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2014-492 TOWN OF QUEENSBURY 742 Ba•Road, uc c nsb i NY 0-- y Q c �r}, 128 d 5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20140492 Date Issued: Thursday, October 16, 2014 This is to certify that work requested to be done as shown by Permit Number P20140492 has been completed. Tax Map Number: 523400-278-019-0001-004-000-0000 Location: 593 MOON HILL Rd Owner: WELLER FAMILY TRUST Applicant: WELLER FAMILY TRUST This structure may be occupied as a: Septic Alteration Residential By Order of Town Board TOWN OF QUEENSBURY (-- 0 Issuance of this Certificate of Compliance DOES NOT relieve the 4 ,43t 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 ` � 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140492 Application Number. A20140492 Tax Map No: 523400-278-019-0001-004-000-0000 Permission is hereby granted to: WELLER FAMILY TRUST For property located at: 593 MOON FULL 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: WELLER FAMILY TRUST JOANNE L LOFTUS TRUSTEE Septic Alteration Residential GERALD J LOFTUS TRUSTEE Total Value 1929 SANFORD RIDGE Rd QUEENSBURY NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2014-492 Res. Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, October 08,2015 (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 Tow . : -ensbu/ W:I ,ofs ay, October 08,2014 SIGNED BY r t de for the Town of Queensbury. Director of Building& Code Enn orcement SEPTIC DISPOSAL PERMIT Office Use Only DATE Received l ,/ Tax Map ID i � TAX MAP ID 027/ / 9 _ /— ` Permit No. / vim l Permit Fee 0 #1 LOCATION OF INSTALLATION 593 /1u /� /I Approvals: APPLICANT �/� i` L—cr��v 5 PHONE/E-MAIL 5-4. 7 9 2- 77 if 3 ADDRESS 02.q ,„-4641 . ; Ofr rn Ccr1 INSTALLER/BUILDER: 011 1 6' l 71. exC 1't V wf` r') PHONE/E-MAIL 5-18- 7q 6 (7 3O ADDRESS: OWNER F "J PHONE/E-MAIL Address /7 CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: �t C L` O"' 46:i1 r- PHONE SC 79 173° RESIDENCE INFORMATION Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow 1980 or older C Garbage grinder installed _Y _N 1981-1991 Spa or Hot Tub installed _Y _N 1992-Present PARCEL INFORMATION Topography ✓Flat rolling Steep slope %slope Soil Nature1,/ and SLoam Clay Other Groundwater At what depth? Bedrock I Impervious Material At what depth? Domestic Water Supply 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 Tank Size /2;T0 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#2 stone Total length 74 0 ft.;Each trench Co x C 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 is 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 Dispo,I(Ordinance_ Print Name: J2rc.4c M t 6v Date: l0 b/1 Signature: Date: (6/b/r y Town of Queensbury Building&Codes Septic Disposal Permit July 2014 1 Town of Queensbury Building & Code Enforcement 1 (A__e).> 01."4\r .A.,..2 Office No. (518) 761-8256 ' Septic Inspection Report Inspection request received: A \ Name: Cc'<<-' (1i ,` Inspected on: Location: i`c; < -- Arrive: _ a.m./p.m. Permit No.:/Y1 O Z /1 ff' !) 4-b- `I q6) Inspector's Initials: Comments and/or diagram Soil Type: Sand!Loam I Cla Type of Water: Municipal/ ell at Waterline separation dista ft. Well separation distance ft. Other wells: ft. Casing CasinggLength 50'+/ Y N N/A °1-Y'S [150'to well required if NO] Absorption Field: Total length c• t44- 1\) Length of each trench ft. +F i, Depth of trenches ff. Size of Stone Seepage Pits: Number Size: _x Stone Size: A -- PX-3-0- I �,jPiping Size ype �1 Building to tank Tank to Distribution Box Distribution Box to Field I Pit ` j�`- uc1$� `1 � Opening Sealed: _Y_N "VN.