2008-587 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20080587 Date Issued: Wednesday, November 12, 2008
This is to certify that work requested to be done as shown by Permit Number P20080587
has been completed.
Tax Map Number. 523400-301-012-0002-012-000-0000
Location: 20 COLONIAL Ct
Owner. GARY & CECELIA LANPHEAR
Applicant: GARY & CECELIA LANPHEAR
This structure may be occupied as a:
Septic Alteration Residential
By Omer of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the r: 4
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: P20080587 Application Number. A20080587
Tax Map No: 523400-301-012-0002-012-000-0000
Permission is hereby granted to: GARY& CECELIA LANPHEAR
For property located at: 20 COLONIAL 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 Queens bury Zoning
Ordinance. Type of Construction Value
Owner Address: GARY& CECELIA LANPHEAR
20 COLONIAL Ct Septic Alteration Residential
QUEENSBURY,NY 12804 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
MORNING STAR SEPTIC
Plans &Specifications
2008-587
septic alteration
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,November 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 the expiration date.)
Dated at the T - ee ry; a esday,November 05, 2008
SIGNED BY for the Town of Queensbury.
Director of Building Code nforcement
..__.__._______________-OFFICE USE'ONLY'--_____.__.__..____ I.___.__.__.__.__.___._-
/
I`V P N PERMIT NO. PERMIT FEE
o APPROVALS: ZONING TOWN CLERK '? `
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.
OWNER: INSTALLER: �^-C
ADDRESS: f7 ( i ADDRESS: le ')
PHONE NOS. ?q 2 �+� PHONE NOS.
LOCATION OF INSTALLATION:
NO.OF RESIDENCE INFORMATION:
YEAR BUILT BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW
-- GARBAGE 1980 or older X 150 gallon per bedroom = INSTALLED?RINDER
1981-1991 X 130 gallon per bedroom = SPA OR HOT TUB
1992-present X 110 gallon per bedroom = INSTALLED?
PARCEL INFORMATION: ` `'"
✓ TOPOGRAPHY: Flat rolling_ Steep slope %Slope
✓ SOIL NATURE: Sand Loam Clay Other
✓ GROUNDWATER: At what depth?
✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth?
✓ DOMESTIC WATER SUPLY: Municipal_ Well (If well: Water supply from any septic
system absorption is ft.)
✓ PERCOLATION TEST: Rate is minutes per inch [MPI]
(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).
TANK SIZE: s+;x-I6"GALLON (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:
❑ ABSORPTION WITH / c d` X 2 r a
FIELD( NO. 2 STONE) Total length h ft. Each trench 5� >��FL
❑ SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Size?
❑ ALTERNATIVE SYSTEM Bed or other type?
❑ 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 regulations with respect to this application and
agree to abide by these and all requirements of the Town ofCQUESTIONS 7 CALL 761-8256 OR EMAIL
Queensbury Sanitary S wa a Disposal Ordinance. codesnaaueensbury.net
UR WEBSITE FOR MORE INFORMATION
www.gueen ,burv.net
4gn�ature of 0&6plhesponsible Date
ri. Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
B 5-LGL 6/06
(earlier. 13 . I(At L
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection r st r ed:
Queensbury Building &Code Enforcement Arrive: '- D rt.
a
742 Bay Rd., Queensbury, NYf 12804 Inspector's Initi
NAME: / i'1. ' ERMIT NO.: s
LOCATION: INSPECT ON:
RECHECK:
Comments and/or diagram
Soil T m/ Clay
Type of Water• M ci ter ti
Watefttrs—epa ration distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length k 0 ft.
Length of each trench ft.
Depth of trenches
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size T
Building to tank
Tank to Distribution Box r-till
Distribution Box to Field/ Pit ` Fi. ;
Opening Sealed: N
End Ca N
Inlet/Outlet Pipes&Baffles N
Location/ Separations
Foundation to tank ft.
Foundation to absorption ` ft.
Separation ft.
Conforms as to N
Engineer Re rt Y N
Location of System on Property:
Front Rea Left Side -Bight Side Middle Front Middle Rear
System Use S
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-01-1)\Building&Codes\Inspection Forms\Septic Inspection Report.doc
518-793-2290
Fax#518-793-2115
V 298 E-mail: morningstarseptic@hotmaii.com
ARwww.morningstarseptic.com
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:-,n or observed, or believe 1 saw evidence of,
t; ;4u," as rouses, yells, trees, fences, etc.,
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