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2008-294 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. P20080294 Date Issued: Thursday, August 26, 2010 This is to certify that work requested to be done as shown by Permit Number P20080294 has been completed. Tax Map Number. 523400-301-012-0003-074-000-0000 Location: 34 ZENAS Dr Owner JASON & DIANE FOGLIETTA Applicant: JASON & DIANE FOGLIETTA 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 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: P20080294 Application Number: A20080294 Tax Map No: 523400-30 1-012-0003-074-000-0000 Permission is hereby granted to: JASON & DIANE FOGLIETTA For property located at: 34 ZENAS 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: JASON &DIANE FOGLIETTA 34 ZENAS Dr Septic Alteration Residential QUEENSBURY,NY 12804 Total value Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2008-294 SEPTIC ALTERATION RESIDENTIAL $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,June 11,2009 (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 T wn of y, June 11, 2008 tfw a esda SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement /__ �J0/ � w___^_�-r'FFICE USE ONLY-----"`_________�_______; %_____________________A R TAX MAP NO. HERMIT NO. ERMIT FEE ; APPROVALS: ZONING TOWN CLERK ; A 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. ---_� OWNER: INSTALLER: ADDRESS: � V )—r ADDRESS: d PHONE NOS—Q61 PHONE NOS. LOCATION OF INSTALLATI N: NO.OF RESIDENCE INFORMATION: BEDROOMS YEAR BUILT X COMPUTATION= = TOTAL DAILY FLOW GARBAGE GRINDER 1980 or older X 150 gallon per bedroom = S 6 INSTALLED? 1981 -1991 X 130 gallon per bedroom = SPA OR HOT TUB 1992-present X 110 gallon per bedroom = INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: Flat rolling Steep slope %Slope ✓ SOIL NATURE: Sand Loa�m/ Clay Other ✓ GROUNDWATER: At what depth? /&' ✓ BEDROCK/IMPERVIOUS MATERIAL: At what depthV. /17--> ✓ DOMESTIC WATER SUPLY: Municipal-4)rWell (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: 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 lengt ft. 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 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. I have read the regulations with respect to this application and agree to abide y these and all requirements of the Town of QUESTIONS? CALL nsbur .n OR EMAIL Queensbur nitary Sewage Disposal Ordinance. codes@gueensburv.net VISIT OUR WEBSI.ci FOR MORE INFORMATION www.aueensbury.net nature of Person Responsible Date Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 B 5-LGL 6/06 Septic Inspection Report Office No. (518) 761-8256 Date Ins ctioere Queensbury Building &Code Enforcement Arrive: t: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's InitiaNAME: �l r'�`TA -�cfiWLOCATION: ��7�� ti�et �-�`1 -C��ri RECHECK: 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: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field / Pit Opening Sealed: Y N End Ca _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 PI o _ N Engineer Report a As-Buil Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use 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 Septic Inspection Rep rt Office No. (518) 761-8256 Date Ins ction r e r ed: Queensbury Building &Code Enforcement Arrive: ,9epart: a n< 742 Bay Rd., Queensbury, NY 12804 Inspector's Initia NAME: f MIT NO.: .2 7 LOCATION: SPECT ON: RECHECK: Comments and/or diagram Soil T Loam / Clay Ty of Water: ell Water lk-la 5e, i y7 t Waterline separation distance o ft. Well separation distance ft. V Other wells: ft. Well CasingLength 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: Piping Size Type Building to tank Tank to Distribution Box ii L Distribution Box leld Pit -5 << �F - Openiri —Sealed: N End Ca N Inlet/Outlet Pipes &Baffles Y N Location Separations Foundation to tank r ft. Foundation to absorption ft. v L1 Separation of Pits Conforms as per Plot Plan —YZZV Engineer Report and As-Built _ N Location of System on Properly: Front ear Left e�Right Side Middle Front /iddle Rear S s em Use S tus: Approved Partial Approv d ing o es Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc zC�4 a Q ZIA � 1 LA i FR I �-ve I sx j evidence of,fenc 1 thaf. have i � I 0 r � � I � I 1 i r v of obS rdold, or .uelievfe ! save evidence of, .,. ^ as ksousas <;9�!ls, trees, fences, etc.. Ghi, dOC MP!3nt, i also represent that i have t y.asu,ed .',e distanceS set forth on tha dia 3am." l �[ pTPU 3 i� i