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2008-120 ,, � ► TOWN OF QUE E NSBIM vers 742 Bay Road, ensb NY 12804-5902 (518)761-8201 ..r Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20080120 Date Issued: Thursday, April 17, 2008 This is to certify that work requested to be done as shown by Permit Number P20080120 has been completed. Tax Map Number: 523400-301-014-0001-005-000-0000 Location: 11 PHEASANT Walk Owner: MICHAEL& EDYCE MULLIGAN Applicant: MICHAEL &EDYCE MULLIGAN 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& de E rcement Planning Board or Zoning Board of Appeals. VIM L. 4 \ TOWN OF QUEENSBURY 114 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 FON Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20080120 Application Number. A20080120 Tax Map No: 523400-301-014-0001-005-000-0000 Permission is hereby granted to: MICHAEL& EDYCE MULLIGAN For property located at: 11 PHEASANT Walk 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: MICHAEL&EDYCE MULLIGAN Septic Alteration Residential 11 PHEASANT Walk Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2008-120 SEPTIC ALTERATION RESIDENTIAL $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,April 09, 2009 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the own o Que u , 4/. 1 •sday,April 09, 2008 SIGNED BY N.. for the Town of Queensbury. Director of Building&Code Enforcement , ', ., vvrirv1 L.tueerrs fury,an r permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or Ifailure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. ' '^�"^ -^^-++tip ro,,ilntinnc with rr.mnact to this application and a/ /4 _/` OFFICE USE ONLY % '; � C' T1TE' TAX MAP NO. PERMIT NO.123120PERMIT FEE rT81 008 APPROVALS: ZONING TOWN CLERK `'� € ' BUILDING & CODES APPLICATION FOR SEPTIC DISPOSAL SYSTEM PE RMll': A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. �(� / l/ OWNER: e'! /.$ `iedi INSTALLER: ��/ J "01-e .--F l ADDRESS: l ` / I , 4'1 GG'4e - ADDRESS: fl2 ! "i'Pf� „re04-:(4-,./ A PHONE NOS. 7 c `�� ; PHONE NOS. // 0 e`€` LOCATION OF INSTALLATION: I NO.OF i RESIDENCE INFORMATION: t YEAR BUILT # BEDROOMS X ? COMPUTATION= = TOTAL DAILY FLOW GARBAGE GRINDER II 1980 or older 1 X I 150 gallon per bedroom = INSTALLED? t-"ta i 1981 -1991 1 y i X 1 130 gallon per bedroom = 5� SPA OR HOT TUB i 1992- resent ' = INSTALLED? U� p I X , 110 gallon per bedroom PARCEL INFORMATION: , ✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND t/ LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL co/".' WELL (IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT. ) ✓ PERCOLATION TEST: RATE IS PER MIINUTE 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). Add 250 gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub. '1us�"° GA✓ SEPTIC TANK: LLSN (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH 5-0 FT. ✓ TOTAL SYSTEM LENGTH: o7-(40 FT. SEEPAGE PIT(S): HOW MANY? ✓ SIZE OF EACH FT. X FT. ✓ SIZE OF STONE TO BE USED: # /DEPTH OR THICKNESS FT. ✓ BED SYSTEM SIZE: X/ ✓ ALTERNATIVE SYSTEM: "''t` 1l '$ LENGTH AND/OR SIZE ✓ " iL/ ✓ HOLDING TANK SYSTEM:(If required) NO. OF TANKS: /SIZE OF EACH ✓ GALLONS./TOTAL CAPACITY: GAL. ii NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN li APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. II 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. . > -- ----....... , 1 . , . 1 --- ,. . ..7.-,........,.23 1 I Ilkltillillira CNA.) S , ----.-A k '1 <1S..... k a,, ,-......,) --,...... ‘ ---- '‘ tsA \ , \ , . 1 \\\ \ , 1 \ ‘1 \ - LA \ 1k, — ,.............. I \ ....----- \ .•-.4 1 ‘ \ k ‘ \ \ k li . _ ... 1 \ \ 0 \ \ 1 .1. 1 1 li \ 1 1.. \ \\ . I 5 k \ ... \ i 'Vt .....k. C) ------- ‘-'-• ,,z- , 1 - — ..Y. ....., 1 , C\, , c'd-...