2009-572 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12904-5902 (518)761-8201
Community Development- Building&Codes (518) 761.8256
E IFICATE �F COMPLI-A-N- CE
Pemut Number. P20090572 Date Issued: Tuesday, November 24, 2009
This is to certify that work requested to be done as shown by Pen-nit Number P20090572
has been completed.
Tax Map Number: 523400-296-009-0002-038-000-0000
Location: 6 OAKWOOD Dr
Owner. ROBERT & MARION CHANDLER
Applicant- ROBERT & MARION CHANDLER
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,
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.
I
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090572 Application Number. a2009O572
Tax Map No: 523400-296-009-0002-038-000-0000
Permission is hereby granted to: ROBERT&MARION CHANDLER
For property located at: 6 OAKWOOD Dr
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: ROBERT&MARION CHANDLER
157 BREVATOR St Septic Alteration Residential
ALBANY,NY 12206-0000 Total value
Contractor or Builders Name/Address Electrical Inspection Agency
IBS SEPTIC
IVAN BELL
2 LOWER WARREN STREET
QUEENSBURY,NEW YORK
Plans &Specifications
2009-572
septic alteration residential
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,November 20,2010
(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 To Queens vember 20, 2009
SIGNED BY /' for the Town of Queensbury.
IV Na
Director of Building&Code Enforcement
OFFICE USE ONLY
IX MAP NO. PERMIT NO. P MIT FE4 •U� + Ili, I
APPROVALS: ZONING TOWN CLERK +' ' l �(
..a___._a....a....._a........................aa_...a.................+. 0T..;iv„5�7,,'r%�_;: i..; .,T�_.;. e.` "
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PEE
A PERMIT MU S E OBTA ED BEFORE WORK EGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT. /-
OWNER: �ti / INSTALLER:
ADDRESS: v 'ADDRESS:
PHONE NOS, r 5 d PHONE NOS. C**"-/
LOCATION OF INSTALLATION:
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION= = TOTAL DAILY FLOW
BEDROOMS GARBAGE GRIN ER
1980 or older I X 15o gallon per bedroom INSTALLED?
1981 -1991 X 130 gallon per bedroom = SPA OR HOT TUQ/
1992-present X 110 gallon per bedroom = INSTALLED? y
PARCEL INFORMATION:
✓ TOPOGRAPHY: Flat rolling Steep slope %Slope
✓ SOIL NATURE: Sand Loam Clay Other
✓ GROUNDWATER: At what depth? /
✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth?/�o
✓ DOMESTIC WATER SUPLY: Municipal Well (If well: Water supply fro eptic
system absorption is�ft.)
✓ PERCOLATION
E COLATIlN TEST: Rate Is Z�Aper 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 (unles installed in a Planning Board approved subdivision).
TANK SIZE: 7// A jN MI . IZE IS '000 GAL.)Add 250 gallons to the size of the septic tank for
6Aeacrbage dnder, spa or whirlpool tub.
SYSTEM TYPE:
❑ ABSORPTION FIELD (WITH NO. 2 STONE) Total length ft. Each trench X
SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size?
❑ ALTERNATIVE SYSTEM Bed or other type? Z 1 A
❑ HOLDING TANK SYSTEM Total required capacity?
Tank size? Number of tanks?
4!2�
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 uoon or is crrnnt-A :� •^�^^^- --- -
Septic Inspection Report
Office No. (518) 761-8256 Date In ion r t re l 0
Queensbury Building &Code Enforcement Arrive: Dep am txr'
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia
NAME: "-- ERMIT NO.: O --5-7Z
LOCATION: ON:
RECHECK:
Comments and/or diagram
soil Ty Clay
- Typeof Water: Munici ater
Waterline se aration distance ft.
Well separation distance
Other wells: ft. ry
Well CasingLength 50' + - Y N N/A AS BU
Absorption Field: Total length
Length of each trench
Depth of trenches ft.
Size of Stone 23 ►c2
Seepage Pits: Number
Size: x
Stone Size: iit �i0L5F
Piping Size Type
Building to tank ,')
Tank to Distribution Box « '5p '_
Distribution Box to LA zC
Openin Sea ed: N
End Ca N
Inlet/Outlet Pipes&Baffles N
Location Separations
Foundation to tank
Foundation to absorption ft.
Separation of Pits ft.
Conforms as Per Plo N
Engineer Report As-Buil Y N
Location of System on Property:
Front Rear ft Side Right Side Middle Fr ' Middle Rear
Use
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 06/18/07 U\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc
,ved, or believe I sau.
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