2008-039 TOWN F QUEENSBURY
Iwo742 Bay Road, eensb NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20080039 Date Issued: Wednesday, August 25, 2010
This is to certify that work requested to be done as shown by Permit Number P20080039
has been completed.
Tax Map Number. 523400-302-018-0002-069-000-0000
Location: 18 HUGHES Ct
Owner. RICHARD & MARY GARRETT JR
Applicant: RICHARD & MARY GARRETT JR
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$uilding 8t Code E rcern
Planning Board or Zoning Board of Appeals.
1�� TOWN OF QUEENSBURY
01 Foto 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080039 Application Number. A20080039
Tax Map No: 523400-302-018-0002-069-000-0000
Permission is hereby granted to: RICHARD &MARY GARRETT JR
For property located at: 18 HUGHES 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: RICHARD &MARY GARRETT JR
18 HUGHES Ct Septic Alteration Residential
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
MORNING STAR SEPTIC
Plans &Specifications
2008-039
SEPTIC ALTERATION RESIDENTIAL- TANK REPLACEMENT
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday, February 05, 2009
(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 • expiration .
Dated at the T wn of ee flu sday, February 05,2008
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
_- ,o. � � - �^�:OFFICE USE ONL � ;
TAX MAP NO PERMIT NO. :<'t /. PERMIT f � L. `~'
APPROVALS: ZONING TOWN CLERK 1 , F` 4
APPLICATION FOR SEPTIC DISPOSAL SYSTEM r 04 N--L `u y
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE 0 ".
PERMIT.
OWNER: P? - • G INSTALLER: Levu- 57, 5,
ADDRESS: / ' (,mti,-- ADDRESS: /e)? •e-E-0424 Q ) -e-,u,- `"C"CPC,
PHONE NOS. PIIONEENNOS. .'? 3 `:161 0 `a`" -4irti '/3 o
LOCATION OF INSTALLATION: le 4j 6
• RESIDENCE INFORMATION:
YEAR BUILT NO OF X COMPUTATION: : TOTAL DAILY FLOW
». BEDROOMS GARBAGE»...»»»....»......»..»».. .»..».».».� .......:»»».».»»...»»......»...•........»....».......»..» GARBAGE GRINDER
1980 or older L.� X 150 gallon per bedroom INSTALLED?
..»»».1981 1991w.... »•...»...•. .»».».......�.X»».».....130 gallon per bedroom...,.,»_•».».»..»».»»....».•»..».....�»»»»..... 1 SPA OR HOT TUB
1992•present X 110 gallon per bedroom : INSTALLED?
PARCEL INFORMATION:
✓ .TOPOGRAPHY: FLAT ROLLING ST EP SLOPE %SLOPE
✓ SOIL NATURE:SAND X LOAM C .Y OTHER
✓ GROUNDWATER: AT WHAT DEPTH? J. BEDROCK/IMPERVIOUS MATERIAL: AT
WHAT DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPA WELL
(IF WELL:WATER SUPPLY FROM ANY PTIC-SYSTEM ABSORPTION IS FT. )
✓ PERCOLATION TEST: RATE IS N PER MIINUTE PER INCH (TEST TO BE
„.
COMPLETED BY A LICENSED PROF SSIONAL 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).Add 250
gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub:.,
1< ✓ SEPTIC TANK: /A CO GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH FT.
I ✓ TOTAL SYSTEM LENGTH: FT. SEEPAGE PIT(S):HOW MANY?
✓ SIZE OF EACH FT.X FT. 4.10,Zeik /;:-/-44-
✓ SIZE OF STONE TO BE USED:# /DEPTH OR THICKNESS FT.
✓ BED SYSTEM SIZE: X OA
✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
✓ HOLDING TANK SYSTEM:(If required) NO.OF TANKS: /SIZE OF EACH
✓ GALLONS./TOTAL CAPACITY: GAL.
NMI•N14•I.I44.NN1!NI.I4.NNYl•14•f ,•I.NW.1.•4.14.14444.MI•I•I.1.1•I•i.14•IV•
: NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN 1�
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. `
144wN1NNN1440111014NYlI.I•NNNNNNYi11fNI1Nl1 YNYNNI•NN{•NVNNNNNNWV•14•.•Yi•i•NNY14•144•NI•NI•NN14•I•i•NI•NI•I.:•14.i•NI444•t•NI.1.1. NI•I!YI•t•NI•t•VI•I•VI.•V4•i•3•I•I•I•Ni•NNNN14.1•YIWNI•I.1.I.YI4.NI•N14.14.1•t•14•l.Nl 1
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 byfor on behalf of an applicant, shall be void,
I have read the rehulatinnc with rocr ++^+,1. --•-ff__.._- - .
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Septic Inspection Report
Office No. (518) 761-8256 Date Inspectio nest received:
Queensbury Building&Code Enforcement Arrive: , . m/pkn art: am/pm
742 Bay Rd., Queensbury, NY 12804 In r`s Initials: J?-
NAME: 60,(i PERMIT NO.: C✓
8 -0C
LOCATION: C7� INSPECT ON: -//2
---
RECHECK:
Comments and/or diagram
Soil Type: 1 ••: lay
Type of Water: Munici•. /Well Water
Waterline sepa :•. .nce ft.
Well separation distance ft.
Other wells: ft.
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/ Partial
End Cap
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---a N
Location of System on Property:
Front Rear Left Side Right Side l
6P/C1{1
Middle Front ddte Rear
System Use Status:
proved
artiat Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 021006
Last revised 1/6/05
Septic Inspection Report
Office No. (518) 761-8256 Date Ins ctiop uest received:
QueensburyBuilding &Code Enforcement Arrive: 0`' am� -D art: am/pm
/
742 Bay Rd., Queensbury, NY 12804 Inspecto 's Initials:NAME: g 6.. 1�_ PERMIT NO.: d 6 r 3q
LOCATION: /7 Ile-6 C . INSPECT ON: —fff
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
Building to tank
Tank to Distribution Box
Distribution Box to Field / Pit
Opening Sealed: _Y
End Cap Y
Inlet/Outlet Pipes&Baffles ,T Y N (it) i - 6,, U`7 -rLocation/ 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
Location of System on Property:
Front R, Left Side Right Side Middle Front Middle Rear
S em Us us'
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
Septic Inspection Report
Office No. (518) 761-8256 Date Inspectiory'e uest received:
Queensbury Building&Code Enforcement Arrive: I', am/ art: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: C.9ke2gL PERMIT NO.: 0 Q
LOCATION: J(,R&5 C_-f 4 INSPECT ON: -.—
RECHECK:
Soil Type: Comments and/or diagram
Sand/ Loam/Clay
Type of Water: Municipal/ Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
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
O ing Sealed: Y/ N/ Partial
E Cap
Inlet/Outlet Pipes&Baffles Y„N RC--C_Ke-C
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
Location of System on Property:
Front Rear/ Left Side Right Side
r
Middle Fro Middle Rear
S m t
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Last revised 021006
Last revised 1/6/05