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2009-455 TOWN OF QUEENSBURY ,,y 742 Ba Road ueensbu NY 12804-5902 518 761-8201 Y ,Q rY> ) Community Development -Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20090455 Date Issued: Tuesday, May 01, 2012 This is to certify that work requested to be done as shown by Permit Number P20090455 has been completed. Tax Map Number: 523400-290-013-0001-026-000-0000 Location: 4 FAIRWAY Ct Owner: JOSEPH &JANE YARZE Applicant: JOSEPH &JANE YARZE 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, j) Variance,or other issues and conditions as a result of approvals by the Directorof Bidding Si Co nfo rnent Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY ` 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090455 Application Number. A20090455 Tax Map No: 523400-290-013-0001-026-000-0000 Permission is hereby granted to: JOSEPH&JANE YARZE For property located at: 4 FAIRWAY Ct 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: JOSEPH&JANE YARZE 4 FAIRWAY Ct Septic Alteration Residential QUEENSBURY,NY 12804 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency MORNING STAR SEPTIC Plans &Specifications 2009-455 septic alteration residential $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday, September 22,2010 (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' ..own-of Queens ury / 2Tu sday, September 22,2009 SIGNED BY o-�'vz� 4for the Town of Queensbury. Director of Building&Co e Enforcement IR . -� + //�(} / -/-2 �^('� /`/� OFFICE USE ONLY � pd�{{{�//)^^^ �-- �i ��r`y�_r d�' i��'� �`�"=,{r-�FF,,yy11` rr . V . V vO. PERMIT NO.I� PERM E il ; APPROVALS: ZONING TOWN CLERK I li c_`7. : :, :-.---, �ii4r4: l H , APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: '' I tZI�. INSTALLER: 6��j-rig-�y,. ,J l - V Lj 4 ADDRESS: 9 F� C.b-� ADDRESS: /0 V-e----,./A 72-LI PHONE NOS. '7 9? 32-1 I PHONE NOS. 79321.-1 a LOCATION OF INSTALLATION: 41 F ( '_ U RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION= = TOTAL DAILY FLOW BEDROOMS GARBAGE GRINDER 1980 or older X 150 gallon per bedroom = INSTALLED? /tom 1981 -1991 X 130 gallon per bedroom = SPA OR HOT TUB / 1992-present 5- X 110 gallon per bedroom = c-s^p INSTALLED? N PARCEL INFORMATION: ✓ TOPOGRAPHY: Flat rolling ,< Steep slope %Slope ✓ SOIL NATURE: Sand Loam X Clay Other ✓ GROUNDWATER: At what depth? f ✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth? ✓ DOMESTIC WATER SUPLY: Municipal X Well (If well: Water supply from any septic system absorption is ft.) ✓ PERCOLATION TEST: Rate is per minute per inch. (Test to be completed by a licensed professional engineer or architect.) PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional engineer or architect (unless installed in a Planning Board approved subdivision). rzs TANK SIZE: 441 GALLON (MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for ./Iro each garbage grinder,spa or whirlpool tub. SYSTEM TYPE: ❑ A• BSORPTION FIELD (WITH NO. 2 STONE) Total length 3o6 ft. Each trench s 1 X G ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? ❑ ALTERNATIVE SYSTEM Bed or other type? ❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? il il NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN • APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. • For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury,any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation 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 with respect to this application and agree to abide by these and all requirements of the Town of QUESTIONS? CALL 761-8256 OR EMAIL Queensbury Sanitary Sewage Disposal Ordinance. codes@queensbury.net A VISIT OUR WEBSITE FOR MORE INFORMATION �--- www.aueensburv.net Signature • erson Responsible Date ` Town of Queensbury •Community Development Office • 742 Bay Road, Queensbury,NY 12804 oi,t4c57 }>= _ 1_ 518-793-2290 I '{i-''� r - %z- Fax#51 8-793 2115_ 9- X E-mail:morrnngstarseptic©hotmail co l '' j Ji 4 www.mornin starse tic c m E il ;w .. .. : L f Date: Sr,•, /e1 " GI 107 Jewel Road,Gansevoort,NY t12831U `J :Y p J lI TO: cfkrx-al-J-.. 