2012-247 TOWN OF QUEENSBURY
742 Bay Road,Queensbuty,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120247 Date Issued: Monday, October 21, 2013
This is to certify that work requested to be done as shown by Permit Number P20120247
has been completed.
Tax Map Number: 523400-301-007-0001-026-000-0000
Location: 4 BUENA VISTA Ave
Owner: JOSEPH & ANGELA LOIACONO
Applicant: JOSEPH & ANGELA LOIACONO
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
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.
0./`
TOWN OF QUEENSBURY
F 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
411111.
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20120247 Application Number: A20120247
Tax Map No: 523400-301-007-0001-026-000-0000
Permission is hereby granted to: JOSEPH&ANGELA LOIACONO
For property located at 4 BUENA VISTA Ave
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: JOSEPH &ANGELA LOIACONO
4 BUENA VISTA Ave Septic Alteration Residential
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2012-247
Res Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,May 16, 2013
(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 Town of sbury; ed •.d ,, , May 16,2012
SIGNED BY f for the Town of Queensbury.
Director of Building&Code Enforcement
01,O1 e COvulI Je)Ser
n, ! Revised 4/14/2010
OFFICE USE ONLY /� j f �: ."`_.."{_:.; (r. r(,j! '
�r �lJ/�/ L.n I_E, i i \.l i
TAX MAP NO I/7—(- PERMIT NO. ica a.Y / PERMIT FEE -- "'""
APPROVALS: ZONING TOWN CLERKi UV ?011
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SLIBJECT2TO R
ISSUANCE,OFVALILl,PERMIT.623
LJ� w ✓dINSTALLER: 1 (feL 1 I S.c "; c "`'OWNER.. IC
ADDRESS: * T I ('O-.4,-U tJ1J? ADDRESS:•17/-0Q � 6i-G, ,I c•I/
PHONE NOS. PHONE NOS. 7,V[i rift' C(
LOCATION OF INSTALLATION: ? /....1( 6 LA LI Q,.
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedrooms GARBAGE GRINDER
1980 or older X 150 = INSTALLED?
1981-1991 X 130 = SPA OR HOT TUB
1992-present X 110 = INSTALLED?
PARCEL INFORMATION:
(\( ..
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE r %SLOPE
✓ SOIL NATURE: SAND LOA CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? /J
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH?f 1� /
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS A/A PER MINUTE PER INCH[mpg
(Test to be complete 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).
TANK SIZE: 1)"J'Z GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for
each garbage grinder,spa or whirlpool tub.
SYSTEM TYPE: "` l
o ABSORPTION FIELD(WITH NO.2 STONE) Total len��' fL Each trench (l X26
❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size?
o ALTERNATIVE SYSTEM Bed or other type?
❑HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks?
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
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 abide by these d all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sanitary Sewag sposal Ordinance. codesfa?pueensburv.net
C t _ e d.0(4 VISIT OUR WEBSITE FOR MORE INFORMATION
Sign of Person Responsible Date www.queensburY.net
Town of Queensbury* Community Development Office *742 Bay Road, Queensbury NY 12804
Septic Inspection Report
Office No. (518) 761-8256 Date Ins on requ-- • •: 'W .
Queensbury Building &Code Enforcement Arrive: a ti depart: .m/pm
742 Bay Rd., QueeeJnsbury, NY 12804 Inspector's Initial •
NAME: '4-0I CG�o A'� \ P•• IT NO.: ;2
LOCATION: 4 i,L' V 1 3$4 SPECT ON: INT 6
RECHECK:
Comments and/or diagram
Soil Ty.- oam/ Clay
Type of Water: un cup,. - ater t,,
tSC
Water'•- .- ion 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 mei ft.
Length of each trench 7.:ice ft.
Depth of trenches V9 -2- ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank 7 1-1D To (4' h(._ -\<-lt)
Tank to Distribution Box CAL./
Distribution Box to Field/ Pit '" QSU Tp R�
Opening Sealed: N
End Cap
Inlet/Outlet Pipes&Baffles
Manholes 12"or less below grade Y_
[provide extension collar if Yes] Y, N A S B Li I LT
Location/ Separations
Foundation to tank ft.
Foundation to absorption .
Separation of Pits ft.
Conforms as per Plot Plan Y,••T,_N
Engineer Report and As-Built Y N
ETU Maintenance Contract _Y_ N
provided
Location of System on Property:
Front R: r L-ft Sid _Right Side Middle Front Middle :--
Stem Use S . s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiffing\2010\Building Codes Forms\Inspection Forms\Septic Inspection Reporf`03 29 10.doc
.; 6 0
3
r f
I
\."/ AS BUIL`
i
//0-vYs '2'7 2 )'") ,
.-T-,:las.F.) 2rvia:jn
' Ill ' ' I
_ ____.. K__________ , Q5 --- )1 . 1' . .-1 ./)A- U al :.I
C'.
A ,
0
0 .;e..zj ,
1no0�1r" 0)- i ��q
t
x-oc- .�1ok-vr'
iiiiiiiir :alea , v)..\, -1,1\ IV,A(d h .wy-Q1Pak 1\N?A _vob--c.."
o7// :48 penneinald
,r 4i •. a'a J l? ON1a-1Ifl ,
-, -- ' = 33110 JO NMOI
)\600 '. \\*.:1, Yv,k5 .n. -1--AJmvca
.4-1 i
----- \-0 5t3a.. ,
L\--a-- irc A f o T) rVV