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2011-392 gati TOWN OFQ UEENSBURY Bay Road, 742 Ba o d,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20110392 Date Issued: Wednesday, August 24, 2011 This is to certify that work requested to be done as shown by Permit Number P20110392 has been completed. Tax Map Number: 523400-289-008-0001-061-000-0000 Location: 988 BAY Rd Owner: VAN & JANE MORRISON Applicant: VAN & JANE MORRISON 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 !1 ;` ..r" 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 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: P20110392 Application Number: A20110392 Tax Map No: 523400-289-008-0001-061-000-0000 Permission is hereby granted to: VAN&JANE MORRISON For property located at: 988 BAY 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: VAN&JANE MORRISON Septic Alteration Residential 988 BAY Rd Total Value QUEENSBURY,NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2011-392 septic alteration residential $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,August 05,2012 (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.) di Dated at the Town o ueet u0 /,Fidayugust 05,2011 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement 1 - `\ --� Ii') 2 ©Rl5 ((��isild W4 ��1Id OFFICE USE ONL , , AUG 0 4 2011f TAX MAP NO. PERMIT NO. j," i PERMIT FEE APPROVALS: ZONING TOWN CLERK TOWN OF Q(J k : APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMI . `' • G& CODES A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: 1 AI'. Ifi p Q k 1 5 0 P INSTALLER: ADDRESS: ! {J try ` clI OurePaS r 02.1 ADDRESS: PHONE NOS. CrJ 1 0 3 0 ) –C1 G 91 PHONE (NOS. LOCATION OF INSTALLATION: U (3R1� (�1'�Gl ) QL i'35Du.2`J I RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT X = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRINDER 1980 or older 3 X 150 = 14 5o INSTALLED? 1981-1991 X 130 = SPA OR HOT TUB i 1992-present X 110 = INSTALLED? /I+D PARCEL INFORMATION: I TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE 10 ✓ SOIL NATURE: SAND /. LOAM CLAY OTHER't I GROUNDWATER: AT WHAT DEPTH? 1!"F Iirl pe f Qc %)' ag4-h I BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? LIN k►ow 0 ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is:>}(X)ft) ✓ PERCOLATION TEST: RATE IS 1 — 5 PER MIINUTE PER INCH[mpi7 (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: GALLON(ttAIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,spa or whirlpool tub. SYSTE E: ----_� S PTION FIELD(WITH NO.2 STONE) Total length NI,;"f,4 c Each trench ❑S PAGE PIT(S)(WITH NO.3 STONE) How many? Size? X ;Ski ALTERNATIVE SYSTEM Bed or other type? Z.—CI y.L7 Ot P 1 47'-7, 'T E B_) ❑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 Sanitary ewage Disposal Ordinance. codes(o�queensburv.net /1. ��� 44 VISIT OUR WEBSITE FOR MORE INFORMATION Sinal re of Peon Responsible Date www•queensburvnet 9 P Town of Queensbury*Community Development Office*742 Bay Road, Queensbury NY 12804 (-7 (---0- 0-7._ ,4 • \ e — Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/Kp Mart:/lac am/pm 742 Bay Rd., Queen •ury, NY 12804 Inspector's Initials: il ;AI /) NAME: iiPERMIT NO.: J??___ LOCATION: AT � 4 , INSPECT ON: - - RECHECK: Comments and/or diagram Soil Type: / Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance . -4( ft. Well separation distance : . Other wells: II1Pr ft. Well Casing Length 50'+/- �., N/A [150'to well required if NO] Absorption Field: Total length 9 t5 ft. Length of each trench /5 ft. -.-1-3.