2014-493 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140493 Date Issued: Friday, April 08, 2016
This is to certify that work requested to be done as shown by Permit Number P20140493
has been completed.
Tax Map Number: 523400-227-018-0001-013-000-0000
Location: 85 PILOT KNOB Rd
Owner: VINCENT & ANNETTE O'NEILL
Applicant: VINCENT & ANNETTE O'NEILL
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 �p
property owner of the responsibility for compliance with Site Plan, ci),,,,„P /GJ
Variance, or other issues and conditions as a result of approvals by the Director of Building&Cod Enforcement
Planning Board or Zoning Board of Appeals.
1
a TOWN OF QUEENSBURY
` W 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20140493 Application Number: A20140493
Tax Map No: 523400-227-018-0001-013-000-0000
Permission is hereby granted to: VINCENT & ANNETTE ONEILL
For property located at: 85 PILOT KNOB 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: VINCENT&ANNE I 1 E ONEILL Septic Alteration Residential
24 LAKEWOOD Dr Total Value
SARATOGA SPRINGS NY 12866-0(
Contractor or Builder's Name /Address Electrical Inspection Agency
CRANDALL EXCAVATING
793-0431
63 WOODCHUCK HILL Rd
LAKE GEORGE NY 12845-0000
Plans&Specifications
2014-493
Res. Septic Alteration Town BOH approved 7/21/14 Reso 25 of 2014
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, October 07,2015
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town o Quee ury ,Tues: • ,if)ctober 07,2014
air �fj1 y
SIGNED BY . �.\ for the Town of Queensbury.
Director of Building&Code Enforcement
•
1 &2-M-C VCCIAll it., 0,e4nt i 4.Ai GL2ke e Ai*, (1 at z ,..9.61(1
SEPTIC DISPOSAL PERMITOffice Use OnIX, r
DATE /0/5// l Received
IIII Tax Map ID . � _
TAX MAP ID 9-g.'7.I 3 -/ -/3 Permit No.. owing
�5 t',L(%Qi� ei [.. ! ytpFee I tt
LOCATION OF INSTALLATION Appp roo vals:
,/ (ter/S'‘ : '',-/76,
APPLICANT &fl,LI2 iP2 Ly 1./14.Z1 I(i 1' r PHONE/E-MAIL al 4 d N CQ'.r(._I, t 5
ADDRESS ,$)s / bX ' ,62.0'6- i�(-1Je. 7 Qu itD j) );2 Sb y eteakr-i q��(1('
INSTALLER/BUILDER: VI-AdlLC(- & PHONE/E-MAIL . 1g) 193 — Df. q
ADDRESS: 63 `461- ��e�C ak. L, d Lab &414/ / ' >o a /
�L . ✓,Nies- ela-°X36 J-/76 5
OWNER ,4111IL&") dill VII1.1 ( ! lilt eA MA
PHONE/ - IL I1tsa4 ear - 349-44l 6 C,
2
4 Address 40,,,i, )Q +417":07014�4)hp —17i �e �r. (Om
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: [/6 Y2,14 &NIit PHONE "/ 9 3,U .3 ! S
RESIDENCE INFORMATION
Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow
1980 or older - Garbage grinder installed _Y _N
1981-1991 • Spa or Hot Tub installed _Y _N
1992-Present
PARCEL INFORMATION
Topography V Flat rolling Steep slope %slope
Soil Nature Sand Loam Clay Other
Groundwater At what depth?
Bedrock/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 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 ft.;Each trench x
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 abideb these and all qui.errepPts of the Town of Queensbury Sanitary Sewage I isp0sal Ordinance.
Print Name: ANN /✓
A 7� \/ V c1 L li Date:
Signature: &/i, lkopr _J-1.1( Date: I, _
l
Town of Queensbury Building&Code Septic Disposal Permit July 2014
JJA
Town of Queensbury Building & Code Enforcement
Office No. (518)761-8256
Septic Inspection Report
Inspection request received:
Name: � NCAInspected on: —
Location: . ` P'\ k-1--)'6Vnnk Y A. Arrive: 6— /a p.m.
Permit No.: ti 'Ac� Inspector's Initials: 111115,frin'
Co ' ents and/or dia•ram
Soil Type: Sand/Loam/Clay
Type of Water: Municipal/Well Water •—�-
Waterline separation distance ft. 6-74r1 -6
°l��f � 'VY
Well separation distance ft. 1
Other wells: ft. YY'1`SS CAS.- blkt t r
Well Casing Length 50'+1- 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 �� x-jtk
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field 1 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 _N
Engineer Report and As-Built Y N
ETU Maintenance Contract provided Y N
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
Septic Inspection Report
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
s
f Community Development-Building&Codes (518) 761-8256
Inspections per Permit
Permit# P20140493
Inspection Date Inspection Type
Approved/Denied Comments Permit Type Person Responsible
10/07/2014 Miscellaneous Septic Alteration Residential STAFF
Misc 2014-493
permit app rec'd&entered
10/07/2014 Septic Alteration Residential JOHN O'BRIEN
Approved 2014-493
permit approved
10/28/2014 Final Electric Septic Alteration Residential COMMONWEALTH ELECTRICAL
Approved 2014-493
10/29/2014 Final Electric Septic Alteration Residential CHARLES DYER Staff
Partial 2014-493
Verified 3 1,500 gal holding tanks w/alarm
Final Elec Done
Provide Engineer as-built report
10/29/2014 Septic Septic Alteration Residential CHARLES DYER Staff
Partial 2014-493
Verified 3 1,500 gal holding tanks w/alarm
Final Elec Done
Provide Engineer as-built report
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received:
Name: Inspected on: tV \251,\,'vc'
Location: 'Y R-4"51- K51, Arrive: • C a.m.lp.m.
Permit No.: 2,C).(A'- Inspector's Initials:
Comments andlor diagram
Soil Type: Sand I Loam I Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50'+I- Y N N/A
[150'to well required if NO]
Absorption Field: Total length ft.
Length each trench ft.
D
Depthpthoff trenches
trenches ft. ��-
Size Stoneo — C –C)
Seepage
Pits: C/
its: Number
Size:
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/Pit zN ,
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 f6fE5V l� te t�
Location/Separations � Y
Foundation to tank ft. 15 v i
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan
Engineer Report and As-Built _Y�6`1►�
ETU Maintenance Contract provided _N
Location of Sys Prope :
Front Rear eft Side Right Side Middle Front Middle Rear
S stem Use Status:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report