SEP-0593-2018 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-0593-2018 Date Issued: Tuesday, October 9, 2018
This is to certify that work requested to be done as shown by Permit Number SEP-0593-2018
has been completed.
Tax Map Number: 295.6-1-11
Location: 1197 WEST MOUNTAIN RD
Owner: Michael Ross
Applicant: Sanitary Sewer Service
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 ("1"
1(175 property owner of the responsibility for compliance with Site Plan, j�
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.
illililk 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-0593-2018
Tax Map No: 295.6-1-11
Permission is hereby granted to: Sanitary Sewer Service
For property located at: 1197 WEST 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: Michael Ross Septic Disposal-Residential $0.00
Owner Address: 1197 West Mountain RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Sanitary Sewer Service
PO Box 224
Glens Falls,NY 12801
Plans&Specifications
Residential Septic Alteration
$ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, September 19,2019
(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 exp4iration a.to
Dated at the To Quee bury W- . -y , September 19,2018
SIGNED BY: ' \ for the Town of Queensbury.
Director of Building&Code Enforcement
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:7.11 SEPTIC DISPOSAL PERMIT APPLICATION 4ii:ro _.Q Y
742 Bay Road,Queensbury,NY 12804 05C15
P.518-761-8256 Perm=t#:
i
Tax Map ID#: 295-6-1-11 Perrn t Fee.5 IS G9lnvoice#. 0.5
Project Location: 11'17 WEST MOUNTAIN ROAD SePtt Variance? Yes No
Primary Owner(s) MIKE ROSS
rY�r's ll'I Address 1 7WESTi i' L: 1-`3
11�. MOUNTAIN ROAD,QUEENBSURY NY ;;
P rle&Email 5187938038 N 1111
Installer/Builder SANITARY SEWER SERVICES
11 a:trig Address LUZERN':ROAD,QUEEZSBURY NY
P lone&Lrnail 51117963760 T ip t.'`,` OF QU.E,,, NS URY
Engineer TOM CENTER Ew'Z's1E7ILOP ENT
Ma-lifig Address 73 SHERIDAN STREET,GLENS FALLS,NY 12801
I�+torte&Email TCEN'rER36drYAHOU.CUM
Contact Person for Building&Code Compliance: GEORGE DRELLOS Phone: S18T963760
RESIDENCE INFORMATION:
Year Bu It #ct bedrooms X gallons per bedroom. --tota daily f cw Garbage Cirincer 'Yes ED
198C cr older Installec? (circle one!
1931-1991 Spa or Ho:Tub ties ®
Installec? (circle one!
1992-Present 3 110 330
PARCEL INFORMATION:
Topography ./ c-at Rolling Steen Slope ':`Slope
Soil Nature Sanc Loam Clay Other
Grcundwate- At w- at depth? DEEPER THAN 6
Bed-ockPmpervvious-Hater a At what depth? NONE
Domestic Water Supply ✓Mun cipal _Wel ;if we I.water supply from any septic system absorption is—tt.)
Percolation Test Rate: 1`-S` per mirute per inch(test to be completed by licensed engrneer/archrtecti
PROPOSED SYSTEM FOR NEW CONSTRUCTION:
Tank s ze 1000 ga lors lmin.size 1,C00eallons.acd 250 gal-ons'or each garbage cy ince'or spa,no:tub
System Aosorption i etc with#2 stone 'oral lergth tt., Eacn Trench tt.
Seepage Pit w th#3 stone How mary: :Size:
A ternative System Bed cr other type: 20 X 25 FT BED
Hcicing'anK System 'otal required capacity? :tan s-ae :#of tanks
NOTES:1.Alarm system&asscr.atec electrical work•nest be inspected by a Towr approved elect-cal irsoectior-
agency;2.We v:i.l no longer allow systems to be covered until such t_me as an as-built plan is received and aopr-ov'ec.
The irsta led system must match the sept c layout on ti e no except ens.
Declaration:Any permit or approval granted which is based upon or is granted it reliance upon ary-nateria
representation or to lure:o make a material tact or circumstance krcwn by cr on beha t ct an aopl cant,=-hat oe void.I
have reac the regulations and agree to abice by these anc al requirements of the Town at Queensbu-y Sanitary Sewage
D spcsa Ordinance.
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PRINT NAME. �'-< OATt1/ 1FIP
SIGNATURE:
'r,4r c' iC511' . :1r` lI4 ?prr' .<,: F rtruar.b:::
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SEPTIC PLOT PLAN
I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HOUSES. WELLS, TREES, FENCES, ETC
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SHOWN ON THIS DOCUMENT,I HAVE PERSONALLY tt
FILE COPY MEA U ED THE MIA SET )7H ON THIS DIAGRAM.
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- Thomas Center Jr - --, .
Septic letters&Permits
September 13,2018 at 11:06 PM
• George Drellos -
See attached.
it 1r
Tom Center I, I I --- +
SEP 18 2018 li; ji
Virus-free. ., _ . ..._. .... .
OytgYi f'eiiiiY a. 3 `tT�'1 >
CENTER PROJECT
SERVICES
73 Sheridan Street.edits Falls.NY 12,01
September 13.201 N
Protect ,__
Ocorge I)rel]os
tianttais Sewer Service
Qucensburs. NY i=titt-;
Re- Proposed Replacement Septic
1197 Vest Mountain Road.Queensburv. NY
Dear ticor^'.
At sour request. we has c reviewed sour prop'ed replacement septic system design o: the
existing=-bedroom house at 1 197 West Mountain Road in Queensbt ry. Ai per our conversation
the residence. has an existing failed septic tlsten:.
We hake reviewed the proposed replacement septic system design and we agree that a standard
absorption bed is acceptable. Based upon a design :low rate of 30(if'[)and a percolation rate oi-
1 to ' minutes_sou Will need a minimum of ,.;s `f of absorption area. We recommend using J
it wide h'. 25 :t long: ahsornuor bed with 4 - 20 It Tong lateral;. The aP:•orption system can he
constructed with the existing :.genii-gallon septic tank. new distribution box, and 4-meh diameter
perforated ripe and stone.
Please feel tree to contact me at ti{,-25 15 if sou have an questions and that vot► for your
assistance with this request.
Sincerely.
O prtalk _v TF:inas trr:c•
Thomas Center U
Thomas R.Center Jr. I.L.f