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2003-339 TaWN OFQ VEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 AT CERTIFI C E F COMPLIANCE Permit Number: P20030339 Date Issued: Monday,June 02,2003 This is to certify that work requested to be done as shown by Permit Number P20030339 has been completed. Tax Map Number: 523400-279-015-0001-059-000-0000 Location: 60 RAINBOW Trl Owner: GREGORY&PAMELA VALASTR.O Applicant: GREGORY&PAMELA VALASTRO This structure may be occupied as a: By Order of Town Board Septic Alteration Residential TOWN OF QUEENSBURY ('4P Director of Building&C de E cement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development—Building'&,Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20030339 Application Number: A20030339 Tax Map No: 523400-279-015-0001--059-000-0000 Permission is hereby granted to: GREGORY&PAMELA VALASTRO For property located at: 60 RAINBOW TrI in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans andother information hereto filed and approved and in compliance with.the NYS Uniform Building Codes and the Queerisbury Zoning Ordinance. Type of Construction Value Owner Address: GREGORY&.PAMELA VALASTR 60 RAINBOW Tit. Septic Alteration Residential Total Value QUEENSBURY,NY 12804 Contractor or Builders Name/Address Electrical Inspection Agency STF,VF,NSON- WATT Plans&Specifications 2003-339 SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATION $25,00 PERMIT FEE PAID THIS PERMIT EXPIRES: Sunday,May 30,2004 (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 a ownrouVensb , F iday,May 30,2003 °. SIGNED B for the Town of Queensbury. 1 Director o£Building&Code Enforcement Application for Permit—Septia Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: Office Use Location of installation: ( l�q�h Tr G f) File Permit No. Tax Map No. Gil a j r 3 Fee Paid Owner's Name: grearvl & ifCe.., a S4--D :......._.........................................................................................:................................. Address: 6C? P 33 F0 2. INSTALLER'S NAME UJcL.� r S—t ei/�c�So�l PHONE NO._ e2 7� 3. RESIDENCE INFORMATION: (circle year of dwelling,.indicate#bedroom(s) and multiply#of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older x 150 gal/bdrm = 1980— 1991 x 130 gal/bdrm km � �� 1 —present x 110 gal/bdrm, _ Garbage Grinder Installed yes / no 5s MAY 2 8 Z003 Spa or Hot Tub Installed yes / no T NNN Of:BUILDING AND CODEY 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) T22ography Soil Nature Ground Water Bedrock or Im ervious Material Domestic Water Supply Zat sand at who!depth at what depth municipal Rolling loam �b feet feet Steep slope clay if well; water supply slope other from any septic-system depth: absorption is ft. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch 5. 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. Gk. Septic Tank: /100 gallon (min. size 1,000gal.) Tile Field: each trench 5-0 ft. Total System Length: �?d C7 ft. Seepage Pit(s): number of size of each: ft. by ft. Size of Stone to be used: # / depth or thickness feet Bed System Size: x Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons Note; Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) 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 Queensbury Sanitary Sewage Disposal Ordinance. Sign re of responsible person Date i i r....,...e,oTrt1 wY�cvr�at�rtsxT�^'I�If7iX:4', �'C}zL.I*�(}IZ.��RI03hII 7S �ThSd'l�LsJIS 'G i = I i - I t..r,,>t ta�• ~W�,�,_,..�—r " �`)I�ys� 111�s?U. tit O CINOd tEmail1If•1hurli h$f}I.I,VII.Vd,518 •.s t1LiLsel�} llsse�<lti�ti ;�:titn»„ I�LrLs s.yani:�;.� • �.iiiclt:Lr:�:�L1Z} fc� unuy.L: . NAP Septic Inspection Report Office No.(518)761-8256 Date Inspection request received: 03 Queensbury Building& Code Enforcement Arrive: am/p � ��Gpart: ' am/pm 742 Bay Rd.,Queensbur�y,,NY 12804 Inspector's Initials: f� NAME: I/- TAR.k v � PERMIT NO.. C>ft LOCATION: 69 0 �:� !