2015-312 411111kbaki TOWN OF QUEENSBURY
^� 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150312 Date Issued: Tuesday, September 08, 2015
This is to certify that work requested to be done as shown by Permit Number P20150312
has been completed.
Tax Map Number: 523400-308-006-0001-070-002-0000
Location: 14 WARREN Ln
Owner: DANIEL LECUYER
Applicant: DANIEL LECUYER
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 /f
property owner of the responsibility for compliance with Site Plan, �d
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
Oro742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150312 Application Number: A20150312
Tax Map No: 523400-308-006-0001-070-002-0000
Permission is hereby granted to: DANIEL LECUYER
For property located at: 14 WARREN 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: DANIEL LECUYER Septic Alteration Residential
14 WARREN Ln Total Value
QUEENSBURY NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
ML CONTRACTING
798-0317 OR 955-8168
34 WARREN Ln
OUEENSBURY NY 12804-0000
Plans&Specifications
BP 2015-312 Legal Address: 14 Warren Lane
New Septic System Installation (new mobile home to be placed on lot in future) This lot is part of a 2 lot
subdivision: SB 20-2005
approved by the Planning Board on November 22, 2005
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 16, 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 o ueen ry�f J� / ,July 16, 2015
�de.
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
•
SEPTIC DISPOSAL APPLICATION Office Use Only
Received
DATE: 74/2_d Tax Map ID .(o—1 -�p•? -
TAX MAP ID: Permit No. JL5 a
Permit Fee . •
ZONE: -
APPLICANT 0/ "'r /c�c C/ y.- PHONE/E-MAIL [5-/?-30?-/-.S6.-7/
74- ADDRESS Cj w4/&/e-L it/ L E ry yLy t/ y / ) >C
INSTALLER/ Y 4e...1.Y LVN Ur1 PHONE/E-MAIL (�
BUILDER /FX /
OWNER ��/-L Li /2.
ADDRESS 3YL.t/r9yi-14-Ln/ C2gvac y ft,/ //2i�o7
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE:
PHONE/E-MAIL
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older Garbage grinder installed —Yes,Y No
1981-1991 Spa or Hot Tub installed _Yes No
1992-Present
PARCEL INFORMATION
Topography Flat rolling Steep slope %Slope
Soil Nature x Sand Loam Clay Other
Groundwater At what depth:
Bedrock/Impervious material At what depth:
Domestic Water Supply )1° Municipal Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate: per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size /OOC) gallons(min. size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total lengthc9'4'4) ft.;Each Trench
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 known by or on behalf of an applicant,shall be void. I have read the regulations and agree to
abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinan e.
PRINT NAME: 4y11 ie-Z 4, C v)7 t�, DATE: / - o s
SIGNATURE: 41. DATE:
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
Town of Queensbury Building & Code Enforcement V'6.)1 .
Office No. (518) 761-8256 i0—
SepticInspection Report
Inspection request received: 1 t 1 LOIS
Name: l� Inspected on: ' Z
Location: 14\ 1NC�.VY.� L-+ J Arrive: �• a.m./p.m.
Permit No.: \S'3\ Inspector's Initials:
IFF" \�
Comments and/or diagram
Soil Type: and Clay
Type of Water: , Gip- /Well Water
Waterline separa ion distance ft. , ci55-- eilb
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 723=1C>ft.
Length of each trench .5 'ft.
Depth of trenches 'Z`'* ft.
