7ONE/E-MAIL
ADDRESS /6 02 .2t� /
INSTALLER/ a PHONE/ -MAIL
CBUILDER Ail g -r, - ��C/il /5 s-I O ‘,.......„,) 40, ..,-,
OWNER r2 i i I /�
ADDRESS 9.7. , 741j-t. /`��i / 7 Ai y /2-go
2go
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 Z /SO 3 00 Garbage grinder installed Yes Xi No
1981-1991 Spa or Hot Tub installed Yes )ONo
1992-Present
PARCEL INFORMATION
Topography Flat rolling )o Steep slope %Slope
Soil Nature )O Sand Loam Clay Other
Groundwater At what depth: /i��-
Bedrock/Impervious material At what depth: wA-
Domestic Water Supply Municipal W Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate: I—S per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size to gallons(mi .size 1,000 g lions,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with stone Total length ft.;Each Trench
Seepage Pit with#3 stone How many: / ;Size 9)68
Alternative System Bed or other type:
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.
p 9 / 2 //(s-
PRINT
�/�
PRINT NAME: �� L.41,40, LAI ' fir DATE:
SIGNATURE: i"� I DATE: 9/2 f /(
'' -w% / /
Town of Queensbury Building&I°i es Principal Structure Application Revised September 2014
I
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Septic Inspection Report
Inspection request rec
Name: `� �W- Inspected on:
/Z
Location: /6 6 L F Arrive: a.m./p.m.
Permit No.: /.— Inspector's Initials: 4i
Comments and/or diagram
Soil Type: Sand/Loam/Clay
Type of Water: Municipal/Well Water
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 ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number /u6 [t4 7
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 Front Middle Rear
System Use Status:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256 • 2-IDAI
Septic Inspection Report
Inspection request received: i c ( 23\>CA---
cl� ,
Name: Ppr'YKi "1 Inspected on: 1 I LD i 1 C'IS
Location: ) 10 C )- kA-- Ct)- u.A-t. 9 Arrive: 3-3` a.m./p.m.
Permit No.: 2-C tc5""`9' (L Inspector's Initials: /hh)-
Comments and/or diagram
Soil Type: a `Loam/Clay
Type of Water: Municipal/ _ . -
Waterline separation distance ,, ft.
Well separation distance -)L,S ft.
Other wells: ft.
Well Casing Length 50'+/- Y N N/A
[150'to well required if NO] Al
Absorption Field: Total length ft.
Length of each trench ft. A1/4,
Depth of trenches ft.
Size of Stone 2-
Seepage Pits: Number /
Size: _` x <<
Stone Size: -2,—
Piping
Piping Size Type
Building to tank 4/'1 PV-
Tank
'VTank to Distribution Box y 4 /tJL
Distribution Box to Field/Pit k✓h-
Opening Sealed: 'Y N
End Cap Y N
Inlet/Outlet Pipes&Baffles X-Y N
Manholes 12"or less below grade _Y N
[provide extension collar if Yes] Y N
i-7
Location/Separations
Foundation to tank i ft.
Foundation to absorption 32 ft.
Separation of Pits 1"-A-. ft.
Conforms as per Plot Plan )6Y N
Engineer Report and As-Built Y N
ETU Maintenance Contract provided Y N
Location of System on Property:
Front Rea Left Side Right Side Middle Front Middle Rear
System Use Status:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
4
Disapproved
Septic Inspection Report
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