The URL can be used to link to this page

SEP-000490-2017 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Petrnit Number: SEP-000490-2017 Date Issued: Friday, August 11, 2017 This is to certify that work requested to be done as shown by Permit Number SEP-000490-2017 has been completed. Tax Map Number: 301.7-1-48 Location: 22 BUENA VISTA AVE Owner: Deborah Allamena Applicant: Tony Signorelli This structure may be occupied as a: Residential Septic Alteration Replacing pipe to tank only By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the f/ property owner of the responsibility for compliance with Site Plan, �d 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 12804-5904 (518)761-8201 OL Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: SEP-000490-2017 Tax Map No: 301.7-1-48 Permission is hereby granted to: Tony Signorelli For property located at: 22 BUENA VISTA AVE 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 Tvce of Construction Owner Name: Deborah Allamena Septic Disposal-Residential $0.00 Owner Address: 22 Buena Vista AVE Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Tony Signorelli 589 WEST MOUNTAIN RD Queensbury,NY 12804 Plans&Specifications Residential Septic Alteration Replacing pipe to tank only $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,August 9,2018 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queens before the(�Q/pirat/i/9n date Dated at the Town -Queen /./ W ,August 9,2017 SIGNED BY: aYJ� 11 for the Town of Queensbury. Director of Building&Code Enforcement SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only ros.morQueensbury 742 Bay Road,Queensbury, NY 12804 "L(q0 Permit#: gyp- 1 (� P:518-761-8256 www. ueensb7 .net Tax Map ID#: 0L -7 -I—q_ g, Permit Fee: $_e& W- Invoice#: Project Location: Septic Variance? Yes No PrimaryOwner(s) beA bie l/4 Meow 4 Mailing Address a 03 L)eFw 9111 .5%A U Phone & Email Installer/Builder Vieae(/2 Mailing Address e f LveST AJ AV Phone & Email 7 fa .(� 6119 Engineer Mailing Address Phone & Email Contact Person for Building&Code Compliance:i '>-5 , ore Phone: RESIDENCE INFORMATION: Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes No 1980 or older Installed? (circle one) 1981-1991 Spa or Hot Tub Yes No Installed? (circle one) 1992-Present PARCEL INFORMATION: Topography _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 engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size gallons(min.size 1,000 gallons, add 2WtalloA for each garbage cylinder ors a/hot tub System Absorption field with#2 stone Total length ft.; Each Trench 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 and approved. The installed system must match the septic 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 known 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 Disposal Ordinance. PRINT NAME: $ a7 �� [ / DATE: SIGNATURE: DATE: Revised February 2017 Town of Queensbury Building Code Enforce nt NO I FJ SEPTIC PL T PLAN 1 HAVE SEEN OR OB ERVED LL OBJECTS SUCH AS H0. S,WELL ,TREE ; FENCES, ETC SHOWN 0 HIS DDC T.I H PERSONALLY 0 THE TANCE E 0 IS.DIAGRAM.., MEAS D `, j' SIGNATURE DATE �� ILCOPS h � F I,Q f •} BULD111 IG , JL� y o ho • z m _ 301.7_ _148 SEP-000490-2017 g Allamena, Deborah 22 Buena Vista Ave. o Septic Alt. (replace pipe only) 1 oq .