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2008-588 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: P20080588 Date Issued: Tuesday, March 29, 2011 This is to certify that work requested to be done as shown by Permit Number P20080588 has been completed. Tax Map Number: 523400-226-015-0001-031-000-0000 Location: 40 BAY Pky Owner: RED CAMP, LLC Applicant: JANE C CAFFRY TRUST 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, ,r Variance, or other issues and conditions as a result of approvals by the Directo wilding&Co nfor nent Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY IE)v 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Buil ing Codes (518) 761-8256 BUILDING PE T Permit Number: P20080588 Application N ber. A20080588 Tax Map No: 523400-226-015-0001-03 1-000-00 Pemvssion is hereby granted to: JANE C CAFFRY TRUS For property located at: 40 BAY Pky in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot p and/onmnionto filed and approved and in compliance with the NYS Unifo Building and theOrdinance. of CoValue Owner Address: JANE C CAFFRY TR S Septic Alt ation Residential 9 LOUDONWOOD EAT Total va e LOUDONVILLE,NY 1 1 Contract r or Builders me/tltss Ele rical Inspection Agency Plans &Specifications 2008-588 septic alteration $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,November 05,2010 (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 Town o ensbury, We saes ay,November 05,2008 SIGNED BY 6 � ! for the Town of Queensbury. Director of Building&Co e Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20080588 Application Number. A20080588 Tax Map No: 523400-226-015-0001-03 1-000-0000 Permission is hereby granted to: JANE C CAFFRY TRUST For property located at: 40 BAY Pky 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: JANE C CAFFRY TRUST 9 LOUDONWOOD EAST Septic Alteration Residential LOUDONVILLE,NY 12211 Total value Contractor or Builders Name/Address Electrical Inspection Agency Plans &Specifications 2008-588 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 o ee ry, ay,November 05,2008 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement For an EPA homeowners guide:-htto://www.e-a.aov/nodes/­­pubs/homeowner guide Iona customize.pdf -------------OFFICE I'OFFICEUSEONLLY k _____________________, , TAX MAP NO. PERMIT NO. ERMIT FEE _ ; e APPROVALS: ZONING TOWN CLERK ; � , , APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT- -A PERT I T MUST BE OBTANNED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMT. OWNER: Jane C. Caffr , Trust INSTALLER: 8 JohnS�reefy ADDRESS: y ADDRESS: Glens Falls, NY 12801 PHONE NOS. 7 4 9-t 5 A 9 PHONE NOS. LOCATION OF INSTALLATION: 40 Bay Parkway at Neighbor's Way, Assembly Point YEAR BUILT N O M X COIPUTATKW a TOTAL DAILY FLOW TM: BED1980 or okler X 150 galon per be toom a 0 GARBAGE GRINDER 1981-1991 X 130 galon per bedroom a 0 INSTALLED? No 1992-present © X 110 90m per bedroom a 550 SPA OR HOT TUB INSTALLED? No PARCEL BPORMATON: ✓ TOPOGRAPHY: FLAT ROLLING X STEEP SLOPE SLOPE 3.5 % ✓ SOIL NATURE SAND X LOAM X CLAY X OTHER S i l t ✓ GROtMM NATER: AT WHAT DEPTH? BEDROCK*VERVIOUS MATERIAL: AT WHAT DEPTH? 28± ✓ DOMESTIC VIWTERSUPLY: Lake George MUNICIPAL WELL (If wet:water mpoy froth any septic system absorption is L_1 ✓ PERCOLATION TEST: RATE IS 3 7 s e C. PER MUNUTE PER INCH(TEST TO BE COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT) PROPOSED SYSTEM FOR NEW CONSTRUCTION: AN nklividual sewage dial syslems must be designed by a licensed Professional engineer or archibW(unless irtstaNed in a Planning Board approved subdivision). TANK SIZE: 1500 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 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 otter type? Mound System ❑HOLDING TANK SYSTEM Total required capacity? Tank s¢e? Number of tanks? NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOV1M APPROVED ELEC7KIia1uL 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 pemut or approval granted which is based tom or is granted in reliance upon any maler or failure ID make a material fact or cftwltstartoe known by or on behalf of an applicant,shell be void. I have read the regulations with reaped to this application and agree QUESTIONS? CALL 761-VA OR EMAIL to abide by these and all requirernertts of the Town of Quraensbury codes�aeteensburv.net Sa Sewage Disposal Ordinance. VISIT OUR YYEBSITE FOR MORE INFORMATION Am r !