- End Cap Y Ne '`,� - � � Inlet/Outlet Pipes&Baffles Y_N �`��'b "` Manholes 12"osi n less below gradeY_N , 'k �„ `_ [provide extension collar if Yes] Y N !� Location/Separations Foundation to tank ft. Foundation to absorption ft. c5....---c Separation of Pits ft. Conforms as per Plot Plan N Engineer Report and As-Built Y N ETU Maintenance Contract provided _Y_N • Location of S st,til ••e : Front r I'•. Left Side Right Side Middle Front Middle Rear S stem Use Sta h . Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Septic Inspection Report Town of Queensbury Building &Code Enforcement Office No. (518) 761-8256 Septic Inspection Report Inspection request received: y Name: c Inspected on: I �' Location: �✓�� ,- 3ZS -1 RI) Arrive: t�- a.m./p.m. Permit No.: '11/4-*�")-- Inspector's Initials: ditit-477 Comments andlor diagram Soil Type:OLoam/Clay Type of Water: Municipal/ ell at Waterline separation distanc ft. Well separation distance 1f( ft. Other wells: ft. Well Casing Length 50'+1- Y_N_N/A [150'to well required if NO] � 'y� Absorption Field: Total length ' b �ft. Length of each trench ft. Depth of trenches 1^_.._ft. Size of Stone 9-- Seepage Pits: Number S Stoneze: / Size: Piping Size Type Building to tank 4 l^ Tank to Distribution Box A « �tZue �_. x _ ,-)4— ;.. Distribution Box to Field/Pit c t 3c--- Opening Sealed: ‘n_N End Cap N Inlet/Outlet Pipes&Baffles N Cr),\,c)v �� NManholes 12"or less below grade _Y_N [provide extension collar if Yes] _Y_N / - S �`)--'►U Location/Separations A — Foundation to tank 1.1 ft. �a Foundation to absorption 47 ft. Separation of Pits ft. Conforms as per Plot Plan Z' Engineer Report and As-Built _Y Jl'Vc ETU Maintenance Contract provided _Y._N Location of Syste on P perty: 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 Septic Inspection Report _ags_3c09485e4eea4f7293213ec2de77cb98 jpg(JPEG Image, 816 x ... ltttp://gis-2.warrencountyny.gov/aregis/rest/directories/arcgisoutput/Util... 593 Moon Hill Rd. - . . /t Ilf,.'L,.. l .:- .:.•:.. '‘‘,,7. t r; •X14 • J, J+ ;> 0. 1 -.1.1',•.•: I1 _ Re,_,, s e.d \ *e: w itil • .1 n 1 t' '''.r ,_ , -•. 4 1. i r - . ti 3 p✓ 71 yy4. ________<, . . ' -' i/ TT 40,.'- October 8.2014 1:1.128 7 0.007E 7.01E 3.02 nu Override 1 0 0.01E 0.02 30e tm is Override 1 igir Override 1 El Parcels jTown Boundaries SEPTIC PLOT PLAN IS HAVESUCAS SEENHOUSESOR SAH ,WELOBLS,TREESERVED , LL FENCESOBJECTS, ETC SHOON THIS iOCUMENT.I HAVE PERSONALLY EASWNT`EDT E D/NCE SET FORTH ON THIS DIAG AI4. /d i /P-/ •-u.nw DATE PA-7-Se(ye 1 of 1 10/8/2014 10:22 AN Zai � 16a ' auanzilOT PLAN I / 41 I HAVE SEEN OR OBSERVED ALL OBJECTS SUCH AS HOUSES, WELLS, TREES, FENCES, ETC SHOWN ON THIS DOCUMENT.I HAVE PERSONALLY MEASURED THE DISTANCE SET FORTH ON THIS DIAGRA i. -4— (°/. // 4 •: \-,- 6 1 $>> RE\-\\ \\:\:,. d.j. \ 'ATE • ../r v r V SI 3 co oti 1 ♦ ur "Co . , r _'IJ.14 ti 1 `e' '. F k �\'ti .Cd �� • t% _ c C7 \\ */' Ili, f, I ~.\, ' \ \\\\ , k..›.: 100 N.Q.a) �I\ ti J �I ', ni •`OLJ\ z (5k ,. co tJ7 � - xj N W \ \\) ir,_.---- A ` O O 1:)- -.4 V /co 1 i \\\/ Lo. \ Cr! �� nu 7 \ / I ( --- ( :)q--4-1.-1\-- TOWN OF QUEENSBURY BUILDING DEPARTMENT Based on our limited exsrnination,compliance with our comments sho); not be construed as indicating the plans and specifications are in full compliance with the Building Codes of New York State. + '------ - --_ � � \ / - ---- � � �� UV v/ (-).---) /-^ / / / \ -- _ __-- / / / '� -_ `�- / ' ' / ~' I � ` / / � � ` | ' __ -_ -- | _ � . / | ,,,e.---------~ //~` / �� _ / � _� �'-___ L' �] �] �p �� /1 -) � ' // / . 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