Size of Stone
Seepage Pits: Number
Size: _
Stone Size:
Piping Size �Ty�pe�,
Building to tank 4 _z�k� *C0
Tank to Distribution Box
Distribution Box to Field/Pit �4X)
Opening Sealed: N
End Cap VY/ N
Inlet/Outlet Pipes&Baffles VY N
Manholes 12"or less below grade Y
[provide extension collar if Yes] Y NI+
Location/Separations
Foundation to tank ft. f`)MW r"
Foundation to absorption ft. ��"�` ^� L�
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built Y N
ETU Maintenance Contract provided Y N
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Statu
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
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(DEED'. I WET. ;)
4 Lands of James and JoAnn Connelly
(6581491)
Tax Mep No.. 308.06-1.71
DEED: 150 F T. )
160.J
Tax Map No.: 308A8.-1.72.2
APPROVED under authority of a resolution
adopted %) " % 7' OR 0 IC by the Planning
Board of the Town of Queensbury, New York
0
Chairmar��` ' iGAI�T! +tel OC-
CAPPED IRON
ROO SET
F ,yI t r r wa-
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WEEN
Min, lot area: 1 Acre
t
Min. lot width: 150 Ft.
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'OAK W000 E°
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VICTORIA$ E\'
Min. side yard: 10 Ft. min., sum
i
Min rear yard: 20 Ft,
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map was prepared by me from
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valid and true copies.
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nce No. 82-2005 approved by the Town
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HERALD ^
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bury Zoning Board of Appeals by
Eresolution
Nrn
SQUARE "^m<� A I
of November 16, 2005.
Location Map
(N T.S )
-- -
----
`- -
Warren Lane (ASPHALT
SURFACE)
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(DEED'. I WET. ;)
4 Lands of James and JoAnn Connelly
(6581491)
Tax Mep No.. 308.06-1.71
DEED: 150 F T. )
160.J
Tax Map No.: 308A8.-1.72.2
APPROVED under authority of a resolution
adopted %) " % 7' OR 0 IC by the Planning
Board of the Town of Queensbury, New York
0
Chairmar��` ' iGAI�T! +tel OC-
CAPPED IRON
ROO SET
aArt
uralry
DEED REFERENCE:
Samuel J. Wahnon, Jr.
To
Andrew Darnley, Jr and
Barbara Sue Darnley
D: 9/3/2004
R: 91712004 14041134
Parcel Tax Map No.: 308.06.1.70
Unauthonzed alteration Of addition to a Nurvey
map bearing a licensed land surveyor's seal is
a violebon of Section 7209, subdivision 2, of the
New York State Education Law.
POLE N.11
NYT SO —
� � 1
11if
JII
EXISTING
HOUSE
vl
�I
I
3o0- 00, 1
1 POLE NM t , l2
C,PPM IRON
^"� )
CAP IRON I NYTtb RODSEY
ROO SET
> I N IN
C' a LOT NO. 2 g I
w I o !�
1 1
o� ; I PROPOSED
(� /I/ d/� i GARAGE I HOUSE
GARAGE '-
--LT �— _-- _J
illy
OFEET i
LOT No. 1 O.AK WITH TWINDIAIJ STEMS rSe-tProposedArea 14.992.5 Sq. Ft. Area: 14,992.5 Sq. Ft. ptic Tank(0.344 AC ±) (0.344 AC. +I --------_-----
L — — — Proposed Absorption Field
CAPED IRON tOF�SO.O
k WIMUMUM
/1A0 RCD SET � - -
f
,300 Cat
^/- J'4 ° 09 S0 " W
1
Lands of Christopher Connelly ------
(i 149r258)
..-
(1149258)
i
I
�r
=1
POLE NM 2
,,1 2
3EED'150F1 --I
Lands of Richard G. Higgins
(639/357)
Tax Map No. 306.06-1.66
IRON ROD DEED'.150 FT. )
j FOUN
Tax Map NO: 308.06-1-72.1
MAP _r v
cv
ZONING INFORMATION:CF
L� QQPY
Parcel falls within -Mobile Home Overlay District,"
and SR -20 zone.
surrounded by SR -1A zone
SR -20'.
S_R1 A :
20,000 Sq. Ft
Min, lot area: 1 Acre
100 Ft.
Min. lot width: 150 Ft.
30 Ft.
Min. front yard: 30 Ft.
30 Ft.
100 min., sum 30 Ft.
