2009-306 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20090306 Date Issued: Monday, July 13, 2009
This is to certify that work requested to be done as shown by Permit Number P20090306
has been completed.
Tax Map Number. 523400-295-015-0001-023-000-0000
Location: 7 CRESTWOOD Dr
Owner. LOREN & JOYCE COMPSON
Applicant: LOREN & JOYCE COMPSON
This structure maybe occupied as a:
Septic Alteration Residential
By Offer of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the ` „A
property owner of the responsibility for compliance with Site Plan,
�Jj
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: P20090306 Application Number. A20090306
Tax Map No: 523400-295-015-0001-023-000-0000
Permission is hereby granted to: LOREN &JOYCE COMP SON
For property located at: 7 CRESTWOOD 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: LOREN &JOYCE COMPSON
7 CRESTWOOD Dr Septic Alteration Residential
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans &Specifications
2009-306
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,July 02, 2010
(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 To eens rY011, July 02, 2009
SIGNED BY ; for the Town of Queensbury.
Director of Building&Code Enforcement
...............��FFICEUSEONLY _-----------------
____i /� cc,
1` L5
TAX MAP NO. PERMIT NO. PERMIT FEE
JUG_ 2009
APPROVALS: ZONING TOWN CLERK �0,_,.., ;
BUILDING CODES
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: L2a it Pj,tam INSTALLER:/t4-L4-f1—T-/z-7-
ADDRESS 1 ��� s��0 0`7 `�" ADDRESS: y ;30 2�y1
PHONE NOS. ;7 6 � � � PHONE Nos. 7 r C
j I
LOCATION OF INSTALLATION: 7 vNl
RESIDENCE INFORMATION:
OF
YEAR BUILT NO. X COMPUTATION= = TOTAL DAILY FLOW
BEDROOMS I I GARBAGE GRIND_E,�
1980 or older Al. I X 1 150 gallon per bedroom INSTALLED?
1981 -1991 X 130 gallon per bedroom = SPA OR HOT TUB go
1992-present X 110 gallon per bedroom INSTALLED?
PARCEL INFORMATION:
✓ TOPOGRAPHY: Flat rolling Steep slope %Slope
✓ SOIL NATURE: Sand— Loam Clay Other
✓ GROUNDWATER: At what depth?
✓ BEDROCK/IMPERVIOUS MATERIAL: At why depth?
✓ DOMESTIC WATER SUPLY: Municipal Well (If well: Water supply from any septic
system absorption is ft.)
✓ PERCOLATION TEST: Rate is per minute per inch.
(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: fqs`J 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:
❑ ABSORPTION FIELD (WITH NO. 2 STONE) Total length Each trench X `'
❑ 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 E'_ECTRICAL WORK MUST BE INSPECTED BY A TOWN
APPROVED Et_FCTRiral InlcaGr`T�n�� ���� .,•, -- -
0.00) ire
Septic Inspection Report
Office No. (518) 761-8256 Date Ins ion r e ec ved:
Queensbury Building &Code Enforcement Arrive: / Repart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initial .
NAME: 4tx'�:AL-+ 1 0 P MIT NO.:
LOCATION: I SPECT ON:
RECHECK:
Comments and/or diagram
Soil Ty nAjjTam Lgk
Type of Wate . Munici ell Water
Wat aration distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N N A
Absorption Field: Total length ft.
Length of each trench Kft.
Depth of trenches ft.
Size of StoneZ,
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field Pit L4 it jcVE9-,:—
Opening Sealed: LA, N
End Ca Y N
Inlet/Outlet Pipes &Baffles vY N
Location Separations
Foundation to tank
Foundation to absorption
Separation of Pits ft.
Conforms as per Plot Plan VY N
Engineer Report and As-Built Y N
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
S t .
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-01-1)\Building&Codes\Inspection Forms\Septic Inspection Report.doc
-�. Community Development Office
Town of Queensbury • 742 Bay Rd.
Queensbury, New York •12804 PLOT PLAN
Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property lines.
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