2003-351 TOWN OF QUEENSBURY
742 Ba Road eensb NY 12804-5902 51 1 2 y ,Qu ury, ( 8) 76 8 Ol
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF GOMPLINGE
Permit Number. P20030351 Date Issued: Wednesday, January 10, 2007
This is to certify that work requested to be done as shown by Perna Number P20030351
has been completed.
Tax Map Number. 523400-296-017-0001-041-000-0000
Location: WEEKS Rd
Owner ROBERTS GARDENS NORTH PARTNERSHIP, THE
Applicant ROBERTS GARDENS NORTH PARTNERSHIP, THE
This structure may be occupied as a:
Septic Alteration Commercial
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES-NOT relieve the (-3J
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 nfotce ent
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: P20030351 Application Number A20030351
Tax Map No: 5234001296-017-0001-041-000-0000.
Permission is hereby granted to: ROBERTS GARDENS NORTH PARTNERSHIP, T
For property,located at: WEEKS Rd
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: ROBERTS GARDENS NORTH PA Septic Alteration Commercial
105 WEEKS Rd Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
QUEENSBURY SEWER
JAY SWEET
Plans&Specifications
BP 2003- 351 Robert Gardens North
Septic Alteration as per plot plan and specifications.
- I
$35.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday, May 30,2004
(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 of sb r a /►! - 30, 2003
SIGNED BY ' for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Permit—Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury, NY 12804 (518) 761-8256
1. OWNER INFORMATION:
)6c
Office Use
Location of installatpp ..ion: ' ';,� r ��
Map
Tax Ma N c24�. -41
Owner's Name: efin.C./S M 2003
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r5�-1e C c-t Qu Enis�a E
�Address: Pet t D C40E
4-Q/7Airieh
2. INSTALLER'S NAME : � .€ ws Bc{ v PHONE NO. . /3‘",r
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply #of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: No. of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdrm =
1980— 1991 x 130 gal/bdrm =
1991 —present x 110 gal/bdrm =
Garbage Grinder Installed yes ar
Spa or Hot Tub Installed yes__. /
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
To ography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
(j � at what depth I at what depth - , ,
Rolling loam feet feet �w �
Steep slope clay if well; water supply
%slope other from any septic-system
depth: absorption is ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: minute per inch
5. 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 Whirlpool Tub.
Septic Tank: a(ozry gallon (min. size 1,000 gal.)
Tile Field: each trench ft. Total System Length: ft.
Seepage Pit(s): number of size of each: 6- ft. by /a ft.
Size of Stone to be used: # 3 / depth or thickness feet
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE & INFORMATION FOR RESPONSIBLE PERSON(please read)
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 Queensbury Sanitary Sewage Disposal Ordinance.
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to a of responsible person Date