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2012-601 � ` 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: P20120601 Date Issued: Thursday, February 06, 2014 This is to certify that work requested to be done as shown by Permit Number P20120601 has been completed. Tax Map Number: 523400-295-015-0001-028-000-0000 Location: 31 OWEN Ave Owner: LEE T GARRAND Applicant: LEE T GARRAND 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 ('N j 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 nfor` ent 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: P20120601 Application Number: A20120601 Tax Map No: 523400-295-015-0001-028-000-0000 Permission is hereby granted to: LEE T GARRAND For property located at: 31 OWEN Ave 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: LEE T GARRAND Septic Alteration Residential 31 OWEN Ave QUEENSBURY,NY 12804-0000 Total valve Contractor or Builders Name/Address Electrical Inspection Agency COOKS SEPTIC NY 12804-0000 Plans&Specifications BP 2012-601 (Rec'd January 3,2013) Should be year 2013 permit number Residential Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,January 03,2014 (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 Queensbury; Thursday,January 03,2013 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement y6_, ;(4_,A___ _40 t -f) kv. I,- - ( OFFICE USE ONLY 60/ /G � ; TAX MAP NO. PERMIT NO.oZUIc- O ERMIT FEE , .IAN ' 7_[i13 APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO R(Lç EFORE ISSUANCE 0 A VALID PERMIT. C/ OWNER: j"f ,7 Rvr`� INSTALLER: S4,1 6" ADDRESS: 7( ,D6�e Al 0' ADDRESS: PHONE NOS. )IO ' 3? !6 PHONE NOS. LOCATION OF INSTALLATION: YEAR BUILT NO.OF RESIDENCE INFORMATION: BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW 1980 or older X 150 gallon per bedroom = GARBAGE GRINDER INSTALLED? 1981 -1991 X 130 gallon per bedroom = '779 c SPA OR HOT TUB 1992-present X 110 gallon per bedroom = INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: Flat rolling /7 Steep slope %Slope ✓ SOIL NATURE: Sand Loam Clay Other ✓ GROUNDWATER: At what depth? �} ✓ BEDROCK/IMPERVIOUS MATERIAL: At wh epth? k— V DOMESTIC WATER SUPLY: Municipal Well (If well: Water supply from any septic system absorption is ft.) V. PERCOLATION TEST: Rate is 1 ,. minutes 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). cloLAF_f HAL-= L TANK SIZE: ,BOO 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: c.,,,:„.I 3z_.3 �` I F-_--_11/4 )a ABSORPTION FIELD (WITH NO. 2 STONE) Total length / ft. Each trench X El SE AGE PIT(S) (WITH NO. 3 STONE) How many? Size? ALTERNATIVE SYSTEM Bed or other t e? # YP l IX-'��� !�TotyE_ -2--,it7 ❑ 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 QUESTIONS? CALL 761-8256 OR EMAIL Queensbury Sanitary S- .c Di os/al Ordinance. codes0.queensburv.net �/ / 1— VISIT OUR WEBSITE FOR MORE INFORMATION / _ ,,l 3 . 0/_2_ www.queensbury.net Signal re of Person Responsible Date '- Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 B 5-LGL 6/06 ,S-i-atu.s Septic Inspection Report Office No. (518) 761-8256 Date Ins.- ion r-. est r-c- .: Queensbury Building &Code Enforcement Arrive: . tart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initia s: _ NAME: GQrrccdvi •E• ITNO.: /A— (00) LOCATION: ,..3 I rO .J e P i?p_ I PECT ON: 7 -(Q-1'A RECHECK: Comments and/or diagram Soil Type: Sand / Loam / Clay Type of Water: Municipal / Well Water q- P — 3-1 Waterline separation distance ft. Well 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. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: _Y_ N End Cap _Y_ N Inlet/Outlet Pipes&Baffles _Y 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 ft. 