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2011-455 TOWN OFQ UEENSBURY ^� 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20110455 Date Issued: Monday, December 05, 2011 This is to certify that work requested to be done as shown by Permit Number P20110455 has been completed. Tax Map Number: 523400-303-020-0002-042-000-0000 Location: 144 RIVER St Owner: 144 RIVER STREET, LLC Applicant: 144 RIVER STREET, LLC This structure may be occupied as a: Septic Alteration Commercial By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the �° J 1 / property owner of the responsibility for compliance with Site Plan, . V 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 411% 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20110455 Application Number: A20110455 Tax Map No: 523400-303-020-0002-042-000-0000 Permission is hereby granted to: 144 RIVER STREET, LLC For property located at 144 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: 144 RIVER STREET, LLC C/O ROBINSON& SON, LLC Septic Alteration Commercial PO BOX 432 Total Value HUDSON FALLS,NY 12839-0000 Contractor or Builder's Name/Address Electrical Inspection Agency MCKENNA CONSTRUCTION 639-8683 /361-3527 562 WEST Rd FORT ANN NY 12827-0000 Plans&Specifications 2011-455 commercial septic alteration $75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 14,2012 (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 T o ueen y;4 /Wednesday,pesday, September 14, 2011 SIGNED BY ✓Y ' "v :; for the Town of Queensbury. Director of Building&Code nforcement OFFI CE USE ONLY( Jy '" S. I TA;M P"NdZ Z '1PER(vt#T NO. // ERMITFEE ?L 1 , } q" `�� APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERM T: ��# G`� `�E.:, '1. A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUB =row ' '-NG , d'� BEFORE ISSUANCE OF A VALID PERMIT. M �C/L_. " OWNER: (1OVj\vSO,4 $ S ON L C' C. INSTALLER: ! ' " ll'i`""' /� ADDRESS: , '4 N .R, V.� S A- ADDRESS: S-6 2 49S - 123 5\74- ,4 PHONE NOS. 5Q1- Vto `9 Z'I© PHONESi NOS. t)r lo g 3 /— G 63 LOCATION OF INSTALLATION: (A-1 p S -VI 4' (J t3.- (-1-k- e 2 RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRIki, 1980 or older X 150 = INSTALLED? v v 1981-1991 X 130 = SPA OR HOT TUB. 1992-present X 110 = INSTALLED? ./-'Nj (- PARCEL INFORMATION: .I!n-,"�� c)Aw�ss ✓ TOPOGRAPHY: FLAT ROLLINGX STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND LOAMLCLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? po"-f ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH?A d,'\-A ✓ DOMESTIC WATER SUPLY: MUNICIPAL T WELL (If well:water supply from any septic system absorption is: ft) ✓ PERCOLATION TEST: RATE IS fOM t' Z 7 P R MIINUTE PER INCH Impi] (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 40 O 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: .� ❑ABSORPTION FIELD(WITH NO.2 STONE) Total length ST) ft. Each trench Z 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? 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 ead the regulations with respect to this application and agree to abid these and all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL Sanita wage Disposal Ordinance. codesCa queensburv.net - 2- (( VISIT OUR WEBSITE FOR MORE INFORMATION Si ture of Person Responsible Date www•queensburv.net Town of Queensbury* Community Development Office*742 Bay Road, Queensbury NY 12804 Septic Inspection Report Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: ) A( 742 Bay Rd.,Queensbury, NY 12804 Inspector's Initials: `'�r NAME: Rc3t- l -- , ' ' LOCATION: 144-akv1`E2. ssr - INSPECT ON: Inv - RECHECK: ./"""11.11""" Comments and/or diagram Soil Type: Sand ►•.m/Cay Type of Water. Municipa / ell Water Waterline sepa ; •. distance ft. Well sepa :tion istanoe ft. -.._ – ;.