Min. side yard: 10 Ft. min., sum
Ft.
Min rear yard: 20 Ft,
I HEREBY CERTIFY that this
map was prepared by me from
actual survey on the ground,
$G
g
2
2jj�
4 r _
/ � % '
survey map which are marked
survey
land surveyor's embossed
,�
• +. �� ��a te
_- .....
original of the
seal and bearing its surveyor's original
_ _ _
Charles T. NaCY.L.S.
Iugnature in red ink shall be considered
�
valid and true copies.
O
SSS
aArt
uralry
DEED REFERENCE:
Samuel J. Wahnon, Jr.
To
Andrew Darnley, Jr and
Barbara Sue Darnley
D: 9/3/2004
R: 91712004 14041134
Parcel Tax Map No.: 308.06.1.70
Unauthonzed alteration Of addition to a Nurvey
map bearing a licensed land surveyor's seal is
a violebon of Section 7209, subdivision 2, of the
New York State Education Law.
POLE N.11
NYT SO —
� � 1
11if
JII
EXISTING
HOUSE
vl
�I
I
3o0- 00, 1
1 POLE NM t , l2
C,PPM IRON
^"� )
CAP IRON I NYTtb RODSEY
ROO SET
> I N IN
C' a LOT NO. 2 g I
w I o !�
1 1
o� ; I PROPOSED
(� /I/ d/� i GARAGE I HOUSE
GARAGE '-
--LT �— _-- _J
illy
OFEET i
LOT No. 1 O.AK WITH TWINDIAIJ STEMS rSe-tProposedArea 14.992.5 Sq. Ft. Area: 14,992.5 Sq. Ft. ptic Tank(0.344 AC ±) (0.344 AC. +I --------_-----
L — — — Proposed Absorption Field
CAPED IRON tOF�SO.O
k WIMUMUM
/1A0 RCD SET � - -
f
,300 Cat
^/- J'4 ° 09 S0 " W
1
Lands of Christopher Connelly ------
(i 149r258)
..-
(1149258)
i
I
�r
=1
POLE NM 2
,,1 2
3EED'150F1 --I
Lands of Richard G. Higgins
(639/357)
Tax Map No. 306.06-1.66
IRON ROD DEED'.150 FT. )
j FOUN
Tax Map NO: 308.06-1-72.1
MAP _r v
cv
ZONING INFORMATION:CF
L� QQPY
Parcel falls within -Mobile Home Overlay District,"
and SR -20 zone.
surrounded by SR -1A zone
SR -20'.
S_R1 A :
20,000 Sq. Ft
Min, lot area: 1 Acre
100 Ft.
Min. lot width: 150 Ft.
30 Ft.
Min. front yard: 30 Ft.
30 Ft.
100 min., sum 30 Ft.
Min. side yard: 10 Ft. min., sum
Ft.
Min rear yard: 20 Ft,
I HEREBY CERTIFY that this
map was prepared by me from
actual survey on the ground,
an
according to record information.
Only///
copies made from the original ortlTls
with an
4 r _
/ � % '
survey map which are marked
survey
land surveyor's embossed
,�
• +. �� ��a te
_- .....
original of the
seal and bearing its surveyor's original
_ _ _
Charles T. NaCY.L.S.
Iugnature in red ink shall be considered
N.Y.S. License No. 49117
valid and true copies.
of a survey of a proposed subdivision of lands of r_
Andrew Darnley,
and
Barbara Sue Darnley
situated in
Town of Queensbury , Warren Co. , N.Y.
Scale. 1"=30' October 28, 2004
Map amended:
Survey and Map by April 29, 2005
CHARLES T. NACY Map Amended'.
Licensed Land Surveyor
32 John street January 26, 2006 to show
Queensbury. NY 12604 additional note, approval
block and certification.
LeCuyer, Daniel BP 2015-312
j.�o Warren Lane
New Residential Septic System
308.6-1-70.2