SEP-000242-2017 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-000242-2017 Date Issued: Thursday, May 18, 2017
This is to certify that work requested to be done as shown by Permit Number SEP-000242-2017
has been completed.
Tax Map Number: 302.14-248
Location: 99 DIXON RD
Owner: Katherine Kenney
Applicant: Sanitary Sewer Service
This structure may be occupied as a: Residential Septic Alteration
By Order of Town Board
TOWN OF QUEENSBBURYA
Issuance of this Certificate of Compliance DOES NOT relieve the �j property owner of the responsibility for compliance with Site Plan, r 999
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-000242-2017
Tax Map No: 302.14-2-48
Permission is hereby granted to: Sanitary Sewer Service
For property located at: 99 DIXON RD
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
Tyne of Construction
Owner Name: Katherine Kenney Septic Disposal-Residential $0.00
Owner Address: 99 Dixon 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
$40.00 PERMIT FEE PAID-TI-BS PERMIT EXPIRES: Wednesday,May 16,2018
(Ifa longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the ex/Q,)nation date97for
)
Dated at the Town o ueensb { / �u017
SIGNED BY: the Town of Queensbury.
Director of Building&Code Enforcement
SEPINC DISPOSAL PERM7 Office Use Oniv
Received
DATE Tax Map ID
WAP -7`30a' Permit No. 17
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AppuyyiIUd (? I /LL PHONE
ADDRESS
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PuONTACT PER60N FOR RU14 11MO at' 9gMPLIAN6€:
F�.oIB@NBF JN€BdfGIAi'IB11 P
Year Built 9 of bedrooms x®ailoas per bedroom =Total Daily Flow
1980 or older Garbagsgdnderinstalled I _Y,�,N
1991-1991 Spa or HotTub fnstailed _Y ZN
7992-prasam
L24 RCM fNPCRMATlON
Topography Mlffatrouing _Maspsiops _%Slope
Soil Nature _Semi _Loam —G* —Other
Groundwater At what depth°
Bedrook I IMpervious Material Atwhat dap
Domestic Water Supply unicipai� _Weu¢twall watersuppiyhnmanyselnisayatemabaerptionis—ft.)
Percolation Test Rata _ per nliltotBlterinCh(teStto be Complstsd by fieensad enginesdng 1 archfieCt)
,(2AOPOSED$VS?EMFOANEW F�7NSTRUC'frO1V
Tank Size N'�) gallons(minimum size 1,000 gallons,add 250 gallons to site for each garbage grinder or spa or hot tub)
5y5tem Type Absorption field with R aloin TOM 1e09Mft;Each bench
Seepage pd with os woos How many- :size
X ARSmaftvo SYs OM Bed orothertype? 2-4 I
Holding Tank System Total required capachy? Tank size a oftanim
No r 1)Platin system&associated eleculed wOrkmustbe kmpeoted by a Town approved eteoWcal inspection agency;2)we will no longer
avow systems w be covered until such iime as an AsBuift plan is MColved&approved. The Installed system must match the septic system
layout oniffe—no exceptiorm
9EO&4RA-e70N:_Any permit or approval granted which is based upon or is granted in reliance upon any material representation or
failure to make a material iaut or oiroumstance Imow by or on behalf of an applicant, shall be void. 1 have read the regulations
and agree to abide by ttgse and Sit re of the Tower of Queensbury Sanitary Sewage Disposalrdinance.
Print Names ' e grData:
Signature: __ Oats:
Town of Queensbury Bull&*&Godes Septic Disposal Permit JPrly 2014
IJ
VOF OUEENSBURYSEPTIC BLOT PLAN
ITY "u ELOPINOE I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HOUSES, WELLS, TREES, FENCES, ETC
SHOWN ON THIS DOCUMENT I HAVE PERSONALLY
M A d ED THE DIST CE S;T 'ORTH ON THIS DIAGRAM.
j(J7C
SI ATURE DATE
302.14-2-48 SEP-000242-2017 - S'
Kenney, Katherine _
99 Dixon Road
a
Residential Septic Alteration
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CENTER PROJECT
SERV I CES
73 Sheridan Street, Glens Falls,NY 12501
Phone-518-796-2515
May 10,2017
roject#251
George Drellos
Sanitary Sewer Service
Queensbury,NY 12504 +
To IN F IE NSSU
Re: Proposed Replacement Septic COMMUM07F-)
EVEtjgt� E T
99 Dixon Road, Queensbury,NY
Dear George:
At your request, we have reviewed your proposed replacement septic system design of the
existing 3 bedroom house at 99 Dixon 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 a new precast concrete 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.
302.14-2-48 SEP-000242-2017
Kenney, Katherine
99 Dixon Road
Residential Septic Alteration
_ SEPTIC PLOT PLAN
D E C E v I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HOUSES, WELLS, TREES, FENCES. ETC
�a� '* :; SHOWN DOCUMENT.I HAVE PERSCNALLY
EMAY 2U` MEAS OISTANeCERTH ONT GRAM.
Zz-r"7
..._ SIGNATURE DATE
TOWN OF QUEEN BURY
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