1- 9.0-",-g- yo,8., E s T i m A T Et - ,,,, ,-,,,,„„A„,,,..; 6.,......,k C, 2_ ors,., 7q 2 32if d',,,4,t1Q1 0,. ), ce-ria:;6 -r„„1, @ 9.s,a) p..?„ i- a.Q.„,,..„, 30 - � � 1J �.tt f c.,,....z • -i nave stem ey'observed, or bP.liAva 7 i�6f t g:,,. ,- r.t ;4-' - res hno—os �3 urr �EaE<��'3"B t: 9 .. �, , w�ls, trees, °, 1! Y`�$0, �1[� '.- J.�' a �4d['S f'r1 L` to-..v e 3h'15 ;e;�,,D 'k' :a" ea,n I ®/ ,Sf ill i5 0:..i I / .j " tot t"P'+ L w '4 � .* "at. b'.m' tl ! • r� ��� pp�{ WA/ OF - sue , VU!L y N '"r1 :..> ', . 1 - 40 Reviewed By. I 1 Septic Inspection Re► ,, r Office No. (518)761-8256 Date Ins•- 'on -• ,t' -•-ived: Queensbury Building&Code Enforcement Arrive: v .4 Depart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Inib- .�IAAr ® NAME: isb W2Z-F._ PE',f IT `O.: Cn ut55- LOCATION: 4 �Ri cZ A C—TV. IN'r ECT ON: — - -- & RECHECK: LA — —i7.— Comments and/or diagram Soil Type: Sand/ Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N NjA [no'to well required if NO] OF�� Ft.�RL—�=�� Absorption Field: Total length ft. Length of each trench ft. Depth of trenches _:ft. Size of Stone Seepage Pits: Number Size: _., x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: Y N End Cap Y N Inlet/Outlet Pipes&Baffles Y N r 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 _-,Y N Engineer Report and As-Built Y N ETU Maintenance Contract Y_N provided Location of System on Property: Front ear Left Side Right Side Middle Front Middle Rear System Use S usA roved e-F_ vG_Z) ‘1. Nk_- Eu 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 • • • • 1 i I # r APR :1 0 2012 I Li) • - - - - ,j • IV Cr- QUEENBURY FAJILDING&CODE COMMONWEALTH ELECTRICALINSPECTION SERVICE,INC. Mn Office 76 Due Run Road-Maribeim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Permit N . Cert. N2 202 8 7 Cut-in Card NO, • Owner : Location i e 4.3.1.iy (am cZ(2J 1, Loy , Installation Consisting of ,„5...y.27,1.4- • • Installed By.,.....-13.0.9.ar./1.rt.“Lials.s1442...... Lie.,No. The conditions following governed the issuance of ttii certificate,and any certificate PreviOuslY issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date, Upon the introduction of additional equipment or altetatiOns,application shall be promptly made for inspection. inspeetors of this Company shall have the privilege of making inspectionS at any time, and if its • ' rules are violated,the Company shall have the tight to revoke this certificate, • Datc • • 39Vd Member N.F.P,A 0.4.E.I. : . • olawnwNO P8S186L 1717:60 "E61g/GE/P0 Septic Inspection Repo Office No. (518) 761-8256 Date Inspection requ=.t ,-•- ,ed: Queensbury Building &Code Enforcement Arrive: am p *part: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: / A. NAME: A Z€. PE• ' NO.: O —'4 LOCATION: 4 FAtQ.u?4k CT IN" CT ON: q—ZA—oq RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/ Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - Y N N/A Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type ` t,k61/4\.-- Building to tank Tank to Distribution Box ..... ----- -?" -C.)1--\\ L-- Distribution Box to Field/ Pit Opening Sealed: Y.N End Cap Y N Inlet/Outlet Pipes&Baffles Y_ N Location/ Separations ---'" Foundation to tank ft. Foundation to absorption ft. Separation of Pits .ft. Conforms as per Plo 1a4ci N Engineer Report As-Bu' Y_ N - ca.s_Ge.‘Q E:S) t _?,LJ t�--�- Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: _vie. proved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc 09/23/2009 14:36 5187932115 MORNING STAR SEPTIC PAGE 02/02 MORNING STAR EXCAVATING, INC. & SEPTIC SERVICE 107 Jewell Road 518-793-2290 Frank Shaw, Pres. Gansevoort, NY 12831-2154 518-695-5505 Fax#518-793-2115 Date: S'7X 23 -4'0' TO: NO. 19065 INVOICE: Terms: Payment Due Upon Receipt of Invoice 1 1/2%Interest After 30 Days A 3� A t, ! ;04 33 A - oi3, /oe 3 744 2 41/41' ` P� 3 ---r.