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 Rear Left Side Right Side Middle Front Middle Rear S stem Use S tus: Approved Partial 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 Report_03 29 10.doc L.L.,-C---,k--- t (ct Septic Inspection Report q Office No. (518) 761-8256 Date Inspection =* 4r- vett --5 Queensbury Building &Code Enforcement Arrive: 4 V=, -; rt: 4m pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial • r NAME: I..4 (- C,p A-j L-'`'- i) P_' IT NO.: r2,cX - C.c, LOCATION: Zt cSwi'- AV( NSPECT ON: t tck k.V. RECHECK: Comments and/or diagram Soil Ty.:; .m/ Clay Type of Water Muniapa ell Water Q Q____s_____SEI OD Water aration distance _AD__ft. "k" Well 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 --3cS=:,-2 ft. 1-- - - c:) X00( Depth of trenches ft. Size of Stone :-2 t_s-- p c N P F) Size: 1 "x Stone Size: Z Piping Size Type . / Building to tank L " foci-t H(1 `�'�,i�L�; Tank to Distribution Box Lk t► 6c4 �C� \ �- \-1 Distribution Box to Field/ Pit L}`t 6{» t� ,-- \--\, .---C.7.---?--- \'n.:A\ - ? Opening Sealed: Y N i t End Cap _ T N H6 oR 35 Tr_ZF Inlet/Outlet Pipes&Baffles ✓Y Manholes 12"or less below grade _Y 7 c-=_.-.0c) LOOPCV) [provide extension collar if Yes] 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 i *3 _-_0 Ct:�\1JE 2i5 � ETU Maintenance Contract _Y, N o provided -/ \i Location of System on Property: Front Rear Left Side Rght Side Middle Front Middle Rear stem Use S .tu Approved Tr Partial 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 Reporl`03 29 10.doc Z. 000 Septic Inspection Repo Office No. (518) 761-8256 Date Inspectioau •,-'. -•: Queensbury Building &Code Enforcement Arrive: "7:/ h a pm 0-part: 7,1►]0 a 742 BayRd., Queensbury, NY 12804 Inspector's Initial•H 72 742 pact NAME: GPrRRPROn PE'MITNO.: Di OG \ z "Ccd LOCATION: I 0 L)E_K INSPECT ON: I , -.S- 17 RECHECK: Comments and/or diagram Soil Type: Sand / Loam/ Clay Type of Water: Municipal / Well Water Waterline separation distance ft. / E?-v\c_ Well separation distance ft. Other wells: ft' -5a-?\ \L , lN`7\ALL Well Casing Length 50' +/ - Y N N/A [150'to well required if NO] 1 OCC ()ALL_. Absorption Field: Total length ft. ��1jV u�L L _PikCA C30? Length of each trench ft. 11 r Depth of trenches ft. ��� O::: Size of Stone �-�N� Q�T Seepage Pits: Number \)k L71-‘"1 �� Size: x 171 ��c Stone Size: T c C EL_ Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: _Y T N End Cap Y_N Inlet/Outlet Pipes&Baffles Y 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 ft. 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 Rear Left Side Right Side Middle Front Middle Rear System Use Status: / Approved Partial 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 Report 03 29 10.doc 169 Haviland Road Queensbury, NY 12804 Hutchins Engineering Phone: (518)745-0307 Fax: (518) 745-0308 January 20, 2014 Mr. John O'Brien Town of Queensbury Building and Codes Department 742 Bay Rd Queensbury, NY 12804 Re: Wastewater System Replacement Lee Garrand, 31 Owen Ave. Tax Map# 295.15-1-28 Dear Mr. O'Brien: Our office prepared a wastewater replacement design for Mr. Garrand at the above-referenced property. A representative from our office visited the site during system installation. Based upon our site inspection and discussions with the installer it is my opinion that the system was installed in general conformance with the attached record drawing. Please contact me if you have any questions or if you require additional information. Best Regards, n."77cflk,A-3 G. Thomas Hutchins, P.E. Enclosure G.Thomas Hutchins,P.E. 4., X ,.., _ - �zkVT-d- N C N Wo wom w m zow-wm W 033N1 a N TW mW 2W U ¢ O^�Z�W m W L ¢'0 � W T Ow��KQ � vw z ooxLI akw j �. CO zom �z mZ mop ti a QOWm¢ 3�- ��'� Z o N Q z ow o_ o J m JI" 03 . m W x "w J �¢c� �o mw z�Q w gzo�m'Wm Q w Z N6 4 % W >- om TJ �o hoz o Q >��3m� ¢ o. �p �o ¢¢ o ? �Wo m w- Q ¢ Q oUr-w o b z> o om ~m foo w a polo o �$ ` ¢ p o r w 't=om. wQ. e¢¢ K -4 Z wp, t a.� (J U �-" o c x v, z�c¢a w W O? �¢ W Z Ooom�¢ ¢ 0 '~ �o �'` m c Z oN -°c �° Weo o kmJ z p zz �¢> ¢ m _ W e a, 0-4 pTm p? ¢o ¢40 ¢ t eQp 3mo 3 �. c m no C)(t)K WWz¢¢.za U J - �.�wt`.�:.. U Q� y oZ V)C) ¢p Ow e0. 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