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2010-089 iA TOWN OFQ UEENSBURY vitro742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20100089 Date Issued: Tuesday, December 11, 2012 This is to certify that work requested to be done as shown by Permit Number P20100089 has been completed. Tax Map Number: 523400-308-018-0001-069-000-0000 Location: 43 NORTH CHURCH Ln Owner: JAMES & CHRISTINE THATCHER Applicant: JAMES & CHRISTINE THATCHER 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 Enforcement Planning Board or Zoning Board of Appeals. l�` TOWN OF QUEENSBURY oilcoo 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100089 Application Number. A20100089 Tax Map No: 523400-308-018-0001-069-000-0000 Permission is hereby granted to: JAMES & CHRISTINE THATCHER For property located at: 43 NORTH CHURCH Ln 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: JAMES & CHRISTINE THATCHER 43 NORTH CHURCH Ln Septic Alteration Residential QUEENSBURY,NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency SANITARY SEWER DAN DRELLOS PO BOX 224 GLENS FALLS NY Plans &Specifications 2010-089 SEPTIC ALTERATION $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday, March 22, 2011 (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 of eeens o ` , arch 22, 2010 ir SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement b _‘? OFFICE • USE vONLY %• \\S TAX MAP NO. PERMIT NO. — PERMIT FEE - n : 1/ i APPROVALS: ZONING TOWN CLERK ; mAR 1 X0101 0 — 17r.tll tom: ;:LNi biitiP =-- APPLICATION FOR SEPTIC DISPOSAL SYSTEM ! ! . ~'�' � A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.. OWNER1-A -\(c 11(2i J j//vt rA 474 12- INSTALLER f c ✓ 41-4- -.� �a2 vc L ADDRESS: q3 'i wI"0R- )..i✓1 CGS Z04r! ADDRESS: P v4t 6 .J PHONE NOS. / 67 1 — / 79/- ,ra y PHONE NOS. / 6 - o F "o LOCATION OF INSTALLATION: /// f't�' YEAR BUILT NO.OF X COMPUTATION= RESIDENCE INFORMATION: BEDROOMS TOTAL DAILY FLOW 1980 or older X 150 gallon per bedroom = GARBAGE GRIND 1981 -1991 INSTALLED? J X _130 gallon per bedroom 1992-present X 110 gallon per bedroom = SPA OR HOT TUB N p INSTALLED? PARCEL INFORMATION: r ✓ TOPOGRAPHY: Flat rolling Steepslope P %Slope ✓ SOIL NATURE: Sand Loam Clay Other ✓ GROUNDWATER: At what depth? ✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth? ✓ DOMESTIC WATER SUPLY: Municipal 17 Well (If well: Water supply from any septic system absorption is ft.) ✓ PERCOLATION TEST: Rate is per minute per inch. (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 Dom 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 27-5- ft. Each trench X 'CS- ❑ 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 f7ili iro+es -- -• Y rved,,, oqr believe I saw ,;�{;,i�i,. ,;l i b'a `3., tan ., Z,P,-4/73t DATE . I I v0 c � a -710 lac a � .. _ Q t t`� ": 2 P e I e Ri —iret Septic Inspection Report Office No. (518) 761-8256 Date Inspection req - --eiv).. -3 3/l u Queens b ry Budding &Code Enforcement Arrive: ‘7i9p •art: \Z�-y� /pm�� 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial• /. NAME: 11 1. T-Gll PE? IT NO.: Z010 - ©‹ .7 LOCATION: j 3 iVC(2;t-1 c e c I/ Liwe_. I' SPECT ON: (1/2-7l( RECHECK: Comments and/or diagram Soil Ty.-._ - oam Clay Type of Wate • • ick,- v v e I Water — Wa - e separation distance �'�``'" ft. Well separation distance ft. Other wells: ft. '9 Well Casing Length 50' + / - Y N N/A Z Absorption Field: Total length ft. Length of each trench ft. Depth oftrenches �� ft. Sizeze of Stone .1�'c_•, 't )F Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank `r-v-r.h-r%: \--1.i' J-4-tA LA Tank to Distribution Box LI 41 �Q e,'27,1/2 Distribution Box to Field/ Pit / LI" -)c)V- 3 5 3-,_; ?ERF-. Opening Sealed: 37.N End Cap N Inlet/Outlet Pipes&Baffles —N Location/ Separations • Foundation to tank E v-.44 t. Foundation to absorption -3"z---ft. Separation of Pits ft. Conforms as per Plot Plan N Engineer Report and As-Built N Location of System on Property: Front Rear Left Side Right Side Middle Fron Middle Re_ar_....� Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc