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2014-632 40111111K TOWN OF QUEENSBURY F 742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201 ��� Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20140632 Date Issued: Monday, December 15, 2014 This is to certify that work requested to be done as shown by Permit Number P20140632 has been completed. Tax Map Number: 523400-308-011-0001-041-000-0000 Location: 354 LUZERNE Rd Owner: SANDRA LOVELAND Applicant: SANDRA LOVELAND 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 property owner of the responsibility for compliance with Site Plan, �� `.�y �� ' ` - 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 ` ll � 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140632 Application Number: A20140632 Tax Map No: 523400-308-011-0001-041-000-0000 Permission is hereby granted to: SANDRA LOVELAND For property located at: 354 LUZERNE 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: SANDRA LOVELAND 354 LUZERNE Rd Septic Alteration Residential QUEENSBURY,NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency FRED SMITH NY 12804-0000 Plans&Specifications 2014-632 Res. Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,December 15,2015 (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 Que sbMo <a/December 15,2014 s✓it'� SIGNED BY - for the Town of Queensbury. Director of Building&Code Enforcement 0./4 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518; 761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140632 Application Number: A20140632 Tax Map No: 523400-308-011-0001-041-000-0000 Permission is hereby granted to: SANDRA LOVELAND For property located at: 354 LUZERNE 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: SANDRA LOVELAND 354 LUZERNE Rd Septic Alteration Residential QUEENSBURY,NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency FRED SMITH NY 12804-0000 Plans&Specifications 2014-632 Res. Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,December 15,2015 (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 Que sbury Mo .y`'December 15,2014 i SIGNED BY 4\ for the Town of Queensbury. Director of Building&Code Enforcement TAX MAP ID C= dRe.1\'''' ,- `LPermit No.Permit • )1(1-La LOCATION OF fNSTALLATlONc�. 1-.3Z KVE- 910 Appro ase 5 �� 3c: i APPLICANT -c. Q0 ID R A t...20v) __ $:-ND PHONE/E-MAIL (0-36-3S& ADDRESS A L\.Y7 G ..1pF__ k c c INSTALLER/BUILDER: PHONE/E-MAIL ADDRESS: OWNER ' O[DR c "-b )ELkt V PHONE/E-MAIL „y ^ �� Address CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PHONE RESIDENCE INFORMATION Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow 1980 or older Z t t�d t30( Garbage grinder installed _Y Spa or Hot Tub installed _Y N 1981-1991 1992-Present PARCEL INFORMATION Topography Fl- rolling Steep slope %slope Soil Nature —Sand Loam Clay Other Groundwater Atwhat depth? 0 Pk Bedrock I Impervious Material At wha Domestic Water Supply Municipal Well(if well,water supply from any septic system absorption is_ft.) Percolation Test Rate: % " th per minute per inch(test to be completed by licensed engineering/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION gallons(minimum size 1,000 gallons,add 250 gallons to size for each garbage grinder or spa or hot tub) Absorption field with#2 stone Total length 1-2-0 ft.;Each trench 3 x �Q System Type Seepage Pit with#3 stone How many: ;size Alternative System Bed or other type? IIIIIIIIIIII Holding Tank System Total required capacity? Tank size #of tanks system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will no longer Na es. 1)Alarmapproved. The installed system must match the septic system allow systemsiO,be covered until such time as an As-Built plan is received& layout on tile-n+exceptions. DE LpR,e 77o k ny permit or app royal granted which is based upon or is granted in reliance upon any material representation or Make'material.- t or circumstance know by or Queensbury Sanitary Sewage D sposal Ordinancehe regulations and failure to *• all r:quire nts o he To Date: 12-o i O I agree to abide bthe� J �� , j l 1 'I S'I N Print Name: . -, . , 4$r0 O L , Date: *Print IY1Yn• Septic Disposal Permit July 2014 ()msbUry W l es t a' Septic Inspection Report// Office No. (518) 761-8256 i, Pate rag•:-..##,#,$,,. -o' - v re iVed: Queensbury Building &Code Enforcement Arrive: o i 'iam/0 Depart: .51 \ ampm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials 4- NAME: _ C ,QC-LPr3 ) PERI TNO.: -°yV A . ..1,1-r.--f(0-__ 2----- LOCATION: _..0Z�V-1.,_ F Rt INNSPECTON: 1?_' -(r) -1t \ RECHECK: i 2-- \-0Z-) st.:- CA-- Nv->Z, � ) Comments and/or diagram Soil Types_Loam / Clay -/ ����,�--��, - ��4. �/ Type of Water: `Etud,jjpal _Well Water v9ot-=� 'A Ci'_c,-- ---1 VL. 2_ \t Waterline separation distance . ft. - ft. '�E R5E �uQ M cc- 6�=�tC� Well separation distance Other wells: ft. ' !\ `� Well Casing Length 50' + / - Y N N/A '')`A 5\ M C \ 1 � AC,1.1C_f\ITt [150'to well required if NO] c , t) Absorption Field: Total length \ 2J ft. > Lk V E -co 1 if\LvZE Length of each trench 7 c'-CD. / Depth of trenches 2..