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2007-467 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLI-ANCE Permit Number. P20070467 Date Issued: Wednesday, January 09, 2008 This is to certify that work requested to be done as shown by Permit Number P20070467 has been completed. Tax Map Number. 523400-301-013-0002-051-000-0000 Location: 15 ALGONQUIN Dr Owner. DAVID & STEPHANIE MAHONEY Applicant: DAVID & STEPHANIE MAHONEY This structure may be occupied as a: Septic Alteration Residential By Older 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: P20070467 Application Number. A20070467 Tax Map No: 523400-301-013-0002-05 1-000-0000 Permission is hereby granted to: DAVID & STEPHANIE MAHONEY For property located at: 15 ALGONQUIN Dr 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: DAVID & STEPHANIE MAHONEY Septic Alteration Residential 15 ALGONQUIN Dr QUEENSBURY,NY 12804 Total value Contractor or Builder's Name/Address Electrical Inspection Agency ACTION SEPTIC SERVICE CHET SANDERS 1212 STATE ROUTE 9 SOUTH GLENS FALLS,NY 12803-0000 Plans &Specifications 2007-467 septic alteration residential $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday,July 27, 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 To o eens ry; i y,July 27, 2007 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement ►..►.....►....__►..._......_►►......►........►►.►...►_•►►....►..►.. r...................... &FFICE USE ONLY ' TAX MAP NO, PERMIT NO. 67 46:7PERMIT F� , , 0 , ' 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: LI& &Azgd'c- INSTALLER: �>0 Jal 04 ✓ �fG ADDRESS: ADDRESS: PHONE NOS. PHONE NOS./ Cell 7?! —t 6Zc LOCATION OF INSTALLATION: .................. .............................................................................................................................................................. . ..... INFORMATION: NO.OF YEAR BUILT BEDROOMS X COMPUTATION= _ ' TOTAL DAILY FLOW i .............................. ..................;.........................................................,....................................................................................1......._.........,.......................................,........,......� GARBAGE GRINDER a { 1980 or older 1 �y X...'.......1.50.gallon per bedroom 1 ( e�)Q........ INSTALLED? N� s..............} ........................................}........... ... .... ` 1981 -1991 130 gallon per bedroom SPA OR HOT X1 f >................_........._..........._......;.........................................................d...................................................._.......................,..,.................._..,,..................................................,...; TUB .1992-present .I X 110 gallon per bedroom I = INSTALLED?, f7- .......................................................I..............................,....................................................... PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING- STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? BEDROCKAMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL.,_ 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. srs�,jo SEPTIC TANK: �012c) 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: G'4rl��/�tor `D& LENGTH AND/OR SIZE ✓ HOLDING TANK SYSTEM:(if required) NO. OF TANKS: /SIZE OF EACH ✓ GALLONS./TOTAL CAPACITY. GAL. it NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN C APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. i:...........:...........:...:.................:..................:...........................:...:..:.:....:..:::.::..:.....:......::.:....:.:....:,:.,...>,.,,..,........,.....,..,..., 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 Sanitary Se ge Disposal Ordinance. codes@aueensbury.net VISIT OUR WESSITE FOR MORE INFORMATION www.aueensburvm nature of Person"r—Responifbile Date 4 Town of Queensbury ■ Community Development Office- 742 Bay Road, Queensbury,NY 12804 Septic Inspection Report Office No. (518) 761-8256 Date I Queensbury Building&Code Enforcement Arrive: VRNO.: rt: '- a 742 Bay Rd.,Queensbbury,,lNY 12804 Inspector's Initi NAME: /�`�Il©)LOCATION: _ - a RECHECK: Comments and/or diagram Soil T : Sa m a -TypeW unid I VoVater Wate ratio ce ft. Well separab nce ft. Other wells: ft• Absorption Field: Total length Length of each trench Depth of trenches ft. Size of Stone -Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box << A C trk\-E Distribution Box I Pit " Vk Openi Sealed• Partial End Ca Inie Outlet Pipes&Baffles Y N Location Separations Foundation to tank Foundation to absorption ft• T© 17 b �,c �� t:� Se ration of Pits ft• Conforms as mr Plot Plan Y N FErigineer Report and As-Built Y N Location of System on Property: -Fro ft Si Right Side Middle Fro Middle Rear m s: Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved Last revised 021006 Last revised 1/6/05 ------------ jo�) tow fJ� IDS lhf C-1 o Q�b JAI