2011-579 TOWN OFQ UEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110579 Date Issued: Monday, November 28, 2011
This is to certify that work requested to be done as shown by Permit Number P20110579
has been completed.
Tax Map Number: 523400-301-006-0002-046-000-0000
Location: 28 SWEETBRIAR Ln
Owner: PAMELA MILLER
Applicant: PAMELA BOYLE
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
` jo 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110579 Application Number: A20110579
Tax Map No: 523400-301-006-0002-046-000-0000
Permission is hereby granted to: PAMELA BOYLE
For property located at: 28 SWEETBRIAR 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: PAMELA MILLER Septic Alteration Residential
P.O. BOX 1238 Total value
BOLTON LANDING,NY 12814-000
Contractor or Builder's Name/Address Electrical Inspection Agency
IBS SEPTIC &DRAIN
ATTN: WAN BELL
2 LOWER WARREN St
QUEENSBURY,NY 12804
Plans&Specifications
2011-579
septic alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,November 23,2012
(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 Trn`"acQueenury;Q /We nesday,November 23,2011
r
SIGNED BY L�/•Zvi 2 /V x,--/>"
p" for the Town of Queensbury.
Director of Building&Codenforcement
,';ion
OFFIC SEONLyY ; n
TAX MA O. � 4/4RMIT NO.�� ERM#T FEE �� �' �' }
Ii)
APPROVALS: ZONING TOWN CLERK ` TOV�[�]p EENSBi/'Y
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: 'GILDING& CODES
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE
ISSUANC/75F A VALID PERMIT.
OWNER: (4., 64. eV C'c INSTALLER: .../. , I3 /' Sc et ! C
ADDRESS: ADDRESS: wf 6 ✓- C--f-^l r C 'A-5/
PHONE NOS. PHONE NOS. 9 V —Y j i' /
LOCATION OF INSTALLATION:
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) C° INSTALLED?GRIN E
1980 or older X 150 = � INSTALLED?_
1981-1991 /v4 X 130 = /U614 SPA OR HOT TUB
1992-present A/4
J X 110 = AAR INSTALLED?
PARCEL INFORMATION: t A,�
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE/1 %SLOPE�V fY7
✓ SOIL NATURE: SAND X LOAIVOL CLAYA/4 OTHER
✓ GROUNDWATER: AT WHAT DEPTH? /VA
✓ BEDROCK/IMPERVIOUS MATERIAL AT WHAT DEPTH? 'V
✓ DOMESTIC WATER SUPLY: MUNICIPAL el WEt (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS J V j` ! 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: ffie 0 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: 1
❑ABSORPTION FIELD(WITH NO.2 STONE) Total length 60 ft. Each trench _X��{__ -
/ V
o SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? /V
o ALTERNATIVE SYSTEM Bed or other type?
o HOLDING TANK SYSTEM Total required capacity? 1 Tank size? l V 4. Number of tanks?4f f
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 Queensbury QUESTIONS? CALL 761.8256 OR EMAIL
Sanitary Sewa Disposal Ordinance, codesOaueensburv.net
C-'
f/fe.)-)��e V VISIT OUR WEBSITE FOR MORE INFORMATION
wSignature of Person Responsible di) •aueensburv.net
Town of Queensbury*Community Development Office*742 Bay Road, Queensbury NY 12804
/o /Z nio,\40.,(62.7_
Septic Inspection Report
Office No. (518)761-8256 Date ins•- ,
Queensbury Building&Code Enforcement Arrive: r- 0 C-1 • • �,. : imOr
742 Bay Rd., Queensbury, NY 12804 Inspector's Initial- _�1�
NAME: /2NO.:
LOCATION: 31/4/27F-41 •
L�G.Jee_/ riL{� I = ' ON: - -
RECHECK:
Comments and/or diagram
Soil Ty• -. 'OP' a.m/Clay
Type of Water.-- Water
Waterline separation distance ,ZT -.-‘1NS.)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 Zc` ft.
Length of each trench CL=_.i-1 u ft.
Depth of trenches ft.
Size of Stone e_ T `�CJ� ii'"7vN
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank 1-[ti I' � x%
Tank to Distribution Box 11
Distribution Box to Field/ Pit / k-t;i� (��; C k1` �R-
Opening Sealed: VY N
End Cap N
Inlet/Outlet Pipes&Baffles Y/_N
Manholes 12"or less below grade vSf v
[provide extension collar if Yes] Y
Location/Separations
Foundation to tankC,G;�_ft.
Foundation to absorption ZI ft.
Separation of Pits
Conforms as per Plot P • t/ —N
Engineer Report ani* Y N
ETU Maintena - • tract Y_N
provided
Location of System on Property:
Front R . Left Si Right Side Middle FrontC.1%;;11_,_s1_gat
System Use Sta :
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
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BUilANNG DE-ARTMENT
Based on our limited e)amination,compliance cm
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with our comments F,hat not be construed as
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