2007-418 i
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
4z Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIIA►NCE
Permit Number. P20070418 Date Issued: Wednesday, January 09, 2008
This is to certify that work requested to be done as shown by Permit Number P20070418
has been completed.
Tax Map Number. 523400-309-015-0001-034-000-0000
Location: 47 CAROLINE St
Owner ARMANDO FIORE III
Applicant: ARMANDO FIORE III
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&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: P20070418 Application Number. A20070418
Tax Map No: 523400-309-015-0001-034-000-0000
Permission is hereby granted to: ARMANDO FIORE III
For property located at: 47 CAROLINE St
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. TWe of Construction Value
Owner Address: ARMANDO FIORE III
47 CAROLINE St 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
2007-418
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,July 09, 2008
(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 Tov,o ensb A y,July 09,2007
SIGNED BY V for the Town of Queensbury.
Director of Building&Code E orcement
_r__r_____r________rr____r r_s___r r_r_ or r____s r______r r_r____�
/ OFFICE USE ONLY 0
• TAX MAP N0. PERMIT NO. ® PERMIT FEE ;
o APPROVALS: ZONING ` TOWN CLERK ;
0
_______r_____r_____ r________ ----
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: a^1 0 A/C/ o PC INSTALLER:
ADDRESS: «C _� ADDRESS: 7T (aG✓G�`�✓�
PHONE NOS. t/ PHONE NOS.
LOCATION OF INSTALLATION: ca C
1.
................._....,........_w....................................................................................................................................... .................................................................... RESIDENCE INFORMATION.
I YEAR BUILT NO.OF ! X i COMPUTATION= _ TOTAL DAILY FLOW
BEDROOMS l
............................ GARBAGE GRINDE
1.................................. ................................ { 9 P _ „3� INSTALLED
i 1980 or older I 2 X '• 150 gallon per bedroom
.............................................................................................L..........t....................................................................................i.........................................................................
,
1981 -1991 ? f X 130 gallon per bedroom •: = i SPA OR HOT TUB
................................................;..............................................I...........a..... ...;...,.......i............,.....,,.......................,..............................,
X 110 gallon per bedroom i INSTALLED?
1992..present 9 P _
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 2(�WELL
(IF WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT. )
✓ PERCOLATION TEST: RATE IS l—S- 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 t0 the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub.
✓ SEPTIC TANK: Q d GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH FT.
✓ TOTAL SYSTEM LENGTH: 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: LENGTH AND/OR SIZE
✓ HOLDING TANK SYSTEM:(if required) NO. OF TANKS: /SIZE OF EACH
✓ GALLONS./TOTAL CAPACITY,- l-v GAL.
+ .:............
NOTE: ALARM SYSTEM AND ASSOCIATED:..:.:..:.::..........:....:.Y,,:.:,...:..:::. .:,:..:..Y.::.:,: :.:, .,:,.:..:..-.,,:.:•:......:.. .,
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 of QUESTIONS? CALL 761.8256 OR EMAIL
Queensbury nitary Sewage Disposal Ordinance. codes®oueensbu net
VISIT OUR WESSITE FOR MORE INFORMATION
www, eensbu .net
du r
Signature of Person Responsible Date
Town of Queensbury• Community Development Office• 742 Bay Road, Queensbury, NY 12804
Septic Inspeci ion Report
Office No. (518)761-8256 Date Ins uest received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Rd., Queensbury, Y 12804 Inspecto Initials: _L4-L1-�-/
NAME: PERMIT NO.: 0 7—4 hQ
LOCATION. Co ro r t.r INSPECT ON:
RECHECK:
Comments and/or diagram
Soil T Sa oa Clay
Typ2 of :Cti
unicl /Well Water
Waterline se on nce ft.
Well separation di nce ft.
Other wells: ft.
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone �--�
SeepM Pits: Number
Size: x
Stone Size:
Piping Siz TyDe
Building to tank
Tank to Distributionl0ox r t 44
Distribution Box id Pit—
Opening Sealed: N Partial
End Ca
In Outlet Pipes&Baffles V Y N
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
En sneer Re rt and As-Built Y N
Location of SystDtr
Property:
Front Left Side Right Side
MiddleMiddle Rear
System Use!!/Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes office
Disapproved
Last revised 021006
Last revised 1/6/05
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