2010-011 TOWN OF QUEENSBURY
^ro 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20100011 Date Issued: Tuesday, December 11, 2012
This is to certify that work requested to be done as shown by Permit Number P20100011
has been completed.
Tax Map Number: 523400-301-015-0001-026-000-0000
Location: 7 WINGS FALLS Ct
Owner: FRANCIS & SUSAN ARCURI
Applicant: FRANCIS & SUSAN ARCURI
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QUEENSBURY
rTh • -
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
Fom 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100011 Application Number. A20100011
Tax Map No: 523400-301-015-0001-026-000-0000
Permission is hereby granted to: FRANCIS & SUSAN ARCURI
For property located at: 7 WINGS FALLS Ct
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: FRANCIS & SUSAN ARCURI Septic Alteration Residential
7 WINGS FALLS Ct
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2010-011
septic alteration residential
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,January 12, 2011
(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 expiratio date.)
Dated at the(fo Que sb iy, / ( ` Tuesday,January 12, 2010
`4� r
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
30/ g ` ' PERMIT
OFFICE USE ONLY
MAP NO. NO. ® /
�( PERMIT FEE
APPROVALS: ZONING
TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:lIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE
RE ISSUANCE OF A VALID
OWNER: ra A L } H. .
C/I\ / INSTALLER: , / if
ADDRESS: , '.A.- JC S
ADDRESS: I d CA—C f
PHONE NOS. I
PHONE NOS. p
LOCATION OF INSTALLATION:
YEAR BUILT NO.OF RESIDENCE INFORMATION:
BEDROOMS X COMPUTATION- = TOTAL DAILY FLOW
1980 or older /. X 150 gallon per bedroom = GARBAGE GRINDER
1981 -1991 X 130 gallon per bedroomINSTALLED?
1992-present =
X 110 gallon per bedroom = SPA OR HOT TUB
INSTALLED?
PARCEL INFORMATION:
✓ TOPOGRAPHY: Flat rolling Steep slop&41 /
Slop.e1��
✓ SOIL NATURE: Sand ��,�
Loa Clay Other,,g
✓ GROUNDWATER: At what depth?4L
✓ BE DROCK/IMPERVIOUS MATERIAL: At what depth? i .1,4
✓ DOMESTIC WATER SUPLY: Municipal Well
(1 (If well: Water supply fr�y septic
✓ system absorption is_p�V/J ft.)
PERCOLATION TESTer minute per inch.
: Rate is_______E±._
(Test to be completed by a lice sed 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 subdiv'
TANKSIZE / GALLON
Ison)(MIN. SIZE IS 1,000 GAL.) Add 250gallons t
each garbage grinder, spa or whirlpool tub. o the size of the septic tank for
SYS M TYPE:
ABSORPTION FIELD (WITH NO. 2 STONE) Total len9ta � �
ft. Each trench�X-�_
❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many?
__,k_6___
ElBed or ALTERNATIVE SYSTEM Size?
other type? / r
❑ HOLDING TANK SYSTEM Total required capacity?
_________42A___
Tank sizes____&_k_ Number of tanks?
•:" 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,
permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation nr
failure to make a material fact or circumstance known hv nr h„s,Ir eensbury, any
C \
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request r- .
Queensbury Building &Code Enforcement Arrive: tom• .M-, '�;.rt: W-
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia s: ✓
NAME: RCI R •ERMIT NO.: kb — O1 ,
LOCATION: _ _ _ G INSPECT ON: — 13 -AC)
RECHECK:
Comments and/or diagram
Soil Ty.-11MeLoam/Clay
Type of Water: _unicipal A ell Water `,
Waterline separation distance FQ r ptec? ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length 2,0 ft.
Length of each trench 1--10!p ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank L-.\ A 6¢V-_ _! \Ap -‘151--N *J(,
Tank to Distribution Box 4 "
Distribution Box to Field/ Pit I-} %L P vL T., F'E.$F-
Opening Sealed: �/
End Cap Vy_N
Inlet/Outlet Pipes&Baffles ✓Y N
Location/ Separations
Foundation to tank ID ft. E,c tS-C\ s1G
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Pla N
Engineer Report a d As- ' _Y— N
Location of System on.Property:
Front ear eft SideRi4ht Sides Middle Front Middle Rear
System Use�tdtus:
�( Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc
4 .. Pipeline SpecialistsJOB 4--j?--,, /1.--.11 /71 /-'"c-- t-y /12
A rils_cilETLATEri, 1,t,
BY: 1c://C- C 1/ OF V
DATE
0 Everett J. Prescott, Inc.
SCALE
Piii,te ),J,
,.-- -
:-..3.L. ______
,,- -
/ I
6/
C ,
.:.
I-i SO?' > 1
0
()Z :co) 1n -12 1Akd1Sc/ 7 .
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection requeved:
Queensbury Building &Code Enforcement Arrive: (Z=10 ajvb- rt: +2-75 a /per
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: `-i
NAME: A ICU � ,9� P • IT NO.: 6�� ol
LOCATION: 3 ; � S C7-j. INSPECT ON: / —'/ {-7O
RECHECK:
Comments and/or diagram
Soil Ty / Clay
Type of Ler. 'IHun' ' ell Water
Wa ' e paration distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length77�fl ft.
Length of each trench go ft.
Depth of trenches 7 —/11ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
01.16114.
Tank to Distribution Box
Distribution Box to Field / Pit
Opening Sealed: _Y N
End Cap Y.__N
Inlet/Outlet Pipes&Baffles _.__.Y N
Location/ Separations
Foundation to tank ft.
Foundation to absorption ft. - ,W" -
Separation of Pits ft.
Conforms as per Plot Plan Y T N
Engineer Report and As-Built _Y_ N l/ ��-'
Location of System on Property: \i'
•
Front Rear Left Side •ight Side Middle Front Middle Rear
System Use Status:
Pa Approved and needs to be re-inspected, please call the Building &Codes Office
F
sapproved
Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc
I I
I ,
, , ,
9
. , ,
--,.., , (i,I , , ,, 1 l91
1 1 � I, A< 1 1 1 1 I �
I) I
C .,_......._. , 1
1
, ,. _ 4 ..i
�4 @� n
i ,^^ f
fate .��
r N1' C` t
1 I 1 1
X11 «•
moi. ---
9
' ti v
(6. 1^�// CJ 6 /�r/� ( af ! C 3
1
IA
I / I
1.._�. I
1
� I 1
rr I
v r ly
(.)c