� �� �� www.aueensburv.net i raorl V Town of Queensba i t Coinmunit evelopinent Office m 742 Bay Road, QueensLniny NY 12804 SEWAGE SYSTEMS: SEPARATION REQUIREMENTS - SEEPAGE PIT POND PROPER � � YYELLIN Please refer to Queensbury Town / ONT �'B MIN CM Code, Sewers and Sewage Disposal, 1N0i Appendix A, 136:A1 and Appendix B, 136:A3, for more detailed information '$ on SEPARATION REQUIREMENTS. �. 2 m 2 e . SEEPAGE PIT ZD N10 oo' HOUSE u D C v Z SEPTI TANK GARAGE ISTRIBUTION BOX PA b PROPERTY LINE l r ' ROAD STREAM PROPERTY LINE PROPERTY LINE ot "", WA ER POND TIGHT WELL IN \SING� WATERTIGHTcaallo 1 W a W a J J G HOUSE�2 ��� \N�MV `2 GARAGE M C� Z HOUSE GARAGE 7 (T uj = ba W Z b,� _ •- SEPTIC Q 10 SEPTIC Q TANK i� TANK a DISTRIBUTION BOX no C � ABSORPTION FIELD 0 b� PROPERTY LINE _ _-------- --------------ROAD SEWAGE SYSTEMS: SEPARATION REQUIREMENTS - ABSORPTION FIELD Please refer to Queensbury Town Code, Sewers and Sewage Disposal, Appendix A, 136:A1 and Appendix B, 136:A3, for more detailed information on SEPARATION REQUIREMENTS. Septic Inspection Repolt Office No. (518) 761-8256 Date Inspection r iv Queensbury Building &Code Enforcement Arrive: 1 Qt p _ part: 6°�-�.5amlOrn 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials. NAME: P—D PE NO.: LOCATION: �Q CAM ' I SPtCT ON: RECHECK: u' Comments andlor diagram Soil Type: Sand/ Loam/Clay Type of Water: Munici I Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/ - Y N N/A 150'to well required if NO 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 Tpe Building to tank Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: Y N End Ca �Y N Inlet/Outlet Pipes&Baffles Y N Manholes 12"or less below grade �Y—N wide extension collar if Yes Y N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan N Engineer Report and As-Built Y N ETU Maintenance Contract Y N provided Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear stem Use us: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\13uilding Codes Forms\Inspection Forms\Septic Inspection Repor1_03 29 l0.doc Septic Inspection Office No. (518)761-8256 Date Ins n Queensbury Building&Code Enforcement Arrive: - part: am/pm 742 Bay Rd., Queensbury, NY 12804 f Inspecba's In' L NAME: �rrf A c'.-I •• i� LOCATION: ti� N CT ON: RECHECK: CQMments and/or diagram Soil Type: Sand/ Loam Clay Type of Water: Municipal I Well Water r�►� Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' +j- Y N N/A 150'to well nwired if NO] Y� Absorption Field: Total length Length of each trench ft. ' ` r!� Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Pi i Size Type Building to tank , Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: Y N End Cap Y N Inlet jOutlet Pipes&Baffles Y N Manholes 12"or less below grade Y N [provide ext rislon collar if Yes Y N Location Separations ��✓ Foundation to tank ft. Qc Foundation to absorption ft. Separation of Pits Conforms as per Plot Plan Y N En sneer Re rt and As-Built Y N ETU Maintenance Contract Y N provided Location of System on Property: Front Rear ft Side Right Side Middle Front Middle Rear s em Use roved rtial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam 2010�Buiiding Codes Farms�Inspectlon Forms\Septic inspection Repor#..03 2910.doc JARRETT Engineers, PLLC Civil&En vironn2enW Engineering February 16, 2011 John O'Brien Town of Queensbury, Building&Codes 742 Bay Road Queensbury,NY 12804 Re: Caffry/Hawn Residence 40 Bay Pkwy,Assembly Point Queensbury,NY 12804 Wastewater Disposal System JE 06-061 Dear John: This letter is to certify that representatives from this office visited the Caffiy/Hawn Residence during construction of the wastewater disposal system to serve the existing residence. Based on our field observations,we feel that the system has been constructed substantially in conformance with 10/27/08 issued design plans prepared by this office, entitled"Wastewater System Upgrade Caffy/Hawn Residence"with construction changes noted on attached Record plans. If you have any questions,please do not hesitate to contact us at 792-2907. Sincerely, JARRETT Engineers,PLLC H. Thomas Jarrett, P.E. Principal 12 East Washington Street 518 792-2907 Glens Falls,NY 12801 Fax 518 798-1864 Septic Inspection Report Office No. (518) 761-8256 Date Ins ction re ei Queensbury Building &Code Enforcement Arrive: art: a m 742 Bay Rd., Queensbury, NY 12804 Inspector's In' I NAME: Q P MIT NO.: 09n ns%$ LOCATION: NSPECTON: _I I =; Q9 RECHECK: 1"7 Comments and/or diagram Soil Type: Sand/ Loam / Clay T of Water: Municipal/ Well Water Waterline separation distance Well separation distance ft. Other wells: ft. Well