�' INSPECT ON: RECHECK: Comments and/or diagram Soil T e: Sand/Loa /Cl Type of Wa nicipal/ ell Wate .Waterline separation distance ft. Well separation distance ft. Other.wells: ft. Absorption Field: Total length Z ft. Length of each trench ft. Depth of trenches Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size T e Building to tank .• L-j Tank to DistributiNi Box 35 Distribution Bo field/Pit Op erring Sealed: Y/N/Partial Location/Separations Foundation to tank ft. Foundation to absorption P ft. Separation of Pits ft. Conforms as per Plot Plan N Location of System on Property: Front Rear Left Side Cight Middle Front Middle Rear Sst em Use Stat : Approved Partial Approved and needs to be re-inspected,please call the Building&Codes Office Disapproved LASueHemingwaySuilding.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003 -Septic Inspection Report Office No.(51&)761-8256 Date Inspection request received: Queensbury Building&.Code.Enforcement Arrive: amlp epart: am/ m 742 Bay Rd.,Queensbuiy,NY 12804 Inspector's Initials: p NAME: Cj LOCATION: PERMIT NO.:. / RECHECK: INSPECT ON: S O5 MWaterline omments and/or diagram SanRE 1 ClCla Wail./ ell Water separation ince ft paration distance: ft. Other.wells: ft Absorption Field: Total,lerigthft Length of each trench ft De th of trenches Size of Stone -Seepage Pits: Number Size: x Stone Size: Pi in Size T e Building to tank Tank to Distribution Box n Distribution Box to Field/Pit $ Opening Sealed: /NI Partial Location/Se arations Foundation to tank ft. Foundation to abso tion ft Se.aration of Pits Conforms as per Plot Plan y N Location of System on Pro rty: Front Rear eft Side Right Side 'Middle Front Middle Rear System Use Status: pproved Partial Approved-and needs to be re-inspected,please call the Building&Codes Office Disapproved L:1SueHeming\vay\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28;2003 Septic Inspection Report Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: !p anjVW art: ('-t�V -aiiVpm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initi�als: _ 7. NAME: 1L57WO PERMIT NO.: -- LOCATION: &-&-(N[3!e�2 INSPECT ON: -7/, F 7 RECHECK: Comments and/or diagram Soil Type: Sand Loam Clay Type of Water: Municipal/Well Water Waterline separation distance Well separation distance Other wells: ft. "S Absorption Field: Total length Length of each trench Depth of trenches ft. Size of Stone --SeTage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: Y/NI Partial Location/Separations Foundation to tank Foundation to absorption Separation of Pits Conforms as per Plot Plan- —Y N Location of System on Property; Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: Ap oved P ial 1)'al Approved and needs to be re-inspected,please call the'Building&Codes Office pproved L'\SueHemingway\]3uilding.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003 Septic Inspection Report Office No. (518)761-8256 Date Inspection request received: i Queensbury Building&Code Enforcement 'Arrive: am&/ Depart: am/p. .1 *0ra Z 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial NAME: PERMIT NO.: LOCATION: INSPECT ON: l --!S RECHECK: Comments and/or diagram Soil Type: Sand Loam Clay Type of Water: Municipal/Well Water Waterline separation distance ft. 4C�' Cpuv, Well separation distance ft. Other,wells: ft, Absorption Field: Total length ft. /--.4 Length of each trench ft. Depth of trenches Size of Stone See ge Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: Y/NI Partial Location/Separations Foundation to tank ft. Foundation to absorption Separation of Pits Conforms as per Plot Plan Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear Status: proved Partial Approved and needs to be re-inspected,please call the'Building&Codes Office System Use L:\SueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection R'eport.doc January 28,2003 Drrlorl + rame4a r, lO AArnbow "Mwl Qu-etnSbu1Y'1V'1 tZ (,51d)'7N5. 5'L61 (03 '41 i "I have seen or observed,nwellsbei�trees,fencer etc-,of, all objects such as house at I have s, f shown on this document.1 also represent th personally measured the distances set forth o �� 03 3 � 5° DATE RECEIVED \ SIGNATURE MAY 1 8 2003 TOWN OF UUEENSBURY BUILDING AND (5 `TcALie l BUILDING& PT REVIE WED BY DATE 6 —fr i i I I