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2008-469 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 4z:t Community Development- Building &Codes (518) 761-8256 CE R TIFICATE OF COMPLIANCE Permit Number. P20080469 Date Issued: Tuesday, September 09, 2008 This is to certify that work requested to be done as shown by Permit Number P20080469 has been completed. Tax Map Number. 523400-315-006-0002-034-000-0000 Location: 13 MOCKINGBIRD Ln Owner. ROBERT & DOREEN BUNTING Applicant: ROBERT & DOREEN BUNTING This structure may be occupied as a: Septic Alteration Residential By Ogler of Town Boat 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. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20080469 Application Number. A20080469 Tax Map No: 523400-315-006-0002-034-000-0000 Permission is hereby granted to: ROBERT&DOREEN BUNTING For property located at: 13 MOCKINGBIRD Ln 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& DOREEN BUNTING 13 MOCKINGBIRD Ln Septic Alteration Residential QUEENSBURY,NY 12804 Total value Contractor or Builder's Name/Address Electrical Inspection Agency IBS SEPTIC &DRAIN ATTN: IVAN BELL 2 LOWER WARREN St QUEENSBURY,NY 12804 Plans &Specifications 2008-469 septic alteration residential $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,August 29, 2009 (If a longerperiod 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 of Qu nsbury; ! rida ,August 29, 2008 SIGNED B 41 for the Town of Queensbury. Director of Building&Code Enforcement '.III./III wIIIIIIIIII w II w Iw IIIIt III wIIIIIIIi Ir IrI IIIIIII.IIIw IIIIIIIII ,/IIIw I.III.r(III/..Ii.r OFFICE USE ONLY � TAX MAP NO. PERMIT NO. �_. ERM1T FEE � r r rr r APPROVALS: ZONING TOWN CLERK ; ............................................ . ....... .........I,... l.ItIIw II.II...wIiIII APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT- A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID —�— )/` ` OWNER: �I ti INSTALLER: l �� �1 ADDRESS: �`� ADDRESS: Off` C r �,kcc� PHONE NHS. y PHONE NOS._ �_ LOCATION OF INSTALLATION: ................... :.0 -..... .....:....................................t RESIDENCE INFORMATION: YEAR BUILT_ BEDROOMS N X µ„~COMPUTATION= _ -,TOTAL DAILY FLOW " ' ' w• _ _ •.I GARBAGE GRINDER 1980 or older X- 150 gallon per bedroom _ �„' INSTALLED? -1981 -1981 -- .X. - 130 gallon per bedroom _ SPA OR HOT TUB .. ..X. •....110...-allon.......... er... b1 1... . •.... .. ,c►....................-............,....... { INSTALLED? ...'1992•present__ . .....,.... ..._.......•...........................g..........•.p.-......__.....•_.. ..•..�_......., f r•••.. ..,...................w...W...... PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE ✓ SOIL NATURE: SANDY" LOAM CLAY OTHER ✓ GROUNDWATER_: AT WHAT DEPTH? ,X •4— BEDROCOMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (IF WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS �FT. ✓ PERCOLATION TEST: RATE IS f 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 1 act►field for each garbage grinder, spa or whirlpool tub., ✓ SEPTIC TANK: GALLON (MIN. �E IS 1,000 GAL.) TILE FIELD: EACH TRENCH a517. ✓ TOTAL SYSTEM LENGTH FT. SEEPAGE ET HOW MANY? 1 ✓ SIZE OF EACH7 'w $ FT. X FT. ✓ SIZE OF STONET BE USED: # /DEPTH OR THICKNESSI—FT. ✓ BED SYSTEM SIZE: X �r ✓ ALTERNATIVE SYSTEM: 1 /q LENGTH ANDIOR SIZE ✓ HOLDING TANK SYSTEM:(if required) NO. OF TANKS: X"�/SIZE OF EACH ✓ GALLONS.(TOTAL CAPACITY.,--►O�AL. 1 NOTE: ALARM SYSTEM AND iASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. I; I`l.1•{•I.YI4•V{•Y{•:•V{•{•i•l............:•..:':y............:............V:4.4VV.i•{•{•i•i•{•i.:•{.:.M{•i•{•5.1.1•1•i•1.1•:•i•i4•iris{V•i,:•VI.{•:•••:•3•:•:•V:•{•V......•1•{•{•{•N:..•:•:.:•:•:•:•:•{.:•:•:y:.:•..........{•{4............•:•:•.......V:•V4:•V..•{V•i•i•i•Vi.1.1•Ni•i•iM•i•1•Y)•1.1.1.......................� 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 by,or on behalf of an applicant, shall be vold� I have read the regulations with respect to this application and QUEs notas? CALL 761.82s6 OR EMAIL agree to abide by these and all requirements of the Town of ggdes0gueensburv.net Queensbury Sanitary Sewage Disposal Ordinance. VISIT OUR WEBSITE FOR MORE INFORMATION l q www.aueenebury.net Signature of Person Responsible Date Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 ul 4 IL Septic Inspection Report Office No. (518) 761-8256 Date Ins ction r re iv Queensbury Building &Code Enforcement Arrive: 0 m art: a 742 Bay Rd., Queensbury, NY 1280 Inspector's Initials: NAME: , MIT NO.: LOCATION: `' - � SPECT ON: RECHECK: v Comments and/or diagram Soil T -am/ Clay Type of Water:municip2ULNell Water Water i ration distance Well separation distance ft. Other wells: ft. Well Casing Length 50' + - Y N_N/A Absorption Field: Total length ft. Length of each trench 2z C121Qb ft..-4 v=—OD� Lopi LD Depth of trenches Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box L4%1 Distribution Box to Field/ Pit " L peei-- Opening Sealed: Y N End Ca 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 _ N _ Engineer Report an -Built N Location of System on Property: Front Rear Left Side Right Side Middle Fro Middle Rear Ss m Use S t 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 �`tT FT —60 Fx ;n4 Map r y lb Septic Inspection Report Office No. (518) 761-8256 Date Ins ction r e r Queensbury Building &Code Enforcement Arrive: a D aFtt: a rn,.,,., ,, 742 Bay Rd., Queensbury, NY 12804 Inspecto s Initials: NAME: �i y 1 )Ti io P IT NO.: - c LOCATION: �� M©C V,i 1(z LA1�'E I SPECT ON: RECHECK: Comments and/or diagram Soil Type: Sand Loam / Clay -Typeof Water: Munici 1 Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - I Y N N/A Absorption Field: Total length ft. Length of each trench ft. A `�TRLLV---'0 � Depth of trenches ft. Size of Stone- Seepage Pits: Number Size: x Stone Size: Piping Size Type Buildinq 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 m 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-01-1)\Building&Codes\Inspection Forms\Septic Inspection Report.doc