-VI-2-ft. ( 7-12\C 3 E -T-1 L ?i,Z NIT Size of Stone 7-'42 -2___ Seepage Pits: Number ( l 5 A' C E 2' V iF 1 C-Stone Size: x 3F c-01 4 �--\ CE .. Piping Size Type �C YvV- ql,A) . Building to tank t:� .\ 1--T\ tJ CD k\s 0\-2 2-)- Tank to Distribution Box \--A k\ 41 O P,'a 1--) Distribution Box to Field / Pit Lk " Q\C_ k--\" Q\fC- Y -S ---� Opening Sealed: _N ��� +\�E� End Cap %.,Y, N Inlet/Outlet Pipes& Baffles V'Y N Manholes 12"or less below grade ,/Y N/ / [provide extension collar if Yes] _Y Location / Separationst" Foundation to tank \ C,) ft. 1t.--)-5\-1%J6 Foundation to absorption 2-C: ft. Q Separation of Pits ft. 0 . Conforms as per Plot Plan VY N Engineer Report and As-Built —Y_ N / ' ETU Maintenance Contract Y N f provided / _ry --� i Location of System on Property: / 1 1 Front (Rear )(Left Side_) Right Side /Middle Front Middle Rear } 0 • S stem Use S:;, 7:.:- / ---7 ---> Approved Partial Approved and needs to be respected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report_03 29 10.doc ) ) ) 8 P 141 -Ca3 .A_ SEPTIC PLOT PLAN I HAVE SEEN OR OBSERVED ALL OBJECTS DEC 1 5 2014 SUCH AS HOUSES, WELLS, TREES, FENCES, ETC SHOWN ON THIS DOCUMENT.I HAVE PERSONALLY ASURE TTHE DIST',CES FO IN THIS DIAGRAM. . . / : / 2 -,S- iq SIGNATURE DATE AS BUILT Q9Y I IIWaTF2 1 HOME1 1 ,\,.., . ________, t.t-ik, , ,,, + tk k. % YJ • ,, �— , s. --- a151`i1.16 , vrdii --rfa plc. ,- 'ld •: J7BOK x.l Septic Inspection Report Office No. (518) 761-8256 Date Ins.- ion r- �- :•: Queensbury Building &Code Enforcement Arrive: r /pm '/.. 742 Bay Rd., Queensbury, NY 12804 Inspector's Init: -. NAME: 4 c ovRi; P • NO.: \E JNia--, C_Clak--Ja LOCATION: 54 \_v 'ECT ON: \Z- 1 -1 RECHECK: Comments and/or diagram Soil Type: Sand / Loam/ Clay Type of Water: Municipal / Well Water U.� T o�C� ) ��`C Waterline separation distance ft. Well separation distance ft. J Other wells: ft. Well Casing Length 50' + / - Y N N/A Eu.c t,;\ [150'to well required if NO] J Absorption of each trench ft. C Field: Totallength ft. Lengthve k F9- mp V- � V V)Q�1� Depth of trenches ft. Size of Stone S C.-D P\` `- \ Seepage Pits: Number rj\D 1---c V%) V---V 01• Size: x Stone Size: \C\ '\5 Piping Size Type \ � � 1 U \`AY_A4D Building to tank \ tk , Tank to Distribution Box Distribution Box to Field/ Pit �t7{� P \---1‘1'\\- :�pt)� Opening Sealed: Y_N �v � ��\ �� End Cap _Y_N t) Inlet/Outlet Pipes &Baffles �Y N 1� 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. k Conforms as per Plot Plan _Y_N Engineer Report and As-Built _,.Y— N FIN/1 T- ki3 \4\ _V ETU Maintenance Contract _Y_ N tail provided ` Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Statu , Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report 03 29 10.doc Septic Inspection Report Office No. (518) 761-8256 Date Inspection r-•u=- r- -''ed: Queensbury Building &Code Enforcement Arrive: 1C)1^4.6 pm D-••rt: ty 2 0 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: 'E? IT NO.: E ` - GCS 3'1 .Q►N41, \ LOCATION: :3. L\ L ?__ER-t E RD I .SPECT ON: ' - 1 - RECHECK: Comments and/or diagram Soil Ty : Sand Loam / Clay Type of Water _Munici a Well Water FQc,43TEn TO p4�� OFA Waterline separation distance ft. Well separation distance ft. '- ti � b-V F\W\_\c c T\bA Other wells: ft. Well Casing Length 50' + / - Y N N/A 6C) 0 \ES \ -ti 'vEM [150'to well required if NO] Absorption Field: Total length ft. A1-jTE_ . 00 C- E_n 00 Length of each trench ft. ta=NV_V Depth of trenches ft. Size of Stone R �CZE F3�T- JC ED tJE Seepage Pits: Number A-) X IJD\ Size: x Stone Size: R\-60 N,c&. l. 16\'\ c -\-) Piping Size Type O ‘‘,JC) 0\n- ,� - 1h Cbtn.G Building to tank Tank to Distribution Box O tJ i\t' O Distribution Box to Field/ Pit Q� `136. c ` \ C-4-6e Opening Sealed: Y_N - �Q�LE> ` -\`tA t)p T End Cap _Y N �! Inlet/Outlet Pipes & Baffles Y N \fTE u t). \1] f c 106 Manholes 12"or less below grade _Y_N D o v [provide extension collar if Yes] _Y T N Location/ Separations , Foundation to tankft. Foundation to absorption .ft. Separation of Pits ft. Conforms as per Plot Plan —Y T 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 Stat Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report03 29 10.doc TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY. 12804-5902 11/26/14 Sandra Loveland 354 Luzerne Rd Queensbury, NY 12804 Ms. Loveland, You currently have a failed septic system that needs to be repaired by code.The sewage leeching to the surface is a violation of section 136-5(A-E). Failure to address this situation by December 6. 2014 will result in termination of the water supply to the mobile home.A court summons will also be issued. You have also started construction to an existing garage which is in violation of section 88-12A of the Town Code. You are to cease all construction of a garage addition and remove the apartment that has been created in the garage or a court summons will also be issued for this violation. If you have any questions you can contact John O'Brien at 761-8255 Thank You for your anticipated cooperation. 4 4fit--- David Hatin Director of Building and Code Enforcement Town of Queensbury 518 761-8253 " Home of Natural Beauty ... A Good Place to Live "