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SEP-000240-2017
TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 — Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: SEP-000240-2017 Date Issued: Tuesday, May 23, 2017 This is to certify that work requested to be done as shown by Permit Number SEP-000240-2017 has been completed. Tax Map Number: 308.17-140 Location: 200 WEST MOUNTAIN RD Owner: Robert Jones Applicant: Sanitary Sewer Service This structure may be occupied as a: Residential Septic Alteration By Order of Town Board TOWN ^OF QUEENSSDURY 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. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201 OL Community Development-Building& Codes (518)761-8256 BUILDING PERMIT Permit Number: SEP-000240-2017 Tax Map No: 308.17-1-40 Permission is hereby granted to: Sanitary Sewer Service For property located at: 200 WEST MOUNTAIN RD 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 Tyype of Construction Owner Name: Robert Jones Septic Disposal-Residential $0.00 Owner Address: 200 West Mountain RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builders Name/Address Electrical Inspection Agency Sanitary Sewer Service PO Box 224 Glens Falls,NY 12801 Plans&Specifications Residential Septic Alteration $40.00 PERMIT FEE PAID-TMS PERMIT EXPIRES: Wednesday,May 16,2018 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town of ueensb [ / /p'ues 2017 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement SEPTA 0®BSPUBAL PERWT Office Use Oniv D,n;€ 7 Received ax flap u)— �Ug, I� - f Erlt �Pa�o-a 0r� / aAKMAP9F1 ac 1� 7J Pm /.0 c 2 CA71BNTO B 1 S A@LA 7BN /►ppr j� Ne COM IJ OF OUEENSBy(�y APPLCANT Pfd PAp 14 ADDRESS y9 /IV97d r S 4A- /� / P�HONElC'-119A1L / <>�� el ADDRE86: 1Gv D/ O � .B ./©�1 PxonrelE-rwii� Address c� {ti PSf O CONTACT PERfiON FOR Rr1M91-N9 R i"igMIAlUE€- f�@.418@N@�1NFBaAOd?18N Year Built 90113edtooms Aaallonsparbedroom =Total Daly Flow 1990 or older Oarbagegrinderinstalled IeYN 1991-1991 SpaorKatTubinslalled _Y _N 1992-Present PzlgaL Aitrp�RNG4TlON Yopography €lafrolling _SYeapslope _%slope Soil Nature I .=sand _Loam _Clay _Other Groundwater At whetdepth% N Bedrock Iimpervious Matedai Atwhatdept" DOm®stieWatgrSOppiy �Municipd _Well(dwa0,>nMrauppiyfiamenysep6csyatemabaoMdUnis_8•) Percolation Test Rate: — perminure i36r Ir1Ch$estto ha compiafed by tkcenaed emginaedng/arch tact) Fie gp FOR Aif5illr E:JNeT'ia UL7rrJN Tanis Size 4 Z 1 gallons(minimum size 1,coo gallons,add 250 gallons to size for each garbage grinder or spa or hot tub) System Type dbsorptton field with#k shone Total length fL;Each trend, x -- SeepageFdwitit�Ssiene How many. =size x Altem2iive61ystem Sedorothartype? art 'x Ll Holding Tank System Totairequired capat;%O Tank size softanks_ Playa! 1)Afa[m sYgM&aSSodatad electrical wmK must be inspected by a Town approved eiecwcai inspection agency;2)We will no longer all9w Systeme w ae covered until such time as an As-aulit plan[9 received&approved The Inslailed system must match the septic system layout on-me—no exceptions ®actaRAi7oN: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or failure to in,WM a rMAWal tact or circumstance know by or on behalf of an applicant, shall be void. i have read the regulations and a res fe abide 17gBe and all ukerrr of the Town of QueensbUT Sanfl sew& a Disposal Ordinance. Print Names Signature• ''� ---s—s—�. Date: E-7 t/— /7 Town 01 Queensbury Bdcffng&Codec Septic nisposal Permit 1ply 2014 SEPTIC PLOT PI AN I HAVE SEEN OR OBSERVED ALL OBJECTS SUCH AS HOUSES, WELLS, TREES, FENCES, ETC `Y SHOWN ON THIS DOCUMENT.I HAVE PERSONALLY 308.17-1-40 SEP-000240-2017 MEA 'DREDTHEDISi CES ORTHONTHIS DIAGRAM. Jones, Robert � ATURE DATE 200 W. Mountain Road Residential Septic Alteration FILE COPY — `' J asl � I j i I ' i TOWN QF QU BUILDIh�G & p Reviewed By: Date: V � I h ' a � i ♦ i � cny ii k F QUEENSEIL)DEVELOPM Y CENTER PROJECT SERVICES 73 Sheridan Street, Glens Falls,NY 12801 Phone-515-796-2515 May 10,2017 Project#250 George Drellos Sanitary Sewer Smirice r__ , Queensbury,NY 12804 E (',. FIE R RCI F Re: Proposed Replacement Septic 200 West Mountain Road, Queensbury,NY ._ __� I TOWN OF OUF— P7SraUr"iY Dear George: COMMUNITY DEVF9.O�lVlvill , At your request, we have reviewed your proposed replacement septic system design of the existing 3 bedroom house at 200 West Mountain Road in Queensbury. As per our conversation the residence has an existing failed septic system. We have reviewed the proposed replacement septic system design and we agree that a standard absorption bed is acceptable. Based upon a design flow rate of 330 GPD and a percolation rate of 1 to 5 minutes,you will need a minimum of 367 sf of absorption area. We recommend using 20 ft wide by 25 ft long absorption bed with 4 - 20 rq long laterals. The absorption system can be constructed with the existing 1,000 gallon septic tank, new distribution box, and 4 inch diameter perforated pipe and stone. Please feel free to contact me at 796-2515 if you have any questions and that you for your assistance with this request. Sincerely, Thomas R. Center Jr,P.E.