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2006-899 TOWN OF QUE E NSBURY Iwo742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20060899 Date Issued: Wednesday, January 09, 2008 This is to certify that work requested to be done as shown by Permit Number P20060899 has been completed. Tax Map Number: 523400-297-009-0001-001-000-0000 Location: 286 MEADOWBROOK Rd Owner. WESLEY & VICTORIA MC NEES Applicant: WESLEY & VICTORIA MC NEES 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, (awaa,,„.94 f. 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: P20060899 Application Number. a20060899 Tax Map No: 523400-297-009-0001-001-000-0000 Permission is hereby granted to: WESLEY&VICTORIA MC NEES For property located at: 286 MEADOWBROOK 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: WESLEY&VICTORIA MC NEES Septic Alteration Residential 286 MEADOWBROOK Rd QUEENSBURY,NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency IBS SEPTIC &DRAIN ATTN: IVAN BELL 2 LOWER WARREN St OUEENSBURY,NY 12804 Plans&Specifications 2006-899 septic alteration $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,December 20,2007 (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'.' = • eens• • , esda ,December 20,2006 i SIGNED BY it 4 for the Town of Queensbury. Director of Building&Code Enforcement 14 _ I OFFICE USE ONLY #• r RF ED • • TAX MAP NO. PERMIT NO. 66- ERMIT FEE •• DEC , 9 :06 APPROVALS: ZONING TOWN CLERK TOVviv or �"v�t URY i _SU LU N.GAND_COLE__; 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: LA- 5 j c !`z _r-r c INSTALLER: f/�, �r / ADDRESS:IN t 6' (C„do C✓ &oo!t r'd ADDRESS: #7}-- (C7 CL--c/76.-0,-tyle-t, i7 PHONE NOS. -3 6 1--- 6- ! V0 PHONE NOS. 7 9i— s--(¢ LOCATION OF INSTALLATION: NO.OF RESIDENCE INFORMATION: YEAR BUILT BEDROOMS X I COMPUTATION= = TOTAL DAILY FLOW GARBAGE GRINDER 1980 or older X 150 gallon per bedroom j = INSTALLED? 1981 -1991 e _ 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 . SAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH??4— BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAX 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 tank and leach field for each garbage grinder, spa or whirlpool tub. ✓ SEPTIC TANK: GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH FT. ✓ TOTAL SYSTEM LENGTH: FT. SEEPAGE PIT(S): HOW MANY? ✓ SIZE OF EACH FT. X FT. ✓ SIZE OF STONE TO BE USED: # ► / 'E' H OR THICKNESS FT. I✓ BED SYSTEM SIZE: , ✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE ✓ HOLDING TANK SYSTEM:(If required) NS. OF TANKS: /SIZE OF EACH ✓ GALLONS./TOTAL CAPACITY: GAL. I NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN `:.I 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 Queensbury Sanitar Sewage Disposal Ordinance. codes@queensburv.net / VISIT OUR WEBSITE FOR MORE INFORMATION www.queensburv.net Sign:tu - •f P- .son R ponsible Date 34`-,- Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 Septic Inspection Report �i Office No. (518) 761-8256 Date Ins 'on request received: 5///U 7 Queensbury Building &Code Enforcement Arrive: _ am/p part. am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector`s Initials: NAME: mc, Nee PERMIT . 06 9 LOCATION: cc-(2 ,Atc oVV- NSECT ON: �� RECHECK: Comments and/or diagram Soil Type: SanClay Type of Water:wuricipal Well Water /,,j/ Waterline separatto e -nce ft. Well separation distance ft. C.7/4_1(..- Other .7/ULOther wells: — _ft. —_- Absorption Field: Total lengthft•Length of each trench ____-___. ft• 2 Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x-- - Stone Size: Piping Siz Type Building to tank If rjc� U Tank to Distribution Box it r1t2&-- Distribution Box to Field/ Pit Opening Sealed: Y/ NJ Partial End Cap flet Pipes &Baffles V,Y N Inlet/Outlet Location / Separations Foundation to tank 71°LL ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan __Y_ _ N —go/L-7- Engineer Report and As-Built Y N Location of System on Property: Front Rear Left Side Right Sid Middle Front Middle Rear System Use Status• Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 021006 Last revised 1/6/05 • I . . 7 . - . ---.........-. . . . . \',..) • i 1 • I 1...._.. . . ,1t i . . I \ ...'..... .• '• -. \ . . ' .. • ll 1 (1/170 ---)ad<:7 , J72,79 In i .... lo S Septic Inspection Report Office No. (518) 761-8256 Date I ip )equest received: Queensbury Building &Code Enforcement Arrive: am/pmpart: am/pm 742 Bay Rd., Queensbury, NY�1/22`804 Inspector's Initials: \-1/`-L- NAME: / NAME: P/�t�'z C/I/'- &47 PERMIT NO.: U� LOCATION: ��6/4c'') /'C 7Th INSPECT ON: 47.171, 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: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field / Pit Opening Sealed: Y/ N/ Partial End Cap Inlet/Outlet Pipes&Baffles Y N Location/ Separations Foundation to tank ft• 4 "l r /6,4,0(/ 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: Appr ed P 'al Approved and needs to be re-inspected, please call the Building &Codes Office isapproved Last revised 021006 Last revised 1/6/05 • i 16(2'-• 11119.,../06' dr(k"- I Oa C 5 (,/ V a Ltd---- 7-65(7)/C-^-\ Glr6 ricc.d064 / `)J A J (LH a 6--266i72/2/0;7 Septic Inspection Report j Office No. (518) 761-8256 Date Ins io request received: Building&Code Enforcement Arrive: 5 am/ impart: am/pm Queensbury �� 742 Bay Rd.,Queensbury, NY 12804 Inspector's Initials: PERMIT NO.: 06-07 NAME: �� ot,._) b�Do ..LOCATION: 2. 7 ' • INSPECT ON: RECHECK: Comments and/or diagram Soil Type: Sand I 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 . T__ ft. Size of Stone Seepage Pits: Number Size: -- ----�- Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: Y/ N/Partial End Cap 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:. Approved Partial Approved and needs to be re-inspected,please call the Building&Codes Office Disapproved Last revised 021006 Last revised 1/6/05