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2009-509 I TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 4z Community Development- Building &Codes (518) 761-8256 (C]s:E RTIFIC.ATE ("I"F C0MPLLA—N("-]TE Pernut Number. P20090509 Date Issued. Friday, October 23, 2009 This is to certify that work requested to be done as shown by Permit Number P20090509 has been completed. Tax Map Number. 523400-301-008-0001-068-000-0000 Location. 61 HELEN Dr Owner. THOMAS & MARIA CORTESE Applicant- THOMAS & MARIA CORTESE This structure maybe occupied as a; Septic Alteration Residential By Under 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,9nforclAient 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: P20090509 Application Number. A20090509 Tax Map No: 523400-301-008-0001-068-000-0000 Permission is hereby granted to: THOMAS &MARIA CORTESE For property located at: 61 HELEN 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: THOMAS &MARIA CORTESE 61 HELEN Dr Septic Alteration Residential QUEENSBURY,NY 12804 Total value Contractor or Builder's Name/Address Electrical Inspection Agency MORNING STAR SEPTIC Plans &Specifications 2009-509 septic alteration residential $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday, October 19, 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 r wee uday, October 19, 2009 7 SIGNED BYfor the Town of Queens bury. ury. Director of Building&Code Enforcement �.. `............ OFFICE USE ONLY t� PERMIT NO. PERMI + ; OCT ` TAX MAP NO. � , TOWN CLERK 0 APPROVALS: ZONING 0 ' --..._--- .---ta7VV ' OF�igE.CODES __------------------ APPLICATION.�_-.n..�.+.�.+.- ...�.7.�...SAL sysM INS r Off` `�L���� DISPOSAL 1 J1 � N IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID A PfrRMrC MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION �E�TIC— PERMIT. �to k — . `I/� � C .r� � INSTALLER: � 0 I2 N J!1�G OWNER l f /J �j��J ^(�'VbO��••• ADDRESS: ADDRESS: (E � , 7 7 3 '� PHONE NOS. PHONE NOS. LOCATION OF INSTALLATION: RESIDENCE INFORMATION: NO.OF = TOTAL DAILY FLOW GARBAGE GRINDER YEAR BUILT BEDROOMS X COMPUTATION= INSTALLED?____,_____ 1980 or older X 150 gallon per bedroom = X 130 gallon per bedroom = a2 O SPA OR HOT TUB 1981 -1991 U INSTALLED? 1992•present X 110 gallon per bedroom = PARCEL INFORMATION: ✓ TOPOGRAPHY: Flat rolling_ Steep slope %Sio p e ✓ SOIL NATURE: Sand. Loam Clay____ Other ✓ GROUNDWATER: At what depth? - ✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth? � Well If well: Water supply from any septic f ✓ DOMESTIC WATER SUPLY. Municipal _ system absorption is ✓ 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: 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: _� � �.. 2 r I�! ABSORPTION FIELD ( NE) Total length © ft. Each trench X _ ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? eQ ALTERNATIVE SYSTEM Bed or other type? k /ll r-HE S ❑ 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 anv material misrcnroc^-4--u-•- - failure to make;; matariai fa,+ ®.. Septic Inspection Report Office No. (518) 761-8256 Date Inspection reque a ived• Queensbury Building &Code Enforcement Arrive: Z'-Lid a it: 2 =30 am pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial NAME: Cc K-�-E, F— .PtRMIT NO.: LOCATION: �� 't fi-1 C i;_ !.l Via - fir-'INSPECT ON: (Q -Z1 - 0 RECHECK: Comments and/or diagram Soil T . Sa oam/ Cla Type of Water: t nici ell Water Waterlin a ion distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' +/ - Y N__N/A C` Absorption Field: Total length ft. \ -�- Length of each trench ft. Depth of trenches ft. �-Z L � Size of Stone See a e Pits: Number � l ►J��C A t��i L ik_ A Size: x Stone Size: il-k J"C Piping Size T � -° 0 Building to tank Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: Y N End Cap Y N— InletjOutlet Pipes&Baffles �Y N \ l"`-• 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 Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear tem Use 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 Septic Inspection Repo Office No. (518) 761-8256 Date Ins req s c Queensbury Building &Code Enforcement Arrive: m epart: - a� 742 Bay Rd., Queensbury, NY 12804 Inspect nitials: NAME: C P NO.: ^ JZ)7-- LOCATION: 1.S CT ON: RECHECK: Comments and/or diagram Soil T Type of Water: unici ell Water Water aration distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - Y N N/A Absorption Field: Total length CC. ft. Length of each trench ft. Depth of trenches Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank '� ,7uA yp Tank to Distribution Box Distribution Box to Field Pit " _ Tl� E — A,-, Opening Sealed: N End Cap N Inlet/Outlet Pipes &Baffles N Location Separations Foundation to tank jay&Tj ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plo Y N Engineer Report an -Built N Location of System on Property: Front Rear �Leftsi ht Side Middle Front Middle Rear m Use 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 r . MORNING STAR EXCAVATING, INC. & SEPTIC SERVICE 107 Jewell Road 518-793-2290 Frank Shaw, Pres. Gansevoort, NY 12831-2154 518-695-5505 Fax#518-793-2115 Date: l D —Z.1 0�— TO: C�zF7-J� No. 19005 INVOICE' Terms: Payment Due Upon Receipt of Invoice 1 112% interest After 30 Days R - 314 13 1_ 0 p I i A tag a3 r Cz-T-= �tb� , tA� t - Ah CA 70 CA N 0 c!, or believe I says S W : i s .: .:; si ful set ', i h` o ni Uh