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SEP-0463-2018 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518) 761-8256 CERTIFICATE CIF COMPLIANCE Permit Number: SEP-0463-2018 Date Issued: Tuesday, July 24, 2018 This is to certify that work requested to be done as shown by Permit Number SEP-0463-2018 has been completed. Tax Map Number: 288.-1-15 Location: 46 BELL MOUNTAIN RD Owner: David Hodgson Applicant: Stone Installations 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, J 4 Variance, or other issues and conditions as a result of approvals'by the W Directo Code E Planning Board or Zoning Board of Appeals. S#fuifdj�g& Xforcemeint fk 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-0463-2018 Tax Map No: 288.4-15 Permission is hereby granted to: Stone Installations For property located at: 46 BELL MOUNTAIN 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: David Hodgson Septic Disposal-Residential $0.00 Owner Address: 46 Bell Mountain RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Stone Installations 4305 Route 50 Saratoga Springs,NY 12866 Plans&Specifications Residential Septic Alteration $75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,July 18,2019 (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 Town of Queensbury; Wednesd ,J ly 18,2018 SIGNED BY: f for the Town of Queensbury. Direct' uilding&Code En cement ✓i D) ECEOWEI SEPTIC DISPOSAL PE 10 LAIC TIO 9 Ile Use Only 742 Bay Road,Queensbu t 12804 -� ) `� P:518-761-8256 L w.qu ensb,,�,,•tee# Permit#: L?- —0 C1 �ZU irg T*' of mass u ZY Tax Map ID#: g Pk j L Permit Fee:$7 04 invoice#: 0 6 7 ,� Project Location: b Jam,,:, �:;., I r Septic Variance? Yes No Primary Owner(s) Avg1-tode) ::)(-IVI Mailing Address v f t!� ) r'���, co , � iA� ����f� EIf/,�J / i Phone& Email 5/f9. 0-'72z/ p Installer/Builder �'" „,r , - /C.. ,��. Mailing Address 7A c �~;Lc6 ✓o c, c� ,,i i /1 28j Phone&Email --0 r j ` `�! f / l' 5/s,s- 51J/" /© Q may-, �42,r, it ad i 1. it .5 r 1. 00-, Engineer Mailing Address Phone&Email Contact Person for Building&Code Compliance: �e J.Aek ic Phone:,cif -Z3'Z b707 RESIDENCE INFORMATION: Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes No 1980 or older Installed? (circle one) 1981-1991 Spa or Hot Tub Yes No 1992-PresentInstalled? (circle one) 3 no33O PARCEL INFORMATION: Topography Flat Rolling Steep Slope %Slope j Soil Nature Ind Loam Clay OtherC44(�- Groundwater At what depth? of C , era/ed 'h 6 u / Bedrock/Impervious material At what depth? orte, 4.4 5e.,--L/t'1r1' 1-7-1 fr Domestic Water Supply _Munic- al _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 CONSTRUCTION: Tank size ROD1) gallons(min.size 1,000 gallons,add 250gallons for each garbage cylinder or spa/hot tub System Absorption field with#2 stone Total length 0 ft.; Each Trench 60 ft. 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 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 reg cations and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME: 040 r DATE: 7 pis SIGNATURE: - fi ,,e,te-i"ti DATE:710 0 Town of Queensbury ilding&Code Enforcement Revised February 2017 TECEUVE-20 : 1 .% 1J ..- .1.„\ II JUL 16 2.018 -, - la[juEgRvt ", � � I TO N OF QUEENSBUR -N BUILDING & CODES D� Ta d �' 1 4 Revi; MI y, t .4_ a ` I ,'�. Date: 0 . I , I TOWN OF QUEENSBUr' �, 1 `�' BUILDING DEPARTME �; Based on our limited examinations compliance with our comments shai! not be construed as indicating the plans and specifications are in 1 full compliance with the Building Codes of New Tr ?n SEPTIC PLOT PLAN 7 I H VE SEEN 0 OBSERVED ALL OBJECTS �.� SUCH, OUSES, TREES, FENCES, ETC MENT.I H SHOWN 0 THIS AVE PERSONALLY THIS D GRAM �" . g/- MEA J THE _�-- GNATU E DATE y. ai y/44011/ ,-----\_...,/ 1,1 , - --- \ ''' 288.-1-15 SEP-0463-2018 Hodgson, David 46 Bell Mountain Rd Residential Septic Alteration . ., , _ .., AS BUILT b Tc,,Kr beelc 11 , )09S4\-eJ FECEOVEO . , u JUL 24 2,0_18 1 ' t TOWiCi-C3F QUEENSBURY 1 BUILDING A CODES1 i NA A 1 \ il $ ).joiiii., 1 ) D, 64 ir . x ii . . lz- .,. ,nleneLl. lc/LI 1 es(\ , Cjil . _