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BOTH-000330-2016 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 st Community Development-Building&Codes (5 18)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: BOTH-000330-2016 Date Issued: Wednesday, July 12, 2017 This is to certify that work requested to be done as shown by Permit Number BOTH-000330-2016 has been completed. Tax Map Number: 295.19-1-57 Location: 4 WESTMORE AVE Owner: ROBERT KOSKEY Applicant: ROBERT KOSKEY This structure may be occupied as a: Residential Septic Alteration By Order of Town Board TOWN OF QUEENSSBURY Issuance of this Certificate of Compliance DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, ���yylyylll"' 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 QUENSBURY 742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201 Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: BOTH-000330-2016 Tax Map No: 295.19-1-57 Permission is hereby granted to: ROBERT KOSKEY For property located at: 4 WESTMORE AVE 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 Owner Name: ROBERT KOSKEY Septic Disposal $0.00 Owner Address: 4 Westmore AVE Total Value 50.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans& Specifications Residential Septic Alteration $ 40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,June 1, 2017 (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 da c.) Dated at the Town o ueen ury; /�/ We , June 1, 2016 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement SEPTIC DISPOSAL PERMIT Office Use Only 1 ATF 5/31/16 _ Received Tax Map ID TAxMAP ID 295-19-1-57 Permit No. (-�07tN• nn�3J• 2Jt4� Permit Fee �'!L�� �r�va,i Com✓ ��� :..00A TION OF INSTALLATION 4 Westmore Avenue -- Approvals: 361-0532 APPLICANT Robert Koskey PHONE/E-MAIL robkoskey@yahoo.com ADDRESS 4 Westmore Avenue, Queensbury, NY 12804 INSTALLER/BUILDER: TBD PHONE/E-MAIL ADDRESS: OWNE PHONE/E-MAIL ---f--, r Address CONTACT PERSON FOR BUILDING&CODESCOMPLIANCE: Robert Koskey a 3 61-0532 It RESIDENCE INFORMATION SEE PLANS T0tM`.l OF i1iJ -Llj�lJf;Y Year Built # of bedrooms X Gallons per bedroom =Total D64MQjar,' i-.,_'__.1G.:K`&.G0DES 1980 or older Garbage grinder installed Y X N 1981-1991 Spa or Hot Tub installed Y XN 1992-Present j 3 110 330 PARCEL INFORMATION SEE PLANS Topography x Flat rolling Steep slope %slope Soil Nature x Sand Loam Clay Other Groundwater At what depth? No evidence of groundwater Bedrock/Impervious Material At what depth? No evidence of bedrock Domestic Water Supply X Municipal Well (if well. water supply from any septic system absorption is ft.) Percolation Test Rate: per minute per inch(test to be completed by licensed engineering I architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION SEE PLANS Tank Size 1250 gallons (minimum size 1.000 gallons, add 250 gallons to size for each garbage grinder or spa or hot tub) System Type Absorption field with#2 stone Total length ft.; Each trench x T Seepage Pit with#3 stone How many: —. size Alternative System Bed or other type? Bed Holding Tank System Total required capacity? Tank size #of tanks Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2) We will no longer allow systems to be covered until such time as an As-Built plan is received & approved. The installed system must match the septic system layout on file—no exceptions. DECLARATION: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or failure tomake a ma al fact or circumstance know by or on behalf of an applicant, shall be void. I have read the regulations and agree to abideb6 tilese, and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Print Name: Robe oskey Date: Signature: IV Date: 31 Mar 2016 Town of Queensbury Building &Codes Septic Disposal Permit July 2014 JA.RRETT Enginects, PLLC Civil&EnvTronrne=d Engr'neerjng Transmittal via Hand Delivered To: Town of Queensbury Building& Codes Date: May 31, 2016 FELE COPY Re: Koskey Wastewater JE 16-006 ITEMS TRANSMITTED Quantill Description 1 Septic Disposal Permit 11 by 17 drawings entitled "Wastewater System Koskey Residence Existing Property Plan—CI 3 Proposed Wastewater Plan—C2 Wastewater Details—DI Erosion Control—EC1 Revision A, dated 5131116 1 Check number 3504 in the amount of$40.00 COMMENTS; For permit. If you have any questions, do not hesitate to contact me at(518) 792-2907. Sincerely, JARUTT Engineers, PLLC Florene Smith Office Administrator Enc. Application Drawings Check Ecopy: Robert Koskey 12 East Washington Street 518 792-2907 Glens Falls, NY 12801 298 _ e � o298 NMI z N9Wo e_© n s.3 1 F wo a m I F >w2 z � l9 ` p � g WU jai R`' Y-.,-^: '� F i ,��. �' _ tl os�.._ a 3=� o f W SIN o -+rvzc+ ff✓ zYaoao w= ,s owl , � o #Po a a CU cul 7 dEw j a DOW J 0 tn (3) IL G ' , ? / / . i / 6 / , w/41MO/3na1 oFS e��EoE �€c23E'E x m 8 Z I _ � Fw2� yv`°nc`8°c v"daa8c c= �= J o �o o T 3 � ®e0 p N w U w � w u 2 csOf w N y ¢ D r ry o � rc Ci o rc O $ - o <= tE tiNwza g a m F Zo 14) U� y eaG E8 exp ' E-1 wE5 Q z wxoz aA a �o o s� rc � W�'o~ �� mwa i o@ e ~ WYym �C O o p o�aa'5 �, a X300 Y ooG w "� UO 3'w (n W 6 amp 4 ga 9 0 w' gp g b NNv gE � o e nye � -" 2` Imo $ 3rjog' LL 2` me w u o C=w a 1.5 Im Y S�oe�oa raoa z z zWea Ew- a'F �b JR` ayoarS�� b� a w 12Ee--Se_�' b N w a N LIRE lz —SS ¢� tN ee @e g OZ 83 tnLL� ., _ E 98 �. 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If you have any questions,please do not hesitate to contact us at 792-2907. Sincerely, JARRETT F.%7g teem, PLLC 2017.07.07 12:51 :18 -04'00' Robert U. Holmes, II, P.E. Project Manager Cc: Robert Koskey robkoskev(@.Yahoo.com 12 East Washington Street 518 792-2907 Glens Falls,NY 12801