SEP-000165-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
OL Community Development-Building& Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Nuunber: SEP-000165-2017 Date Issued: Tuesday, April 18, 2017
This is to certify that work requested to be done as shown by Permit Number SEP-000165-2017
has been completed.
Tax Map Number: 302.17-145
Location: 40 WINTERGREEN RD
Owner: Thomas Egan
Applicant: Thomas Eagan
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,
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: SEP-000165-2017
Tax Map No: 302.17-1-45
Permission is hereby granted to: Sanitary Sewer Service
For property located at: 40 WINTERGREEN RD
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plat plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Tyne of Construction
Owner Name: Thomas Egan Septic Disposal-Residential $0.00
Owner Address: 40 Wintergreen RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's 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-THIS PERMIT EXPIRES: Tuesday,April 17,2018
(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 o umnsb ; / / /Mona , 017
SIGNED BY: [�trjf�'/ �-VJ for the Town of Queensbury.
Director of Building&Code Enforcement
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CGN7-AG7 PERSON FOR RUIO N4 A oaMP41ANGE:
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Year Built d of tledtooms n Gaifons per bedroom =Total Daily Flow
1920 Or Older Garbage gitndarinstalled _Y �N
1961-1991 �/O 30 SpaortiotTub installed _Y_N
t99a-Present
PARCEL INMAM770
Topography Aad roiling _Sleep slope _%slope
Soil Nature I Sand _Loam _Clay _other
Groundwater At what depM-) A",Iq
Bedrock f Impervious Material At what dept" N
Domestic Water Supply Municipal _Well(dwell,water supplyflom any saptio system absorption is_ft.)
PenrolefionTesi Rate: ' S— per7cklut@parinchhesttDbecomplatedbyClOenSad�ngineering/archhect)
PRopoSL'O MnS, FOR AM f+YNSTi7UL77ON
Tank SizecZo gallons(minimum size 1,000 gallons,add 290 gallons to size for each garbage grinder or spa or hot tub)
System Type Absorption field with#2 stone Total length ft.,Each trench
Seepage Pit Willi dS stone How many- 'size
Altamative System Bed orothertype? �C' x of L
Holding TankSystam Total required capacity? Tank size #of tanks_
Nates• 1)Alarm system&associated electrics[woricmust be inspected by aTown approved electrical inspection agency;2)we will no longer
snow systems to be covered urdli such time as an As-Bulit plan IS recolved&approved. The Insiallad system must match the septic system
layout on-file-no exceptions.
®EGL4RAAny Permit or approval granted which is based upon or is granted in reliance upon any material representation or
failure to make a mate0ai fact or circumstance know by or on behalf of an applicant, shall be void. I have read the regulations
and agree 10 abide by a and alt requir tmertts cif fihB Town of Queensbury Sanitary Sawage Disposal Ordinance.
Print Names o r r e itis Data: 3,— /-7 -i7
Date; (-1 - 17 -17
Signature:
Septic Disposal Permit dirty 2014
Town of Quesnsbuly Bonding&Codes
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I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HO ES, WELLS, TREES, FENCES, ETC
SHOWN S DOCUMENT.I HAVE PERSONALLY
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CENTER PROJECT
SERVICES-
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
April 12, 2017
Project#247
George Drellos
Sanitary Sewer Service
Queensbury,NY 12804
Re: Proposed Replacement Septic
40 Wintergreen Road, Queensbury,NY
Dear George:
At your request, we have reviewed your proposed replacement septic system design of the
existing 3 bedroom house at 40 Wintergreen 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 ft 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.
pECEOWE
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TOWN OF QUEENSBURY
COMMUNITY DEVELOPME"7
302.17-1 -45 SEP 165-2017
Tom Egan
40 Wintergreen Road
Res. Septic Alteration