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2011-190 .41." TOWN OF QUEENSBURY FOTO742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 CERTIFICATEF O COMPLIANCE Permit Number: P20110190 Date Issued: Wednesday, May 18, 2011 This is to certify that work requested to be done as shown by Permit Number P20110190 has been completed. Tax Map Number: 523400-309-014-0001-076-000-0000 Location: 7 RYAN Ave Owner: HOLLIE LAMKINS Applicant: HOLLIE LAMKINS 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&Co e Enfo ement Planning Board or Zoning Board of Appeals. a TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building & Codes (518) 761-8256 \' CERTIFICATE OF COMPLIANCE Permit Number: P20110190 Date Issued: Wednesday, May 18, 2011 This is to certify that work requested to be done as shown by Permit Number P20110190 has been completed. Tax Map Number: 523400-309-014-0001-076-000-0000 Location: 7 RYAN Ave Owner: HOLLIE LAMKINS Applicant: HOLLIE LAMKINS 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 Enfo ement 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: P20110190 Application Number: A20110190 Tax Map No: 523400-309-014-0001-076-000-0000 Permission is hereby granted to: HOLLIE LA 4KINS For property located at: 7 RYAN Ave 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. TTYpe of Construction Value Owner Address: HOLLIE_LAMKINS" Septic Alteration Residential CHRISTIAN MELICK 7 RYAN Ave Total Value QUEENSBURY,NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2011-190 septic alteration residential $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,May 12,2012 (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 ueensb ; ursoay,May 12,2011 SIGNED BY !' rF S-� for the Town of Queensbury. Director of Building&Code Enforcement OFFICE USE ONLY PERMIT NO. PERMIT FEE MAY 11 2011 APPROVALS: ZONING TOWN CLERK Y APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: BUILDING&CdOES A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. J� OWNER: ` - 'Y,tt 1�j INSTALLER: ''nn ADDRESS: \ 14GA Aix-- ADDRESS: (�P''et,. PHONE NOS. l //n y ePHONE NOS. LOCATION OF INSTALLATION: ✓`TV`[ RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW BEDROOMS Gallons per bedroom GARBAGE GRINDER 1980 or older X 150 = p INSTALLED? 1981-1991 X 130 = SPA OR HOT TUB 1992-present X 110 = INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT RO NGJ �STEEP SLOR1 %SLOP ✓ SOIL NATURE: SAND LOAN CLAY OTHER/1 ✓ GROUNDWATER: AT WHAT DEPTH? T� ✓ BEDROCKIIMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPA WELOAAJ (If well:water supply from any septic system absorption i�fft) ✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpi] (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). TANK SIZE: I �GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,spa or whirlpool tub. SYSTEM TYPE: 1 ABSORPTION FIELD(WITH NO.2 STONE) Total lengtl�_�ft. Each trench X. ❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? ❑ALTERNATIVE SYSTEM Bed or other type? /� ❑HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? r 1 NOTE: ALARM SYSTEM AND ASSOCIATED 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. have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury QUESTIONS? CALL 761.8256 OR EMAIL Sanitary Sew Disposal Ordinance. codes(daueensbury.net l b e G VISIT OUR WEBSITE FOR MORE INFORMATION Signature of Person Responsible Date www.aueensburv.net Town of Queensbury*Community Development Office*742.Bay Road, Queensbury NY 12804 Septic Inspection Rep Office No. (518)761-8256 Date Inspection iv Queensbury Building &Code Enforcement Arrive: - a / epart, am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials NAME: P)6 P RMIT NO.: -- LOCATION: E SPECT ON: — RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/ - Y N N/A 150'to well required if NO Absorption Field: Total length ft. 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 17 End Cap Y—N Inlet/Outlet Pipes&Baffles _Y N AS BU Manholes 12"or less below grade _Y_N [provide extension collar if Yes Y N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits Conforms as per Plo _ N Engineer Report an -B ' Y N ETU Maintenance ontract Y_ N provided Location of System on Property: Front ZRe Left Side Right Side Middle Front Middle Rear S stem Use Sta Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report,03 2910.doc i ` I h ie een or • ase ve , or bell ve sa e r' e�1 , �fl o�. . sf_ch s h as s, �v l,s, rre -.., anc t¢ th :�n h d a r m. -_ , ,- -•,�- E - -AEI=—�—1 - II • t/ 41 -7/-Cu Septic Inspection Report Office No. (518)761-8256 Date Ins on iv Queensbury Building&Code Enforcement Arrive: L' m rt: 2,r a /rr) m 742 Bay Rd., Queensbury NY 12804 Inspector's Initi Is, NAME: I �t P IT NO.: no LOCATION: SQ �Q_ , SPECT ON: — --� RECHECK: Comments and/or diagram Soil Ty Lpam4-Clay Type of Water: Well Water Waterline se aration distance tl ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N N/A 150'to well required if NO Absorption Field: Total length ZoO ft. Length of each trench 1± ft. Depth of trenches 1 u— ft. Size of Stone # Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank he Tank to Distribution Box V4 ik Distribution Box to Field/ Pit Opening Sealed: N End Ca _ N Inlet/Outlet Pipes&Baffles N Manholes 12"or less below grade Y_ [provide extension collar if Yes Y N Location Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Y � Engineer Report and -Bu' _Y ETU Maintenance bmiTakt Y_N provided Location of System on Property: Front Rear Left Side Right Side Middle Fro Middle Rear stem Use S to . Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\13ullding Codes Forms\Inspection Fortis\Septic Inspecdon Report_03 2910.doc ` Ila rIF U Q k Irk ►. -� � - - ; o �1- ! ` I ha�r� gee �D I'a I. e -_�- 1 - - - %)1 e'.� sa ev den e f, AY 7n11 _ J"i0W i ^il flli' 0r e + Ar Yt1 /� �+ ;s._nrN ? `�r ` I V N O1" UEENSBURY NV �— h 7: i,7; r� !BUIIi.DI ODE - 411' 1- Iuin�1T i"E -