2014-335 TOWN OF QUEENSBURY
Fos742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140335 Date Issued: Wednesday, August 06, 2014
This is to certify that work requested to be done as shown by Permit Number P20140335
has been completed.
Tax Map Number: 523400-302-014-0001-078-000-0000
Location: 2 BENTLEY PI
Owner: STEPHEN & SHELLY REGAN
Applicant: STEPHEN & SHELLY REGAN
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of his Cof the cate f Compliance DmOES NOT rive 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&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
4O742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140335 Application Number: A20140335
Tax Map No: 523400-302-014-0001-078-000-0000
Permission is hereby granted to: STEPHEN & SHELLY REGAN
For property located at: 2 BENTLEY PI
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: S I EPHEN & SHELLY REGAN
2 BENTLEY PI Septic Alteration Residential
QUEENSBURY,NY 12804 Total value
Contractor or Builder's Name /Address Electrical Inspection Agency
MORNING STAR SEPTIC
793-2290 744-8139
107 JEWELL Rd
GANSEVOORT NY 12831-0000
Plans&Specifications
2014-335
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,August 04,2015
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To of Qu nsb /� i i d:( . :ust 04,2014
4
f�
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
- SEPTIC DISPOSAL PERMIT ..-+•10.•,...,•••••- '1
_........r...!,..", n w/ L, Office Use Only
DATE .D•n-1-10tYJ 1Received p
1 �n�l Vii Map ID 3b . c1 - 1-t) A
1 ' zat4 W er ii /y_335
Tax MAP lo ,�1,!L 2 5 �Permlr No.
LOCATION OF INSTALLATION lu u—� F QU )FPermft�Fee P d
BUIL lu4G&CODE Approvals:
APPLICANT IJJt$s..r CT......., PHONE/E-MAIL
ADDRESS !l
INSTALLER/BUILDER: "inst..? �5/o���5 ,,( PHONE/E-MAIL 2 9 3 Z2q 0
ADDRESS: C . /07"inst..?
1 ' Al fnt4c4..- �- /L�
OWNER J er .a PHONE/E-MAIL
Address aJ-��8.n.-,,ti Pte.t2 - i eQ ? ..;\/ r
r i(
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE /rire.n.il/1 Si PHONE'74(948131
RESIDENCE INFORMATION
Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow
1980 or older493. ugh /PA 3mo Garbage grinder installed _Y .S.N
1981-1991 Spa or Hot Tub installed _Y _K.N
1992-Present
PARCEL INFORMATION
Topography 4) .Ding Steep slope %slope
Soil Nature X.Sand Loam Clay Other
Groundwater At what depth? ‘i"r-
Bedrock/Impervious Material At what depth? _
Domestic Water Supply 1C Municipal Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate: per minute per inch(test to be completed by licensed engineering/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION 2, Fge..,.. I D D3
Tank Size /ono gallons(minimum size 1,000 gallons,add 250 gallons to size for each garbage grinder or spa or hot tub)
System Type Absorption field with#2stone Total length ll116735-ft.; Each trench qr x 3
Seepage Pit with#3 stone How many: ;size
Alternative System Bed or other-type?
Holding Tank System Total required capacity? Tank size #of tanks
Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will'no longer
allow systems to be covered until such time as an As-Built plan is received &approved. The installed system must match the septic system
layout on file-no exceptions.
DECLARATION: Any permit or approval granted Which:is based upon or granted in reliance upon any material representation or
failure to make a material fact or circumstance know by or on behalf of an applicant,shall be void. I have read the regulations and
agree to abide by these and all requirements'Of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Print Name: .- Date:
Signature: --... c 5,& Date: _ ,Q 21- - /y
6
Town of Queensbury Building&Codes Principal Structure Application July 2014
I
Town of Queensbury Building &Code Enforcement a 4ptvi
Office No. (518) 761-8256
Septic Inspection Report
Inspection request r ceived: S ,7 1_ 14-
Name: �^ / _ � Inspected on: I. , ei L
lir
Location: d '� P�c_, Arrive: - max. m. p.m. it
Permit No.: a014- �J3 Inspector's Initials: Si'
ar
• .• ,.�dia.ram
Soil T .- .. pr.!7gpr9v
Type of Wate .• J,31 � � rte yro f r '�
Waterline separation distance _\Q_ft. F, ._>J '� rte.
, DSI, tit
Well separation distance , Or f
Other wells:
VIciti—
Well Casing Length 50'+/- Y N_NIA
A`� Md f v v
q� s6 . ,
1150'to well required if NO]
e)arr
Absorption Field: Total length ft. ,/ vc1n
Length of each trench 7��' aft 1,I
Depth of trenches 21 – 'rp ft
Size of Stone F OLIA Fcr) jam,*Z
Seepage Pits: Number
Size. x
Stone Size:
Piping Size Type
Building to tank t..4+" __3i-LAA \--to Fit y.� c---E to Distribution Box 4" IVB 3
Distribution Box to Field/Pit / tit` 4•T)V— 35- YrkINs F t=PbNICw ,
Opening Sealed: +✓✓✓"""�YYY%%%� N
sij 6
End Cap
Inlet/Outlet Pipes&Baffles /
Manholes 12"or less below grade —y/ N
[provide extension collar if Yes] Y N
Location!Separations
Foundation to tank M D ft.
Foundation to absorption 7:1 ft.
Separation of Pits /""" ��/rft.
Conforms as per Plot PI �( v/—N
Engineer Report a As-eu _..............„.„--
0
Y_N
ETU Maintenance Contract provided _Y_N
Location of System on Property:
Front Rea Left Side Right Side Middle F ont Middle Rear
S stem Use Statu .
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
k
MORNING STAR EXCAVATING, INC.
& SEPTIC SERVICE
107 Jewell Road 518-793-2290
Frank Shaw, Pres. Gansevoort, NY 12831-2154 518-695-5505
Fax#518-793-2115
Date: OtAit I ` (
TO: ¶--e. .4. No. 24790
a facm, pi.
14.4 0,^41
INVOICE: Terms: Payment Due.Upon Receipt of Invoice
1 1/2% Interest After 30 Days
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RX Date!Time 08104/2014 15:02 5187932115 P.001
02/04/2014 14:40 5167932115 MORNING STAR SEPTIC PAGE 01/01
RUG-4-2014 14:21 FROM:G. PETER JENSEN 5187993959 70:7932115 P.2'2
) c 33 5
G.Peter Jensen
17 West Road
South Glens Falls
New York 12803
(518)798—3859
August 04,2014
To Whom It May Concern:
Today,August 04,2014,I observed a test pit that was dug at the Regan residence
located at 2 Bentley Place,Queensbury,New Yodc The test pit was dug to a depth in
excess of 5 feet There was no evidence of mottling observed.
Sincerely,
,•
G. 'eter :Assn Agt.�i
sr to ea
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Baton -43(�'
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