2012-313 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120313 Date Issued: Tuesday, July 03, 2012
This is to certify that work requested to be done as shown by Permit Number P20120313
has been completed.
Tax Map Number: 523400-289-008-0001-074-000-0000
Location: 1 FIELDVIEW Rd
Owner: CHRISTIAN & MELISSA GUAY
Applicant: CHRISTIAN & MELISSA GUAY
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,
Variance, or other issues and conditions as a result of approvals by the Director of Building : Cod nforccmcnt
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120313 Application Number: A20120313
Tax Map No: 523400-289-008-0001-074-000-0000
Permission is hereby granted to: CHRISTIAN & MELISSA GUAY
For property located at: 1 FIELDVIEW 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: CHRISTIAN & MELISSA GUAY Septic Alteration Residential
3 FIELDVIEW Rd Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
ELLSWORTH & SON EXCAVATING
57 ELLSWORTH Ln
LAKE GEORGE, NY 12845-0000
Plans&Specifications
2012-313
Res Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,July 02, 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 o uee bury; on: . , ' 1 02, 2012
is
SIGNED BY for the Town of Queensbury.
Director of Building& Code Enforcement
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Community Development Office Ii JUL 0 1 2012
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 __,I
Office Use Only
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TAX MAP NO. I p�Jv'(y.% - I - PERMIT NO. 1 ^3 I PERMIT FEE 0
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS.APPLICATION
APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.
OWNER: Clef 4 C lit I� 66(41.f INSTALLER: //. k or 11- SQn fa eA //# 'jr9 <
ADDRESS: ! /Q 111:, }O� f ADDRESS: )6: ClekG /CIr P 4A/` /i
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PHONE NOS. /6 /— S y'7 PHONE NOS. 7 *."‘2 - f2 '/
LOCATION OF INSTALLATION:
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINDER
1980 or older .. X 150 = INSTALLED? N 0
1981 -1991 X 130 = SPA OR HOT TUB
1992-present X 110 =
INSTALLED? AJ
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING / STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM / CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL. AT WHAT DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL V(If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS 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: to#1.511.4c 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: /
G'ABSORPTION FIELD(WITH NO. 2 STONE) Total length 9C,0 ft. Each trench ,'cO X
❑SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Size?
❑ALTERNATIVE SYSTEM Bed or other type?
❑ 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 regyirements o the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sanitary ewag bis�,o 1 OrdjnancodesAqueensbury.net
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Signature of Person Responsible date VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburv.net
NYS-Real Property System Subject Property Inventory Summary RPS030N04/L001
County of Warren For Current Year File 2013 Date:7/2/2012
Town of Queensbury Parcel ID:289.8-1-74 Sheet 1 of 1
SWIS Code-523400 Active
Parcel Information Parcel Land Size File Maintenance Info
Curr Owner: Guay,Christian Acct#: Front: 0.00 Acres: 0.62 Created: 11/20/1984
Location: 1 Fieldview Rd School Cd: 523402 Queensbury Un.fr.s Depth: 0.00 Sq Ft: 0 j Modified: 04/19/2012 04:14 PM
I Queensbury, NY 12804 Roll Sect: 1 Taxable RS/S: , B : Mark
I
Grid Coordinates Y
Prop Class: 210 1 Family Res East: 719316 North: 1654411 Folder: Improvement
Site Characteristics
Site No: 1 Nbhd Cd: 162 OldSubdv,Rs,Ru Site Desire: 2 Typical DC Entry Type: 1 Inter inspec Economic Obs: 0
Site Type: R Residential Sewer Type: 2 Private Nbhd Type: 2 Suburban Zoning Cd: MDR Mod Density ResData Mailer: No
Prop Class: 210 1 Family Res Water Supply: 2 Private Nbhd Rating: 2 Average Last Phy Insp:
Route No: Utilities: 3 Electric Road Type: 3 Improved Reappraisal: 02/09/2005
Residential Building Information Bldg -
Style: 03 Split level No.Bath: 1 Fuel Type: 3 Electric Area in Sq.Ft.
Y P YP Grade Adjust: 0 1st Story: 1,070 Fin Bsmnt: 286
No.Stories: 1.0 No.Half: 1 Central Air: No Pct Good: 0
2nd Story: 0 Unfin 1/2: 0
Ext Wall Mtrl: 03 Alum/vinyl Bath Qual: 3 Normal Bsmt Type: 3 Partial Func Obs: 0
Addl Story: 0 Unfin 3/4: 0
Act Yr Bit: 1979 No.Bdrms: 3 Bsmt Gar Cap: 2
1/2 Story: 0 Unfin Rm: 0
Eff Yr Bit: No.Rooms: 7 Overall Cond: 3 Normal
314 Story: 0 Unfin Ovr Gar: 0
Yr Remodel: No.Fireplcs: 1 Ext Cond: 3 Normal
Over Garage: 528 SFLA: 1,884
No. Kitchen: 1 Flreplc Type: Int Cond: 3 Normal
Fin Attic: 0 Fin Rec Rm: 0
Kitchen Qual: 3 Normal Heat Type: 4 Electric Constr Grade: C Average
Land Breakdowns
Land Soil Wtrfrt Depth Infl Infl Inti Infl Land Unit Dim
Type Front Depth Acres Sq Ft Rating Type Factor Pct Cd 1 Cd 2 Cd 3 Value Price Code
01 Primary 125.00 219.00 0.00 0 0 0 34736 277.888
Additional Improvements
Structure Measure SQFT Overall Act Eff Yr Pct Func Sry Unit Bld Bld
Code Code Dim1 Dim2 MISC Qty Grd Cond Yr Built Gd Obs Life RCN RCNLD No. No. Sec
CP7 Canopy,Screen On Slab Dimensions10.00 10.00 .00 1.00 C Norm 1979 0 0 0 3018 1630 0 0
RP1 Porch,Open Dimensions12.00 16.00 .00 1.00 C Norm 1989 0 0 0 2452 2256 0 0
RP4 Porch,Enclosed Dimensions16,00 14.00 .00 1.00 C Norm 2004 0 0 0 6424 6424 0 0
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SWIS: 523400
Print Key: 289.8-1-74
Comment: Photo
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Septic Inspection Report
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Office No. (518) 761-8256 Date Ins QQ -• =•-i -•• 7 a- do
Queensbury Building &Code Enforcement Arrive: _ -IV .j /p;� rt: a •••
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials I►"
NAME: lsttt P RMIT NO.: /
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LOCATION: J— ervlt' 6,.1
NSPECT ON: —7/3-74_0 / . —
RECHECK: ,,
Comments and/or diagram
Soil Type. .jrlac _
Type of Water: MunicipalyWell Water
Waterline separation is nce ft.
Well separation distance Ici0 ft.
Other wells:
Well Casing Length 50' +/ - Y N N/A
[150'to well required if NO]
Absorption Field: Total length401,-) ft.
Length of each trench L ft.
Depth of trenches 0 ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank I.-1 t( 19 C,1- 1,-
Tank to Distribution Box 1�L' c \-\ U
Distribution Box to Field/ Pit I/1 '` V'—TV Raf
Opening Sealed:
End Cap Y N
Inlet/Outlet Pipes &Baffles N
Manholes 12"or less below grade _N
[provide extension collar if Yes] Y N
Location/ Separations
Foundation to tanks
T, ---7--
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built Y N
ETU Maintenance Contract Y N
provided
Location . Sy em on Proper.:
Fron R r Left S'•- Right Side Middle Front Middle Rear
Use Sta s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
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