2007-203TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201
Permit Number:
Tax Map No:
Community Development -Building & Codes (518) 761-8256
BUILDING PERMIT
P20070203 Application Number: A20070203
523400-289-011-0002-014-000-0000
Permission is hereby granted to: PAUL & SUSAN PONTIFF
For property located at:
23 COUNTRY COLONY Rd
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
Owner Address: PAUL & SUSAN PONTIFF
23 COUNTRY COLONY Rd Septic Alteration Residential
QUEENSBURY, NY 12804 Total Value
Contractor or Builder's Name /Address
QUEENSBURY SEWER
JAY S WEET
Electrical Inspection Agency
Value
Plans & Specifications
2007-203
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday, May 03, 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 Tow=-o eensb 3 T,r ay, May 03, 2007
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SIGNED BY ~' ~ P " ~- ~ .`~ for the Town of Queensbury.
Director of Building & Code Enforcement
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' ~0/FFI~,CE USE ONLY _ _' _.. _.... _ . _ . ;
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;TAX MAP N0. ~ _ PERMIT N0. /~ ' ~ RE~~~VE~ '
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' ERMIT FEE-~~ % '
APPROVALS: ZONING ~ ~ ;' ''~ t
~ TOWN CLERK
~_-•--_-•------------- r %fOVVN ur• ~.tuC.~rvJt~t1RY
APPLICATION FOR SEP """' ________________________~ ;'_B>a,I.D~nI~AN~.~9pE..:
TIC DISPOSAL SYSTEM PERMIT;
PERMIT.
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
OWNER: _ ~'`~ ~ Pp~ -~ ~~
ADDRESS: ~~ ~~ ~, ~ C Orv ~~
PHONE NOS.
LOCATION OF INSTALLATION:
NO. OF
YEAR BUILT
BEDRO
.......
X
- ,
OMS
...» .........................»......................
,1980 or older
...... X
........_.......
..........................
...
.
.
...........
....
X
.. ...........
1 X
.............................
present
~.....-1992 ....
.
PARCEL INFORMATION:
...'.COMPUTATION=
150 gallon per bedroom
130 gallon per bedroom
.............................
110 gallon per bedroom
INSTALLER: U~-Qsv.r6~rn5 ~/p,W~~~~~~~
ADDRESS: C.7 Q ~x (~ ~~ ~p
PHONE NOS. ~ 6 ~ ' y/ ~~ !
= i TOTAL DAILY FLOW
RESIDENCE INFORMATION
GARBAGE' GRIN
INSTALLED? -,-,,
SPA OR HOT TU -~
INSTALLED7~_
/ QOGRAPHY: FLAT OLLING ~ STEEP SLOPE
SLOPE
/ IL AT RE: SAND LOAM
CLAY OTHER
/ GROUNDWATER; AT WHAT DEPTH?
WHAT DEPTHS BEDROCK/In~pERVIOUS nna-r~o~n~ .
~„~. AT
/ DOMESTIC WATER SUPLY: MUNICIPAL WELL
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS `~~ +
FT.
/ PERCOLATION TEST: RATE IS
COMPLETED BY A LICENSED PROFESSIONAL ENGINEEIR OR ARCHITECT(TEST TO BE
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.
/ SEPTIC TANK: ~~ GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH ~~
/ ~TAL SYSTEM LEN ~TH• FT.
• ~~~ ~• SEEPAGE PIT(S): HOW MANY?
/ SIZE OF EACH FT. X FT.
/ SIZE OF STONE T BE USED: # _~ /DEPTH OR THICKNESS
/ Z' FT.
/ BED SYSTEM SIZE: X
/ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
/ HOLDING TANK SYSTEM: (If required) N0.OF TANKS:
/SIZE OF EACH
/ GALLONS. /TOTAL CAPACITY.• GAL.
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY~A TOWN
~~ .APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. ~
...:...:...::...:.:.:.:..:...:.....:.:.:...:.:.:.:.::.:..:.::: ... ~, ::::::, l
For your protection please note that •............. .....: . :.:.:.:..:.:.::.:.:.:..........:.::....::..:.::::.::....~...:..:::,:::::~:,.......,.,..,...,....,.,.,:.i!
........
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 re a regulations with respect to this application and
agr o Ide by the nd ali requirements 'of the Town of QUESTIONS 7 CALL 761-8256 OR EMAIL
sans ry Sanitar S age D' posal Ordinance. codes~a~een:h~~~,.. .
VISIT OUR WEBSITE FOR MORE INFORMATION
WWW.QU@@hShUCV It@t
ature o son Responsible Date
Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
COMMONWEALTH ELECTRICAL INSPECTION SERVICI3, INC.
Main Office 176 Doe Run Road - Manheim, PA 17545
MUNICIPAL CERTIFICATE -ELECTRICAL APPROVAL
Permit No....Q ,~ ~ Cert. N~ 9 4 8 7 8
.................. Cut-in Card No...................
Owner ................. ~~ ~`~ ~T~ ..................
.................................................................................................................. ..
..
Location ... """••••••••
f L
.....................................................l. C~'-~~ ~'.....
................................................... ............
Installation Consisting of ...:.... ~~- ~L(/`L4 ~¢- ~,~~ ~r
.......................................................................
~ .
.................................................................................. .
Installed By......... ~..... ........................
.................~G.Sr...~/.C.....~............... ........... Lic. No................
.......
The conditions following governed the issuance of this certificate, and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations, application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of maki inspections at any time, and if its
rules are violated, the Company shall have the right t r ke rtifica
Date......J~...-~--.~ ~
.................................. INSPECTOR ...............:. .
Member N.F.P.A., I.A.E.I.
k.~ ~ s ~ o ,ter ! ~ I
~,~ '~ ~
~.
Septic Inspection Report
Office No. (518) 761-8256
Queensbury Building & Code Enforcement ~~ Inspet
742 Bay Rd., Queensbury, NY 12804 ~~' ~`
Inspecb~r's ;
NAME:
LOCATION:
RECHECK:
CIY
part-
Scents and/or diaarwn,
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Front Rear Left Side __WQht Side
Middle Fro le Rear .~
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Approved
Partial Approved and needs to be re-inspected, please call the Building & Codes Office
Disapproved
Last revised 021006
Last revised 1{6105
Location of System on Property:
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