-f, z -iv' 1-la s a 3- 93'1� ,��. ca ti 1 c1 Septic Inspection Report Office No. (518) 761-8256 Date Inspection r-• -iv-o Queensbury Building &Code Enforcement Arrive: - y , ►-part: i i , 742 Bay Rd., Queensbury, NY 12804 Inspector's I ,_LG NAME: '( A PE/IT NO.: f LOCATION: 4 FA 1 I,IPECT ON: RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/ Clay Type of Water: Municipal/ Well Water Waterline separation distance ft. Well separation distance ft. P v I-1\‘' tRLcA i1M J Other wells: ft. Well Casing Length 50' + / - Y N N/A 0 V\' Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number k \ Size: Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field / Pit - &I LT Opening Sealed: _Y_N End Cap _Y_N Inlet/Outlet Pipes&Baffles _Y N Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan _Y_N Engineer Report and As-Built _Y_ N I Location of System on Property: • Front Rear Left Side Right Side Middle Front Middle Rear S stem Use Statu . Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc -,,_ -, g-, /1) ii,u,„ Septic Inspection Report Office No. (518) 761-8256 Date Inspection r es r eive //a /Q Queensbury Building &Code Enforcement Arrive: 9 a pm D art: • a ' o a .,e 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: ���' Z / ®/ Lf 5 J II PERMIT NO.: J LOCATION: �As / WA J � `IF-- I SPECT ON: `1/7-- C/4! RECHECK: h Comments and/or diagram Soil Ty nd Lo Saac m lay Type of Water:�Munic pal)Well Water _ `' Waterline separation distance ft. -TO i Well separation distance ft. FLU -\--J U..-7-cAb Other wells: ft. Well Casing Length 50' + / - Y N N/A V‘)tAV5 C•TVA0 Absorption Field: Total length ft. Length of each trench ft. =r_ i '\l— iLEt"�, p Depth of trenches ft. \ it,. b �G Size of Stone ``� .- Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank 1-i11 ,6CN \-'C Pi)M?-Ni, gs AA�0 Q0 4 Tank to Distribution Box Zf! N C—re‘itAQ�t Distribution Box to Field / Pit y - =r:—„ - �►1.6V K) V,?-F-- Opening Sealed: _N End Cap 17Y N Inlet/Outlet Pipes &Baffles Y_ N Location/ Separations Foundation to tank e-t ft. Puke`p, r\ \O1". Foundation to absorption ` "ft. Separation of Pits fti via Conforms as per Plot Plan Y_� ' - �- PR- \V E i j--s3\3`q- Engineer Report ani As-Built 1 _Y N A-, 6 EP'c- e_. ?L o.T-- T\___ Pit Location of System on Property: Front ear Left Side Right Side ! Middle Front Middle Rear System Use Statu : �� CY- F,�� Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc 169 Haviland Road Queensbury, NY 12804 Hutchins Engineering Phone:(518)745-0307 Fax:(518)745-0308 September 16, 2009 Mr. Dave Hatin, Director of Buildings & Codes Town of Queensbury 742 Bay Road Queensbury, NY 12804 - Reference: Joseph & Jane Yarze —4 Fairway Court - Tax Map # 290.13-1-26 Percolation Tests Dear Mr. Hatin: • _ - At the request of Frank Shaw of Morningstar Excavating, this-office performed two _ percolation tests at the referenced project site. These tests were performed in the vicinity of where a replacement wastewater absorption field will be constructed. The percolation test holes were hand dug to approximately 20 inches and encountered medium brown very fine sand with silt and orange-brown very fine silty sand. Please note that a deep soils test pit to determine the seasonal high groundwater table was not performed. The results of the two tests are as follows: PT-1 — Stabilized percolation rate: 7 minutes per inch PT-2 — Stabilized percolation rate: 8 minutes per inch • Enclosed please find a map showing the locations of the percolation tests generated from Warren County GIS data and an Aerial Photo. Best r Lucas W. Dobie, EIT Enclosures C.c. Frank Shaw— Morningstar Excavating Lucas W.Dobie,EIT LWDobie@hutchinsengineering.com •