SEP-000297-2017 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-000297-2017 Date Issued: Thursday, June 15, 2017
This is to certify that work requested to be done as shown by Permit Number SEP-000297-2017
has been completed.
Tax Map Number: 302.14-1-34
Location: 118 DIXON RD
Owner: Casey Scoville
Applicant: Sanitary Sewer Service
This structure may be occupied as a: Residential Septic Alteration
By Order of Town Board
TOWN
^OF QUEENSBBURY
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-000297-2017
Tax Map No: 302.14-1-34
Permission is hereby granted to: Sanitary Sewer Service
For property located at: 118 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
Tvce of Construction
Owner Name: Casey Scoville Septic Disposal-Residential $0.00
Owner Address: 118 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-THIS PERMIT EXPIRES: Saturday,June 2,2018
(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 of eensb - [ / ,�riday J net
SIGNED BY: Vj!('/ �VJ for the Town of Queensbury.
Director of Building&Code Enforcement
SF-P- 11C®BSP®814L PERMT Ofliea Use Oniv
Received
Bay Tax Map ID
TAX WAP#D Permit No. S�� a�17- 2017
Permit Fee �nya
P_eE47/Bar®RINSPALLAF?8N o I�V r' `� Approvals:
AAPLlCANT M M-' PHONE/E-MAIL . S, 1/ — LJ 7,F'
ADDRESS
Ilk �i ,<eN 20a
/NSYALLwJ�'UiLtJEA: e,,-4110 PHONE/E-MAIL
ADDREBB: 0 X ZZ El D '
le N1 f� ll /1/y A ► iEML
f;/// COMMUN�7Fyp EENSBURY
Address �
CONTAOTPERSONFOR EJrfffi,AfNB t?r�i0ld�.5FfHfrfPLfANOE' C ?f02e. Q^�-/`Ol MOW
f�l35lBli'NCt=7N1:BARBdSfBAf
Year Built y UT bedrooms XOallonsper bedroom =Total Dally Flow
1980 or older Garbage grinder installed —Y XN
1981-1991 SpaorHotTubinstalled _Y SGV
7992-Pretreat
PARCK fNFOfretfeMAY
Topography )j./_Flat rolling _Steep slope _%slope
801 Nature _Sand _Loam _Clay _Other
Groundwater At what depth?
Bedrock fimparAoue Material Atwhatdepth9
Dmoittie Warr SuppiY Municipal _Well(dwall,water supply from any 30PHO system absorption is—it.)
Percolation Test Rate: _L-n.5 par;iji a per mesh(tact to be completed by licensed engineadng/architect)
PPROPOSFO.07irS-EM FOa NEW CONSTv7UC'i70N
TanK 51ze I gallons(minimum size 1,000 gallons,add 250 gallons to size for each garbage grinder or spa or hottub)
eysrom Type Absorption field with#2 atone Total length ft:Each trench
Seepage Fitwittt dS StOne How many. :size
AiteMOMSystem Sed orothertype? Zd x 2J
HoidingTankSystem TotalWuiredcapacRy? Tankstz�aoftantte_
NOia9! 1)Alarm system&assoctaled electrical worK must be inspected by a Town approved elecirtcal inspection agency;2)We will no longer
allow eyatems w be covered until such fime as an As-eulft plan Gs received&approved. The Insialled system must match the septic system
layout on HIB-no exCeptions
g/WWArTON: 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 vold. i have read the regulations
and agree to abide bytha and all req ui erns a Town of Queensbury Sanitary�Sawage_fepoeal Ordinance.
Print Names
8igtiature: Date.
Town of Queensbury BuHdfng&Codas Septic Disposal Permit.Wyr2014
o�R 6
�EtiN opM-
ecerir pLbt FLAI HAVE N
N OR
ED ALL OBJECTS
FTY
n 2 SUCH AS HO SES,MLLS.R TREES, FENCES, ETC
SDOTFD I HAVE PERSONALLY
ONN THIS DIAGRAK6—l—17
SIGNATURETOWN
BURY
ELOPMENT
m m ti
P4114e
,. 1ITOWN OF QUEENSBURY
BUILDING & CO ES `
Reviewe
Date: Z
�lov°xt.
i--- p rel---
rl ; •�-' _�-
�'
I
20' -
TOWN OF QUEENSBURY
BUILDING DEPARTMENT J
82sed on our limited examination,compliance I
with our comments shall not be construed as
indicating the plans and specifications are in
full compliance with the Building Codes of
New York State. 1
i
302.14-1-34 SEP-000297-2017
Scoville, Casey
118 Dixon Road
Residential Septic Alteration
f �� ; V 6 ri 0 014
N
CENTER PROJECT,
SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
May 27, 2017
George Drellos Project#256
Sanitary Sewer Service D
Queensbury,NY 12804 E 6 E
Re: Proposed Replacement Septic d 1 WED
118 Dixon Road, Queensbury,NY
TOWN OF QUEENSSURY
Dear George: COMMUNITY DEVELOPMENT
At your request, we have reviewed your proposed replacement septic system design of the
existing 3 bedroom house at 118 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 348 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.