2006-816 .4` TOWN OF QUEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201
lo_ Qu rY�
Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20060816 Date Issued: Wednesday, January 23, 2008
This is to certify that work requested to be done as shown by Permit Number P20060816
has been completed.
Tax Map Number. 523400-301-009-0001-006-000-0000
Location: 23 APPLEHOUSE Ln
Owner. RICHARD & MARY SPECTOR
Applicant RICHARD & MARY SPECTOR
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 the4
4l -.
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: P20060816 Application Number. a20060816
Tax Map No: 523400-301-009-0001-006-000-0000
Permission is hereby granted to: RICHARD & MARY SPECTOR
For property located at: 23 APPLEHOUSE Ln
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: RICHARD & MARY SPECTOR
23 APPLEHOUSE Ln Septic Alteration Residential
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2006-816
septic alteration
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, November 16, 2007
(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 Qu nsb d;{ ► :vember 13, 2006
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Richard Spector 200616 Ii /, •�.
TAX 'ERMIT FEE ) ,/f� ,
,Mary. Spector , , ,
APF Ivan Bell, Contractor Septic K I
,
23 :Opplehouse Lane , ,
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. _r
OWNER: ( L ( CC/O r INSTALLER: I /--.? 5 SC // L
ADDRESS: 4ff(e /`C(J--S( (04---C ADDRESS (C) 4---c t 6---0 r to A- 5/^
PHONE NOS. 7 V —7/ 41' PHONE NOS. 2 W-179 k
LOCATION OF INSTALLATION:
NO.OF 3 RESIDENCE INFORMATION:
YEAR BUILT BEDROOMS X COMPUTATION= = i TOTAL DAILY FLOW
• f/ GARBAGE GRINDER
1980 or older X 150 gallon per bedroom = 7 .) INSTALLED?
1981 -1991 X 130 gallon per bedroom = SP• +'HOT TUB
1992-present X 110 gallon per bedroom I = IN • LED?
i
/
PARCEL INFORMATION:
/ / .
✓ TOPOGRAPHY: FLAT ROLLING(\STEEP SLOPE ASLO'
✓ r
SOIL NATURE: SAND LOAM ' ,Y OTHER
72/i
✓
GROUNDWATER: AT WHAT B PTH?414.—/ BEDROCK/IMPERVIOUS MATE- AL: AT
WHAT DEPTH? /
✓ DOMESTIC WATER SUPL /MUNICIPAL ELL- --__,
(IF WELL: WATER SUPPLY FROM ANY SEP C-SYSTEM ABSORPTIIN IS FT. )
✓ PERCOLATION 6 T: RATE IS 7`,A - - MIIN - R INC (TEST TO BE '
COMPLETED BY A LI SED PROFESSIONAL ENGINEER OR ARCHIT T) .e
PROPOSED SYSTEM FOR NEW CONS RtCTION: All individual sewage ' posal syster must be de•'gned by
a licensed professional engineer or architect (urhlQss installed in a Plannin oard app a fed subdivision). Aid 250
gallons to the size of the septic tank and leac fieleach garbage grinder, sp. . whirlpool tub.
(..-.)6 5
/ SEPTIC TANK:/oO() GALLON (MIN. SIZE IS .00 GAL.) TILE FIELD: EACH TRENCH d FT.
/ TOTAL SYSTEM LENGTH:D-0(') FT. SEEPA . PIT S): HOW MANY? it
✓ SIZE OF EACH FT. X FT.
,7 SIZE OF STONE TO BE USED: # ( /DEPTH OR THICKNES / 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.
1. 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 by these and all requirements of the Town of QUESTIONS? CALL 761-8256 OR EMAIL
Queens - Sanitary Sewage Disposal Ordinance. codes@queensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
t? WO ?/li www.queensbury.net
_ .i/(1("
ignature of Person Responsible Date
' Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury,NY 12804
V-- to co-
1-=, ()'`A-71'J4
Septic Inspection Report f ff
Office No. (518) 761-8256 Date Inspection requ: t
Queensbury Building &Code Enforcement Arrive: ND •IP a p ..rt: m
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: J --
NAME: G�0 PE'i� NO.: 1p a/6
LOCATION: �¢. - �- IN.%'EU ON: ty nlitopo W t '7
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.
Absorption Field: Total length ft.
Length of each trench _ ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size:
Stone Size: __
Piping Size Type
Building to tank C.iAr»,kjC)
Tank to Distribution Box ‘` `
Distribution Box t9- ' Id Pit 1-A\I ? N
Opening Sealed / Partial
End Cap 4y)')
Inlet/Outlet Pipes&Baffles �..Y
Location / Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft
Conforms as per Plot Plan Y `v�� �'"�J `'
Engineer Report and As-Built Y N
Location of System on Property:
Front Rear Left Side Right Side
Middle Fr•nt _ ,�_Q Rg�r
_mUr ' s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 021006
Last revised 116/05
I_1 Richard Spector 20061‘
rR. ri ra \S Mary Spector
il &Ia. Lem Ivan Bell, Contractor Septic
23 Applehouse Lane
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REVIEWED BY \_ .41ra"_---i*
DATE________
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