2014-599 era TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140599 Date Issued: Thursday, November 20, 2014
This is to certify that work requested to be done as shown by Permit Number P20140599
has been completed.
Tax Map Number: 523400-297-010-0001-054-000-0000
Location: 654 RIDGE Rd
Owner: MICHAEL HIGGINS
Applicant: MICHAEL HIGGINS
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 c f r
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
`
l Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140599 Application Number: A20140599
Tax Map No: 523400-297-010-0001-054-000-0000
Permission is hereby granted to: MICHAEL HIGGINS
For property located at: 654 RIDGE 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: MICHAEL HIGGINS Septic Alteration Residential
654 RIDGE Rd Total Value
QUEENSBURY,NY 12804-0000
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
2014-599
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,November 19,2015
(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 reQue 129 fig' Wellies .ovember 19,2014
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SIGNED BY 14. for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT Office Use Only
DATE Receiy c f 1 r 2114
ID
h Tax Map ID t-
TAX MAP ( — f_ Permit No. �� "
/ Permit Fee111,
•. •_..
LOCATION OF INSTALLATION Approvals:
APPLICANT PHONE/E-MAIL
ADDRESS / d > IZ1
1NSTALLER/BUILDER: PHONE/E-MAIL
ADDRESS:
OWNER 1.7.tiva /�� PHONE/E-MAIL
Address 5'617/
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PHONE
RESIDENCE INFORMATION
Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow
1980 or older �/ s f jc , a} ,G o 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 Nature Sand X Loam Clay Other
Groundwater At what depth?
Bedrock/Impervious Material At what depth?
Domestic Water Supply /1 Municipal Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate: �e ,2 3 per minute per inch(test to be completed by licensed engineering/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank Size /doe*-, 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 2G.cta ft.; Each trench S. x 5--
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 require of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Print Name: —"�- 1 Date: G(—/7—/7
Signature: Date:
Town of Queensbury Building&Codes Septic Disposal Permit July 2014
Town of Qv'.Asbury Building &Code Enforcement
Office Nr I8) 761-8256 l
Septic Inspection Report
Inspection request receiv d: [ i [ / )
Ins
Name: -
p 1 l� /)-0 � �
� ! 6'L� ected on:
Location: ( - w 6. Arrive: J`.fid a.m.I p.m.
Permit No.: ,),D4-6-99 _ Inspector's Initials:
Comments and/or diagram
Soil Type: Sand oa lay
Type of Water: nicipal ell Water
Waterline separation distance >/U ft. —
Well separation distance ft.
Other wells: ft. 1
Well Casing Length 50'+l- Y N N/A
[150'to well required if NO] if 41,0 A
1
Absorption Field: Total length 0-2(00 ft.
Length of each trench 3-3 ft.
Depth of trenches /-2 ft.
Size of Stone Z g l 39
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box 7/":GP
Distribution Box to Field 1 Pit ci"JOIL
Opening Sealed: Y N
End Cap 1G'Y_N
Inle CIP Pipes&Baffles Y N
Manholes 12"or less below grade _Y.N
[provide extension collar if Yes] Y X N •
Location/Separations
Foundation to tank ft.
Foundation to absorption SO ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built Y 9G N
ETU Maintenance Contract provided Y N
Location of System or2roperty:
Front ear ' Left SideRight Sid 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
518-793-2290
Fax#518-793-2115
1110 E-mail: morningstarseptic@hotmail.com
www.morningstarseptic.corn
.01r".1111111PTIC 1111•RVICIII
Date:
107 Jewel Road,Gansevoort, NY 12831
TO:
MAP
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_ -
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SEPTIC PLOT PLAN
I HAVE SEEN OR OBSERVED ALL OBJECTS
6°°
SUCH AS HOUSES, WELLS, TREES, FENCES, ETC 1�/
SHOWN ON THIS DOCUMENT.I HAVE PERSONALLY (�� 1
MEASURED TH 'IS TANCE S RTH ON THIS DIAGRAM. LJ
SIGNATURE- 7-
DATE
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TOWN OF QUEENSBURY
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BUILDING & s *AAP
Reviewed By: -:.�
Date:
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y0U-14-2014 11:57 FROM:G. PETER JENSEN 5187983859 TO:7932115 P.2'2
G.Peter Jensen 1
17 West Road
South Glens Falls ki �
New York 12803
(518) 798—3859
November 14,2014
To Whom It May Concern:
I have performed a soil percolation test at the Higgins residence, located at 654
Ridge Road,Queensbury, Warren County New York. The testing,performed in
accordance with the NYS DOH guidelines,resulted in a stabilized percolation rate of 6
minutes and 23 seconds.
Sincerely,
G. PeterJ`,,:en ( gE \
\04.kt.oz.ora ir