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2014-553 TOWN OF QUEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 � Q rl, Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20140553 Date Issued: Monday, November 10, 2014 This is to certify that work requested to be done as shown by Permit Number P20140553 has been completed. Tax Map Number: 523400-295-015-0001-019-000-0000 Location: 15 MOORWOOD Dr Owner: RUSSELL W PATTERSON Applicant: RUSSELL W PATTERSON 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 1 ;cot./ property owner of the responsibility for compliance with Site Plan, t �% �C, ,�J Variance, or other issues and conditions as a result of approvals by the Director of Building&Cod Enfo ment Planning Board or Zoning Board of Appeals. 1 TOWN OF QUEENSBURY Ott 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140553 Application Number: A20140553 Tax Map No: 523400-295-015-0001-019-000-0000 - Permission is hereby granted to: RUSSELL W PAI I ERSON For property located at: 15 MOORWOOD Dr 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: RUSSELL W PATTERSON Septic Alteration Residential 15 MOORWOOD Dr Total Value QUEENSBURY NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency IBS SEPTIC & DRAIN ATTN: IVAN BELL 2 LOWER WARREN St OUEENSBURY.NY 12804 Plans&Specifications 2014-553 Res. Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,October 31,2015 (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 . 1 r •nsbuty j Fri. • , ,;i ctober 31,2014 SIGNED BY s r for the Town of Queensbury. Director of Building&Co.e Enfo`cement Community Development Office Town of Queensbury - 742 Bay Road • Queensbury, New York -12804 OCT 31 2014 Office Use Only � / TAX MAP NO. (q 5, I5--/`/ /q PERMIT NO. J1_j_55 3 PERMIT FEE 1G�c� APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: 19 l IA55 II pUtC r ()i^ INSTALLER: ---a S S e p r 1► 1 \AI O Z.�(WV e \iv(,1r(.?,, 5 i- . ADDRESS: � I �64'6 �l 0 O r(rv((" `Xl'' ADDRESS: q�C( 9-1i l.� PHONE NOS. c Ini 64- 6 3 " J PHONE NOS. J U X 1 LOCATION OF INSTALLATION: RESIDENCE INFORMATION: NO.OF COMPUTATION _ TOTAL DAILY FLOW YEAR BUILT BEDROOMS X (Gallons per bedroom) GARBAGE GRINDER 1980 or older Li X 150 = () O INSTALLED? 1981-1991 X — 130 = 6 J SPA OR HOT TUB 1992-present X 110 = INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT RO LING \ STEEP SLOPE I\ %SLO PE I\ I SOIL NATURE: SAND LOAM IV NCLAY W\\ OTHER\J ? ✓ GROUNDWATER: AT WHAT DEPTH? V ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WH T DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL``V (If well:water supply from any septic system absorption is: ft) I PERCOLATION TEST: RATE IS \\I‘ \-\ PER MIINUTE PER INCH[mpij (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). �,,t,)i'i r� TANK SIZE: 1�) �i() 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. l SYSTEM TY E: (� ABSORPTION FIELD(WITH NO.2 STONE) Total length)�� ft. Each trench X `J ❑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 of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL Sanity . 7ance. 10-31--19 codes(a)queensburv.net � ,� VISIT OUR WEBSITE FOR MORE INFORMATION o• .e n es�ble Date Signature p www.oueensburv.net Town-of Queensbury Building &Code Enforcement Office No. (518) 761-8256 • Septic Inspection Report — y D0 Inspection request received: Name: fC Inspected on: Q� to, -,-- Location: I `J 1\(\Q�� ��j 4- OR Arrive: birff p,m, Permit No.: / "1-5~S3 Inspector's Initials: C. merits and/or diagram Soil Typ(Sand)Loam/Clay Type of Water: M unici al Well Water F .k 4\42.c) Waterline separation distance ft. Well separation distance ft. Other wells: ft. "4, U Well Casing Length 50'+/ Y N N/A , Li [150'to well required if NO] Absorption Field: Total length '7150 ft. Length of each trench 5@O ft. Depth of trenches 5 —(o ft. alon ` n , k„..\6 -V) Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank !._k" 6 C) Tank to Distribution Box Lt 6 �• Distribution Box to Field!Pitt t o R� F -� L\" Opening Sealed: End CapN E -00��� e� '-iia�1 OR35 -To Inlet/Outlet Pipes&Baffles z �t�%N [� �- ��� �� C��A �L T1 vER Manholes 12"or less below grade Y [provide extension collar if Yes] N Location/Separations Foundation to tank t--; ft. Foundation to absorption 2.1 ft. TO _i3e Separation of Pits Conforms as per PI• ' . ✓Y N Engineer Report and As-B Y_N ltd E1- G - F1ta—Ec) ETU Maintenance Contract provided Y N e . n E eK) i Q Mt�j�}F t Location of System�nProperty: (��V�� - Front CRea _1eft Side Ri ht Side Middle Front Middle Rear S stem Use Sta l U —� \C.-\1/4<F- Approved F t �� Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved Septic Inspection Report //1 72 G aiGO2) 2),e, -,-.... . AS BUILT Z4S5" -' T 0c. t:ii„ _ _ 311 \ f --v - I IT?" `1-1 I— — — — — --- ` — ii ! 5, 50/i ,9c-j/ ,'a /1 1-, 11-1/:/./o OS E / U 7—OA/I< 7,X rt5- yi 9 7-2 4 /K /000y 3 .1y-Woi, fe %n /4A/A/ ,/ -/ft, 7 ///oc',f2, 7c .2-17-i,.i a"Ti'F�,e, 3©x', , 57-4..?S ' /levr.e 'ra Z, 7 , • 1 U w 6:�' '1i2Coil 7=e`/ 7•eo e a vl� 1 SEPTIC PLOT PLAN I HAVE SEEN OREB�S.TREOLL ESAFENOgS ETC BJECTS SUCH AS HOUSES,W SHOWN O THIS DOCUMENT.I HAVE PERSONALLY EAS .•� �. �+ ANCE SET FORTH ONTIjI . i l // E DATE l� ri • ';" �-;) 5p` 0:;3 Z.6 # I� MooremoJ P\LA55e1 Pu--t-rer)or, TOWN OF QU •�; '�� _A/O�er BUILDING & O, p ; , 1,�z Reviewed B / L Date: ANEW I 0