2010-128 TOWN OF QUEENSBURY
IF4TO742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20100128 Date Issued: Tuesday, December 11, 2012
This is to certify that work requested to be done as shown by Permit Number P20100128
has been completed.
Tax Map Number: 523400-302-009-0001-020-000-0000
Location: 51 ZENAS Dr
Owner: VINCENT& RHONDA SCICUTELLA
Applicant: VINCENT & RHONDA SCICUTELLA
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, r4,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Cide En I cement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
FoN 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100128 Application Number. A20100128
Tax Map No: 523400-302-009-0001-020-000-0000
Permission is hereby granted to: VINCENT & RHONDA SCICUTELLA
For property located at: 51 ZENAS Dr
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: VINCENT&RHONDA SCICUTEL
51 ZENAS Dr Septic Alteration Residential
QUEENSBURY, NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
IBS SEPTIC &DRAIN
ATTN: IVAN BELL
2 LOWER WARREN St
QUEENSBURY, NY 12804
Plans &Specifications
2010-128
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,April 08, 2011
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Quee ... •efore th-.p. tion. tq) f
Dated at the To.. •f ;0•, !;: sday,April 08, 2010
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
71111
:f7G2, -` - ----�- ---- OFFICE USE ONLY _--- �... _
1AX MAP NO. PERMIT NO. i--, ,
PERMIT FEE 'R _ •
-\i
APPROVALS: ZONING i
TOWN CLERK i� ADR / 2010
APPLICATION FOR SEPTIC "______________________"____" ;_.,,,_.�_: ;' _ fi`
DISPOSAL SYSTEM PE- , ' ,
- c
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECTfi�rr+
PERMIT. �1•,_ ,` ,`, '.
TO REVIEW BEFORE ISSUANCE OF A VALID
OWNER: //4. `L
CA 64 INSTALLER:
ADDRESS: : - _ A r,
ADDRESS: i s (0 �� r a miff--J ot U
PHONE NOS.
PHONE NOS. ( SI-- J) Y
•
LOCATION OF INSTALLATION:
YEAR BUILT NO.OF
BEDROOMS X COMPUTATION. = TOTAL DAILY FLOW RESIDENCE INFORMATION:
1980 or older 71) X 150 gallon per bedroom
1981 -1991 b GARBAGE GRIN
X 130 gallon per bedroom INSTALLED?
1992-present X 110 gallon per bedroom
at
SPA OR HOT TU
PARCEL INFORMATION: INSTALLED? _
✓ TOPOGRAPHY:
Sand
Flat rolling Steep slope o
✓ SOIL NATURE: /oSlope 0
Loam
Clay Other
✓ GROUNDWATER:
At what depth?
___7d254_
✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth?/_
✓ DOMESTIC WATER SUPLY:
Municipal Well
(If well: Water supply from ny septic
system absorption is
V PERCOLATION TEST: Rate is_Ea_ ft)
per minute per inch.
(Test to be completed by a licensed professional engineer or architect.)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal
a licensed professional engineer or architect (unless installed in a Planning Board
`j g p sal systems must be designed by
/6_011___GALLON
1� approved subdivision).
TAN-S
f ,!
Septic Inspection Report
Office No. (518) 761-8256 Date Inspectiop-pequ,.-, -140' /
Queensbury Building&Code Enforcement Arrive: , �!j a - • = :rt: IL' /pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:'
01,
NAME: 1: 5 1 SG;eli' (.1c.. P ' IT NO.: c)-c' 16--1
LOCATION: t `L eAts j> ,,-Ci PECT ON: 41-10-1
c'
RECHECK:
Comments and/or diagram
Soil Ty• __:.,•r:r,'fr ;m/Clay
Type of Water: ' • •.. ell Water
Wate •�:. .: on distance •
Well separation distance ft.
Other
ft.
Other wells: _ _ ft.
Well Casing Length 50'+/ - Y N N/A
[150'to well required if NO]
Absorption Field: Total length 7—Q ft.
Length of each trench __E442=11ift.
Depth of trenches ` _- ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank etc t4-f5 e-act91-
Tank to Distribution Box \
C 'p
Distribution Box to Field/ Pit 1-4ctCL Tom ,
Opening Sealed: _N
End Cap _N
Inlet/Outlet Pipes&Baffles - N
Manholes 12"or less below grade _Y_ N
[provide extension collar if Yes] Y N
Location/Separations
Foundation to tank 10 ft.
Foundation to absorption ft.
Separation of Pits . ft.
Conforms as per Plo • N
Engineer Report an, As-Built VY_N
ETU Maintenance • act _Y_ N
provided
Location of System on Property:
Front Rear -ft Side Right Side Middle Front Middle Rear
S stem U - Sta'•s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
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