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BOTH-000319-2015 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: BOTH-000319-2015 Date Issued: Friday,November 13, 2015 This is to certify that work requested to be done as shown by Permit Number BOTH-000319-2015 has been completed. Tax Map Number: 309.6-1-58 Location: 20 HARRIS ST Owner: Melvin Cowles Applicant: Morning Star Septic 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 n 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 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: BOTH-000319-2015 Tax Map No: 309.6-1-58 Permission is hereby granted to: Morning Star Septic For property located at: 20 HARRIS ST 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: Melvin Cowles Septic Disposal $0.00 Owner Address: 20 HARRIS ST Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Morning Star Septic 107 Jewell RD Gansevoort,NY 12831 Plans&Specifications Residential Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,November 6,2016 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensburybeforethe/y�xpirattiion date.) Dated at the To f Quee ry { / // T r vember 12,2015 SIGNED BY: (wM.'XI/ /d for the Town of Queensbury. Director of Building&Code Enforcement BOTH 000 319-2015 SEPTIC DISPOSAL PERMIT Melvin J. Cowles 20 Harris Street DA TE l- 17�- ( s Residential Septic Alteration TAxMAP ID �O / •l(/ -� y✓a Permit No. WTD 5H_du1a- - n Permit Fee1 n✓u�Le... *99 LOCATION OFINSTALLATION _ d� 1'>v✓+A� ST Qi...aa.,,, Approvals: ii APPLICANT / t':N�A'i.v(� STtN- PHONE/E-M - _... - j ADDRESS c� o s% cn �1. = NOV 12 2015 U INSTALLER/BUILbER: % S PHONE/E-M IL '3 SCj'r EENSBURY �f(7'! '^ ADDRESS: Ltl7 -'G[AInELL OWNER - Vol- ( M>'a>,//I J CAW�� PHONE/E-MAIL 339 -Aal M111 Address p'o Ho,v,iro 5T Q ,u.y- CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PHONE, ' RESIDENCE INFORMATION Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow 1980 or older 3 / s-o y s p Garbage grinder installed _Y �6 N 1981-1991 Spa or Hot Tub installed Y A N 1992-Present PARCEL INFORMATION Topography _Y,Flat rolling _Steep slope _%slope Soil Nature -.6,Sand _Loam _Clay _Other Groundwater At what depth? 6 r -!- Bedrock/Impervious Material At what depth? Domestic Water Supply -4 Municipal _Well(if well,water supply from any septic system absorption is_ft.) Percolation Test Rale: per minute per inch(test to be completed by licensed engineering/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION Tank Size /saa 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 /BO ft.;Each trench G o" x_e 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. I have read the regulations and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Print Name: Ona v Ar',- s Date: d- I% -!r Signature: Date: 6 Town of Queensbury Building&Codes Principal Structure Application July 2014 518-793-2290 Fax# 3-2115 498 ' Aj4 E-mail:morningstarseptic@hotmhotmail.com www.morningstarseptic.com lwCt`Mllf'�TM� �� RYICiEI Date: 107 Jewel Road,Gansevoort, NY 12831 TO: f1F� CM FILE COPY f2W 12 20)"i CL 1 �a G �C, SEPTIC PLOT PLAN I SEEN OR OBSERVED ALL OBJECTS Date: SUCHA S HOUSES, WELLS,TREES, FENCES, ETC SHOV ON THIS DOCUMENT.I HAVE PERSO ALLY MEAS EtT NGESCFf(3 T 'i M SIGN TURE _ DATE VG� BOTH 000 319-2015 Melvin es 20 Harris Street Residential Septic Alteration .A 518-793-2290 A Fax 3-2115 I�u `i 9'] � E-mail: momingstarseptic@holmhotmail.com www.morningstarseptic.com SPTIC SERVICE Date: I 107 Jewel Road,Gansevoort, NY 12831 TO: MAP r H 10 2--A --,• 70 RG, i c� p �E`>'