2010-581 IA TOWN OF QUEENSBURY
Fora742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20100581 Date Issued: Wednesday, December 22, 2010
This is to certify that work requested to be done as shown by Permit Number P20100581
has been completed.
Tax Map Number. 523400-296-017-0001-001-000-0000
Location: 6 GREENWAY Dr
Owner. CORINNE FOOTE
Applicant: CORINNE FOOTE
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 ( r<Q
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
ET 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100581 Application Number. A20100581
Tax Map No: 523400-296-017-0001-001-000-0000
Permission is hereby granted to: CORINNE FOOTE
For property located at: 6 GREENWAY Dr
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: CORINNE FOOTE
TRAVIS &NICOLE AKINS Septic Alteration Residential
6 GREENWAY Dr Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2010-581
septic alteration residential
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,December 22,2011
(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 expiration date.)
Dated at the Town of Queensbury; Wednesday, December 22, 2010
SIGNED BY V 7 for the Town of Queensbury.
Director of Building&Code Enforcement
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Community Development Office " ����
Town of Queensbury • 742 Bay Road • Queensbury, New York •1 28 04
Office Use
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TAX MA /7_/—!
/ PERMIT NO._J _e j PERMIT FEE_ 2_,S160
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINEI
BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW FORE ISSUAN E OF A VALID PERMIT.
OWNER: cq(4.4(6 IO Jre - n l ,tt�'
r l� liS/N�Ct�I/— f' INSTALLER: �/JG> 1 biz_Ulm
ADDRESS: r� —
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�CJ — ' -7)-K.-1S�C..- ADDRESS:--- P ) • S� ,X 2-�� 6
PHONE NOS._7'0 _ -_-__ Q/ PHONE NOS./96 — o Sa
LOCATION OF INSTALLATION:
RESIDENCE INFORMATION:
NO.OF COMPUTATION
YEAR BUILT BEDROOMS LOW
(Gallons per bedroom) GARBAGE GRIND
1980 or older i' X 150 = 9455 INSTALLED?
1981 -1991 X 130
SPA OR HOT TUB N -
1992-present x 110 = INSTALLED? `"`
PARCEL INFORMATION:
V TOPOGRAPHY: FLAT RLLIQ OSTEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND ` LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT IPTH?
✓ 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: Locro 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? ISize? 1 L
El TERNATIVE SYSTEM Bed or other type?
11(
0 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.
I have read t -• ations with respect to this application and agree to
e by these -n. -11 require ir-nts of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sa tary Sew._e , )osal if. nance. codesCa,queensbury.net
A. t o
i• ature of Pers•n Responsible aft,Date VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.net
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Septic Inspection Report
Office No. (518) 761-8256 Date Ins rqiuor-'' ed.
Queensbury Building &Code Enforcement Arrive: % ' ;,rt: \'lj twTham/pp
742 Bay Rd., Queensbury, NY``12804 Inspector's Initials ...
NAME: X '-� RMIT NO.:
LOCATION: (r .N,i,,:;C AT INSPECT ON: —2 0
RECHECK:
Comments and/or diagram
Soil Type: m I Clay
Type of Water - v1uni / W ter
Wate ' ion distance1 "`^ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
[150'to well required if NOl
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number 1
.,i
Size: l L` x 1;
Stone Size:
Piping Size Type
Building to tank Lk" 1)C.-k-1 yrr`
Tank to D tifla» x �� 1-)02-3z:—)
Distribntiart' azd/;Pili
Opening Sealed: 4' Y N
End Cap Y N
Inlet/Outlet Pipes&Baffles N
Manholes 12"or less below grade -7,;,77' N
[provide extension collar if Yes] 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
ETU Maintenance Contract Y N
provided
Location of S stem on Property:
Fron Left Side--- Right Side Middle Front Middle Rear
stem Us- S e
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
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