2002-436 / 1
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804.5902 (518)761.8201
Community Development-Building&Codes (518)761.8256
U`rtRT1FIC%.jA'1'E
PenuitNumber; P20020436 Date Issued: Wednesday,January 16,2008
This is to certify that work requested to be done as shown by Permit Number P2Q020436
has been completed,
Tax Map Number. 523400-304-017-0001-004.000-0000
Location: 118 RIVER St
Owner. JOSEPHÐEL FRAWLEY
Applicant': JOSEPHÐEL FRAWLEY
This structure maybe 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-o#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: . P20020436 Application Number: A20020436
Tax Map No: 523400-304-017-0001-004-000-0000
Permission is hereby granted to: JOSEPH&F,TAF'L FRAWI,FY
For property located at: 118 RIVER 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. Type of Construction Value
Owner Address: JOSEPHÐEL FRAWLEY
11$ RIVER St Septic Alteration Residential
Total Value
HUDSON FALLS,NY 12839
Contractor or Builder's Name/Address Electrical Inspection Agency
I.B.S. SEPTIC
2 LOWER WARREN STREET
OT TFF.NSBT TRY.NY
Plans&Specifications
2002-436
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,May 30,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at wn of ensbury; Thursday,May 30,2002
SIGNED Y for the Town of Queensbury.
Director of B ' ding& ode Enforcement
Application for Permit—Septic Disposal System t
7invt7 of Queensbuly 742 Bay Road Qleensbury,NY 12804_ (5I8) 76I-82SG
I. OWNER INFORMATION:
..................................
..............................
Location of installation: t (��. /� Office:Use
y Jam/
Tax Map No. ! y Fite Permit No.
er' `L� Fee Paid- S` �
Owna Name:- C �'l^ {�,
Address: Z,c (' sI
2. INSTALLEWS,NAME : c ee r✓ PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate #bedrooni(s)1.and multiply N j !
bedrooms with applicable gallons per bedroom to equal total daily,hoty)
Year of House• No`of Bedrooms 'x Computation Total Daily Flow
1980 or older 150 `— 0 V
x gaUbdrni = -� i
1980— 2991 x 130 gallbdrm =, Pd1AY 2 4 2002
1991 —present x i 10 g' I/bdrm =
Garbage Grinder Installed yes 'TOWN O�QUEEl�SBURY_ '! no Bull-DING AND CC�DE
Spa or Whirlpool Installed yes" ! no -
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
rantiv _ tsl_co Sl.rou:td Vlratcr__ �DVslioGk.or llnporxivu$_LAP Qd, . np �. _atgr_$s pply
I'laI ecrr err sOuit depth fit /rift nnirrlrrljrcrl
lg orurr leer ��t.'
Steep slope clay — feet
if
v svell; water supply
_/o slope other from any septic-system
depth: absorption is f).
other
Percolation TO a be completed by11censed professional engineer or architect)
Rate: -� A-mb11Ne per Itch
S. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systcros must be designed by it licensed
proi'essional engineer orarchilect(unless instniled-in a Planning Boat—dal—proved subdivision). Add 250 galkins to tip size
of the scplic,lank and l
eac
h Held for cacti Garbage Grinder, Spa or Whirllx)ol-'l'ub.
Septic Tank: 7C gallon(min. size 1,000 gal.)
Tile Field: -each;trench 10—• t. Total System Length: lL
t.
Seepage Pit(s): 'number of stze of each: fI. by ft.
Size of stone to be used: . li '� _ / depth or-thick»ess -
-Bed System'Size; x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of.tanks: 1 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 tile Town
of Queensbury, nny permit or approval granted which is based upon or is granted in
reliance upon any material misrepresentation or failure to nmako a material fact or
circumstance known by or oil behalf ofan aptilicarrt, shall be void.
I have read the regulations with respect to this application'and agree to:aliide by ilseso and all
requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
• - _ :�- � � -ate •
gnature of respgnslble person . Date
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p5 epart: am/pm
742 Bay Rd.,Queensbury, NY 12804 Inspector's Initials:
NAME: PERMIT NO.: � J�
LOCATION: Gr- INSPECT ON: i-116 L �
RECHECK:
Comments and/or diagram
Soil Type: Sand Loam Clay
Type of Water: Municipal/Well Water
Waterline separation distance •
Well separation distance ft.
Other wells: ft•
Absorption Field: Total Te-nc:j-th--
Length of each trench ft•
Depth of trenches ft•
Size of Stone C/10
Seepage Pits: Number
Size: x
Stone Size:
Piping Site Type
Building to tank
Tank to Distribution Box
Distribution Box to Field Pit
Opening Sealed: Y N Partial
End Ca
Inlet/Outiet Pipes&Baffles Y N
Location/Se arations
Foundation to tank ft•
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built I Y—N
Location of System on Property:
Front Rear Left Side Right Side
Middle Front M' dle Rear
S stem Use to
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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Septic Inspection Report
Office No. (518)761-8256 Date Inspection re es re eiv d:
Queensbury Building&Code Enforcement Arrive: p epart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initia s:
NAME: l2MTT NO.:
LOCATION: INSPECT ON: — - 6
RECHECK: _ ]
Comments and/or diagram
Soil Type: Sand/Loam/Clay
Type of Water: Municipal/Well Wat
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Absorption Field: Total length $.
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/Partial
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft
Conforms as per Plot Plan Y VN, �
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
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