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2012-244 TOWN OF QUEENSBURY EIT 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20120244 Date Issued: Friday, November 29, 2013 This is to certify that work requested to be done as shown by Permit Number P20120244 has been completed. Tax Map Number: 523400-308-010-0002-060-000-0000 Location: 45 NICOLE Dr Owner: WILLIAM & THERESA REDMOND Applicant: WILLIAM & THERESA REDMOND 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 /1 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 QUEENSBURY 01— 1 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20120244 Application Number: A20120244 Tax Map No: 523400-308-010-0002-060-000-0000 Permission is hereby granted to: WILLIAM &THERESA REDMOND For property located at: 45 NICOLE Dr 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 &THERESA REDMOND 45 NICOLE Dr Septic Alteration Residential QUEENSBURY, NY 12804 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency STONE INSTALLATIONS 4305 ROUTE 50 SARATOGA SPRINGS,NY 12866-0000 Plans&Specifications 2012-244 Res. Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, May 16, 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 of bury; Wednesday, May 16, 2012 SIGNED BY for the Town of Queensbury. Director of Building&Code ''nfor\, ent Community Development Office Town of Queensbury • 742 BayRoad • Queensbury, New Yor gyp® C,tUEENSgURY BUILDING & CODES Office Use Only f TAX MAP NO. 20 .1b-D-615 PERMIT NO. 0- a w PERMIT FEE C` D C,�� APPROVALS: ZONIN' TOWN CLERK 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. OWNER: a e—c-S e.. fry P�Cl r-,c�Y..1 INSTALLER: 674:1 te J-1-, 714j!a A,,,,...‘f f ADDRESS: /c/ �A C c•1 CF^`. ADDRESS: `f Jar Al-c . c.-6 Se-r,."f"o 54i�1v.?- 1 2 47g6 NOS. 7 yb -? !7Z 7 / -0;z nG PHONE NOS. ?j `.-A 701 LOCATION OF INSTALLATION: 1 AL ,i,I c ..i>i-•,).;c.. RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRINDER 1980 or older X 150 = INSTALLED? 1981 -1991 X 130 = SPA OR HOT TUB 1992-present X 110 = 9.17 INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING X STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND A LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft) ✓ PERCOLATION TEST: RATE IS 3 PER MIINUTE PER INCH[mpi] (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: 1,15-P 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: ^ectlef ell eh4oil c!'f-lige f ct ABSORPTION FIELD(WITH NO.2 STONE) Total length 02120 ft. Each trench 14 X 6-0 r o SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? o ALTERNATIVE SYSTEM Bed or other type? o HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? 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 San ary Sewage Disposal Ordinance. codes a,queensbury.net 1��Iti'�15:5-11- Date \, VISIT OUR WEBSITE FOR MORE INFORMATION Sighaturof Person Responsible \ wl^.'%'A.,.t IL![ is bur v..11et ` _ ' 5-rs Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/p Depart:c7 - am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: R6CIMOncl PERMIT NO.. ._ A LOCATION: y 5 A) 0 OIL INSPECT ON: RECHECK: Comments and/or diagram Soil Type: Sand / Loam/ Clay Type of Water: Municipal / Well Water s-/L_,(3 Waterline separation distance ft. '1(3 Well separation distance ft. Other wells: ft. Well Casing •th 50' + / - Y N N/A [150'to ell equired if NO] 2.vLE- A/ t' > Absorptio Field Total I•ngth ft. l� - -r'�Iti�i -ngth o each rench ft. �i - Nt 4 Dept oft enches _ ft. �..\ S •e •f Stone Seepage Pi I. Number Size: x MO A-4 �.� to,e Size: rVI�1��`� Piping Size Type ,& �,,. r..