2011-488 �A\ TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
OA/
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110488 Application Number: A20110488
Tax Map No: 523400-302-018-0002-022-000-0000
Permission is hereby granted to: JOSHUA&RACHEL LOGAN
For property located at: 3 RIPLEY P1
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: JOSHUA&RACHEL LOGAN Test Pit/Perc Test Review
3 RIPLEY P1 Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-488
DEEP HOLE/PERC TEST
$200.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 28, 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 5,7cpiration . e
--•.., f A
Dated at the To n of Queensbury; •/, '!•' ' ,•sday, September 28, 2011
1 . ;ti wti
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
I/ 7-1
Town of Queensbury• Building&Codes Enforcement Office■742 B ,t '}
DEEP HOLE/PERC TESTI `\r°i; K 1 I yR I
Request for Town Engineer R 41W _
;t.4t;Y
-1'1:511c;'13-1
Property Owner: 3064 L.06Ma Phone:
Property Owner's
Address: 22�j 1 PLe-1 f tpe, (aim;N1S'tsI A'IG`r
Location of Test: Tax ID#:
*Applicant's Engineer: UG455 4 44A1 .- A Ct4 inEequat Phone: — HOS
Applicant's Agent: tuiAt•I 'DI.L, Phone: r►'I,r
Additional Notes: 301 , / --? 2 2_
1. Reason for Request? New Septic System ✓ Replacement Septic System Failed Septic System
Subdivision Site Plan Review
2.Are Wetlands present? YES NO UNKNOWN
*Note: Applicant is required to engage an engineer for design and testing of the system. The Town
Enaineer's responsibility is to witness system testing only.
PLOT PLAN: Plot plan, to scale, to be submitted with application
FE:
a. $ 200 Flat ee Date Paid: 7-2 7J/
Check No.:
b. OR Fee to be determined during To Be Determined:
Site Plan /Subdivision review process
SIGNATURE:
In carrying out the provisions of Article IV, the Local Board of Health or the enforcement officer may
engage the services of a qualified professional consultant for expert review and recommendation arising
from the carrying out of the provisions of Art. IV, including but not limited to the review of plans,
specifications and reports, attendance at inspections, dye tests, deep hole test pits, septic related deep
hole and percolation tests, system installations, and any other aspect of any matter contained in this Art.
IV, and any costs incurred in such review shall be paid to the Town by the owner of the property before
any approval can be granted under this Art. IV shall become effective within 30 days of presentment of an
invoice for same, whichever is sooner. Such costs shall not exceed $1,500 without prior written notice to
the party to be charged with same.
My signature below indicates I have thoroughly read and understand the instructions, agree to the
submission requirements and have completed the application. I also fully understand that additional
engineering fees may be necessary per Town of Queensbury Local Law 136-14D.
SIGNATURE OF APPLICANT: // Date:
SIGNATURE OF AGENT: Date: 27 .-6 Lii/
Original (B&C File) Canary(Planning) Pink(Applicant) Gold (Town Clerk)
\L7/..)
Septic Inspection Repo
Office No. (518) 761-8256 Date Inspection req .� \ 0
Queensbury Building&Code Enforcement Arrive: 2.'7b am �- : 7- am 't
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: jii..�
NAME: Lo GA PF T. NO.: k
LOCATION: ?j RARE' P (--I1 ON:
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.
Well Casing Length 50' +/ - Y N N/A
[150'to well required if NO]
Absorption Field: Total length ft.
Length of each trench _ R.
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
End Cap Y N
Inlet/Outlet Pipes&Baffles Y N
Manholes 12"or less below grade Y—N
[provide extension collar if Yes] Y N
Location/Separations
Foundation to tank
Foundation to absorption ft. AS
Separation of Pits
Conforms as per Plot PlanN
Engineer Report and As-Built Y—N
ETU Maintenance Contract Y_ N
provided
Location of System on Property:
Front • -.r Left Side Right Side Middle Front Middle Rear
em U - Ss:
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspecfion Fwrns\Septic Inspection Report_03 29 10.doc
L
RUCINSKI HALL ARCHITECTURE �v�
4-�
Ronald Richard Rucinski N ,cJ
Ethan Peter Hall G\c5G
627 Maple Avenue ¢`J,v�
Saratoga Springs NY 12866 P
Voice 518 580 1905
Fax 518 584 5012
Email ephallcnycap.rr.com
Septic Install for Logan Residence
13 Apr 2013
APR 16 2013
John O'Brien—Town of Queensbury Building Department
742 Bay Road
Queensbury NY 12804
Re: Septic Installation for Logan Residence—3 Ripley Place
John,
At the above referenced project location I observed the installation of the sewage disposal system
including the septic tank, distribution box and Eljen bio-mats prior to back fill. All items appear to
be installed in accordance with the construction documents and are acceptable to this office.
If there are any additional questions please call to discuss.
Regards, ' r %.
00 ei / .'
!
han Peter H. 6,4' , '.
Architect 0,, -,
BUlUt
Y:\Ivan Bell Septic(IBS)\Logan Septic\Letter 12 Apr 2013.doc 1
epi,. s . ��
ies i4
ns
Septic pection Report
Office No. (518) 761-8256 Date Inspection req ; -',• :
Queensbury Building &Code Enforcement Arrive: '"�': • -part: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia . ,9
NAME: o QQrl P_• IT NO.:
LOCATION: 3 R I P 0 0:-(ti pi a e...? NSPECT ON: is
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.
Well Casing Length 50' +/ - Y N N/A
[150'to well required if NO]
Absorption Field: Total length ft. Tt�`,'Af i IAV .14\
Length of each trench ft. �E
Depth of trenches ft. II - 1.01-1
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
End Cap Y_N
Inlet/Outlet Pipes&Baffles Y N
Manholes 12"or less below grade Y._N
[provide extension collar if Yes] _Y__..N
Location I 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
ETU Maintenance Contract _Y_N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
stem U S us:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report_03 29 10.doc