The URL can be used to link to this page

2012-304 TOWN OF QUEENSBURY I 742 Bay Road, NY 12804-5902 (518) 761-8201 dor Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20120304 Date Issued: Friday, June 29, 2012 This is to certify that work requested to be done as shown by Permit Number P20120304 has been completed. Tax Map Number: 523400-309-007-0002-032-000-0000 Location: 14 NATIIAN St Owner: MERVIN HERCULES Applicant: MERVIN HERCULES 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. TOWN OF QUEENSBURY 742 Bay Road,Quccnsbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20120304 Application Number: A20120304 Tax Map No: 523400-309-007-0002-032-000-0000 Permission is hereby granted to: MERVIN HERCULES For property located at: 14 NATHAN St 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: MERVIN HERCULES ANGEL SMITH Septic Alteration Residential 14 NATHAN St Total Value QUEENSBURY,NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2012-304 Res. Septic alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 28,2013 (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 ue sbuty• iiTh .‘,i,June 28, 2012 e SIGNED BY ` for the Town of Queensbury. Director of Building& Code Enforcement , / p(— L Revised 4/14/2010 OFFICE USE ONLY 2 TAX MAP NO. 304', / �3 OERMIT NO.1 e PERMIT FEE JUN 2 2 2012 APPROVALS: ZONING OWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OFA VALID PERMIT. 402 / 3v7 _ //(,2- 0�,, �{ OWNER r 11 Y �)I It ,f-�L..`1_e.S INSTALLER: �j-{C'\�'r° SL.,_le QA-- c J SS 3 ADDRESS: IL-1 IQ C h r-- 5T r-•, ADDRESS: SOC. PHONE NOS. 51SS - 3(.o S- (-(-)-1-)v LI PHONE NOS. LOCATION OF INSTALLATION: 1'T /L �'1;"'L b-f RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT X = TOTAL DAILY FLOW • BEDROOMS (Gallons per bedroom) GARBAGE GRINDSL.) 1980 or older X 150 = 5 C)V INSTALLED? 1981-1991 X 130 = SPA OR HOT TUB `-'j 1992-present X 110 = INSTALLED? P�V PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLL NG f STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND \ LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL I WELL (If well:water supply from any septic system absorption is: ft) ✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH(mpi] (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). TANK SIZE: I k I)0 D 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: I ABSORPTION FIELD(WITH NO.2 STONE) Total length 150 ft Each trench 3 x co ❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? ❑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 and all requirements o 'e Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL Siafiltary ewage Dispose • ina in e. codesa,queensburv.net o%mf ��, . x . /-N ) VISIT OUR WEBSITE FOR MORE INFORMATION Signature o rson Responsible J Date www.queensburv.net Slg p Town of Queensbury* Community Development Office*742 Bay Road, Queensbury NY 12804 fr, 4c0,_,. l-3 C\fln) Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/pm Depart: t A cam/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:e.., 4' NAME: ' e-r(1_4L.1 3 PERMIT NO.: 0-3 o I LOCATION: / Y ti c_7i-h n Si- INSPECT ON: L ---,1q--.la RECHECK: Comments and/or diagram Soil Type: 51a '/ 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 Absorption Field: Total length /2j cY 3- ft. Length of each trench � ft ----- --4--'51/16- 146 -C-7a1 Depth of trenches �-k-6-- ft. Size of Stone "Z�. Seepage Pits: Number Size: Pll__,x Stone Size: Piping Size Type Building to tank Tank to Distribution Box << -`*' --l�f) Distribution Box to Field / Pit k ,$ ,�� ' '-(� Opening Sealed: N End Cap VY-N Inlet/Outlet Pipes &Baffles Y— N ---2---- -- 3634--. Location/ Separations • Foundation to tank ft. Foundation to absorption fillilrfftt. �..� j .. � Q �Separation of Pits . Conforms as per Plot Plan Y/ N aF meer-Repat and As-Built vY , N Location of System on Property: Front Rea Left Side Right Side Middle Front Middle Rear -t U - . 2 . 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 rAY1-1 /1/4.-/h /t) s-1- Qe 6cm/y pdt„.19 I'V\r vt?,.11 cI 1111-erc,...si.J42 411 1‘1— 6 /7_ Qom ) �,� 1 c1(3 �r s D '`')/e E-' ,--- f I i V'. i ic( --). i SI <----1D •6 telLSeArt4;1I D\\`) - i of2A u/L- 1 e.,:f.....7_, 5., 046 5/04 c4.._ 1,--7 -..,-i f` , I 1 � ' i L , ) ...is clin% , e!_ . 0 Septic Inspection Re• • Office No. (518) 761-8256 Date Inspection r-. ••- - •. Queensbury Building &Code Enforcement Arrive: •: t �14. .-Dart: = am_ 742 Bay Rd., Queensbury, NY 12804 Inspector's Initia —! NAME: 4 E RC_ l l_E_6 PERMIT NO.: 1-z..—.. LOCATION: 1'4 13 PT r-t Pr I3 -17 INSPECT ON: Co--7 -17 RECHECK: Comments and/or diagram Soil Type: Sand/ Loam / Clay Type of Water: Municipal/ Well Water VO 13,F 1 Laa •b EPT1 C LA`OUT-) Waterline separation distance ft. I Well separation distance ft. a Other wells: ft. �` �� Well Casing Length 50' + / - Y N N/A t— �� ": 7-1:3 F [150'to well required if NO] ; 0`µ � � 42:37-I Absorption Field: Total length ft. Lt" PP E�Fa l Length of each trench _ ft. �,pT ED 6-j- 71 Depth of trenches ft. Size of Stone rP-0 M Qb cc-- Qt D-E Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit \ te1b� 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] 1 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 _Y_ N provided 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 L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report03 29 10.doc Septic Inspection epo Office No. (518) 761-8256 Date Inspecti n -• ; r: eived: Queensbury Building &Code Enforcement Arrive: ��(-0OM Depart: a /p,n.2__.) 742 Bay Rd., Queensbury, NY 12804 Inspector's Initia . IO NAME: N-e-r�C.ut P -r NO.: I og~304/ LOCATION: / Y A) Q --k(11.1 S't. INS•E ON: (2-25e --Vt.-- RECHECK: 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 T_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: _Y_N ��l�- U OF_ C E \ End Cap _Y _N 051 tFc--FIJOPV Inlet/Outlet Pipes &Baffles T Y-__,_• N Or� E_ VD b Oo Pl\)E 1�1L Location/ Separations • Foundation to tank ft. Zbt V,V O T h t\T \\EO qt VEff- Foundation to absorption ___ft. Separation of Pits ft. \)00k___ 0 CO` � Conforms as per Plot Plan •^Y N Engineer Report and As-Built „ Y____ N -EE G \J E S ..._t Location of System on Property: TO C-E- 1\t�V) �Ll Op -�,�Pa�14 L e_6 �t �� Fron' Rear Left Side Right Side Middle Front Middle Rear S -n - . 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 p c7/570A)e., r. 1 $0 f 7777 moic / v 1 11,14,; "1-0( U -- l Da ke a alviAze. TOWN OF QUE" , Fl! COPY BUILDING & ' tw �tT` RE-_,viewed By Date: I ?- 1 (7< ' 71() 0 ( (-/?1