2008-401 ` TOWN OF QUE E NSBURY
742 Ba Road eensb NY 12804-5902 518 761-8201
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Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20080401 Date Issued: Thursday, August 26, 2010
This is to certify that work requested to be done as shown by Permit Number P20080401
has been completed.
Tax Map Number. 523400-309-018-0001-003-000-0000
Location: 16 ISLAND VIEW Dr
Owner. WINSLOW& JOANNA MC GUIRE
Applicant WINSLOW&JOANNA MC GUIRE
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 (--- a4P x4ft
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.
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TOWN OF QUEENSBURY
i 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
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Community Development- Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20080401 Application Number. A20080401
Tax Map No: 523400-309-018-0001-003-000-0000
Permission is hereby granted to: WINSLOW&JOANNA MC GUIRE
For property located at: 16 ISLAND VIEW 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: WINSLOW&JOANNA MC GUIRE
16 ISLAND VIEW Dr Septic Alteration Residential
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2008-401
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday,August 04,2009
(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 ► e n,ay,August 04, 2008
SIGNED BY f ' _� for the Town of Queensbury.
r.
Director of Building&Code Enforcement
, 1
;30?o —/'' `�
t3 OFFICE USE ONLY ' �/ r'".�" L� 'q' � -
GD
TAX MAP N0.
PERMIT N0. �
ERMIT FEE , JUL' 2 9 2008
APPROVALS: ZONING
TOWN CLERK , ;
T VVN OF QUEENSBURY
APPLICATION FOR. SEPTIC DISPOSAL SYSTEM PERMIT.
I.
A PERMIT MUST BE OBTAINED BEFORE WORK.BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT,
OWNER: '
_ INSTALLER: .:
ADDRESS: - :- 5� 'I li L�.//
t. ADDRESS:
PHONE NOS. '' . 3� ��+f sj(�
PHONE NOS._ / �% %.
LOCATION OF INSTALLATION:
X COMPUTATION>Q
YEAR BUILT NO. RESIDENCE INFORMATION:
.. •:•».•.r...•....•r••».-•.».•». BEDROOMS = T FLOW
'TOTAL DAILY
1980 or older. X 150 gallon per bedroom :
GARBAGE
»-»»» ..........J 0 • INSTALLED R a
IN FL i
1981 -1991 : X 130 gallon per bedroom = (/
1992µpresent X 110gallon SPA OR HOT TUB.
per bedroom = INSTALLED? t�
PARCEL INFORMATION: .
. V .TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE_
✓ SOIL NAT RE;SAND ,
LOAM CLAY . OTHER
1 .GROUNDWATER: AT WHAT DEPTH? , `'
WHAT DEPTH? BEDROCK/IIUIPERVI ►G "ATE AL: AT
✓ DOMESTIC WATER SUPLY: MUNICIPAL_•_;_. WE
(IF WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS IC_Q2�:
✓ PERCOLATION TEST: RATE IS PER MIINUTE 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);Add 250
gallons to the size of the septic tank and leach field for each garbage grinder, spa or h po b:
/ ` � ��:
45' �� SEPTIC TANK: /a�GALLON (MIN. SIZE IS 1,000 GAL.J it€- �
EACH TREJVC
✓ H �1�_FT.
TOTAL SYSTEM LENGTH:rFT, SEEPAGE PIT(S): HOW MANY?'
✓ SIZE OF EACH FT.X � _ FT.
•
✓ SIZE OF STONE TO BE USED:# /DEPTH OR THICKNESS FT,
✓ BED SYSTEM SIZE: X •
•
✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
✓ HOLDING TANK SYSTEM:(If required) NO.OFTANKS: /SIZE OF EACH
✓ GALLONS.,/TOTAL'CA- PACITY.•—_—_GAL.
•
!1•MI.1.41.1•Irlrl•14.1!1•Iry1 V rlrl•14r1.1.1.14.1•IIrlrl•Irl•1.1.11.1.1.1•Irlr1Y•i•1.1•I.Irlrl.l•1.1.1.YI.1•IY•IV.1.1.41.1.1.1'1.1»r14.1•Irl•i•1.1.1•1.1.1•IrUI•Irl•1.1»•Irl•1 W I.1»»».1•
•
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED Bl
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED, A TOWN
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 QUESTIONS? CALL 761.8256 OR EMAIL
Queenabu itay1 Sewage Dis al Ordinance. • codesaaueenaburv),et
VISIT OUR WEBSITE FOR MORE INFORMATION
RMATION
d www,cueensbur�r,het
S e of Per n esponslble ate
Town of Queensbury • Community Development Office:■ 742 Bay Road, Queensbury,NY 12804
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Septic Inspection Report LNG
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Office No. (518) 761-8256 Date Inspection req • - - ed: _
Queensbury Building &Code Enforcement Arrive: 7.ca • !r`Pepart: 3'- /�a i pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initial k►,!1
NAME: MCQ t 2.F PE/IT NO.: OS—Lin V
LOCATION: %to tt_F+60 V►ELb CE. I :PECTON: "7--I1-045
RECHECK: L_> oFF Ti)310 CAVNI3EL R'
Comments and/or diagram
Soil Type: Sand/ Loam/ Clay
Type of Water: Municipal / Well Water
Waterline separation 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 _ ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x �-
Stone Size: _ _ \o
Piping Size Type c_ j -C-'kC--
Building to tank
Tank to Distribution BoxC} -SVi---(\\C
Distribution Box to Field/ Pit
Opening Sealed: _Y_N
End Cap _Y N
Inlet/Outlet Pipes &Baffles _Y_ N
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
System Use Status:
proved
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
11'301\4..1
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection re t • ' _
Queensbury Building &Code Enforcement Arrive: ` , a Q rY � '2 C 1
742 Bay Rd., Queensbury, NY/ 12804 Inspector's Initials: L/
NAME: tIG6\_.‘A�E MIT NO.: Q —'-}-O�
LOCATION: IL l on \1 Ea) nR o , INSPECT ON: (6—L-1 --O
RECHECK:
Comments and/or diagram
Soil Type at_.
Type of Water: Municipa a Water
Waterline separation distance ft.
Well separation distance 1 rio-r. ft.
Other wells: ` l"ft.
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length ft.
Length of each trench h\ C7 ft.
Depth of trenches .ft.
Size of Stone ‘ ‘s.—g-K14
Seepage Pits: Number _
Size: x
Stone Size:
Piping Size Type
Building to tank kV' 1 QJ
Tank to Distribution Box `' �C.--k i-%tv
�/
Distribution Box to Field / Pit /14c' QL}
Opening Sealed: N
End Cap N
Inlet/Outlet Pipes & Baffles :/Y N
Location / Separations
Foundation to tanks .;Ft.
Foundation to absorption wt.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built Y_ N
Location of System on Property:
Flo _ a Left Side Right Side Middle Front) Middle Rear
S stem Use St s:
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