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SEP-000627-2017 TOWN OFQ UEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: SEP-000627-2017 Date Issued: Thursday, December 7, 2017 This is to certify that work requested to be done as shown by Permit Number SEP-000627-2017 has been completed. Tax Map Number: 290.14-1-5 Location: 68 ROCKWELL RD Owner: Roger Brassel Applicant: Eddy Enterprises Inc. This structure may be occupied as a: Residential Septic Alteration Replacing leach fields only By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the 4 44t 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-000627-2017 Tax Map No: 290.14-1-5 Permission is hereby granted to: Eddy Enterprises Inc. For property located at: 68 ROCKWELL 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: Roger Brassel Septic Disposal-Residential $0.00 Owner Address: 68 ROCKWELL RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Eddy Enterprises Inc. PO Box 9 Athol,NY 12810 Plans&Specifications Residential Septic Alteration Replacing leach fields only $40.00 PERMIT FEE PAID-TI-HS PERMIT EXPIRES: Friday,October 5,2018 (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 ex iratioon date.) Dated at the Town o ueens 4Th to 5,2017 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement SEPTIC DISPOSAL PERMIT APPLICATION Office Use Oniv 742 Bay Road,Queensbury,NY 12604 _ P:516-761-5256 www.gueensbury.net Permit#: Tax Map ID#: 07 C/o, /4 — /—,5' Permit Fee: $��; invoice#: 2.5'0 2- Project Location: _ 6S Rocxa)'211 kol (. wl-leti.4I Septic Variance? Yes V No Primary Owner(s) r. 1� L reASSe- l Mailing Address p-d &dUeer)sbvrv,")1 / Z�b Phone & Email 5 /9 .--7 q 3 , 3 2-Ao Installer/Builder Edctu E n�ern c Mailing Address Q© -f ho I 9 to I Z�-I v V E F i Phone & Email j i b 2 Z a i Engineer N OCT U 4 2017 Mailing Address Phone & Email BUILDING&CODES C�<I�> � Contact Person for Building&Code Compliance:�z��T Phone: S IS /O� RESIDENCE INFORMATION: Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes o 1980 or older 3 Installed? (circle ane) 1981-1991 Spa or Hot Tub Yes Vb Installed? (circle one) 1992-Present PARCEL INFORMATION: Topography o/ Flat Rolling Steep Slope %Slope Soil Nature Sand _JL Loam Clay Other Groundwater At what depth? i -o r c r Bedrock/Impervious material At what depth? A,) Domestic Water Supply —Municipal V Well if well,water supply from any septic system absorption is_ft.) Percolation Test Rate: per minute per inch (test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTR Tank size gallons(min. si 1,000 gallons,add 250 gallons for each garbage cylinder or spa/hot tub System Absorption field with#2 s e Total length ft.; Each Trench ft. Seepage Pit with#3 stone How many: ;Size: Alternative System Bed or other type: Zn 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 and approved. The installed system must match the septic 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 known 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 Ordinance. PRINT NAME: G , SIGNATUR �� DATE: ° U/ Town of QueensKury Building&Code Enforcement Revised February 2017 P1 KRTY TAX S - S ( L-J 290.14-1-5SEP-000627-2017 t4 2i7�.id»1»1 2SO �aa»i»2 Stairs,Lorraine Brrassel' Roger Sweenor,Dennis 68 Rockwell Road nza,Gary Res. Septic Alt. (leach fields only) J� * f -s" _ Z ..