2011-612 I
,, �„� TOWN OF QUEENSBURY
�
742 BayRoad, ueensbu NY 12804-5902 (518)761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110612 Date Issued: Friday, December 28, 2012
This is to certify that work requested to be done as shown by Permit Number P20110612
has been completed.
Tax Map Number: 523400-308-014-0001-052-000-0000
Location: 183 PITCHER Rd
Owner: ARC COMMUNITIES 14 LLC
Applicant: ARC COMMUNITIES 14 LLC
This structure may be occupied as a:
Septic Alteration Commercial
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the e
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 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110612 Application Number: A20110612
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: ARC COMMUNITIES 14 LLC
For property located at: 183 PITCHER 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 filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: ARC COMMUNITIES 14 LLC
PO BOX 61102 Septic Alteration Commercial
CHICAGO IL 60606-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
RAYMOND JONES
424-0508 P.O. BOX 702
BALLSTON SPA,NY 12020-0000
Plans&Specifications
2011-612
88 & 89 Gregwood Circle- septic alteration
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,December 19,2012
(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 T it oif9ueenpcbury;` Monday,December 19,2011
SIGNED BY y for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY E t-TE11- v�n
�19
TAX MAP NO. PERMIT NO. ERMIT FEE _
DEC it, 2011 :11-ji
APPROVALS: ZONING TOWN CLERK ,
T4
BUILDING NG& CO ES
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PE • •
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.
OWNER: 4 Pro per INSTALLER: R. mand
ADDRESS: iv r ('f Ottwadt /t q ADDRESS: U .10,9 + (I(s n .e' Y 1L (0
G /a•' ,
PHONE NOS. �0 71-15-- 77740 PHONE NOS. 570-eia g
LOCATION OF INSTALLATION: "Uu.:QQJ`o .=8-Z W Gr429 et
NO.OF 1 RESIDENCE INFORMATION:
YEAR BUILT BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW
GARBAGE GRINDER
1980 or older X 150 gallon per bedroom = INSTALLED?
1981 -1991 X 130 gallon per bedroom = SPA OR HOT TUB
1992-present X 110 gallon per bedroom = INSTALLED?
PARCEL INFORMATION: v
•,( TOPOGRAPHY: Flat rolling /� Steep slope %Slope
✓ SOIL NATURE: Sand ) Loam Clay Other
✓ GROUNDWATER: At what depth?
✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth?
✓ DOMESTIC WATER SUPLY: Municipal "6 Well (If well: Water supply from any septic
system absorption is ft.)
✓ PERCOLATION TEST: Rate is minutes 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: /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:
O ABSORPTION FIELD (WITH NO. 2 STONE) Total length 806 ft. Each trench 50 X Co
0 SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size?
O ALTERNATIVE SYSTEM Bed or other type?
O 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.
900 �e ,
Septic Inspection Report
Office No. (518)761-8256 Date Insp on request received:
Queensbury Building&Code Enforcement Arrive: `7',. Yr am/pm Depart: am/pm
742 Bay Rd., Queensbury, NY 1280'� Inspector's Initials: )//
NAME: L e KrA / PERMIT NO.: 1/— 6/2
LOCATION: '� � ... INSPECT ON: /Z 717 l/�
RECHECK:
Comments and/or diagram
Soil Type: oam/ Clay
Type of Water: `/ Well Water
Waterline separation distance AA 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 .
+? ft. t 0 ' £4 le,4 `
Length of each trench ft.
Depth of trenches 2-3 ft.
Size of Stone 2.--
Seepage
,,Seepage Pits: Number
Size: x
Stone Size:
Piping Size T
Building to tank V''
Tank to Distribution Box 94'
Distribution Box to Field/ Pit y~
Opening Sealed: .�N
End Cap Y N
Inlet/Outlet Pipes&Baffles :Y_N
Manholes 12"or less below grade Y_.NN/�
[provide extension collar if Yes] Y N
Location/Separations
Foundation to tank Z/A.ft.
Foundation to absorption ft.
Separation of Pits
Conforms as per Plot Plan Y_Jr,
Engineer Report and As-Built Y✓N ,,r 4#*.ce ,tu cr A�
ETU Maintenance Contract Y_ N
p✓, E
provided
Location of System on Property:
Front Rear 410110
3 fight Si Middle Front Middle Rear
System Use Status:
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
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§tc:1,15.,(_-----1.711111.11‘
Offi
Ce No. (518) 761-s25 Septic Inspection Report
Queensbury Building& e Enforcement Y Rd. NY12 Date Inspection QUeensbu. Arrive: req receiv
� �am/ ed:
NAME: }
In Initials: ��part:
►'ER1N1T NO.;
INSPECT ON:
'//
Soil I ,-; Sand/Loam Cla
T .- of Water: Munici••I Well Water mm n lig ticsim
Waterline se.. r
radon distance
Well separation distance
Other wells:
Well Casing Length 50'+/-
ISO'to well •
wredifNo
Absor•tion Field: ...../.11// Vl/ "`"04 '..
Total len•th
- . 1 of each trench /
De of trenches _ Mg �J /3 X eJ
Size of Stone �'
--tee Pits: Number �- _ Lde'e�e� "`�� 04 /4f�
Size: &reed
Stone Size: - --
pi, - rd✓de_ SJ Xi,7/-
..t. SizeIIIIIPMIIII
Building to tank
Tank to Distribution Boot
Distribution Box to Field/Pr1
Opening Sealed: Y N
End Cap ....Y N
Inlet/Outlet Pipes&Baffles Y N
Manholes 12"or Bess below grade
Mill
(provide extension collar if Yes
Location I Separations
Foundation to t* ft.
Foundation to absor�tin ft.
Separation of Its ft.
Conforms as Per Piot�i _Y__._N
r Engineer Report and As-Bu . Y_N
ETU Maintenance Contras Y_ N
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
Pm Us_Stmt g
Approved
Partial Approved antes to be re-inspected, please call the Building &Codes Office
Disapproved
,______
t.:\Pam Wtting\2010ilding Codes'Fo \lnsPeL'ma c Inspection Repat_03 2910.doc