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2015-336 TOWN OF QUEENSBURY vps742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20150336 Date Issued: Friday, August 07, 2015 This is to certify that work requested to be done as shown by Permit Number P20150336 has been completed. Tax Map Number: 523400-301-013-0001-014-000-0000 Location: 271 FULLER Rd Owner: DEBORAH DAWE Applicant: DEBORAH DAWE 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, /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. #11./` TOWN OF QUEENSBURY er, 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20150336 Application Number: A20150336 Tax Map No: 523400-301-013-0001-014-000-0000 Permission is hereby granted to: DEBORAH DAWE For property located at: 271 FULLER Rd 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: DEBORAH DAWE Septic Alteration Residential 271 FULLER Rd Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name /Address Electrical Inspection Agency IBS SEPTIC IVAN BELL 2 LOWER WARREN STREET OUEENSBURY.NEW YORK Plans&Specifications BP 2015-336 Residential Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 30,2016 (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 t expiration da e.) Dated at the T wn of en u4 rsday,July 30,2015 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Communityr------ e)f tT e 9fikL i 3 7015 Town of Queensbury ° 742 Bay Road = Queensbury, New York -12804 1 Office Use Only TAX MAP NO. \ ' t�J-1 _1 1 PERMIT NO. aotS-33 PERMIT FEE 1 L(Or00 APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WV RIS BEGINS_ PLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: 'A 1 �OI�1V �1.�INSTALLER: J )f60-1.(-- I1 A ) �} ADDRESS: 1 FIA 1,1 1�'. ( PJ ' ADDRESS: n - 0 . U rr6-\. i• 0 61 i PHONE NOS. 19- I - 9 i — 1 1 PHONE NOS. S\ 'J ) v V ! Lid LOCATION OF INSTALLATION: X11 (~V�-Z( 1(J . RESIDENCE INFORMATION: NO.OF COMPUTATION TOTAL DAILY FLOW YEAR BUILT BEDROOMS X (Gallons per bedroom) GARBAGE GRINDER 1980 or older Lis X 150 = 6 0 0 INSTALLED? 1981-1991 X — 130 = SPA OR HOT TUB 1992-present I X 110 = INSTALLED? PARCEL INFORMATION: I\ f I TOPOGRAPHY: FLAT ROLLI G STEEP SLOPE t V %SLOPE ISI ik I SOIL NATURE: SAND LOAM IV I \ CLAYN 1t OTHER IV Pv I GROUNDWATER: AT WHAT DEPTH? 1\I I BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? / (�(� ✓ DOMESTIC WATER SUPLY: MUNICIPAL'' `i.'-, WELL (If well:water supply from any septic system absorption is:JD 0 ft) ' I PERCOLATION TEST: RATE IS 1 v '— PER MIINUTE PER INCH[mpg (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: 115 O 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 irE \ ABSORPTION FIELD(WITH NO.2 STONE) Total length () ft Each trench ` X ❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? IV I - ❑ALTERNATIVE SYSTEM Bed or other type? \\ V ❑ HOLDING TANK SYSTEM Total required capacity? N't Tank size? I\1 ., Number of tanks? Nf 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 f QUESTIONS? CALL 761-8256 OR EMAIL Sanitary Se, .•,�. posal Ordinance. odesra)oueansburv.net i-)°--I Vlsrr\ OUR WEBSITE FOR MORE INFORMATION Sign: - • •erson Responsible Date \ www.cunansbury ne \-________ f f/ 1 Town of Queensbury Building & Code Enforcement C 10 S e 6 3 Office No. (518) 761-82561 1 ''F,1, - )_/ I Septic Inspection Report Inspection request received: g(V/ S Name: /A - Inspected on: 3_/ S Location: 7 ( RJ ,(L)V- (?t.5 -- Arrive: AY •.m./ Permit No.: I S ' 53(0 Inspector's Initials: o• ments and/or dia•ram Soil Typ ': San am/Cla Type of Wa er: Municipa /Well Water Waterline separation dist ft. Well separation distance 1 u c,ft. Other wells: ]cc)ft. Well Casing Length 50'+/- Y N N/A [150'to well required if NO] Absorption Field: Total length —ft. A(E Length of each trench 5P_JU ft. Depth of trenches "Z ft. Size of Stone 7____ Seepage Pits: Number Size: x Ill Stone Size: VloC Piping Size Type Building to tank LVv\ t40 Tank to Distribution Box L-k," L 37 Distribution Box to Field I Pit / Lk r % E)�7jif 1‘ Opening Sealed: ✓�/ N ,h35 C- End Cap ✓//--- N Inlet/Outlet Pipes&Baffles N Manholes 12"or less below grade ; VII [provide extension collar if Yes] Y -✓ N • +:;s Location/Separations Foundation to tank `31 ft. Foundation to absorption _iii,. ._ft. 1 ) TO ©--6c)( Separation of Pits ft. ' Conforms as per Plot ‘/I- Engineer Report d As- uilt Y N ETU Maintenance Contract provided Y N Location of S stem on Pro•::;. Front lr Left Side eight Side Middle Front Middle Rear S stem Use St. s: V Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office4 Disapproved Septic Inspection Report ;: gcori rt s III t 34„,._\Ist 'P,z(dJ ?j ry6e .oi_. r -) yi w Zai _i_ . i ,i ____91 ,/ � , 1 MIN 1 I _ i MIMI 1 1 __L__ I Cal-1111111 1 -I- 1_-_;_ OP II ■■■e , , s I ■■■■ _ ` • u . , _ ce, APA ) 1111 11117'' .. - C7-'"..■ _ •Ell ■■ ■ ■■ Mill ■ TOWN OF . ► : : 2_11 — t ■uau ■ BUI�D NG & �` , E. `-'..5�■ I f 1)- ' k, - Ill ■ Rev ewe, ' .. ; W'bI ■� ■■■■ Date: .�: , 11 '�le � 1111= MN 1111■ ■ I _i . . o�'P � ■■■■■ BWILD e�DEP - 8= Y' (� NOR OBSERV D •L '. .® ■ T W:1':' raw Ltg� �'T.7■� ■�® xamnatioicom hence t� iw ' °tLY h� .coCmer is sh.ii not b ', p . ,rk r. �, ■ fut co Mame with es c+ficatio s arP in litr211,TAN SETiFORT ON num �!N1 , � , . _ luau _, , i ., , , ,_,_\\ . 1 , iii ■ ■trt�1 ■■■■■■ ■ 11'■1 ■ i III I 1 . Weil i 1E- i,„‘ 1 1 i� '� �� Deborah r h D w BP 2015-336 Dawe 271 Fuller Road a Residential Septic Alteration ■ I i F e urd • i Queensbury Web Map , i .APPL-f_it:;USE•"i'' ; �, cc 1 z _ � C1 -LES'TER-DZ Z= 0 BRAVO • I1._.- s ,I .., __Ft Rp= — - � ' + I PEGGY-ANN-RD I1'I 11 1 11 1 II 1 4 f c a Y j7,...--- MOHAWK TRL C'": II +�' I { 7 II 1 IIII Ill il I it i I 1 1 — -Rt3UNTAINSID-I)R _--_ Map is for GENERAL REFERENCE ONLY. 111.11 .11.1111.111286 Fee Printed 7/30/2015 1 : 3596 Page 1 / 1;