CasingLen Other + - Y N N/A �c Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Buildin to n "�-eAA Lku (oC) V---V-n GTi't►�� an o Distribution Box " Pt Opening Sealed: Y N <� r End Cap N Inlet/Outlet Pipes&Baffles Y N Location Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits Conforms as per Plot Plan Y Engineer Report and As-Built Y NN ,�i�NEfO GEE`-C%c- E® p6 t�x)1 LT Fv Lp ��p© fit Location of System on Property: Front ar Left Side Right Side Middle Front Middle Rear Sygam Use s: 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 ti IJ t75 FLo T 5 A F%V-J"'� TE6Te-D Septic Inspection Report Office No. (518) 761-8256 Date Inspe ion request received: Queensbury Building &Code Enforcement Arrive: j am/pm epart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: Q/0 NAME: PERMIT NO.: LOCATION: INSPECT ON: / / 2J RECHECK: ' Comments and/or diagram Soil T : Sand Loam Clay Type of Water: Municipal 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. 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: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved r 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 Inspection req r e' ed Queensbury Building &Code Enforcement Arrive: e a /pm rt: 1 a m 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial NAME: C FF M �— P MIT NO.: LOCATION: _� Q SPECT 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 L+% RPM AL�-.- T `T-KPjJ 'FW1J9Rt loc T-co ink to Distribution Box L4 It ►� Foss m��� To -gpX. Pq���F Distribution Box to Field Pit Opening Sealed: Y N End Ca N Inlet/Outlet Pipes&Baffles Y N b►J �3Ti_ o t Location Separations Foundation to tank ft. Foundation to absorption ft.— Separation of Pits ft. Conforms as per Plot Plan Y Engineer Report and As-Built Y IrJ�EO C-ERT%FtED 4'N LT F E\-v Location of System on Property: -� Front Rear 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 11\ To 4AGY\Fi LL T-pq i� (CZ) 2� Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc Z�000pM Septic Inspection Repo Office No. (518) 761-8256 Date Inspection req eive . Queensbury Building &Code Enforcement Arrive: ZpZS a part: y, a Dm, 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: `----� NAME: PE MIT NO.: LOCATION: SPECT ON: RECHECK: Comments and/or diagram Soil TypwgC-SSagg,&Ewla Type of Water: er �-o p-rE� Waterline separation distance ft• 1J G\6HC Well separation distance ft. Other wells: Well Casing Length 50' + Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size- PiDina Size nge PUMP Building to tank , oT rKw Fa0wWpPrTt©V;) Sv-Q•rtc Tank to Distribution Box °t PU V 0E 'To +D—eoXL Distribution Box to Field/ Pit SAN P ZF e� Opening Sealed: Y N ° �TE9AL5 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 Y_ Engineer Report and As-Built —Y N a�Ep CE�'RFtE� P.SQ�It_C ��Elp FRr�m Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear e StatusY Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 LABuilding&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc f Mar .i29. 2011 9:28AM QBY WATER WASTEWATER No. 9276 P. 2 41 154674 . . ELECTRICA .CERTIFICATE COMMONW P_t!. LT LEC,,0. 4AL t• x6Y,s••4t.r INSPECTION SERVICE,.INC.. 176 DOE'Rt7,1`T ROAD; 1vf,A1VHEIM, P,A, 17545 'TELEPHONE:'(717)664-2347 Pt a }Y`ti,� _ (:J M 4 lnsp_ Ppie.:11/2212009 -- Appl S. L16518 Premises of:GAFFRY&HAWN as ,address: 40 BAY PARKV IAY, QUEENSBURY,NY County of:WARREN �:.... •lnstailed by;.TI;tOQM:i ILF—.:.k....L[�C,4.T.R.CC_ w" fippi raius:SEWER PUMP AND CONTROL APPROVED Inspectiec,by: DONALD LOVELAND � �j 2f4'•'� a^t d5' 1lte cogdiliotrs `ollowing pverned i3sttanee pf,tliis cettifieaie,End on, celtiGeate previously , issued.is cansellej.Faii re to lt¢iv:the r rei tec�•�vheit addi ipnal ul ment'nr wirin is ! �x v. P may. rdp?c eq P 8 t. ,f a lied:ct Nithiq on8 year f Tt the date of llte cenifit ale shall void tlts cedificaM ii;its entirely End the - ejm spar:n6i be liablr:rw any damages wholsocver: 't :u r f11S CzrfiT5 dt0 apes nsit gtriit'�diit?o ei'E'1tftcy."yYe�ir>B gUBhties;Aieintiwnce or repz3r aml the I f R„ S 't company s1sal!no!be liable fotatiy damages resuliing from any def8i f or fault sr[he,plags oft ifroa• e �• ticns,including relrair,roc or>Sin!etipn,per5ona(in�ljry or for the death of grry per.:on;acid ccrti mo iytwiFiy ,aad des i=el cj^d Monti, $ j++st :lur:.vl'this Gutrrpan�sh:U iTa�c We pilvite�e of makinlj nspeotims at any ti:"..and if �w.-=s<; •:.c< ( i;s rules arc VVialed,ilie cOrtt'aithot,have the fi itt to revoke the certisricale. M it ; .4 Y s• & v st�t;�•� v9