2011-170 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: P20 110 170 Date Issued: Tuesday, December 11, 2012
This is to certify that work requested to be done as shown by Permit Number . P20110170
has been completed.
Tax Map Number: 523400-297=006-0001-031-000-0000
Location: 743 RIDGE Rd
Owner: DANIEL J-SILVEY
Applicant: BMW PROPERTIES LLC
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:, P20110170 Application Number:. A20110170
Tax Map No: 523400-297-006-0001703 1-000-0000
Permission-is hereby granted to: BMW PROPERTIES.LLC
For property located'at: 743 RIDGE 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
'.C►rdinance. Type of Consttucrion Value
Owner Address: BMW-PROPERTIES LLC
292 REYNOLDS Rd Septic Alteration Residential
FORT EDWARD NY 12828-0000 Total Value
Contractor or Builders Name/Address Electrical Inspection Agency
Plans&Specifications
2011-170
septic alteration residential
$40.00, PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,May 05,2012
(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 Town' f Queens Th �d Y 05 2011
a`
SIGNED BY for the Town of Queensbury.
Director.of Building&Code Enforcement
I i F
Community Development Office
Town of Queensbury - 742 Bay Road • Queensbury, New York •12804 C W�
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E3� Ji` ;"U'LENSB R
ILDINCr A Y
Office Use Only r ��
1 PERMIT FEE �7®
TAX MAP NO. PERMIT NO.
APPROVALS: ZONING TOWN CLERK
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: Pr0!f)e14]eS LL (L TISTALLER: Cr,"
ADDRESS: �cl R P.i�o I1-s Rol N Y-1 2 3 T ADDRESS:
PHONE NOS. oZ - I S 7 PHONE NOS.
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LOCATION OF INSTALLATION: -/3 1 Z A uA
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS, Gallons per bedroom GARBAGE GRINDER
1980 or older X 150 = L o INSTALLED? N O
1981-1991 X 130 = SPA OR HOT TUB
1992-present X 110 = INSTALLED? /U O
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE.
✓ SOIL NATURE: SAND LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCKIIMPERVIOUS MATERIAL: AT WHAT DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL, WELL (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpi] (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 length ft. Each trench X
❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size?
❑ALTERNATIVE SYSTEM Bed or other type?
El 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.
have read the regulations with respect to this application and agree to
abide by these and all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sanit S age Dis sal Ordinance. codes(faueensburv.net
� -vLI-i l
Signa urg of Person Responsible Date VISIT OUR WEBSITE FOR MORE INFORMATION
www.aueensbury.net
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Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received: _
Queensbury Building&Code Enforcement Arrive: am/ m Depart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials•
NAME: PERMIT NO.:
LOCATION: i INSPECT ON:
RECHECK:
Comments and/or diagram
Soil Type: Sand 4Kda'VAyl
Type of Water: Munici I ell r
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50'+/- Y N N/A
150'to well required If NO
Absorption Field: Total length ft.
Length of each trench 'ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
qvv
Piping Size Type
Building to tank � ��
CC-
Tank to Distribution Box
Distribution Box to Field Pit
Opening Sealed: Y N
End Ca N
Inle Outlet Pipes&'Baf i s Y N
Manholes 12"or less below grade _ —N
[provide extension collar if Yes Y N
Location Separations Pon
Foundation to tank ft.
Foundation to absorption ft. �A��"'��— ter►
Separation of Pits ft.
Conforms as per Plot Plan Y
Engineer Report and As-Built
ETU Maintenance Contract V Y N
provided
Location of System on Property:
Front R Left Side Right Side Middle Front Middle Rear
st Use S s:
JZ Approv d
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
DI roved
LAPa Whiting uilding Codes Forms\Inspectlon Fonns\Septic Inspection ReporL03 2910.doc
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Community Development O •ice y
Town of Queensbury • 742 Bay Pd.
Queeusbury, New York •12804 PLOT PLAN
• U INU•CO
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Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from
9 gr&erty lines.
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