BOTH-000255-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000255-2016 Date Issued: Wednesday, May 4,2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000255-2016
has been completed.
Tax Map Number: 315.6-2-13
Location: 679 CORINTH RD
Owner: SAMSON MARANVILLE
Applicant: Straight's Septic Service
This structure may be occupied as a: Residential Septic Alteration
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the r ) 4 k_
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 +QUEENSB RY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
d
Community Development - Building& Codes (518) 761-8256
BUILDING PERMI "
Permit Number: BOTH-000255-2016
Tax Map No: 31.5,6.2-13
Permission is hereby granted to: Jack Straight
For property located at: 679 CORtINTH 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 tiled and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: SAMSON MARANVILLE Septic Disposal $0.00
Owner Address: 679 Corinth RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Naive/Address Electrical Inspection Agency
Straight's Septic Service
I Myron AVE
South.Glens Falls,NY 1:2803
Plans&Specifications
Residential Septic Alteration
$ 40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday,April 24, 2017
(1f 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 ue bury; Fri , , 2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT
Office lJse only
Received
Tax Map I _ 2- _t
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w � � Permit No.
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INSTAILEWBUuILDER: Pr-tOrEIE-MA.fL
OWNED PHONE I E-AAMC
Address <i � :, . � �t�� ��,� iw AIV.
CONTACT PERSON Daae BuxmNG&CODES COMPLIANCE.- PHONE
Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow
1980 or older Garbage grinder installed _Y XN
1981-1901 Spa or Hot Tub installed �'Y k N
1992-Present
PARCEL INFORMATION
Tfr•N
Topography Flat rolling Steep slope %slope
Soil Nature Sand Loam Clay Other
Groundwater At ghat depth?—
Bedrock?Impervious Material At what depth?
Domestic Water Supply >0 Municipal Well(if well,water supply from any septic system absorption is ft.)
Percolation Test fate: per minute per inch(test to be completed by licensed engineering/architect)
PROPOSED SYST45M FOR Ngw_QqNsLPucpoN
Tank Size0(2—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 17-0 ff.; Each trench x
Seepage Pit with#3 stone How many. -;size
Alternative System Sed or other type?
Holding Tank System Total required capacity? Tank size tf of tanks
Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)we will no longe
allow system's to be covered until such time as an As-Built pian is received & approved. The installed system must match the septic systerr
layout on file-no exceptions.
Qc17Any permit or approval granted which is basedupon or is granted in reliance upon any material representation of
failure to make a material fact or circumstance know by or on behalf of an applicant, shall be void. I have read the regulations anc
Print larrre; ! A, * 'c Crate;
_if agree to abide by these an all re u�ire ants oft e Town of C ueen bu Sanitary Sewage Dis o aal Ordinance.
Signature: Crated a(ZrlI t
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EXISTING
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SEPTIC TAN
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EXISTING SHED I HAVE.PER30NALI_Y MEASURED THE DIS TANCE
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±445 FT. PROFUSE -'STRUCTURE(S) OR SIGN(S)
SIGN' JRE
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GRAPHIC
GRAPHIC SCALE IE
20 0 10 20 40 a 80 -PLOT
- PLAN.
>,.IN FEET ) .. SCALE: '1"�20'
0
1 inch =20 ft:
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