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SEP-0455-2018 TOWN OF QUEENSBURY P ".; 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building& Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: SEP-0455-2018 Date Issued: Tuesday, July 17, 2018 This is to certify that work requested to be done as shown by Permit Number SEP-0455-2018 has been completed. Tax Map Number: 308.19-1-21 Location: 28 DIVISION RD Owner: Thomas Thornquist Applicant: Fred Smith 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 11 property owner of the responsibility for compliance with Site Plan, 4 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. ,fib , TOWN OF QUEENSBURY g4, ., 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 . if'',;� Community Development-Building& Codes (518) 761-8256 8256 BUILDING PERMIT Permit Number: SEP-0455-2018 Tax Map No: 308.19-1-21 Permission is hereby granted to: Fred Smith For property located at: 28 DIVISION 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 Type of Construction Owner Name: Thomas Thomquist Septic Disposal-Residential $0.00 Owner Address: 28 DIVISION RD Total Value $0.00 Queensbury,NY 12804 - Contractor or Builder's Name/Address Electrical Inspection Agency Fred Smith 23 VERMONT AVE Queensbury,NY 12804 Plans&Specifications Residential Septic Alteration $ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,July 12, 2019 (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 To • I f Quee b bury; Th,r d 12,2018 SIGNED BY: 1 - \ for the Town of Queensbury. Director of Building&Code Enforcement fin_ . SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only 742 Bay Road,Queensbury,NY 12804 Permit#: -'P-0it���- ?�z toRm ofi -ensbary P:518-761-8256(� x a Bens +' .ne Tax MapID#: 30 C5 J9 ®/ ~2I Permit Fee:$ 95 ;Invoice# 65 - Project Location: I)i v/s2,i--1 led Septic Va €anee?i r--' KY �, 7„ri N Primary Owners) wat ! '�` ~ _ _ __. _I, Mailing Address 2.6 ThVI3lm)n J L. if II11 !l JUL 1 1 201E 1 1.i li Phone&Email 6-18 6 ' 67 y1 � .,a -�___ �� II Installer/Builder h ub �sl r u- 1,' PS Y O 5r ) . rirr LAC"Dvwr/ tv �99 �, Mailing Address f/ ,?�'V�3i 7�$ 4(j,C l B gv !c3 ii -.-__ T,--._---- Phone&Email 31 sb 3e01 qt 64, Sr\ T .xjki w `019 itirok L ` CZTA, Engineer �t 1 ahfiri4 / dei1ianl' R.A)te il) (e5 Mailing Address 173 (-7)aP)Yon Phone&Email (VS3 "2194 c9.51 Contact Person for Building&Code Compliance: 'Rni1A Phone: 'i ' RESIDENCE INFORMATION: 34,/ 0 7c 6. Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes lil� 1980 or older 3 /!D 3 gz) Installed? (circle one) 1981-1991 Spa or Hot Tub Yes N,oV Installed? (circle one) v 1992-Present PARCEL INFORMATION: / Topography k.//Flat Rolling Steep Slope %Slope Soil Nature V Sand Loam Clay Other Groundwater At what depth? 04 Bedrock/Impervious material At what depth? 'it)A Domestic Water Supply _ tiunici .l _Well(if well,water supply from any septic system absorption is_ft.) Percolation Test Rate:J40 per minute per inch(test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size km 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 ft. / Seepage Pit with#3 stone How many: ;Size: IV Alternative System Bed or other type: :2 6-se '9,1 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: 4 2......),i9F-V),00::;47,i JJQQ DATE: 71//0/(90C? SIGNATURE: DATE:_!_iffriadiI Town of aueensbury Building&Code Enforcement - Revised February 2017 , A m 4 tlt 11 IV [fl Y t :, i i i \ i•, - \ \ t \ ,.___ ,Q-N \I \ \ t 1, '1,,, \ G O( 1} `t 'Y+ }� 9 4\ \ . V , , 5 i \ V jib, : -____-_,___„. \ \ l',.(tt.7 .._ - . -,i \ \III ______________-----,-- , a .-- -- ' --,\ "A'iz:),...\,. I x- t. \ ,.. . i. .111 %.;. \ \1\ _.....:::;c740447::,....1•_.:,_... .:,,___,:x., \ `t _ T 1 • - O 0- , • jL : `l Airi tr, (� 1 — .d , \ 17 •O5 7 c % •% ��} C i rus �� r M i ® a? 6Ca �' u_p 4 ' --":—C. ' \ 6 rrr i © tr.)y 1' _ " \ ...--\ it? h y ", Oy .�,n.) 0 r} 0••••• j,, :,.‘ C''' cf) "741111%----,., i G.v4. %\ cP y 2 — �fry 1 � , ''"10 --6 " u,;z ' " y0 ci CENTER PROJECT SERVICES . 73 Sheridan Street, Glens Falls,NY 12801 Phone-518-796-2515 July 9, 2018 Project#271 Fred Smith Smith's Trucking 23 Vermont Avenue Queensbury,NY 12804 Re: Proposed Replacement Septic 28 Division Road, Queensbury,NY Dear Fred: At your request, we have reviewed your proposed replacement septic system design of the existing 3-bedroom house at 28 Division 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 367 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 a new 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, /V; Thomas R. Center Jr, P.E.