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2010-581 IA TOWN OF QUEENSBURY Fora742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number. P20100581 Date Issued: Wednesday, December 22, 2010 This is to certify that work requested to be done as shown by Permit Number P20100581 has been completed. Tax Map Number. 523400-296-017-0001-001-000-0000 Location: 6 GREENWAY Dr Owner. CORINNE FOOTE Applicant: CORINNE FOOTE 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<Q 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 ET 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100581 Application Number. A20100581 Tax Map No: 523400-296-017-0001-001-000-0000 Permission is hereby granted to: CORINNE FOOTE For property located at: 6 GREENWAY 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: CORINNE FOOTE TRAVIS &NICOLE AKINS Septic Alteration Residential 6 GREENWAY Dr Total Value QUEENSBURY,NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-581 septic alteration residential $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,December 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 Town of Queensbury; Wednesday, December 22, 2010 SIGNED BY V 7 for the Town of Queensbury. Director of Building&Code Enforcement r K-- l `: ill) or..0-,,,,,, Community Development Office " ���� Town of Queensbury • 742 Bay Road • Queensbury, New York •1 28 04 Office Use ..Us a nl I TAX MA /7_/—! / PERMIT NO._J _e j PERMIT FEE_ 2_,S160 APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINEI BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW FORE ISSUAN E OF A VALID PERMIT. OWNER: cq(4.4(6 IO Jre - n l ,tt�' r l� liS/N�Ct�I/— f' INSTALLER: �/JG> 1 biz_Ulm ADDRESS: r� — �-IJ- �CJ — ' -7)-K.-1S�C..- ADDRESS:--- P ) • S� ,X 2-�� 6 PHONE NOS._7'0 _ -_-__ Q/ PHONE NOS./96 — o Sa LOCATION OF INSTALLATION: RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT BEDROOMS LOW (Gallons per bedroom) GARBAGE GRIND 1980 or older i' X 150 = 9455 INSTALLED? 1981 -1991 X 130 SPA OR HOT TUB N - 1992-present x 110 = INSTALLED? `"` PARCEL INFORMATION: V TOPOGRAPHY: FLAT RLLIQ OSTEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND ` LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT IPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft) ✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpi] (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: Locro 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 ft. Each trench X SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? ISize? 1 L El TERNATIVE SYSTEM Bed or other type? 11( 0 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 t -• ations with respect to this application and agree to e by these -n. -11 require ir-nts of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL Sa tary Sew._e , )osal if. nance. codesCa,queensbury.net A. t o i• ature of Pers•n Responsible aft,Date VISIT OUR WEBSITE FOR MORE INFORMATION www.queensbury.net (/Z : Oo,) /0-/a. c Septic Inspection Report Office No. (518) 761-8256 Date Ins rqiuor-'' ed. Queensbury Building &Code Enforcement Arrive: % ' ;,rt: \'lj twTham/pp 742 Bay Rd., Queensbury, NY``12804 Inspector's Initials ... NAME: X '-� RMIT NO.: LOCATION: (r .N,i,,:;C AT INSPECT ON: —2 0 RECHECK: Comments and/or diagram Soil Type: m I Clay Type of Water - v1uni / W ter Wate ' ion distance1 "`^ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - Y N N/A [150'to well required if NOl Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number 1 .,i Size: l L` x 1; Stone Size: Piping Size Type Building to tank Lk" 1)C.-k-1 yrr` Tank to D tifla» x �� 1-)02-3z:—) Distribntiart' azd/;Pili Opening Sealed: 4' Y N End Cap Y N Inlet/Outlet Pipes&Baffles N Manholes 12"or less below grade -7,;,77' N [provide extension collar if Yes] 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 S stem on Property: Fron Left Side--- Right Side Middle Front Middle Rear stem Us- S e 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 Report03 29 10.doc , „,, , , ....„ , , ........,,,,_. „ r----' -:,7" :: n �� � s� F ed, or believe I saw evidence ft/l� SUCn as nouses, wells, tees, --r —1-' r 6,. - o n t � �,� ��as G � Ai �a� A� #}tU a "iL Cf1 � I y Fd c" �� t n c...,—...„....v^� ' -----1 a --) IF) 2//0:0 . u • * cicif At"(. n TOWNOFOUE l. c : f L 7 BUILDING & Coo;: ' r4 .i- ', Reviewed By; 4,../�/` Ad/ Date: �.a.. . ► IA, - yJ 04 r 041—"-- 1.-1 "f 60- I giv bJ`Al 1)K