- f 1�� :uildi • to tank Tank to l istri.,ution Box Distribution .ix a Field SPit in `5 c� v •.: ing Sealed: ed: Y_ N �) End Cap N Inlet/Outlet 'ipes&Baffles — N Manholes 12"or less below grade _Y N [provide extension collar if Yes] Y N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits Conforms as per Plot Plan ; _Y_N Engineer Report and As-Built , _Y_ N ETU Maintenance Contract _Y N provided Location of System on Property: Front Re-r Left Side Right Side Middle Front Middle Rear S stem Use Sta Approv- •. a Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Repor 03 29 10.doc fire SAR A ,..„ rc) r) Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: & -" 5--/,:z ,: Queensbury Building &Code Enforcement Arrive: am/pm Depar9t am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: L_� , NAME: PERMIT NO.: / a- A {/ ) LOCATION: `l &) r L.,9-{6 LA INSPECT ON: LQ—5—J d ECHECK: ' Comments and/or diagram Soil Type: Sand/ Loam/ Clay Type of Water: Municipal/ Well Water Ki h,,.----- Waterline Waterline separation distance ft. Well separation distance ft. Other wells: _ ft. Well Casing Length 50' + / - Y N N/A Absorption Field: Total length c-3z] ft. Length of each trench ft. Depth of trenches ft. '7--- r F -1.L- S Size of Stone k J Seepage Pits: Number [v Size: x Stone Size: Piping Size Type Building to tank -___ C � - T Tank to Distribution Box �` `'`�l0 Distribution Box to Field/ Pit ir--2 Opening Sealed: ,y" N End Cap ✓ N Inlet/Outlet Pipes&Baffles . Y—N Location/ Separations • Foundation to tank '10L_ ft. Foundation to absorption --/;2--, ft. Separation of Pits Conforms as •er Plot Plan J �, �-1, �)QC�r Engineer Report and As-Built Y N �f �� Location of Syste Property: Front Rear Left Side Right Side Middle Front Middle Rear S -I Us- - Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc nonda. w Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: (s? -1 a Queensbury Building &Code Enforcement Arrive: am/ m Depart:c(am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: R� Jr Cin c-i" PERMIT NO.. / l a.94/ LOCATION: q ik) u Att. INSPECT ON: (o• � �„ RECHECK: Comments and/or diagram Soil Type: Sand / Loam / Clay Type of Water: Municipal/ Well Water 0•126- al-Lc''t� Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - Y N N/A Absorption Field: Total length ft. Length each trenchft. D Deptt h of trenches ft. Size of Stone f) Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank A kt`5 n i(S Tank to Distribution Box Distribution Box to Field / Pit Opening Sealed: Y_N —� End Cap Y N Inlet/Outlet Pipes &Baffles Y— N Location/ Separations • Foundation to tank _ ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N Engineer Report and As-Built Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear S e Use Approved - •'al Approved an. needs to be re-inspected, please call the Building &Codes Office —147 Disapproved Last revised 06 : e L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc C I1==n7"-----, -1.' gt.cfyho,cf, t', 1_elc/),ce.... .;?A. :-,gommunity Development Office ,Y L -_, `',•:',.' 'D wn of Queensbury •• 742 Bay Road •• Queensbury, New York •12804 ,= 0.1.1,..6 i -ifii.-.4 C.C...;II z.-'1.1.-- "‘',7 ›•4-4---- 1 i in f gLt)1 j_ I l f ' i(v L c. cc oil ` 3e-c1 rug.•-+ sin ; shBE PROPERTY LINE 11!111 -, 111 ibYi X12 - ,5.1-,., 1 . „ c, poi ._ ARC -1 U lj'44/clI-cs5 , ,., „ . • ,_ w94--13'. ‘01-1.-it'i'll-k,,5;e.ed i-c.c;:c"):(3 • 1//'tow : '. , ,I. :.- . .. , . . �: AL we 1.1 S L '1 moi n 7� MEIN II 111111111111 icP ' 4.:1 .`517:,,,...)"-t 7„7,t f.� � V"----.-1"--4 - '1 t G ) G. I W a- IIII 111111111111111111 r �reser1t that I have �����������������������EMI' 1111111■11■■�E�M�IIiii- ,� ces set{girth on the diagram.” 111111111111 II ii 1111 ici i /) , .. ef,r_cd_____ _____,5/4-__5/i2-_- _ Orli ___---------- TOWN OF QUEENSBUFY BUILDING & Ce a ci�if Reviewed By:' 41, __ Date: k 7 -