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2011-483 ..411% TOWN OFQ UEENSBURY i4.3y742 BayQueensbury,Road,Quee sbury,NY 12804-5902 (518)761-8201 Community Development- Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20110483 Date Issued: Monday, October 24, 2011 This is to certify that work requested to be done as shown by Permit Number P20110483 has been completed. Tax Map Number: 523400-308-019-0001-049-000-0000 Location: 60 PINELLO Rd Owner: MICHAEL & RENE' KESLER Applicant: MICHAEL & RENE' KESLER 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 • '\ �� r ro er owner of the responsibility for compliance with Site Plan i „r f Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY Forg 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: P20110483 Application Number: A20110483 Tax Map No: 523400-308-019-0001-049-000-0000 Permission is hereby granted to: MICHAEL&RENE'KESLER For property located at: 60 PINELLO 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 Value Owner Address: MICHAEL&RENE'KESLER 60 PINELLO Rd Septic Alteration Residential NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency STONE INSTALLATIONS 232-6707 4305 STATE ROUTE 50 SARATOGA NY 12866-0000 Plans&Specifications 2011-483 septic alteration residential $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 28,2012 (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 To ueens ry; a e�. es .•y, September 28,2011 SIGNED BY / for the Town of Queensbury. Director of Building&Code Enforcement 17a E C ELlj__Viii r 17`), 1-- il I Community Development Office s , Z �� i i Town of Queensbury • 742 Bay Road • Queensbury, New York •128 4 LI rOvN OF QUFEN GBURY Office Use Only BUILDING- & CODES TAX MAP NO. 3C;) '-i -/ •-L/? PERMIT NO. PERMIT FEE • - 1�C - - APPROVALS: ZONING TOWN CLER 413 APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT M ST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFO E ISSUANCE OF A VALID PERMIT. OWNER: fit/�G , n c /G t,� 'Gr- INSTALLER: t"/t C ins S 744//h.71/o„.5- ADDRESS: IsJ ADDRESS: 6 O keen O 2 , ADDRESS: 'Jac /eft• JO �4/'4 7'65.4i/in/SW PHONE NOS. O //// PHONE NOS. 70 LOCATION OF INSTALLATION: Al 1 n e f/O 47.. Qti C e k-, Ivy/AIK /a a O RESIDENCE INFORMATION: YEAR BUILT NO. X COMPUTATION = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRINDER 1980 or older X 150 = INSTALLED? n0 1981-1991 X 130 = SPA OR HOT TUB 1992-present X 110 = Gf P INSTALLED? 00 PARCEL INFORMATION: ti d ed-c d T i x Tv r Cf ✓ TOPOGRAPHY: FLAT ROLLING�/ y STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND /& LOAM CLAY OTHER I GROUNDWATER: AT WHAT DEPTH? "..-----i ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL X WELL (If well:water supply from any septic system absorption is: ft) I PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpij (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: �f Ott/ GALLON iMIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder, spa or whirlpool tub. E.-xi-Jr/ $ SYSTEM TYPE: / hf4„cop//,‘ l'8 6/'✓•..At/l e$.S (%4 ..,iK'J lit-ABSORPTION FIELD(WITH NO.2 STONE) Total length ,0 0 ft. Each trench X So ❑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 Sanity swage r IOrdinpnce. codesCcadueensburv.net C+•'��— /IVISIT OUR WEBSITE FOR MORE INFORMATION Si ature of a on Responsible 7-11- ate www.queensburv.net isda,7 • Septic Inspection Report Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: Ill) am/pm 742 Bay Rd., Queen{sbury, NY 12804 Inspector's Initials: ("A) 1NAME: Ii )� PERMIT NO.: LOCATION: ‘0 Aiello _ INSPECT ON: RECHECK: Comments and/or diagram Soil Type: 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 '"Z ft. Length of each trench S'‹)_ft. Depth of trenches ft. C 1 - 5 Size of Stone ,n Seepage Pits: Number Size: I Stone Size: )VjI Piping Size Type Building to tank Tank to Distribution Box 4'' A° Distribution Box to Field/ Pit ZD Opening Sealed: N End Cap N Inlet/'Pipes&Baffles .„_N Manholes 1 or less below grade Y_N [provide extension collar if Yes] Y—N Location/Separations Foundation to tank ft. 4-Z-- Foundation to absorption A © ft. Separation of Pits / at ft. Conforms as per Plot Plan N Engineer Report and As-Built Y—N ETU Maintenance Contract Y N provided Location of Syste . .I Property: Front Rear Left Side Right Side Middle Front Middle Rear em - • • ,111•1 Approv • - • Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved L:\Pam Whiting\2010\Buiiding Codes Forms\Inspect on Forms\Septic Inspection Report_03 2910.doc fibte eleene KcS loc. ,he.//0 a�,d ° Zio � � 222011 10 I' /0'rnifrr bo4// �'o e� mtf SEP� //,,�� (^ TOWN OF QUEENSBURY 713" 7 7D BUILDING &CODES . t 0 IP tcs-o /&es✓egsiliie,`„6e/s 1- �d ' Mato/Nei, Idle /N 46 c• . ilewviv, 4,/C, i /Vt h SA/e w f1i f ccd L157n PreGGnfe G /4 ✓1 YlCV 1t/'S xST 1/>N yG� 44.Elt o ! vji 1N"/if w +41. baa ' #‘0 . , 41.11P.... ,---- ______, hi/c F `i� -v seen or observed, or believe I saw evidence of, e � ,i Nt)?ects such as houses, wells, trees, fences, etc., /' f' Y,.',t, 1•- .is document. I also represent that I ;lave D�4CZ n�tti� �jc�%e0 , _o!scnall mscsured t • threes ces set firth on the diagram." J t � _ Ota ygd,4,0m5, 1/7 vrnin . ),_,,,e �1, 1 .. LY, �/4 ,,c r , ! sic . r�r•.� DAT 4 RNs 7Z4 1/,mia pi) / BUILDING & i ii,." 1;4 Reviewed B IdAir 7421111 Date: Mani T * ----"---. _____...---) ?Iiiclit, pi , - ----- __________) , ...,..z_ •