2015-175 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: P20150175 Date Issued: Friday, June 05, 2015
This is to certifythat work requested to be done as shown byPermit Number
q P20150175
has been completed.
Tax Map Number: 523400-301-007-0001-052-000-0000
Location: 29 BUENA VISTA Ave
Owner: RICARDO REYES
Applicant: RICARDO REYES
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 ( 41)4
4Ipot
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
WO$41 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150175 Application Number: A20150175
Tax Map No: 523400-301-007-0001-052-000-0000
Permission is hereby granted to: RICARDO REYES
For property located at: 29 BUENA VISTA Ave
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: RICARDO REYES Septic Alteration Residential
29 BUENA VISTA Ave
Total Value
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-175
residential septic alteration
PERMIT FEE PAID-THIS PERMIT EXPIRES:
$40.00 Thursday, May 19,2016
(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 T n of ens ry4 +�`/, , ay 19,2015
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT • Office Use Only
c
DATE : �� I .�. Received
1 TaxmMapitI '' Zo yjbTAx APID
41111.111 Pf3rNo
M
�G2�Ns� l/ igTOVUDermit pprovat
LOCATION OF INSTALLATION BUILDING Als:
APPLICANT J G� S 7/,`,� A? ij e r PHONE/E-MAIL
ADDRESS D2 < /C(eA-1A- (/,s f,4
INSTALLER/BUILDER Sid}/V b IA �� 7 r14- PHONE/E-MAIL / -
72 r 7
ADDRESS: /*_ 72-V G leiW
OWNER dlr i ~' /`e PHONE/E-MAIL
Address 229 ✓✓�ieo'"4 //% 1 43--
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: G-14'0 r"5 bf,i2_402_rCPHONE L 9 ,‘
RESIDENCE INFORMATION
Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow
1980 or older Garbage grinder installed Y N
1981-1991 Spa or Hot Tub installed _Y
1-OKI-Present 7L /J-D 6 CT-Z)
PARCEL INFORMATION >n
Topography )iat rolling Steep slope %slope
Soil Nature > -Sand Loam Clay Other
Groundwater At what depth? A.24
Bedrock/Impervious Material At what depth? /1 /4-
Domestic Water Supply >/--Municipal Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate: /` S- per minute per inch(test to be completed by licensed engineering/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank Size /Zs gallons(minimum size 1,000 gallons,add 250 gallons to size for each garbage grinder or spa or hot tub)
System Type Absorption field with#2 stone Total length )S L ft.:Each trench S C ' x
Seepage Pit with#3 stone How many: ;size
Alternative System Bed or other type?
Holding Tank System Total required capacity? Tank size #of tanks
Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will no longer
allow systems to be covered until such time as an As-Built plan is received&approved. The Installed system must match the septic system
layout on file-no exceptions.
DECLARATION: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or
failure to make a material fact or circumstance know by or on behalf of an applicant, shall be void. I have read the regulations
and agree to abide by those and all reqiAremegs of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Print Name: �� c' r' u •e Date: - / y —es
Signature: < Date: j-- /( - /s
Town of Queensbury Building&Codes Septic Disposal Permit July 2014
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256 Li b0-l
Septic Inspection Report
Inspection request received: 5\2-0 t5
Name: 9-"S Inspected on: . IX-\ —
Location: '19 bALArtt016Arrive: V" riledp•.m.
Permit No.: I )—\�"3 Inspector's Initials: T,P
C„ • ents and/or dia.ram
Soil Ty : Sa;c1,1 lty
Type of WatorMu-rliatef—
Waterline separation distance ft. i3k)6AIN .)%15-NA .; 4,94> k;',Z Dt. Je,t.,304.-4
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 2... O ft.
Length of each trench 3� ft.
Depth of trenches Z-v ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank Li" Qvc__ V.--4-O 1 OC-,
Tank to Distribution Box \A" )9l?---3
Distribution Box to Field/Pit / R" 5 -3C m LA" `�tt3SPEW=
Opening Sealed: ✓Y N
End Cap _Y N
Inlet/Outlet Pipes&Baffles .7Y/i N
Manholes 12"or less below grade ✓Y Ni
[provide extension collar if Yes] Y ,J
Location/Separations
Foundation to tank Vb ft.
Foundation to absorption y.t ft.
Separation of Pits ft.
Conforms as per Plot P .- Y
Engineer Report. d As-Built N
ETU Maintenanc. on . : s' .ed Y NC� �` -\(, Np' —�
Location of S stem on Prose
Front Rear Left Side Right Side Middle Front Middle Rear
S stem Use St us:
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
4
f
y`
SEPTIC PLOT PLAN,
cio I HAVE SEEN OR OBSERVED ALL OBJ CTS
�t'k VC> SUCH AS HbUSES. WELLS. TREES, F LACES, ETC
SHOWN ON HIS DOCUMENT.I HAVE PERSON LLY
\/ MEAS le
DIST., E FORTH' ,,,►-I i AGR M. I
T �� `;'GF:r,:1 ur2� DATE
�,�,�Ali �,.�� TOWN F UE • 1 yA
��i` BUILDI G C.7_,:")". ‘ip , -
Review d By al
, T %-dDate:
IfF
1 t _-\-C __,6
1
z_` ZI Go 0 \,,�
?, (.2
$ BU1Lt
_ 1...... , .__ _ I
II
SEPTIC PLOT PLAN
I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HOUSES, WELLS, TREES, FENCES. ETC --
SHOWN ON THIS DOCUMENT.I HAVE PERSONALLY t.", FILE COPY
M D THE DIS'/.•CE SETAi THIS DIAGRAM.
• < - F- 7r
SIGNATURE DATE S-01
. _
MAY 18 2015 ,�,. _ __ �.� •.� �.. �..
TOWN OF QUEENSBURY SD a R-, �'
BUILDING & CODES
rn --------1-ii i
.1-r..,°
s--ery •...
ci,,,\ !
_-\'- ----
, o
'k . ,
,..,
..... .
, .,., : .
s .
. _ _
_i
,,z ,.
q sac
n o1
„,_,V\- '
cck
TOWN OF QUEE . •
CyBUILDING & CiReviewed By: /Attr �/
,�,._��.__._.�..�._.__..�_.�.� ,�_ ..__......��.....� __ _M.�.�...�,_.._y�_..��_.______.. Date: (CMS
9 owe PI fit,. �I SA A