� O S 1 v G n't Monahan 7imot#iji r m .. j *„ m c o n FILA G � a >� COR m m dm' �i� Z+ O P 200.54-1 oan,joh C —+ mX-- D n IT, Z :�. 9 2ifC3. »i-i3 � iaoi» ;, rn m ,y m 1�+ r�m tiugrs oy Li\7 TrUbt ,:S r�r,,r''�<�r i,F2D�igr�Ai F r mC n U) 1 \\ M.54»1ce dor,Annai�ele M »Ty I a f kala � i^r Jon�e�,Nnit3 ji 2001,4-i-1 A8x",Jaam P r ,DO bi@ffi a 6 Y; 280.62-1»21 s OV01,100k ii eoillrneri; : t ' Jenkin.;rr ' 1. Overtook H vinersA -90.64. A H r,J n R it d Dy 2503.62 Rail)+:ciarn8�J > ` $x i E- rov x r D 185 250.6 1» y Seilig,R art I a a � F s 290.6 1»6 90.6 l- ore, iriey U Severance, .S gi" 290.94-1-7.2 290. 2»1-16 Kamm,Micheal � OCT U � 290• »7 lea,Charl e 2937.13-1-2 R in,Mitchell L caA Z�� fir L.L.C. Chaveliate, .im.Ca�. yy y TOWN OF QUEENSBURY 2A0.r52- a o3 R yn$ 290. -1- q BUILDING&CODES Curintngham Joh onnor,Michael i--- IMPORTANT NOTICE AND DISCLAIMER THIS MAP AND INFORMATION IS PROVIDED AS IS AND WARREN COUNTY MAKES NO WARRANTIES OR GUARANTEES,EXPRESSED OR IMPLIED,INCLUDING WARRANTIES OF TITLE,NON-INFRINGEMENT, r MERCNANTABILiTY,AND THAT OF FITNESS FOR A PARTICULAR PURPOSE CONCERNING THIS MAP AND inch 150 �� THE INFORMATION CONTAINED HEREIN.USER I h ASSUMES ALL RISKS AND RESPONSI:RILITY FOR DETERiWINING`A+HETHER THIS MAP IS SUFFICIENT FOR PURPOSES IW rENDSo. j 3 GIS MAPS ARE NOT LAND SURVEYS! WARREN COUNTY F 290.14-1-5 SEP-000627-2017 �' -29f41 Steen,Lpr�aine Brassel, Roger .1-3 Sweanor,Dennis �+ ,Gary 1 z 68 Rockwell Road Res. Septic Alt. (leach fields only) I k , } M 90.54.1- ani h Co x -- •, ra , X290, -1 6 Roger y G�theso. 1-4 Liv' g T f � - J 290.54-1-4 Peer,AnnabaM :,� 290. -1-10 " Vale ,James 290.54-1-2 '' no ,Den 290. 4-1-1 Ale \Ja w rozl 'Dolore I '�'=' .._ '• ;290.621-21 290.14-1- F to k eowners AssJ ° Jenkin,Craig T 29 .6x1= 4 . :Overlook Hogle Wngrs Ass .°s 90.54; H per,J r► _ #; .621 12 Reli °* Y rov lay E 290, Sell l 90.6 1-+ 290.6?-1-6 ore, teY i I ' r w Kerman, 1io salt +[l Saxe,ance,'�.Scott t 2510. 21-15' 1� 2 .FZ�f=7 las,Charl t r Y t Q 290.1-2 P in,� �� I • `r� € Chaveliete t C. 290,62- 6 90. r°COnningha on I _ i + SEPTIC PLb7 IMPORTANT NOTICE AND DISCLAIMER } r��AN. THIS MAP AND INFORMATION IS PROVIDED AS IS AND 3 I HAVE SEEN OR OBSERVED ALL OBJECTS WARREN COUNTY MAKES NO WARRANTIES OR GUARANTEES,EXPRESSED OR IMPLIED,INCLUDING - -. SUCH AS HOUSES, WELLS, TREES, FENCES, ETC WARRANTIES OF TITLE,NON-INFRINGEMENT, I " ° MERCHANTABILITY,AND THAT OF FITNESS FOR A SHOWN ON THIS DOCUMENT.I HAVE PERSONALLY PARTICULAR PURPOSE CONCERNING THIS MAP AND ��,:��„S THE INFORMATION CONTAINED HEREIN.USER MEASURED THF�'p 5ET H% IS DIAGRAM. ASSUMES ALL RISKS AND RESPONSIBILITY FOR /J �/ DETERMINING WHETHER THIS MAP IS SUFFICIENT FOR I _0 PURPOSES PURPOSES INTENDED. .SI NATURE DATE GIS MAPS ARE NOT LAND SURVEYS!