2011-611 "Pk TOWN OF QUEENSBURY
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742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110611 Date Issued: Friday, December 28, 2012
This is to certify that work requested to be done as shown by Permit Number P20110611
has been completed.
Tax Map Number: 523400-308-014-0001-052-000-0000
Location: 183 PITCHER Rd
Owner: ARC COMMUNITIES 14 LLC
Applicant: ARC COMMUNITIES 14 LLC
This structure may be occupied as a:
Septic Alteration Commercial
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, 4
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.
ti
TOWN OF QUEENSBURY
irF0 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110611 Application Number: A20110611
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: ARC COMMUNITIES 14 LLC
For property located at: 183 PITCHER 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: ARC COMMUNITIES 14 LLC $eptic Alteration Commercial
PO BOX 61102 Total Value
CHICAGO IL 60606-0000
Contractor or Builders Name/Address Electrical Inspection Agency
FRED SMITH
796-0850
23 VERMONT Ave
QUEENSBURY NY 12804-0000
Plans&Specifications
2011-611
85 & 87 Briwood Circle- septic alteration commercial
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,December 19,2012
(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 o Quee ur r; , 816ndly,December 19,2011
f
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
0 Community Development Office
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804
Office Use On �� 7
AX tv(P( O PERMIT NO. PERMIT FEE
APPROVALS: ZONING C. TOWN CLER
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE SSUANCE/fn
OF A VALID PERMIT.
G /it�'� `=�'L � aOWNER: . �0 ' -[r � 4��t3INSTALLER: ) $ ,ricl /�WCAV rrc
ADDRESS: (, p 3 ? IT cf.-CA- ADDRESS: )'� p VIA-M
PHONE NOS.(pi O g�2-
Cw 7 y PHONE NOS. 7 ! - u i-.
LOCATION OF INSTALLATION: R'S-.4 p7 r"' let s, a /Lc(.-e:
RESIDENCE INFORMATION:
NO.OF COMPUTATION = TOTAL.DAILY FLOW
YEAR BUILT BEDROOMS X (Gallons per bedroom) GARBAGE GRINDFJi
1980 or older
)( 150 = INSTALLED? rV 0
1981 -1991 X 130 = SPA OR HOT TUB Wo
INSTALLED?
1992-present X 110 =In
PARCEL INFORMATION:
titef
✓ TOPOGRAPHY: FLAT ROLLIN STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY— OTHER
i GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT EPTH?
I DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft1
✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpg (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 i Planning Board approved subdivision).
TANK SIZE: 1 6 V®CGALLON(MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,
spa or whirlpool tub.
SYSTEM TYPE: , r
BSORPTION FIELD(WITH NO.2 STONE) Total length 2 D a _ft. Each trench _X
091-A
0 SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? — Size?__-
0 ALTERNATIVE SYSTEM Bed or other type?— —
0 HOLDING TANK SYSTEM Total required capacity? _—Tank size? Number of tanks? _
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 regulati• s with respect to this application and agree to
abi•- • these a d all :-•uirements of the Town of eensbury QUESTIONS? CALL 761-8256 OR EMAIL
- anit. Sew., Dis osal Ordipcodest?a.queensburvnet
_ 'ance. /1-- i /�l
i GL_ — VISIT OUR WEBSITE FOR MORE INFORMATION ,
Si•nature of Per —Responsible Date www.queensburv.net
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Septic Inspection Report
Office No. (518)761-8256 Date Inspection req
Queensbury Building&Code Enforcement Arrive: 72J2) a , •li i =, •rt: 2.t Na am,•y
742 Bay Rd., Queensbury, NY 1 04 Inspector's Initials:bitor
NAME: NO.:
LOCATION: Ff, P7 it��,F C INSPECT ON: ' - — 1
RECHECK:
Comments and/or diagram
Soil Type- Loam/Clay
Type of Water: um, Well Water_
Wate -=paration distance 1 C: ft. 4--
Well
t'Well separation distance ft.
Other wells: ft.
Well Casing Length 50' +/- Y N N/A
[150'to well required if NO]
Absorption Field: Total length b ft.
Length of each trench / ft.
Depth of trenches zr — 2.44 ft.
Size of Stone
Seepage Pits: Number
Size:
Stone Size:
Piping Size Type
Building to tank ‘41‘41. LAO to Distribution Box l-‘'t onfk 35
Distribution Box to Field/ Pit r-Alt .0\A h4
TO '. 6CC VE-9--F .
Opening Sealed: N
End Cap _N
Inlet/Outlet Pipes&Baffles _N
Manholes 12"or less below grade Y
[provide extension collar if Yes] Y N
Location/Separations
Foundation to tank B ft.
Foundation to absorption • `
Separation of Pits ft.
Conforms as per Plot Plan Y..! EEO
Engineer Report and As-Built _,..Y N e VtECRi 1j 12-.��p�
ETU Maintenance Contract _Y N p - Betc \LL
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
-m S .t
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
L:\Pam Whiting\2010\Buiiding Codes Fonns\Inspectlon Forms\Septic Inspection Report_O3 29 10.doc
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