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SEP-000705-2016
TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 QL Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: SEP-000705-2016 Date Issued: Tuesday, October 18, 2016 This is to certify that work requested to be done as shown by Permit Number SEP-000705-2016 has been completed. Tax Map Number: 279.19-1-28.1 Location: 205 SUNNYSIDE RD EAST Owner: James Trottier Applicant: Straight's Septic Service This structure may be occupied as a: Replacing Tank Only(going from 500 gallon to 1250 gallon tank) By Order of Town Board TOWN OF QUEEENNSBU/JRY Issuance of this Certificate of Compliance DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, (((iiivvvJJJkkk V Variance,or other issues and conditions as a result of approvals by the Planning Board or Zoning Board of Appeals. Director of Building&Code Enforcement A;2h 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-000705-2016 Tax Map No: 279.19-1-28.1 Permission is hereby granted to: Straight's Septic Service For property located at: 205 SUNNYSIDE RD EAST 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: James Trottier Septic Disposal-Residential $0.00 Owner Address: 222 Robinson LN Total Value $0.00 Wappinger Falls,NY 12590 Contractor or Builder's Name/Address Electrical Inspection Agency Straight's Septic Service I Myron AVE South Glens Falls,NY 12803 Plans&Specifications Replacing Tank Only(going from 500 gallon to 1250 gallon tank) $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,October 13,2017 (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 ofns n 'phursd 0 ber 13,2016 SIGNED BY: �•Vl/ for the Town of Queensbury. Director of Building&Code Enforcement SEPTIC DISPOSAL PERMIT Office Use Only DATE Received .S2311vo 2751 -Z g Tax Map ID TAxMAP1D Permit No. 2,C0 Permit Fee Q-lIo �lYivokLe-. 1)50 LOCATION OF INSTALLATIOW�I.7� mnnrk !a, Approvals: APPLICANT J/rtMM�r� �1 JT711 f{'r41�.1 �' PHoNE/E-MAIL(-5"/�,Z y�O� y�g3 ADDRESS / IV/Ory ICG S.�GIG1US /g 11 s N•, 12*-,03 INSTALLER/BUILDER: /�/91 �yS JE/7/IC S4:YUIC_E PHONE/E-MAILS ki-saOhC SE7jkt-FAJ /uy�ow S &WS- f / �-✓Nkl t ,COAN Vi ADDRESS: � �f /tfL>J /2�a3 OWNER //d (l[C►� PHONE/E-MAIL (5- 's�3b Address /99 �w�n v S'o�.e �Aff Qu uSJsL r �/ n 93�j CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: �_irr�K S77R r4 PHON SIB' 7/ - `3 RESIDENCE INFORMATION Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow 1980 or older Garbage grinder installed _Y 1981-1991 Spa or Hot Tub installed _Y 1992-Present PARCEL INFORMATION Topography _Flat rolling _Steep slope _%slope Soil Nature L Sand _Loam Clay -"O)nt{¢ts Groundwater At what depth? Bedrock/Impervious Material At what depth? Domestic Water Supply _Municipal _Well(if well,water supply from any septic system absorption is Percolation Test Rate: per minute per inch(test to be completed by licensed engineering/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION Tank Size 1,Z_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 ft.; Each trench x 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 Or mance. Print Name: �,lnf Date: /Z © r?O I Signature: Date: /Lyc ,-v 1 b Town of Queensbury Building&Codes Septic Disposal Permit July 2014 a { i z i W j 17bN�s��lk�yGp �� 57 -3r86 )1b Q�s-33�� S)) 90s,114,hlU 0E80 &d0�S ODlV SbHS / T • I o c j N O LO Y O C Ih fu s O � w ca U) a � U IN, _ �\ U w Q r• 1 ` cdN — {I r cc L. a) N N goo rn mri Ln- all . D ' /r7,�- -e � or N� c- P'l SES � -� - zjva � j f ' 02_SQL a tw j f