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SEP-000429-2017 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-000429-2017 Date Issued: Friday, August 4, 2017 This is to certify that work requested to be done as shown by Permit Number SEP-000429-2017 has been completed. Tax Map Number: 289.8-1-17 Location: 55 YORKSHIRE DR Owner: Melissa Hipp Applicant: Melissa Hipp 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 �,J 4t property owner of the responsibility for compliance with Site Plan, V 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-000429-2017 Tax Map No: 289.8-1-17 Permission is hereby granted to: Boucher&Son Excavation For property located at: 55 YORKSHIRE DR 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 TvM of Construction Owner Name: Melissa Hipp Septic Disposal-Residential $0.00 Owner Address: 55 Yorkshire DR Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Boucher&Son Excavation 7935 State Route 40 Hartford,NY 12838 Plans&Specifications $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,July 19,2018 (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 ofeensb �ednOt2017 SIGNED BY: r the Town of Queensbury. Director of Building&Code Enforcement F SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only 742 Bay Road,Queensbury,NY 12804 1,wn n7�juccnn shuPermit#: �� 9-, 7 P:518-761-8256 www.gueensbury.net pG Tax Map ID#: ��, —/s— 1 -7 Permit Fee: $ `�; Invoice#:,.J. 0 57-3 Project Location: l ori S4;/`e n ✓i ✓`t° Septic Variance? Yes No Primary Owner(s) Mailing Address 53- Yo 6 N. /`"` o' Phone & Email 9qMQ h Installer/Builder Mailing Address �73 v`1- S4 - D a 3 Phone & Email Engineer Mailing Address L11i I110 1 Phone & Email Contact Person for Building&Code Compliance: S'c � %3r� C�1 ei C m✓✓aUli` 'J11 :' -50-;( O 'c Sirs- -8�i1 RESIDENCE INFORMATION: Year Built #of bedrooms X gallons per bedroom = total daily flow Garbage Grinder Sep' No 1980 or older Installed? (circle one) 1981-1991 Spa or Hot Tub Yes o, Installed? (circle one) 1992-Present PARCEL INFORMATION: Topography Flat Rolling Steep Slope Lo _%Slope Soil Nature Sand I Loam Clay Other Groundwater At what depth? Bedrock/Impervious material At what depth? Domestic Water Supply —Municipal I/Well (if well, water supply from any septic system absorption is/,Afft.) Percolation Test Rater per minute per inch (test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size0 gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or spa/hot tub System Absorption field with#2 stone Total length ft.; Each Trench Seepage Pit with#3 stone How many: ; Size: r' Alternative System Bed or other type: T 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: 3 c co .k 30UCA DATE: 41z; i ,, SIGNATURE: C3CJ'Ci DATE: Town of Queensbury Building&Code Enforcement Revised February 2017 s p ``_�h b o kK% vie oV S a 0 VIN OF BuiLDING Revieweci E ' 13®co ca' Q 289.8-1-17 SEP 429-2017 (wYetK m5h , t e D R (z Melissa Hipp 55 Yorkshire Drive Residential Septic Alteration — IE i �-`i�``, SEPTIC PLOT PLAN br" I HAVE SEEN OR OBSERVED ALL ON 3 f SUCH AS HOUSES, WELLS, TREES, FENCES, E SHOWN ON THI�DOCUMENT.I HAVE PERSONALE p© �� ` VI'; „ , {m6 t� �, H DISTAN6E SE RTH ON THIS DI RAM _ �o ,c, 17 I? �r5 COi' i�lJ; ' ' �). +° a ''sJ6 �?T 1z I ,� IUREDTE The Equalizer® 36 11 Ll 19 14 9 oil) • C ~ SYSTEMS I N C hamber Environmental Onsite Wastewater Solutions" � l ,tri , f The Equalizer 36 Chamber meets special sizing requirements when a narrow trench is specified. The chamber fits in a 24" wide trench and is . available with 10", 9" and 6" invert end plates to provide a variety of design r , solutions. The Equalizer 36 also features the SideWinder sidewall, which enhances evapotransporation and delivers optimum infiltrative perform- ance. With 12" of compacted cover, it supports 16,000 lbs./axle, equivalent to an H-10 AASHTO rating. The Equalizer 36 Chamber Tested and Proven with More System Offers You These than 600,000 Installed Unique Benefits: q • Infiltrator is the number-one septic • Slim chamber profile that fits leachfield chamber system in the 1 narrow trenches onsite industry =J • Greater design flexibility due to • More than 600,000 systems installed, ` multiple invert endplates with over 20 million units in-ground • Easy assembly and installation in all 50 states and 13 countries. with as few as two people, a back- Infiltrator's established history of jM hoe and a pickup truck performance and reliability began r. • Lightweight chambers that can be in 1987. delivered in one pickup truck • Field surveys show Infiltrator load and hand-carried into position chamber systems are measurably • Inspection port option for easy more resistant to hydraulic failure access to leachfield with no site than stone and pipe systems. disruption • Infiltrator is ISO 9002 registered • OVERALL REDUCED COST and is IAPMO and UPC approved. Approved in 1; J } � ? '- , � V✓ e l 1 H' o PIS Ru " i 5 e,i-= ' Pie 7ci QUEE DING Ir - 289.8-1-17 SEP 429-2017 i 3h ® � Melissa Hipp 55 Yorkshire Drive Residential Septic Alteration -- r 7Z � ! - {;� ! SEPTIC PLOT PLAN l I HAVE SEEN OR OBSERVED ALL QSJE 3 SUCH AS HOUSES, WELLS, TREES, FENCES, E r. �A �Nfnw f SHOWN ON THIS DOCUMENT.I HAVE PERSONALE , H DISTANCE SE F RTH ON THIS DI RAM r SI A URE f vff DTE 7 y The Equalizer'16 4 9 ® � Chamber SYSTEMS INC Environmental Onsite Wastewater Solutions" "O rs - -rr The Equalizer 36 Chamber meets special sizing requirements when a narrow trench is specified. The chamber fits in a 24" wide trench and is available with 10", 9" and 6" invert end plates to provide a variety of design solutions. The Equalizer 36 also features the SideWinder sidewall, which enhances evapotransporation and delivers optimum infiltrative perform- ance. With 12" of compacted cover, it supports 16,000 lbs./axle, equivalent to an H-10 AASHTO rating. The Equalizer 36 Chamber Tested and Proven with More w .. System Offers You These than 600,000 Installed " Unique Benefits: • Infiltrator is the number-one septic • Slim chamber profile that fits leachfieltl chamber system in the yf narrow trenches onsite industry } • More than 600,000 systems s . • Greater design flexibility due to installed, multiple invert endplates with over 20 million units in-ground • Easy assembly and installation in all 50 states and 13 countries. with as few as two people, a back- Infiltrator's established history of hoe and a pickup truck performance and reliability began • Lightweight chambers that can be in 1987. 4 r delivered in one pickup truck • Field surveys show Infiltrator -K load and hand-carried into position chamber systems are measurably • Inspection port option for easy more resistant to hydraulic failure access to leachfieltl with no site than stone and pipe systems. disruption Infiltrator is ISO 9002 registered • OVERALL REDUCED COST and is IAPMO and UPC approved. ` Approved in -