SEP-000241-2017 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-000241-2017 Date Issued: Tuesday, May 16, 2017
This is to certify that work requested to be done as shown by Permit Number SEP-000241-2017
has been completed.
Tax Map Number: 301.7-1-14
Location: 6 CENTENNIAL DR
Owner: Daniel Lucynski
Applicant: Sanitary Sewer Service
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
6L Community Development- Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: SEP-000241-2017
Tax Map No: 301.7-1-14
Permission is hereby granted to: Sanitary Sewer Service
For property located at: 6 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
Tvoe of Construction
Owner Name: Daniel Lucynski Septic Disposal-Residential $0.00
Owner Address: 6 Centennial DR 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,May 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 axxR)nation date.)
Dated at the Town o Queens { /�M0 17
SIGNED BY: [[[nnn���...✓✓✓_iiilllrrr/// kT!?Ofor the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPDSAIL PERWr
S= / - 7
DAM
T ID
T4f)i!NlAP913 P mut 0.
QF QUEEN 6 40 tic i...-0,CC 177(.
�flea�i®meFlNs'aLta�sN TQC TY DEVEL
APPLICA6( GuC� �✓�l PHON6/E-MAIL
ADDRESS �/✓1�Nr✓rA-L ble
hus'Ma cmom wff, /Vr ,C _ PHONB/L--MAIL 71R
ADDRE66: �1 - OX zZ1
®INNER /Jy N TT� /�� It l�C /I.SK l PHONNV E-MAIL
Address F� Av
S.ONTAGTPER60N FOR E31YfL9ING e!'f'i®®ES�i°81I?PLIAN6�: �e®r �e %'1 PHOfd< V -5/t'��
f4@Al&F'NC@7Nl+Bpft4d41BN
Year Built ai uediooms x ei tuns per bedroom _Total Daily now
iSao orolder Garbagegdnderinstalled _Y _N
11991-1991, % /U 3!7 Spa or HotTub installed _Y _N
1992-PrasenL
AIRGELfNPORM9A0N
Topography pial rolling _GIMP Slope _Yo slope
Soil Nature Sand _Loam _Clay _Other
Groundwater At what depth? ✓
Bedrook f impervioue Material At what deprlry r
Domastie Water Supply MuNcipel _Well(if well,water auppiy from any septic system absorption is_it.)
Percolation Teri Rata: % - S per tnlnute per inch(test to be completed by licensed engineering l architect)
PAOPOSEo s4S-EM FOA Maw COMMUL770N
TanK Size gallons(minimum size 1,000 Boons,add 250 gallons to size for each garbage grinder or spa or hottub)
System Type Absorption Wd v dh#2 atone Total length it;Each trench
9aepega Pit VIM 48 Mne Flow many size
AiterrtOWSYatemBadorothertype? r�O K
Holding Tank System Total requiredcePeothr? —Tank ebze #ot "_
Net= 1)Alarm WOM&associated electrical work must be Inspected by a Town approved electrical inspeoaorr agency;2)We wai no conger
avow systems to as covered until such time as an As-Bdtit plan is received&approved. The installed system must match the septic system
layout onTtl9-no exCUP110M
DECL4RAi7CN: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or
failure to make a material 9act or circumstance know by or on behaff of an applicant, shall be void. I have read the regulations
and agree to abide byth�ee atnd all requiremQryts of p�own of Queensbury Sanitary Sowage Disposal Ordinance.
Print Mame_ CC��33 C)r C c� JUS/��z9 Data: Y—11-1,7
Signature: Date:
Town of Queensbury Building&Codes
Septic Disposal Permit July 2014
TOWN, O*SU
BUILDIN
Revi n
Date:
`a -r
� I
c+ oot�! iJ>llo,�
301.7-1-14 SEP-000241-2017 ! a�
Lucynski, Dan & Andrea
6 Centennial Drive o�
Residential Septic Alteration lir
cz
Z O l5 0
ac:
mm
Soo-rlr PI OT PLAN m Z Q
I HAVE SEEN OR OBSERVED ALL OBJECTS � -um
v
SUCH AS HOUSES,WELLS,TREES, FENCES, ETC A ��
SHOWN ON THIS DOCUMENT.I HAVE PERSONALLY M-C �
A R DTHE DIST N TF ONTHISDIAGRAM. I
— AT--
SIG A URE DE
1
i
CENTER PROJECT
SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
ay 10, 2017
D
George Drellos C E E Project#252
D
Sanitary Sewer Service
Queensbury,NY 12804 i
Re: Proposed Replacement Septic TOWN OF QUEENSBURY
6 Centennial Drive, Queensbury,NY COMMUNITY DEVELOPMENT
Dear George:
At your request, we have reviewed your proposed replacement septic system design of the
existing 3 bedroom house at 6 Centennial Drive 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.
Sincere 3,
Thomas R. Center Jr, P.E.