„._b '‘. '''41,ssit.................s ,. i \ S '4 1 ‘ k ‘i. \\\".......... : "••••... 's..' . . \ ......,....*,"•-,•^.\ i SIGNORELLI PLUMBING AND HEATING DATE: NAME: ADDRESS: PHONE: ( ) ESTIMATE GIVEN FOR JOB: PAID BY: CASH CHECK ( ) TOTAL AMDUN T OF JOB: JOB (XH'LE TED: DATE PLUMBER BER TIME/PER HOUR PLUMBER TIW/PIIt HOUR DATE 'HELPER TDE/PER HOUR aMA AP • MATERIAL ON OTHER SIDE Septic Inspection Report Office No. (518) 761-8256 Date Insp.ction�_Kequest received: Queensbury Building &Code Enforcement Arrive: I'4GUam/pr y,Depart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: V``�- NAME: tAA vts:1 C9/1- ) PERMIT NO.: ® -- P--° LOCATION: &q4 4/!` K INSPECT 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. 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: N ,- End Cap Y N L i7'C✓'1•C_.. 6-NSD 5A6 a lC 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 Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: pproved 1Partial 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 Insp request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: %2t NAME: � f eft,-��/ INSPECT PERMIT NO.: 1��C LOCATION: 51 L.: N• � T�" !� �� O 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, 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—N Location of System on Property: Front Rear Left Side Right Side �L UGC a r r/6//, � Middle Fr nt Middle Rear System Use tus: Approved Partial 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 In .- • request received: Queensbury Building &Code Enforcement Arrive: am/pj ?3epart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspecto s I itials: V.J '` �-- ^,� `�/ (,� NAME: it ziiCODA✓ PERMIT NO.: ��r��r��///// LOCATION: /1-( 441 PM-C,k.. INSPECT ON: -1/rin 45 RECHECK: ` r 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 [� i� ���� ")--7j d?- Building to tank �� � �`��- `d Tank to Distribution Box /� �kA Distribution Box to Field/ Pit 1'� Opening Sealed: Y TN // End Cap Y_N L, © L-..� - 4--‘L A L G A)v)5 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 Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: roved 12 artial 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 Inspectio request received: Queensbury Building &Code Enforcement Arrive: gam/pm Depart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: �1 NAME: C.9AA PERMIT NO.: D LOCATION: pod_A -t,(-r 4J‘/itf a t/{,J/C'i K, INSPECT ON: s 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 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 Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: proved artial 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 r Ilt- �^ z_ 2' Septic Inspection Report Office No. (518) 761-8256 Date Inswctio i re uest received: Queensbury Building&Code Enforcement Arrive: , Lim/ c Depart: am/pm 742 Bay Rd.,Queensbury, NY 12804 Inspector's Initials: NAME: i t C PERMIT NO.: 1 LOCATION: d/ . 5 �- %- -lC INSPECT ON: � , RECHECK: Comments and/or diagram Soil Type: Sa•• / Loa / lay Type of Wa -r: Munici• /Well Water Waterline sepa .;•, _ .nce ft. Well separation distance ft. 2 L A r itZ vL4 /A) ,q-eL- Other wells: ft. Absorption Field: Total length -2--ill ft. Length of each trench SZ1 ft. Depth of trenches / r,� �� ft. Size of Stone Ad 7?L 'g,7`e/(1 ' Seepage Pits: Number Size: x Stone Size: Piping Si 1.670 Building to tank _ 4 _ Tank to Distribution Box 0i' • Distribution Box to Field/ Pit .,i /c,[4i.-ry J 4 Opening Sealed: Y/ N/ Partial V 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 N Location of Syste , -• Property: Front It Left Side Right Side Middle Front Middle Rear System Use Status: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 021006 Last revised 1/6/05