BOTH-000037-2016 TOWN OF QUEENSBURY
�r 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000037-2016 Date Issued: Tuesday, June 19, 2018
This is to certify that work requested to be done as shown by Permit Number BOTH-000037-2016
has been completed.
Tax Map Number: 296.11-1-14
Location: 46 BROWNS PATH
Owner: MARY MCCOSLIN
Applicant: MARY MCCOSLIN
This structure may be occupied as a: Residential Septic Alteration
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, Y
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
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTH-000037-2016
Tax Map No: 296.11-1-14
Permission is hereby granted to: Cools Septic Service
For property located at: 46 BROWNS PATH
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
Tvae of Construction
Owner Name: MARY MCCOSLIN Septic Disposal $0.00
Owner Address: 46 Browns PATH Total Value $0.00
Queensburv,NY 12845
Contractor or Builder's Name 1 Address Electrical Inspection Agency
Cook Septic Service
194 Hall Hill RD
Lake Luzerne,NY 12846
Plans&Specifications
Residential Septic Alteration
$0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,January 29,2017
(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 date.)
Dated at the Town of ry; fI hur rt 4,2016
SIGNED BY: �•Y1/ for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT
,.,.____-----• Office Use_Only_
DATE It i L.. I' Received
4 Tax Map ID
TAX MAP ID 296.11-1-14 y ��` 2MrmitN6,, -o I�c
Pe
Fee
LocaJQKOFINSTALLATION 46 brown each is
APPLICANT Mary *9cCoAlin PHONE/E-MAIL Tart'.mccn�lin• triiGlebcleaningi 1c.
c-cxn
ADDRESS 46 a=owrs Path, viceenscury, NY 1-2804
{S18}695-4500
INSTALLERMUILOER: Cook Septic Sevice PHONE/E-MmL ccokboy.dc,•Igmail.cam
ADDRESS: Igo Hal: Hill Road, Lake Luzerne, NY 12346
wNER same as Above PHoNE/E-MAIL
Address
CONTACT PERSON FOR BUILDING&CQDES COMPLIANCE: par' cook PHONE (518 S 69G-4sa o
RESIDENCE INFORMATION SEE PLANS
Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow
1980 or older Garbage grinder installed _Y _N
1981-1991 Spa or Hot Tub installed _Y _N
1992-Present
PARCEL INFORMATION SEE PLL&Nls
Topography Flat rolling Steep stope %slope
Sail Nature _Sand Loam Clay Other
Groundwater At what depth?
Bedrock 1 Impervious Material At what depth?
i
Domestic Water Supply Municipal _____Well(it 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 SYSTFhf FOR NEw CONSTRUCTioN SFF Pr.ANS
Tank Size 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
I+ Seepage Pit with#3 stone How many: ;size
Alternative System Bed or other type?
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 to make a material fact or circumstance know by or on behalf of an applicant, shall be void. 1 have read the regulations
and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage gisposal r 'nance.
Print Name: Mary Mccosl•r T1� Date:
Signature: _.1//mac Date:
Town of Queensbury Building&C�es Septic Disposal Permit July 2014
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