-0-f Depth of trenches ft. ZZ 0 Size of Stone - z Seepage Pits: Number4-'-'"xli `l) Size: = g—e- iffrociLls — Stone Size: Piping Size Type Building to tank Tank to Distribution Box A, S5,07-5 I _ � Distribution Box to Field/ Pit t` lit.:3 _ 12_P Opening Sealed: 2%,_N End Cap V Y N Inlet/Outlet Pipes&Baffles Y N 1..--a50-4LT•.rC.7444Y1/4,. . Manholes 12"or less below grade Y �� [provide extension collar if Yes] Y_�X N Location/ Separations Foundation to tank LO ft. Foundation to absorption ��kft. Separation of Pits Conforms as per Plot Plan Y Engineer Report and As-Built Y li//}- ETU Maintenance Contract _Y N provided Location of Syste' • •roperty: Fron •ear Left Side Right Side Middle Front Middle Rear stem s- I ICl/Approved `' Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspectlon Fomms\Septic Inspection Report_03 29 10.doc / 0EAEAV?;ocZI b * \-:------------------------------- • Well \ ----------............ N. .5 -__.................... „ . < 1U > 0 v .............__ \s, fl E CEOVE ,,:l.,. ..I.,:-;:,,,-,-it,,I. 4.14• ",.41 .e•-, e.":„:" :4_,,,"'%.' V.: \ AUG 0 4 2011 10, \TOWN OF QUEENSBURY , \, BUILDING& CODES ,, ,. . ,„ Garage , ; Nil *\S• 2.0 Y-2-0i • ,-14° ••-‘14--brt (:, ‘01:X.:• 642A_ \ , 0 „ ' v Dist. Box 9‘rl'E.41,b1—W.E31 i c--Ot.TRNVVt_ hsi\-<c._ N-fu , • , . , „.- .. :.,,..' ' '...,",„.• ,.".„.1, „,,, ,,,,' / , ...,z„, , . , .,..',., -.,:". ..,--;',':14 .;,:n.-.,-----,,,a,,,,,,,,•:...4," - ',N,..7',,ese....me,,,,,,,,,'„-11,„A-',...,,,,..,.•-,'7"-- ,- ,:, :,: , ..%\ House •,,,,,,....., ... , . „----- ....---- .„--- ..„.." ...„-- wEA6b\pia_ii3 3 , ,‘,...- , , ,, ------ "I have seen or observed, or believe I saw evidence of, all oblects such as houses, wells, trees, fences, etc., ,17 ,,,,„ —,..,..,,,•,-.. ,r,,, ,.,,r --;," ,,,t' T -:AY;Lu iN14:, ,-,-, , ,, ,4, i i . * showr .;in 1Ms document. I ast.) represent that I have II ti personady m asured the distances set tsrth on the dlagrarr. / E) _ Well ak(iNetkniOn _ \..‘, SIG\IAT RE E 1 -N3 N "Z = 00 Septic Inspection Report Office No. (518) 761-8256 Date Ins req • ed• �� Queensbury Building&Code Enforcement Arrive: ! -Arrive: -46700+- ••rt: 7---I 7-74-15-arir► 742 Bay Rd., Queensbury,\ NY 12804 Inspector's Initia •!!"�` NAME: \Y A, 'M R R f'RMrrNO.: C 1.�Q ) ta LOCATION: A PioA NSPECT"ON: 1 -1D1 RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/Clay Type of Water: Municipal/Well Water !J EPTC_ Waterline separation distance ft. Well separation distance ft. krc..D Other wells: Well Casing Length 50'+/- Y N N/A [150'to well required if NO] IDE-‘),Th Absorption Field: Total length ft. Length of each trench ft. j Depth of trenches ft. Z� � P7‘ D 1• - Size of Stone Seepage Pits: Number Size: x V t) C) Stone Size: 1962-,M -� Piping Size Type A/� Building to tank � �t �‘0 � � Tank to Distribution Box r` Distribution Box to Field/ Pit Opening Sealed: Y N End Cap Y N Inlet/Outlet Pipes&Baffles Y_N 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 ft. Conforms as per Plot Plan Y N Engineer Report and As-Built Y_N ETU Maintenance Contract Y—N provided Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: proved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiiting\2010\Building Codes Fams\Inspectlon Fortes is Inspection Report_03 29 10.doc NE-e t3oR' 5 Well - - _ _ - -- < 2U" _..•TO' AUG,,‘. E C FE B \\11 E n ,,1 .. flib. ' , .. "'', : ' � . lo^ � g PI' 0 -� 2 011 0 .. , ,, :,....,-., `'•,TOWN OF QUEENSBURY +� 1 a BUILDING & CODES 'ill02 Z.O y-zQs Dv Garage X54 bT p bilk_ `' rJ ►00 ro Dist. Box P1 PE- 5 c o►x-Q.ETE SVA-NC _ TAw. al `� Ta:�€�t1 3 gEORbotA House / IE. FALL czl Te,. M A\3c 06 Ft V-TveE6 ►i\) HomF A.L ‘5d+I— , ,,,.nrve i or believe I Sa'a"� ///( ,- ,, i--!:...,. ,,,.i '''' ' '.. . ‘e) I Welliii(1>P1 )//kien‘ Zell? f