2014-439 TOWN OF QUEENSBURY
OS742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140439 Date Issued: Wednesday, September 24, 2014
This is to certify that work requested to be done as shown by Permit Number P20140439
has been completed.
Tax Map Number: 523400-308-018-0001-074-000-0000
Location: 28 TRIPHAMMER Rd
Owner: BRENDAN & CINDY MURRAY
Applicant: BRENDAN & CINDY MURRAY
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 G 1 J�l
property owner of the responsibility for compliance with Site Plan, v ;Me
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
too 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140439 Application Number: A20140439
Tax Map No: 523400-308-018-0001-074-000-0000
Permission is hereby granted to: BRENDAN & CINDY MURRAY
For property located at: 28 TRIPHAMMER 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: BRENDAN & CINDY MURRAY
28 TRIPHAMMER Rd Septic Alteration Residential
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
SANITARY SEWER
GEORGE DRELLOS 792-7257
PO BOX 224
GLENS FALLS NY
Plans&Specifications
2014-439
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 18,2015
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town o e-jb; ryi i :y, September 18,2014
'
SIGNED BY I • I for the Town of Queensbury.
Director of Building&Code Enforcement
•
)II- Office Use Oniv i 1> '
Town of Queensbury Building & Codes ; - '• ryed: - - "��I \
Tax Mapil• 2114 3. 5--y1),, 1 //_
SEPTIC DISPOSAL PERMIT � � nFfinj - 37
A permit must be obtained before beginning construction Fe �.�.• ;C'� p�
\..................
Permit Fee/UEe`$vyb 1 3
-Approvals:.lc,b ^'U ✓1
2n rn1 M..J.•'.
Applicant: ice&tNJ u r✓ /27u'rr�. InstallerBuilder ✓ft01/2 IA. , 1;2_4,04- dewire
Address: g e rt 1 p /ti ttn ter Address Pp- &y0 ZZ Y
Bneeas 6 !w- ( /PA✓J Fxl.//J /L'' /2 r0
Phone: Z1--5-- /d/o Phone 7991 -72J 7 /
Owner: Location of Installation 0f J r 'p /I/f ern rt e
Address: L.54/"`e
Phone
Contact Person for Building&Code Compliance: 8 f 5 e lb tea./ Day Phone: 7/6-1760
Residence Information:
Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow
1980 or older x 150 = Garbage Grinder installed? AA
1981-1991 Y x 130 = -5—2-0Spa or Hot Tub Installed? Nv
1992-Present x 110 =
Parcel Information: ,,//
Topography )(flat Rolling _Steep Slope _%Slope
Soil Nature .x Sand _Loam _Clay _Other
Groundwater At what depth? /vim'
Bedroddimpervious Material At what depth? ///-
Domestic Water Supply _. Municipal _Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate- /'i— per minute per inch(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 /2,1-0 gallon(minimum size 1,000 gallons),add 250 gallons to size of septic tank for each garbage grinder,spa or whirlpool tub
System Type: Absorption Field(with#2 stone) Total length 25—o' ft Each trench v 0 X s"
Seepage Pit(S)(with#3 stone) How many? 'C Size? .h
Alternative System Bed or other type? h
Holding Tank System Total required capacity? )c Tank size? #of tanks?
NOTE: 1)Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agency-see Certified Electrical form
on Town website; 2) Effective as of March 23, 2006 Septic System-As Built Plot Plan: The Building Department will no longer allow systems to be
covered until such time as an As-Built Rot Plan is received and approved by the Building Inspector. The installed system must match the septic system
layout on file. There will be no exceptions.
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.
Il have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary
Sewage Disposal Ordinance. /�//
Print Name: C-4 I f € he-M-1 Date: 9_ /7—1 L/
Signature: �7�.c2e Date: 7—/7—/S
Town of Queensbury Building&Codes Septic mal Permit 518-161-8256
of Queensbury Building & Code Enforcement &A-AA)g: v\ 3 Q
No. (518) 761-8256 �, 3
Septic Inspection Report
Inspection request received: ZZ
Name: mCt. Rite-1 Inspected on:
Location: a b r%A.?.
A.? /l lvYn'►`L 1 I * cArrive: a / •.m.
Permit No.: 1 d -93 /
Inspector's Initials: /�
o •ntsand/or dia•ram
Sir
SoilTyp- al e• la�
Type of Wat- . Munic' Nell Water
Waterline separation distance `D 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 751:7 ft.
Length of each trench trn D ft.
Depth of trenches y ft
Size of Stone
Seepage Pits: Number
Size: x
Stone Size
Piping Size Type
Building to tank Lk t 1 r_i il 14C5
"" 7
Tank to Distribution Box 4. 99 �1
Distribution Box to Field/Pit i,
Opening Sealed / N ••' �`
Cap
End �/Cr�/Y
Inlet/OutletIN
Pipes&Baffles
Manholes 17 or less below grade N
[provide extension collar if Yes] Y N
Location/Separations
Foundation to tank - ft.
Foundation to absorption 6 ft
Separation of Pits ft.
Conforms as per Plot Plan Ver N
Engineer Report and As-Built Y N
ETU Maintenance Contract provided Y N
Location of System on Property:
ZR 1 t?\.3
Front Rear -eft Side Right Side Middle Front fiddle Rear 2`
System Use Status
Approved
Partial Approved and needs to be re-inspected, please call the Building & Codes Office
Disapproved
Septic Inspection Report
11=ooArk
Septic Inspection Report
Office No. (518)761-8256Date Ins•-• on4100,
Queensbury Building &Code Enforcement Arrive: %tire). I •.rt:
742 Bay Rd., Queensbury, NY 12804 In ' - ur's Initia -
NAME: tf p IP t lari:ans NO.: -4431 K,- 1
LOCATION: 29)) TR PAAMMFJLft(3 ' CT ON: `ri VL 14I
RECHECK: -b a-7rt _ F4;11\
Comments and/or diagram
Soil Type: Sand/ Loam/ Clay
Type of Water: Municipal/Well Water
Waterline se'.ration distance ft.
Well separation distance ft. 1J E71 \Th k'&s
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 Sta s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
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SEPTIC PLOT PLAN N. '1 '
i\ I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HOUSES, WELLS, TREES, FENCES, ETC
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