2013-123 TOWN OF QUEENSBURY
OW742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130123 Date Issued: Monday, April 22, 2013
This is to certify that work requested to be done as shown by Permit Number P20130123
has been completed.
Tax Map Number: 523400-301-012-0002-015-000-0000
Location: 26 COLONIAL Ct
Owner: PETER& AUDRA CORLEW
Applicant: PETER & AUDRA CORLEW
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 e.
property owner of the responsibility for compliance with Site Plan, ���YYY / ,''
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.
jj111� TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130123 Application Number: A20130123
Tax Map No: 523400-301-012-0002-015-000-0000
Permission is hereby granted to: PETER&AUDRA CORLEW
For property located at: 26 COLONIAL Ct
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: PETER& AUDRA CORLEW Septic Alteration Residential
26 COLONIAL Ct Total Value
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
IBS SEPTIC & DRAIN
ATTN: IVAN BELL
2 LOWER WARREN St
OUEENSBURY,NY 12804
Plans&Specifications
2013-123
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, April 05,2014
(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 Queebury• w/�j'i ri , ri105,2013
SIGNED BY
for the Town of Queensbury.
Director of Building&Code Enforcement
'Community Development'Office
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 APR 0 4 2013
Office Use OnlyLiod
TAX MAP NO. 301 PERMIT NO. ) 3-03 PERMIT FEE
APPROVALS: ZONING 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: l/U//JrG1 ( Or \Jaw INSTALLER: 10
t ,, , (ll t^'J
ADDRESS: L Cobbon�t \ (`�• ADDRESS: DpI .OW?rVVCtrT"f AS+. V .
PHONE NOS. 136— l� b O PHONE NOS. 15S-9i
LOCATION OF INSTALLATION: it(0101, 10 C-1-.
RESIDENCE INFORMATION:
NO.OF COMPUTATION
YEAR BUILT X = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRI R
1980 or older . X 150 = INSTALLED?
1981 -1991 X 130 = 11\Q SPA OR HOT TUBI
1992-present INSTALLED? BE
ft 1 X 110 = I�
PARCEL INFORMATION: lV (� (n( �/I
• TOPOGRAPHY: k
OILATU : SAND ROLL STEEP LOAM LN IV1•�' C 3ALOPE, lYft OTHER N 11
✓ GROUNDWATER: AT WHAT DEPTH? IV � Y I`(1/�
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHA DEPTH? IV Pc
✓ DOMESTIC WATER SUPLY: MUNICIPAL
WELL N i�(If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS i V (k 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: I n() 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 TY : 1
ABSORPTION FIELD(WITH NO.2 STONE) Total length-00 ft. Each trench I`` 1 X b0
o SEEPAGE PIT(S)(WITH NO.3 STONE) How many? (V Size?IV T
o ALTERNATIVE SYSTEM Bed or other type?_ p ,V ik �(
ID HOLDING TANK SYSTEM Total required capacity? IV et Tank size? N N Number of tanks? 1`�
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 II re. ir- ents of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sanitary Se spoil(Srdinance. codesrEaueensburv.net
,A VISIT OUR WEBSITE FOR MORE INFORMATION
Signature of Pe n • -sponsible Date
www.aueensburv.net
�' ()Las a-&[ CA pe?‘
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: rzzscg am/pm
742 Bay Rd., Queensbury,/� NY 12804 Inspector's Initials:/J.,r)))
NAME: ( Dt1J PERMIT NO.:__ / 3 — /c 3
LOCATION: ele C b Io^i a. r INSPECT ON: -l- 9-13
RECHECK:
Comments and/or diagram
Soil Type: / Loam/Clay
Type of Water:-Mli"r / Well Water 1 L.'wtU / I Q S
klikik.
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' +/ - _Y 1 N N/A
[150'to well required if NO]
Absorption Field: Total length 1c3 ft.
Length of each trench , ft.
Depth of trenches •4c ft.
Size of Stone _
Seepage Pits: Number 4itleti_-
Size:
Stone Size:
Piping Size Type
Building to tank It SA-+k
Tank to Distribution Box At 5[.-t
Distribution Box to Field/ Pit u Cn -La2
Opening Sealed: /.. N
End Cap )4
Inlet/outlet Pipes&Baffles Vie
Manholes 12"or less below g e X it
[provide extension collar' 1/ Y_(t f
Location/ Separations
Foundation to tank fh; ft.
Foundation to absorption &5 ft.
Separation of Pits ft.
Conforms as per Plo _N
Engineer Report and 4s Bu' Y_ N
ETU Maintenance Con ct Y N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
S em Use Sta s:
•pprov=.
Pa [al Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Fomis\Septic Inspection Report.03 2910.doc
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--_ „ SEPTIC PLOT PLAN •• B r a
I HAVE SEEN OR OBSERVED ALL OBJECTS a .n
SUCH AS HOUSE , WELLS, TREES, FENCES, ETC CD
SHOWN ON THIQ/e0CUMENT.I HAVE PERSONALLY fl
Ell d �db MEASU ��y1� ANCESET FORTH ONT}iISDI G \ E m
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SIGN:- U''E DATE -�$1*.,.
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