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2011-410 TOWN OF QUEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 Q may, Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20110410 Date Issued: Monday, April 09, 2012 This is to certify that work requested to be done as shown by Permit Number P20110410 has been completed. Tax Map Number: 523400-309-013-0001-054-000-0000 Location: 17 CONNECTICUT Ave Owner: TONY CONDON Applicant: TONY CONDON 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 �p property owner of the responsibility for compliance with Site Plan, ,�f Variance, or other issues and conditions as a result of approvals by theDire or of Building&VVV Co:!�nfo\ ment Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY gia, I O.0 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20110410 Application Number: A20110410 Tax Map No: 523400-309-013-0001-054-000-0000 Permission is hereby granted to: TONY CONDON For property located at: 17 CONNECTICUT 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. Type of Construction Value Owner Address: TONY CONDON 17 CONNECTICUT Ave Septic Alteration Residential QUEENSBURY,NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2011-410 septic alteration residential $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,August 15,2012 (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 To6--.. of ens yi Ay , # . ,, , ugust 15,2011 viAtil SIGNED BY \ for the Town of Queensbury. Director of Building&Code Enforcement pECEN9E ��_ AUG 15 2011 _ . _. ... . , ,. .. TOWN'OF QUEENSBURY BUILDING & C•• Office Use Only � /-�,A �,' , 1/4/40 4, ,TAX MAP NO. '��4 ? / ) t PERMIT NO. PERMIT FEE ./(.' 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 jA VALIDOPERMIT. OWNER: j3�Lh,.4 C 044 C/011 INSTALLER: ✓/ai e .1-�h f t4//4 7i off // ADDRESS: / 7 G on/t(1! G lye: ADDRESS: rftf /�ie,r S`d Jrc/41".0/6_1/Z 80 f7 PHONE NOS. f / 2-7/0 j PHONE NOS. 0/5 - 7d 7 LOCATION OF INSTALLATION: /7 i nifec7C Y/fip'r, Ot!'CCY11 LJ7 / RESIDENCE INFORMATION: YEAR BUILT NO. X COMPUTATION = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRINDER 1980 or older X 150 ■ INSTALLED? '---' 1981-1991 X 130 : SPA OR HOT TUB 1992-present 3 X 110 at Ile)e) INSTALLED? PARCEL INFORMATION: y� ✓ TOPOGRAPHY: FLAT ROLLING /L STEEP SLOE %SLOPE ✓ SOIL NATURE: SAND X••• LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS 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(mpl) (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 Walled in a Planning Board approved subdivision). TANK SIM: lj©DO 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: Gro✓e/AJf em44'r'i // /' %ABSORPTION FIELD(WITMn /cT ) Total length ! d ft. Each trench 9' X 7 / N ❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? O ALTERNATIVE SYSTEM Bed or other type? o HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? 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. I 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 Sari ,'4 epoaalOrdinance. �"" ' /Z l/4/4444 fl- VISIT OUR WEBSITE FOR MORE INFORMATION SaResponsible Date1 A-I-/ern Septic Inspection Report Office No. (518)761-8256 Date Inspection request received: 4/L4f, -O 10)-. Queensbury Building&Code Enforcement Arrive: am/•, ', •.rt: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: 50t/A5)` d v L PERMIT NO.: '. %� /• I. • LOCATION: 1'7 e°�rn,C ` ,.,v‘•47` INSPECT ON: L!1 Y RECHECK: Comments and/or diagram Soil Ty•-. • • `oa• /Clay Type of Water: unix•- ell 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] �i Absorption Field: Total length 140 ft. Length of each trench '21 ft. Depth of trenches -t— ft. Size of Stone Seepage Pits: Number Size: Stone Size: Piping ize Type Building to tank Tank to Distribution Box '< iN1'L3 _ Distribution Box to Field/ Pit / Opening Sealed: V N End Cap N Inlet/Outlet Pipes&Baffles Y N Manholes 12"or less below grade Y_.N [provide extension collar if Yes] Y—N < 1" Location/ Separations Foundation to tank l EJ.-ft. Foundation to absorption Separation of Pits X 1" Conforms as per Plot Plan Engineer Report and As-Built Y N ETU Maintenance Contract Y N provided — Location of Syste•. •n Pro•- : Front Rear -ft Side Right Side Middle Front Middle Rear tern i S . pprov:,. Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Fomis\Inspecdon Forms\Septic Inspection Report_03 29 10.doc i ' - -- - il'ill'i/4/ 4,.. „. AD,,,„,,,f ,.. . ., 1 ::$4.... ! C S .1 Jj �+.A /174. _ -T- .. > # �,/ �r (° . 4).4.," rid.ht7i 4,4 i a , .P -/z >E ,` t ' ': ///........,„.....1..• ��" J+ =;� `' ....zr • - , IV I I I . ' itj j , . , , i; - 1 • - L e • ; . •• „ • .. _... : , . • : .• -. i ..... , f; ; i; 1 . . , ., : 31d1c ,,y,, 1/ 7 1 .. ..._. , ,._ 1 . . ,. .. . . i . t. At.;4, •u. , • ,, . .„.„•T' , ..) :. , ., ' I � Mf f i_i }f r lL /,4 � " s' .-. 1.5-rt. -, !4 F : . .tJ ;n...a . 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