The URL can be used to link to this page

SEP-000331-2017 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 41w-L— Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: SEP-000331-2017 Date Issued: Friday, June 16, 2017 This is to certify that work requested to be done as shown by Permit Number SEP-000331-2017 has been completed. Tax Map Number: 301.7-1-63 Location: 26 CENTENNIAL DR Owner: JAMES MULLEN Applicant: Stone Installations 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 r: a; �,J property owner of the responsibility for compliance with Site Plan, V 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 i r Community Development- Building& Codes (518)761-8256 BUILDING PERMIT Permit Number: SEP-000331-2017 Tax Map No: 301.7-1-63 Permission is hereby granted to: Stone Installations For property located at: 26 CENTENNIAL 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 Tvce of Construction Owner Name: JAMES MULLEN Septic Disposal-Residential $0.00 Owner Address: 26 Centennial DR Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Stone Installations 4305 Route 50 Saratoga Springs,NY 12866 Plans&Specifications Residential Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 15,2018 (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 exp tionAdateka , eI05�2(017 Dated at the Town of ueensb /('hu SIGNED BY: (((nnnMMM.��"'��""VVV ,vfor the Town of Queensbury. Director of Building&Code Enforcement SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only 742 Bay Road,Queensbury,NY 12804 ,rte � r� P:518-761-8256 www.gueensbury.net Permit#: `C t - 51-� I - 2Q Tax Map ID M �� • 1 �3 Permit Fee: $ �a ; Invoice#:116 Project Location: ✓7 Cir.+ a. /'++✓'� Septic Variance? Yes ✓ No Primary Owner(s) Mailing Address L,,,,�, �, veen�v� i✓ • /ZSo Phone & Email Installer/Builder 4 H6 4/aTicvsS Mailing Address So a a �1 Phone & Email Engineer Mailing Address Phone & Email Contact Person for Building&Code Compliance: Zac Phone: zfc _4 7o-7 RESIDENCE INFORMATION: 11 Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes 1980 or older 0 o p Installed? (circle one) 1981-1991 Spa or Hot Tub Yes o Installed? (circle one) 1992-Present PARCEL INFORMATION: Topography JK Flat Rolling _Steep Slope _%Slope Soil Nature Sad _Loam _Clay _Other Groundwater At what depth? AloAfe o 77 Bedrock/Impervious material what depth? -7-z ," Domestic Water Supply Munici al _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 engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size gallons(min.size 1,000 gallons,add 250 gallons for each garbage cylinder or spa/h t tub System Absorption field witA#•2SLOPte Total length ft.; Each Trench 50 ft.IeV4/ Seepage Pit with#3 stone How many: ; Size: Alternative System Bed or other 7-tr 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 tirn s an as-built plan is received and approved. The installed system must match the septic layout on file—no exceptiogs. ti 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 known by or on behalf of an applicant,shall be void. I have read the reions and agree to abide by these and all regtirem_ents of the Town of Queensbury Sanitary Sewage Disposal Ordinance PRINT NAME: �""^� 1/'�c" DATE: �5 7 SIGNATURE: DATE: Town of Queensb uilding& En cement Revised February 2017 Q4 Cd Lo � � FILE COPY ! FY 30 ryi Pf / P PL0TP I HAVE 1EE OR BSEVED LL 0 JECT �' " S CH A HOU ES, LLS. TREES, FENC S.ET 7 7 S OWN N TH DOC MENT I HAVE PER NALL 7 / D M ASUB THE D FORTH ON HIS D RAM. S GN RE DA TE r r it I� ll, I_a LI '1J L 4 r ,. _ P i-OVIN r 301.7-1-63 SEP-000331-2017 17- �U5 2017 I1' pli'` Mullen, Jamesc 26 Centennial DriveTo W I Date: Residential Septic Alteration " =' v LI BUILT S s CA e