BOTH-000462-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201
at Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000462-2016 Date Issued: Thursday,July 21, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000462-2016
has been completed.
Tax Map Number: 309.14-1-79
Location: 1 RYAN AVE
Owner: Kathleen Ringer
Applicant: Stone Installations
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 TV�
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)761-8201
= Community Development - Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTH-000462-2016
Tax Map No: 309.14-1-79
Permission is hereby granted to: Stone Installations
For property located at: 1 RYAN 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
Owner Name: Kathleen Ringer Septic Disposal $0.00
Owner Address: 1 Ryan AVE Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Stone Installations
4305 Route 50
Saratoga Springs,NY 12866
Plans& Specifications
Residential Septic Alteration
$ 40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, July 14,2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queen before thrf xpiWTU
ration d e.)
Dated at the Town uee
Qs y 9, 2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT Office Use Only
DATE 7'/ -�� Received
Tax MAP ID
Tax Map ID 21 el �'4' 19 2016 Permit No. �-- 1
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Permit Fee lqn ock
LOCATION OF INSTALLATION Approvals:
APPLICANT � �rarrc 1j:� 5 4� 4DXf PHONE/E-MAIL
ADDRESS - O_ n � �o ��E�7zCt �0r.r�iS. N . �
INSTALLER/BUILDER: _ ` :n �w S Ta I1C, ld r 5 PHQNE/E-MAIL 939-1707
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ADDRESS: bra ura c� G. sr
NER c. PHONE/E-MAIL 0 �Z-bIO_y
Address Z'9 C)
CONTACT PERSON FOR BUILDING 1Pc._COPES_,COMPLIANv► d PHOME Z 3 Z- `70--7
RESIDENCE INFORMATION
Year Built #of bedrooms X Gallons per bedroom Total Daily Flow
1980 or older Garbage grinder installed _Y AN
1981-1991 ( Spa or Hot Tub installed _Y _X-N
1992-Present
PARCEL INFORMATION
Topography Flat rolling Steep slope %slope
Soil Nature Sand Loa Clay Other
Groundwater At what depth? Aloit "9.*4
Bedrock I Impervious Material At what depth? Ropfe Y/Cscai—
Domestic Water SupplyMunicipal 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 engineering/architect)
PROPOSED SYSTEM FOR NEw CONSTRUCTION
Tank Size gallons(minimum size 1,000 gallons, add 250 gallons to size for each garbage grinder or spa or hot tub)
System Type Absorption field with#2 stone Total length _/Y 0 ft.; Each trench ` x
Seepage Pit with#3 stone How many: ;size
Alternative System Bed or other type?
Holding Tank System Total required capacity? Tank size q #of tanks
�,.zJc� gena - �;+c,/cllels �,k c ra`5 d`+
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 know by or on behalf of an applicant, shall be void. I have read the regulations
and agree to abide these aj all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Print Name: L11e, Date: 7- 6-4
Signature:' Date: i—If /t
T.,,.n r.i!ld aonnL. mr RClrlinn Q. niinn
Q+!n r);l D-4 I..I,.Illi A
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Copy 5FpTIC PLOT PLAN
F11-� k HAVE SEEN OR OiSERVED ALL OErJECTS
UCH AS HCuSES, WELLS, TREES, FENCES, ETC
f SHOMN ON THIS OCCUMENT.I HAVE PERSONALLY
ch THE CS11E S RTHOP THIS DIAGRM E
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TOWN OF QUI
BUILDING & C D T.
Reviewed By:
Date:
309.14-1-79 BOTH-000462-2016 Jug 1i5
Binger, Kathleen
1 Ryan Avenue
Residential Septic Alteration
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