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SEP-000036-2017 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 l Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: SEP-000036-2017 Date Issued: Thursday, February 9, 2017 This is to certify that work requested to be done as shown by Permit Number SEP-000036-2017 has been completed. Tax Map Number: 301.14-2-5 Location: 34 MCECHRON LN Owner: Kevin O'Brien,Susan O'Brien Applicant: IBS Septic This structure may be occupied as a: Residential Septic Alteration Subdivision Name: The Grove By Order of Town Board TOWN OF QUEENSBBURYA Issuance of this Certificate of Compliance DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, � `l/i)aavvSalF" VV 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-000036-2017 Tax Map No: 301.14-2-5 Permission is hereby granted to: HIS Septic For property located at: 34 MCECHRON LN 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: Kevin OBrien Septic Disposal-Residential $0.00 Owner Address: 34 McEchron LN Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency IBS Septic 2 WARREN ST Glens Falls,NY 12801 Plans&Specifications Residential Septic Alteration Subdivision Name: The Grove $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,February 8,2018 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbu before the exxwratio��nn date.) Dated at the Town o Queensb f/ //We a ruary 8,2017 SIGNED BY: (/ �d for the Town of Queensbury. Director of Building&Code Enforcement 301.14-2-5 SEP 36-2017 IBS Septic for Kevin & Susan O'Brien 34 McEchron Lane (The Grove) Residential Septic Alteration OFFICE USE ONLY <�� 7 D D Vy TAX MAP NO.361,I4a1 5' PERMIT NO. t PERMIT FEE FFEB0 7 2017 APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT. TOWN of QUEENSBURY Y DEVELOPMEN A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJEC ISSUANCE F A VALID MIT. n'{ fir` OWNER: r ` INSTALLER: 7 U 1 ` ADDRESS:A q ADDRESS: DL=0 'Pr PHONE NOS. T_ �-- PHONE NOS. I I 1 LOCATION OF INSTALLATION: L r'1. RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT BEDROOMS X Gallons r bedroom = TOTAL DAILY FLOW •. GARBAGE GRINg7 1980 or older X 150 = INSTALLED? N 7f 1981-1991 X 130 = - SPA OR HOT 1992-present X 110 = INSTALLED? PARCEL INFORMATION: �(�, ✓ TOPOGRAPHY: FLAT ROLD G STEL Et: %SLOPE ✓ SOIL NATURE: SAND LOAM_n CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCKIIMPERVIOUS MATERIAL: AT W DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL_ WELL(If well:water supply from any septic system absorption is:hl ✓ PERCOLATION TEST: RATE ISPER MIINUTE PER INCH[mpii (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: ���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. �x� (�y �D SYSTEM E: C� ABSORPTION FIELD(WITH NO.2 STONE) Total length�� ft. Each Vench 1 X�_ 17 SEEPAME PIT(S)(WITH NO.3 STONE) How many? Size? _ ❑ALTERNATIVE SYSTEM Bed or other type? ❑HOLDING TANK SYSTEM Total required capacity?AL�—Tank size?A4—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 the regulations wi r ect to this application and agree to abide by these and all r s of the Town of Queensbury QUESTIONS? CALL 761.8256 OR EMAIL Sanitary Sewage ' p ante. codes aC.t rmnrc ueensbumnet VISIT OUR WEBSITE FOR MORE INFORMATION Sign P Responsible Date Wwwuueensburv.net T W eensbury* Community Development Office*742 Bay Road, Queensbury NY 12804 moon on ME wo MEN ma,I Sam mmm Jim y Y -M �