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 "