-- • • - wells: ft. Well Casing Le 1 I i'+/- Y N N/A [150'to well required NOl 7BUILT Absorption - •: Total - , • ft. - . r of each i - ft. •- . f Of i ft. Size of .. See•.! - Pits: Number f r 7Size • k x mtstonePipes Type Build to tank Tank to Dish ution Box IR)r- Distribution Box jig / Pit ' f • Opening Sealed' Y- —N 454 1!_End f , Y N Inlet/Outlet Pipe4 & :. - Y- —N Manholes 12"or less b low g •- Y—N [provide extension collar if es] Y—N Location/ • .. .tons Founda,, to tank ft. Foundation to absorption ft. Separation of Pits .. ft. Conforms as per Plot Plan N Engineer Report and As-Built N ETU Maintenance ContractN provided — — Location of System on Property: Fron Rear Left Side Right Side Middle Front Middle Rear 7k1! 1.: "At.;IA 1WAPProved MOW Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved L. Pam WhitinfA2010\8uiiding Codes Forms\!nspectlon Formic Inspection Report_o3 2910.doc • e • • •• f-* „ e•P'%, er '•f• ••01, • ,••, 4 110 Septic Inspection Report Office No. (518)761-8256 Date Inspection request received: /`//// ' Queensbury Building&Code Enforcement Arrive: am/pm rte/ am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: � .� f-c �c?� PERMIT NO.: //- `�S LOCATION: /94/ Riverth-tel' INSPECT ON: / )I/1/?O ii RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/Clay Type of Water: Municipal/Well Water it4f "`� Waterline separation distance ft. (` j Well separation distance ft. 1 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. 4� V Size of Stone � Seepage Pits: Number Ir44A4Z-PA Stone Size: Piping Size Type Z> Building to tank flir4=7tk)r-illTank to Distribution Box � � 1 ' C f/iC2Distribution Box to Field/ PitE` iii ` ,� 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 v l 6 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 Prope . Front Rear ft Side Right Side Middle Front Middle Rear stem - S _ Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Buiiding Codes Forms\Inspectlon Forms\Septic Inspection Report_03 29 10.doc [ -3P ti r\r- (RA. CV"Cm Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: to 7 'i / Queensbury Building &Code Enforcement Arrive: amPm Depart: ACM, am/pm 742 Bay Rd., Queenstlury, NY 12804 Inspector's Initials: NAME: 7 PERMIT NO.: tom'' LOCATION: 1 4 f'�Pier) _ INSPECT ON: GEil i i RECHECK: Comments and/or diagram Soil Type: f a 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 E_J ft. 'L {QT) Length of each trench Depth of trenches _____`'`ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping ize4c) Building to tank IL Tank to Distribution Box l Distribution Box to Field/ Pit ------- Opening Sealed: - N End Cap , ,TN Inlet/Outlet Pipes&Baffles Y—N `j \g2212-1:C7 Manholes 12"or less below grade Y_N ' [provide extension collar if Yes] Y N - Location/ Separations Foundation to tank l2` 4 ft. -- Foundation to absorption Z... ft. Separation of Pits I • ft. o ...R /1,c Conforms as per Plot Plan ' v N Engineer Report and As-Built _Y ETU Maintenance Contract _Y_ N - tiC7'✓° � ��� provided Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear Y -m Use Statu . 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 29 10.doc G. Peter Jensen 17 West Road South Glens Falls New York 12803 (518) 798—3859 October.13,2011 To Whom It May Concern: I have designed(plan 11-0508)and observed the installation of the septic system for Robinson& Son, LLC at 144 River Street, Hudson Falls, Town of Queensbury, Warren County,New York. It would appear that the installation is within the intent of the design documents. To the best of my knowledge and belief, no field conditions were encountered that would require a re-design of the septic system. Sincerely, �,.�-' AS BUILT G. Peter Je..en EO qRC (4::::te" ERJF,`,sy��ti` Fy -A sr'r 028020 �� FOF NE41 m r OFFIGE d 1 J I j PIPE PITCf!H fit, PR I -"-o07- it / LI DEVERY r f 000 GAL 5E(0-r/G TANK P!=_ .._ . _...... __ L�_, 40/0 SOLIZ) P1 PE ��. ,1,154)0 CsAL LIFT STAri0W VVri