BOTH-000208-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000208-2016 Date Issued: Thursday, April 21, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000208-2016
has been completed.
Tax Map Number: 296.9-2-62
Location: 142 MONTRAY RD
Owner: STEPHEN PORTO
Applicant: STEPHEN PORTO
This structure may be occupied as a: Residential Septic Alteration
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the �,t,--(/NS4
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 Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8'201
Community Development - Building & Codes (518) 761-8256
BUILDINGPERMIT
Permit Number: BOTI-I-000208-2016
Tax Map No: 296.9.2-62
Permission is hereby granted to: Sanitary Sewer Service
For property located at: 142 1W ONTRAY 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 fled and approved and in compliance with the NYS Uniform
Building;Codes and the Queensbury Zoning..Ordinance
Type of Construction
Owner Name: STEPHEN POWFO Septic Disposal $0.00
Owner Address: 142 Montray RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name l Address Electrical Inspection Agency
Sanitary Sewer Service
PO Box 224
Glens Falls,NY 12801
Plans&Specifications
Residential Septic Alteration
S 40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday,April 10, 2017
(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 ate.)
Dated at the Towne' sbury: Fr` u l5,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT idle l�nly
Received
Tax Map ID
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TAX
NAP Permit No. Ian Ik 9-C SVD
Permit Fee 4L ly)""f
Loc YMcEMrA Approvals:
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ADDRESS
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-0 PHomEIE-AwL
Address
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Year Built ##of bedrooms XGlallonsperbedroorn =Total Daily Flow
1990 or alderGarbage grinder installed Y
1981.1991 Spa or Hot Tub installed —Y �N
a sea-i�reser�r
Efiffmt �ca
TopographyFlat rolling Steep slope —%Slope
Soil Nature Sand Loam Clay Other
Groundwater At What dept°i'rZ ,272
Bedrock!impervious Material At what depth?
Dor rie tic Water Supply . municipal Well(if gall,water supply from any septic system absorption Is—ft.)
Percolation Test bate:/' �per minute per inch(test to be completed by licensed engineering#architect)
Eggegggp SYSTSWe
Tanis 8I e � gallons(minimum size 1,a' o gallons,add 2:80 gallons to size for each garbage grinder or spa or hot tub)
System Type ,absorption field with#2 stone Total length fL,Each trench
Seepage Pit mM 10 stone grew many: size
Altermative System Bed or other type?
Holding Tank System Total required capacity? Tank size of tanks
Note: 1)Alann system tip associated electrical worts must be Inspected by a Town approved electrical inspection agency,2)We will no longer
allow systems to be covereduntil such time as an As-Built plan Is received'&approved. The Installed system most match the septic system
layout on lite-no exceptions.
DEc ,q,7ox— 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 know by or on behalf of an applicant, shall be void. I have read the regulations
and agree to abide byhese and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
s' Date-
signature-
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sigroalture:
' date
Town of Queensbury Building&Codes Septic Disposal Permit Jply 2014
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296.9-2-62 BOTH-000208-2016
Porto, Steve
142 Montray Road
Residential Septic Alteration
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