2005-907 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: P20050907 Date Issued: Monday, December 05, 2005
This is to certify that work requested to be done as shown by Permit Number P20050907
has been completed.
Tax Map Number: 523400-316-009-0001-021-000-0000
Location: 10 IRONGATE Rd
Owner: ALBERT & SUSAN ALDEN
Applicant: ALBERT & SUSAN ALDEN
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.
Aq TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050907 Application Number: A20050907
Tax Map No: 523400-316-009-0001-021-000-0000
Permission is hereby granted to: ALBERT & ST JSAN ALDEN
For property located at: 10 IRONGATE Rd
in the Town of Queensbury, to constrict 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. Tyne of Construction Value
Owner Address: ALBERT & SUSAN ALDEN
10 IRON GATE Rd Septic Alteration Residential
Total Value
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
STONE INSTALLATIONS
4305 ROTJTE 50
SARATOGA SPRINGS_ NY 12866-0000
Plans&Specifications
2005-907
SEPTIC ALTERATION
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, November 29, 2006
(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 n of ens ues November 29, 2005
1-1
SIGNED BY k for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY-___._.__.__.____._____.._
RECEIVED
TAX MAP NO. PERMIT N0. 05-907PERMIT FEE>
NOV 2 1 2005
APPROVALS: ZONING TOWN CLERK ;
' ._- %+T�UILDINGJOUEENSBUR-Y
D CODE
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:!� � GL � l Cr S
ADDRESS: 6 4 ✓zePsa vV/� ADDRESS: J Q anCtX
PHONE NOS, r46&9 PHONE NOS.
LOCATION OF INSTALLATION:
......................................................... .....I......................... ...................,...........................................................................................................:.....................................: RESIDENCE INFORMATION:
NO.OF
YEAR BUILT X I COMPUTATION= 1 = TOTAL DAILY FLOW
BEDROOMS
......... . .................1...........;..........................................................,.,,...........a...........;........................ .................................. GARB G
1980 or older X ( 150 gallon per bedroom = i i INSTALLED?R
................................................................ .... .................................................................................................;.........,............. Q....� ...
GRINDER
1981 -1991 X 130 gallon per bedroom = i SPA OR HOT TUB
...............>.............. ........... ............ .
... i = I (� INSTALLED?
1992-present ! X 110 gallon per bedroom
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING—�r STEEP SLOP %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY OTHER
✓ GROUNDWATER: If AT WHAT DEPTH? BEDROCK/IMPERVIOUS MATERIAL: AT
WHAT DEPTH? AL
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT. )
✓ 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 an and leach field for each garbage grinder, or ' (pool tub.
✓ SEPTIC TANK: OG GAL N (MIN. SIZE IS 1,000 GAL.) EACH TRENCH FT.
✓ TOTAL SYSTEM LENGTH: 0 FT. 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. OF TANKS: /SIZE OF EACH
✓ GALLONS./TOTAL CAPACITY. GAL.
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
I ,
;i APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
...................................................:.......:.......................:...................:.:.;.:.:.:.:.,.:.,..,.,..,.........,,......,.,........:..,..:.,...,.:................„, ........:.,.,.........,.,.,.,.R
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 the and all requirements of the Town of QUESTIONS? CALL 761-8256-OR EMAIL
Queensb ry anit ry S age Disposal Ordinance. codes@gueensbury.net
VISIT OUR WEBSITE FOR MORE,INFORMAT119N
www.clueensburv.net
Signa re of fj rs Responsible Date �.
J rt Town of Queensbury - Community Development Office . 742 Bay Road, QLteensbury NY 12804
l
Septic Inspection Report �F "3 %
Office No.(518)761-8256 Date Insp glomquest received: - /C)—s
Queensbury Building&Code Enforcement Arrive: I • 'N am/ rp e Depart: a pm
742 Bay Rd., Queensbury,NY 12804 Inspector's In tials.
NAME: A �f�� PERMIT NO.: ZOOS
LOCATION: T tr��, (��c� 2 p INSPECT ON: 2
RECHECK:
Comments and/or diagram
Soil Type: San / am Clay
Type of Wa • Municipa /Well Water
Waterline sep ation distance ft.
Well separation distance ft.
Other wells: ft.
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone AJ p
See a e Pits: Number
Size: x
Stone Size:
Piping Siz /I Type
Building to tank 649
Tank to Distribution Box u
Distribution Box to Field/Pit —/7d
Z'b
Opening Sealed: Y/N/Partial
End Caps ✓
Location/Separations
Foundation to tank
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan dY 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 Staeus:
Approved
Partial Approved and needs to be re-inspected,please call the Building& Codes Office
Disapproved
Last revised 1/6/05
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„r this rioc;.0 � r;t; d ,3dsn reorelsent that is have �..
n;easur Gistapkes set forth on.the di
agram.''
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