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2012-211 eaki TOWN OF QUEENSBURY Fors 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 Q ur}, Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20120211 Date Issued: Thursday, May 03, 2012 This is to certify that work requested to be done as shown by Permit Number P20120211 has been completed. Tax Map Number: 523400-296-018-0001-022-000-0000 Location: 92 SWEET Rd Owner: GERALD & GERALDINE WELCHER Applicant: GERALD & GERALDINE WELCHER 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 r:DA,,PVPro 414:- 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. 0.14 TOWN OF QUEENSBURY f742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 1 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20120211 Application Number: A20120211 Tax Map No: 523400-296-018-0001-022-000-0000 Permission is hereby granted to: GERALD & GERALDINE WELCHER For property located at: 92 SWEET 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: GERALD & GERALDINE WELCHE 92 SWEET Rd Septic Alteration Residential QUEENSBURY,NY 12804 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2012-211 septic alteration S40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, May 01,2013 (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 Town uee bury /rue• • :y, , 01,2012 al41 SIGNED BY I \ for the Town of Queensbury. Director of Building&Code Enforcement / Revised 4/14/2010 OFFICE USE ONLY ,/ ". I) TAX MAP NO 6.1eg -J MIT NO. ha � v'� � '�I PERMITF E �.,:;�, �j i �i J • APPROVALS: ZONING TOWN CLERK ,O'z APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. - T C OWNER: ,J��T r w CS\ LAV-,e r INSTALLER: }T. �1 1 S��1 I C C ADDRESS: I 1 9-1. �A!(,P ?J • ADDRESS: I 5 tn/('r WC/ r f P, S i-• \'1 PHONE NOS. 1 (Y‘'5P-,1 C) 1 PHONE NOS. 1,13(� 0 1 1 l LOCATION OF INSTALLATION: r_ S./J/l� r RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT BEDROOMS X (Gallons per bedroom) = TOTAL DAILY FLOW GARBAGE GRIND AZ 1980 or older3 X 150 = 4 INSTALLED? 1981 -1991 X 130 = SPA OR HOT Tye, 1992-present X 110 = INSTALLED? IV I1 PARCEL INFORMATION: , {{�� ✓ TOPOGRAPHY: FLAT ROLLING J STEEP SLOPE`U, A %SLOPE ✓ SOIL NATURE: SAND N N LOAMI,\I \ CIAYIV N OTHER\\I N- ✓ GROUNDWATER: AT WHAT DEPTH? 1\1 \ `r ✓ BEDROCK/IMPERVIOUS MATERIAL AT WHA DEPTH?\I \ I Q ✓ DOMESTIC WATER SUPLY: MUNICIPAL I WELL �v 11(If well:water supply from any septic system absorption is:{(�i l 1 ft) ✓ PERCOLATION TEST: RATE IS W \ PER MIINUTE PER INCH Impil (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: \ 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 TYPE: \ 13,413uSORPTION FIELD(WITH NO.2 STONE) Total length t k() ft. Each trench ( X '1') \t` ❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Iv Size? N ❑ALTERNATIVE SYSTEM Bed or other type`?I N N p ❑HOLDING TANK SYSTEM Total required capacity? N- Tank size? \v EN IV Number of tanks? `,V 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 QUESTIONS? CALL 761-8256 OR EMAIL Sanitary S a e Disposal Ord" ance. codes(a?queensburv.net tt r c+1)--- VISIT OUR WEBSITE FOR MORE INFORMATION Signature of Pers:n sponsible Date www•queensburv.net Town of Queensbury* Community Development Office*742 Bay Road, Queensbury NY 12804 Cej-esurtz- 3 ?.) b -)ecici)ta,--4-1 Septic Inspection Report Office No. (518) 761-8256 Date Inspection requ�- -cei 5//,),DI � 1,,,,m Queensbury Building&Code Enforcement Arrive: 2 a •��• �, � .rt: 3j:a. T am/Rtti` 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: _ NAME: er rJ i1Je✓ 1 Cll-e r P NO.: 101 ".!). I I . LOCATION: q_2Sw— (d-'' INSPECT ON: ©. - -• ,1te.4 RECHECK: Comments and/or diagram Soil Tys:ell°-'oa / Clay Type of Water:( 1 ci .sell Water 3 b D)i) i---lc-- Waterline separation distance ft. �, �� Well separation distance ft. <".p Other wells: ft. C-{' -L Yew 5 Well Casing Length 50' +/ - Y N N/A [150'to well required if NO] 13,4-dLlep''C, gd-5 Absorption Field: Total length Aft. I'S Oh-t. .11‘ Length of each trench ti 69, - 6---ft. es'l e61"j Depth of trenches Zi ft. -1" Size of Stone Z ...----- Seepage Pits: Numberylr- 'g/ial5i)i L (S 6 Size: x Stone Size: is; Piping Size Type • Building to tank 1-1" L \AD Tank to Distribution Box il.t - Distribution Box to Field/ Pit / y U. N)N)(...-- ccU Q \.)�t, 1 W Opening Sealed: ,/ _N End Cap V/ N ( Vte.C.—C) Inlet/Outlet Pipes&Baffles N Manholes 12"or less below grade N [provide extension collar if Yes] N Location I Separations Foundation to tank ft. Foundation to absorption - Separation of Pits ft. Conforms as per PI• ° an .i —N Engineer Report a•• As-Bu Y N ETU Maintena ice •.. .ct Y N provided Location of System on Property: Front �' '�'• Right Si Middle Front Middle Rear 5ystem Use S . .s: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Bullding Codes Forms\Inspectfon Forms\Septic Inspection Report`03 29 10.doc eeenSm.o . i ` �1JPw IC O�S�l1\cn "-4A . 3C4 v\Oct Cu`S c\-?, (per, c neC /ve* t'aycw S-.\,o\e 76,()V,\-6 t-80XW�# 4 r(:a Nc.,\,,c4 •40\t\ 0 , • , . .....,. " -.-.. - 14 L NAY. 0 1 2012 1 (. (' _ . c---- • "I have seen or observed, or believe I saw evidence of, -10N C-,,- :),i:Iii-1,133URy . tall (Thiir.ts such as houses, wells, frees, fences, etc., BUILDING ,..;•::i- .',RTMENT r" Based on our limited examination,complianr.:e ' ":,'''.' al^o rr-7,-,P-,,--,nt tt—t have with our comments shrill not be construed as li. . oac, . f ' indicating the pldn6 and specifications re in hey," • t ..1._ tr ,.,-, - -, . .i, (,•(.,.1 ro,r.k\ ' .'• • ' '- ' .. • 1.)1C distances set f:n-th ',..!-Ie diagram." full compliancb with f he Buiiding Codes of 0/ ' C i-IL New York State. • — '- ---- --- ______. _ ._. . TOWN OF QUEENSBURY BUILDING & CODES DEPT, (Do Reviewed B :(1 ,7N1-7-6-vg---- irci- e . Jtr, 1' We\C•Le. Date: \_ L [ _ L._ EH Ffi5r.i _ _ 5Qtii.ic_ S y ck l'""" -(-1 . ; —_ __ ----___ 'r