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2009-510 - TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5942 (518)761-82Q1 Community Development- Building &Codes (518) 761-8256 (].ir"'R T I F I CAT E (". F C0M P L I-A►-N- �E Pen-nit Number. P20090510 Date Issued: Tuesday, November 03, 2009 This is to certify that work requested to be done as shown by Permit Number P20090510 has been completed, Tax Map Number. 523400-302-014-0001-066-000-0000 Location: 3 SPRUCE Ct Owner: ROWLAND & MARIE HUGHES JR Applicant: ROWLAND & MARIE HUGHES JR This structure maybe occupied as a. Septic Alteration Residential By Order 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 8t 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: P20090510 Application Number. A20090510 Tax Map No: 523400-302-014-0001-066-000-0000 Permission is hereby granted to: ROWLAND &MARIE HUGHES JR For property located at: 3 SPRUCE Ct 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. Tune of Construction Value Owner Address: ROWLAND &MARIE HUGHES JR 3 SPRUCE Ct Septic Alteration Residential QUEENSBURY,N.Y. 12804 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency QUEENSBURY SEWER JAY SWEET Plans &Specifications 2009-510 SEPTIC ALTERATION RESIDENTIAL $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday, October 26,2010 (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 T Quee ury- day, October 26,2009 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090510 Application Number. A20090510 Tax Map No: 523400-302-014-0001-066-000-0000 Permission is hereby granted to: ROWLAND &MARIE HUGHES JR For property located at: 3 SPRUCE Ct 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: ROWLAND &MARIE HUGHES JR 3 SPRUCE Ct Septic Alteration Residential QUEENSBURY,N.Y. 12804 Total value Contractor or Builder's Name/Address Electrical Inspection Agency QUEENSBURY SEWER JAY SWEET Plans &Specifications 2009-510 SEPTIC ALTERATION RESIDENTIAL $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday, October 26,2010 (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 thrter/ o y, October 26, 2009 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement ......................... r' ' OFFICE USE ONLY TAX MAP N0. PERMIT NO b - APERMIT FEE1 9 2009 APPROVALS: ZONING TOWN CLERK T /WN OF QUEENSBURY I...................................................,-- �1ILDING&-CODES 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. as� INSTALLER: OWNER: ADDRESS: C' ADDRESS: PHONE NOS. PHONE NOS. (2 yi S"3 LOCATION OF INSTALLATION: RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION= = TOTAL DAILY FLOW BEDROOMS GARBAGE GRI ER 1980 or older X 150 gallon per bedroom = INSTALLED? 1981 -1991 X 130 gallon per bedroom = SPA OR HOT Tq) 1992-present X 110 gallon per bedroom = INSTALLED? Al PARCEL INFORMATION: ✓ 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__ 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: /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 a �D ft. Each trench X u� ❑ 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 hp vnir+ �nrved, or believe t sa-,;: : t. "Z3 '0 I 7P r �{i Q © � t' I 1 i 1 + 1 I l 1 Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/p art: am/pm 742 Bay Rd., Queensb ry, NY i—,- 128 Inspector's Initials: f� NAME: PERMIT NO.:6-14 -/ O /- LOCATION: INSPECT ON: 'L' RECHECK: Comments and/or diagram Soil T n Loam/ Clay Type of Water: i Well Water Waterli aration distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - Y N _N/A Absorption Field: Total length t7 ft.Le Len th of each trench Depth of trenches ' ft. Size of Stone 2 Seepage Pits: Number Size: x Stone Size: Piping ize Type , Building to tank Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: Y N End Ca N Inlet/Outlet Pipes&Baffles Y N Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits Conforms as per Plot Plan Engineer Report and As-Built Y VN Location of System on Property: Front Re Left Side Right Side Middle Front Middle Rear S em 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