The URL can be used to link to this page

SEP-000338-2017 TOWN OF QUEENSBURY at 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: SEP-000338-2017 Date Issued: Tuesday, June 20, 2017 This is to certify that work requested to be done as shown by Permit Number SEP-000338-2017 has been completed. Tax Map Number: 308.16-1-7 Location: 9 STEPHANIE LN Owner: Claudia Harrington Applicant: IBS Septic This structure may be occupied as a: Residential Septic Alteration By Order of Town Board TOWN OF QUEENSBUURY Issuance of this Certificate of Compliance DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, ��.��JJJ(GGA��✓�� 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 OL 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: SEP-000338-2017 Tax Map No: 308.16-1-7 Permission is hereby granted to: IBS Septic For property located at: 9 STEPHANIE LN 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: Claudia Harrington Septic Disposal-Residential $0.00 Owner Address: 9 STEPHANIE LN Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency IBS Septic 2 WARREN ST Glens Falls,NY 12801 Plans&Specifications Residential Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,June 20,2018 (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 n Wuesd u 2 17 SIGNED BY: (-iVjk('/ for the Town of Queensbury. Director of Building&Code Enforcement SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only n +2sQ rr,•n orTrens un. 742 Bay Road,Queensbury,NY 12804 Permit#: c t" ' J✓lJ 7Z P:518-761-8256 www.gueensburv.net �r Tax Map ID#: ��• b'1 ^� Permit Fee: $ 4Q ; Invoice#: l Project LocationSeptic Variance? Yes ✓ No Primary Owner(s) ` ;n Mailing Address Phone & Email Installer/Builder S Mailing Address Lo W r ` L Phone & Email – I Engineer Mailing Address TOWN OF QUEENSBURY Phone & Email J S Contact Person for Building&Code Compliance: Phone: RESIDENCE INFORMATION: Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage GrinderYes N 1980 or older Installed? (circle on Spa or Hot Tub Yes o 1981-1991 Installed? (circle one) 1992-Present PARCEL INFORMATION: TopographyAhatdepth? ing _Steep Slope _%Slope Soil Nature _Loam _Clay _Other Groundwater Bedrock/Impervious material Domestic Water Supply _ _ ell, water supply from any septic system absorption is Percolation Test Rate: per minute per inch (test to be completed by licensed engineer/architect) m R NEW CONSTRUCTION: gallons(min.size 1,000 gallons,add 250 gallons for each garbage cylinder or spa/hot tub ion field with#2 stone Total length ft.; Each Trench ft. Pit with#3 stone How many: ; Size: ive System Bed or other type: 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. I - PRINT NAME: � k ` hi� V, C �I DATE: \(%SIGNATURE: DATE: _ Town of Queensbury Building&Code Enforcement Revised February 2017 ■■■■■■■■■■■■■..0■■■■■■OMEN■■■n■■ ■ ■■■■■ .� ■�...■■■ ..CC.■■►�r��. ■1 �.■■�i ■ on .■ ; . ,. , ' ■■■■.■ ONE■.■ sLlmir■I�.■ ■■ on ■■■ ■ ■ =IM .■■■■■. ■■■�■�■ ■ ■ 0 ■ ■ ■Nommom■■ .�■■■■■■■■ ■■■■■■ ■■.�■■■■ ■ ■ ■ ■■w ■■■■■ ■■■.■■■ ■■ ■ ■�.■ ■ ■■■ In ■■■■■mma111.■.. .. m .■■�■ ..■■ .1. ■ .■■ .!I■l�■■■■ lit■■■■■■■■�r��■■.■■ W ■ ■ ■ .■■■■■ifl■■■ !' ■■■■■■■■■■■ ii■■.� _ ■ ■■ ■ ■■ ■■■��/II�J ■Imirlommommomm■■■■\■.■■ ' ■■ ■ ■■ 3� 71f■tt■■■ii■■■■■■iii■ ■■� ■■ ■■■ ■ . _ �.lam • Q It !lM ■■N . .■moi0 NMIII ■■■ 1'1 ■i�.�i�:F; m,�. L�"jm �lMEN _ ■■■ ■ ■.�■■ III��F■F. �■j■■ki �� ■�■ ■ii ■�j r■ ■ ■ ■■■ ..W:■■ ■■w ■■. ■. .. ■■■.!�■■■■ �,10 ■ No �:!■■■i�j;■!■.!� ■■ ■■■ .. 111 ■■ice■�■ ■:■■ . ■■■ I M1� 01 IN■■ ■. .. ■�■w■o.m■■■�■■�i■ ■■■ 1111111111111 Now�■■i■■■i NNE ii■■■i.■f■■.III ■■■ MINN ' ■■■■■■■.■■■■■■■■■ ■.I■fbl■■W f■.■■ , ' • : ■■■ a■i_ mmmmo _■■ .■ ■■ ■ i■�iINN I.■■ ■ ■■■ a-un■L�._07-11 n■■■■■■■I■■tl■■ ■ . .IONE In ■■■ IEEE IS III Sm MEE No ■ ■Nr ■ ! ; ■■■■ i■ ■ ■■■ ■■■ ■■■■� 9'E9ommomm■mmoom ■MIMME:9999:99'9999' '■'■:::: 99 .qM moEC:C':EMOONS :::CC9CC:C'1 CC:�■9E■: ■f f1 �M■■ .l■.. ■■m■o■ . ... IN NI■ -.. MIN■.�..:. .9IN 0 . �99 ! ■■ on 09 . ► .■. . IN :r IN IN 9999■C IN no ■ . ■■C C9■C9■CC�:■ ■ El. ■sAl■JN:■■:��1■ .■■.. ■■moss■■. ■::■ 9:::ri:CC:CC■ Ci: : ■' :9C' ■■■■■■■■vM-1 MOON C9 ■ E l� = ■■ MOON■■■■ ■■1t■■ ■ PE ■. m.:■ E■ : HE ■..... .■ ■ C. ■ ■■CME E. ..9 ■ ■ ■i ■i■ '1■■ oss ■ C■. .C.: 90 . 9■■ : 9C.: 9'C.. C . . ■■ ■ .. ME . ... .. :■■■9 . 9■ .::■.: : ::: ■■ :.. .■.[J ■ 9MEN 9 IN IN . ■ ■��!�■ r� ■o ■.:C ■ 9 ■■m■ N9 C ■N■■CNN MIN ■ :■ ::999::::::C:9::n:::.9C:::0 SEEN Ea:.a9CC: ': ::loons :::: : 9:::99 9999: :: ININ jimmm■■■■ 9.■■■ ■ ■O■.■ ■■n■�■ ■E ■.■99■ N■■ ■■ ■ !1� I[' ��I: 99 . I a :a: - . 110111 99..C. 9a ■ . C9�. : No CC:C:.C:: . . .■ . . ■ M■■■■■■■. . .�. .. . .... . ■ ■.■ .. .9.9...99;.■ :9��!911i�i minim MEMO 99.99■C■a ■■:N N■ 9999■ ■■ ■.■■ so ONE MO�7�sI1.7��■■■■■■■■■■■■ ■■■■■■■■■ ■■■■■ ■■■■■■;■■■MO #w,eve u WE MEN MEN::CNCWs ONEEMSEMENEECii i :C�' '■ 119, 011111101 E■C9�9:'9"MMM: .;��..� ;.;;;;;;;;;;;..;.;;;;;;;;;;;;;;;;;;N Roo;;;;;N