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SEP-000569-2017 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-000569-2017 Date Issued: Tuesday, September 19, 2017 This is to certify that work requested to be done as shown by Permit Number SEP-000569-2017 has been completed. Tax Map Number: 309.14-1-64.1 Location: 7 MURRAY AVE Owner: Neil Dufresne Applicant: Neil Dufresne 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-000569-2017 Tax Map No: 309.14-1-64.1 Permission is hereby granted to: Neil Dufresne For property located at: 7 MURRAY AVE 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: Neil Dufresne Septic Disposal $0.00 Owner Address: 7 Murray AVE Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Straight's Septic Service 72 Sisson RD South Glens Falls,NY 12803 Plans&Specifications Residential Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,September 12,2018 (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 exp' tion date.) esbDated at the Town offlues y m er 12,2017 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement 10--.__"_____________ ___- OFF 11 ICE USE ONLY ) TAX MAP NO 1 IL 'PERMIT NO. PERMIT FEE ` -l?(�C7 _ `1(?.UCS 01�0 1'gi I! , APPROVALS: ZONING 0 $EP 0 7 2017 f TOWN CLERK 0 , I -------------------------------- _________ APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT; A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO R PERMIT. EVIEW BEFORE ISSUANCE OF A VALID -- OWNER: IV E'_e: I 2<;c G � (J G INSTALLER: ��`'r� � Sk,;;7 r V c �� ADDRESS: F, �3 mc``'1tF�nrf� ADDRESS: Z PHONE NOS. PHONE NOS.5 `M �' o (w J LOCATION OF INSTALLATION: YEAR BUILT OF X COMPUTATION= TOTAL DAILY FLOW RESIDENCE INFORMATION: BEDROOMS 1980 or older X 150 gallon per bedroom = GARBAGE GRINDER INSTALLED? 1981 -1991 X 130 gallon per bedroom = 1992-present 3 X 110 gallon per bedroom = SPA OR HOT TUB 31<D INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: Flat rolling ' Steep slope %Slope ✓ SOIL NATURE: Sand 'f Loam Clay Other ✓ GROUNDWATER: At what depth? ✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth? ✓ DOMESTIC WATER SUPLY: Municipal Well (If well: Water supply from any septic system absorption is ft.) ✓ PERCOLATION TEST: Rate is per minute per inch. (Test to be completed by a licensed professional engineer or architect.) PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional engineer or architect (unless installed in a Planning Board approved subdivision). TANK SIZE: GALLON (MIN. SIZE IS 1,000 GAL.) Add 250 gallons to the size of the septic tank for each garbage grinder, spa or whirlpool tub. SYSTEM TYPE: ABSORPTION FIELD (WITH NO. 2 STONE) Total length t. Each trench X 5 Cl ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? ❑ ALTERNATIVE SYSTEM Bed or other type? ❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? OTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN ' APPROVED ELECTRICAL INSPECTION AGENCY PLEASE REVIEW LIST PROVIDED. ............. For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to mnko n mnfnrinI fort nr n;r^i—^+.,r.,.,, __ _ _ Ll SCEP 0 7 2017 ��4PVEV t;�c•����'r-�.��� 4..�r E 6�i.tis a 0 700 i- j ti O kL N CO Lo O N 00 1 c a)LL . _ =s a mZ � r Q cu � r � � � Ncu = a) MOti � S S`PTIC �,' ;; I HAVE SEEN OR OBSERVED ALL kJ iECTS SUCH AS HOUSES,WELLS,TREES, FENCES, ETC p \ SHOWN N THIS DOCU T.I HAVE PERSONALLY ri � DATE l IGNATURE - "c--v-- 0 C)D b (i:"1--Z-0 N AS BUIL` E C IE 0 SEP 18 20 7 d TOWN OF QUEEN E BUILDING&CO E J -z- r4 N � g Lo