2015-388 TOWN OF QUEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201
Q rY,
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150388 Date Issued: Friday, August 28, 2015
This is to certify that work requested to be done as shown by Permit Number P20150388
has been completed.
Tax Map Number: 523400-308-006-0001-060-000-0000
Location: 51 WARREN Ln
Owner: WILLIAM E MANNEY
Applicant: WILLIAM E MANNEY
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
/g (wr -
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 nforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
41111A 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
1r0
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150388 Application Number: A20150388
Tax Map No: 523400-308-006-0001-060-000-0000
Permission is hereby granted to: WILLIAM E MANNEY
For property located at: 51 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: WILLIAM E MANNEY
PO BOX 2343 Septic Alteration Residential
GLENS FALLS,NY 12801-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
IBS SEPTIC &DRAIN
ATTN: IVAN BELL
2 LOWER WARREN St
OUEENSBURY,NY 12804
Plans&Specifications
2015-388
Residential Septic Alteration
replacing existing tank
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,August 26, 2016
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Tow of Qu sbu 4 ' �.�t ay,August 26,2015
SIGNED BY , for the Town of Queensbury.
Director of Building&Code Enforcement
C omm jp •y 'Development qm 0 E C .E4 E
Cr
ice
of Queensbury b 742 Bay Road = Queensbury, New York iii$
Office Use Only
- - - i
* i If/
PERMIT NO. \ (.4' PER, IT Ti e
TAX MAP NO. - ";o, • :: -
APPROVALS: ZONING TOWN CLERK •. ODES
APPLICATION F1tR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.
OWNER: ,--f r 1 N\C\v\'n ` INSTALLER: T St p)-1 L
ADDRESS: 1")" 1 VAI CA r r?v` L rN. ADDRESS:1—o 1�(- "V C/If r• ,-.. )A. CV)--i,
I
PHONE NOS_ 1T- ()3`1-) ` ,p PHONE NOS. 1 1 5_� '6-X I 'l
WO('v
LOCATION OF INSTALLATION: S \ Or r L^ ^r
RESIDENCE INFORMATION:
YEAR BUILT
NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRIVDAR
1980 or older X 150 = 1.i4 q INSTALLED? /11//
1981-1991 I X - 130 = SPA OR HOT
1992-present X 110 = INSTALLED? IV
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLL G STEEP SLOPE I \\1- %SLOP
‘1 SOIL NATURE: SAND LOAM\\.!\� CLAY_W:1_144-
OTHER V ii
✓ GROUNDWATER AT WHAT DEPTH? I`� i.
✓ BEDROCK/1MPERVIOUS MATERIAL: AT WHA DEPTH? W IXV
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL'1/ (If well:water supply from any septic system absorption is:_ ft)
' ✓ PERCOLATION TEST: RATE IS \\(1\‘ PER MIINUTE PER INCH[moil (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: nfr, GALLON (MIN.SIZE IS 1.000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,
spa or whirlI tub.
SYSTEM TYPE: +O N \C n AI \\I `f r r 1�4
❑ABSORPTION FIELD(WITH NO.2 STONE) Total length r\\ I\ ft_ Each trench 111{\ X `
CI SEEPAGE PIT(S)(WITH NO.3 STONE) How many? 'V k Size? 1\1
\1 i
❑ALTERNATIVE SYSTEM Bed or other type? N'I\ , i'
❑ HOLDING TANK SYSTEM Total required capacity? _ I\ Tank size? I V iA- Number of tanks? n
N
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 a all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sa 'a aj•Disposal Ordinance"
.--)1_1(,)
� f codes r cuaansburv.net
r `) VISIT OUR WEBSITE FOR MORE INFORMATION
Signa re Person Responsible Date www.dueensburv.net
Town of Queensbury Building &Code Enforcement Trm
Office No 518
c ) 761-8256 2
Septic Inspection Report
Inspection request received: 812-1-17.4:
Name: I0V\Y1 `` Inspected on: 8 7-1- _vi'r►
�3\ ' Arl - ;��
Location: \ � - Arrive: -AMA, a .l p.m.
Permit No.: 1 cam"�e Inspector's Initials: _�'`
�� 6L>1 Cents and/or dia•ram
Soil TOP
e: �� f
Y •Y
Type o ,. erI- + ell Water
Waterline s ion istance ft. al y 1S 3(a i - 21 e-
3Well separation distance ft.
Other wells: ft.
Well Casing Length 50'+/- Y N N/A
[150'to well required if NO]
Absorption Field: Total length ft.
Length of each trench ft. ',nu
Depth of trenches ft.
F :
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank Lk< < ) 4—
Tank to Distribution Box " 92— 3 .---t) Y-e tr
Distribution Box to Field/Pit �J
Opening Sealed: �/1 N
End Cap Y N
Inlet/Outlet Pipes&Baffles
Manholes 12"or less below grade Y
[provide extension collar if Yes] Y
Location/Separations
Foundation to tank k"7j ft. "\-"b G 6ie-t
Foundation to absorption ft.
Separation of Pitsft.
Conforms as per Plot P.n N
Engineer Report an-. As-Buil / N
ETU Maintenanc:Contr. provided Y N
Location of S stem of 'ro•-s;•
Front Re, ., Right Side Middle Front Middle Rear
S stem Use Stat :
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
•
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