SEP-000416-2017 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-000416-2017 Date Issued: Thursday, July 20,2017
This is to certify that work requested to be done as shown by Permit Number SEP-000416-2017
has been completed.
Tax Map Number: 266.3-I-11
Location: 977 State Rte 149
Owner: Stewarts Shops Corp.
Applicant: Stewarts Shops Corp.
This structure may be occupied as a: Commercial Septic Alteration(temporary
system) By Order of Town Board
Stewarts Shops Corp. TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
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-000416-2017
Tax Map No: 266.3-1.11
Permission is hereby granted to: Stewart's Shops Corp.
For property located at: 977 State Rte 149
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: Stewarts Shops Corp. Septic Disposal-Commercial $0.00
Owner Address: PO Box 435 Total Value $0.00
Saratoga Springs,NY 12866
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Commercial Septic Alt.
Stewarts Shops Corp.
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,July 13,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town ofensb { / �hu94710'r
17
SIGNED BY: uethe Town of Queensbury.
Director of Building&Code Enforcement
Er
r=
SEPTIC DISPOSAL P I PPLICATION office Use Only
GL 742 Bay Road,Queensbu 2ao�L )
T..fQyr.,bur p:518-761-8256 www. .net 2 2011 Ipermit#:
Tax Map ID M 266.03-1-11 TOWN OF 4 Permit Fee:$Z ,0D Invoice#: a U3
L�OYILDING& rpr„-JR
Project Location: 977 State Route 149 ”' _Septic variance? Yes No
Primary Owner(s) Stewart's Shops Corp.
Mailing Address PO Box 435 Saratoga Springs, NY 12866
Phone & Email 518-301-1466 c otter stewartssho s.com
Installer/Builder Same
Mailing Address
Phone & Email
Engineer Lawrence H. Rutland
Mailing Address PO Box 171 Middle Grove NY
Phone& Email 518-584-8284 Ihr e n ca .rr.com
Contact Person for Building&Code Compliance: Chris Potter Phone: 518-301-1466
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
Installed? (circle one)
1992-Present
PARCEL INFORMATION:
Topography X Flat Rolling _Steep Slope 2 %Slope
Soil Nature X Sand _Loam Clay _Other
Groundwater At what depth? None found down to 112"
Bedrock/Impervious material At what depth? None found down to 112"
Domestic Water supply _Municipal X Well(if well,water supply from any septic system absorption is 112ft.)
Percolation Test Rate: 5 per minute per inch (test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION:
Tank size 1000 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:.2 -Size: 'dl 4' high
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 orfailure 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: ChrisPotterDATE: 7/11/17
SIGNATURE: z/24 A�— DATE: 7/11/17
Town of Queensbury Building&[ode Enforcement Revised February 2017
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5TORE NAME,ABBREVIATION 4 NO.
SURVEY NOTES: \
OUEEN5BURY OUEE 2a2
1. DEED REFERENCE: MADELiNE DREISGOLL TO STEWART'5 ICE CREAM COMPANY, INC.,DATED JUNE 16, --
I ;'' SITE LOCATION
IgBq AND FILED IN THE WARREN COUNTY CLERK'S OFFIGE.IN LIBER 758 OF DEEDNY 12e>45
S AT PAGE 225.
1 I
A PARED WITHOUT THE BENEFIT OF AN UP-TO-DATE ABSTRACT OF TITLE, AND 15 !
� " r • ��� ROUTE Iia - LAKE
2. THI5 5URVEY W 5 PRE
THEREFORE SUBJECT TO ANY AND ALL GOVENANT5,EA5EMENT5, RESTRICTIONS AND RIGHT5-OF-WAY �� #js.� •r. + +
_. -.�`" � DATE NO. REV151ON5 , DRAWN BY: GP
OF RECORD AS WELL A5 ANY OTHER FACTS WHICH SAID ABSTRACT WOULD DISCLOSE. ® '> sy 1/I2/I-1 1 DRYWELL LOCATIONS t8
SCALE: "
f. 8U1 = 20
3. BOUND5 OF N.Y,5. ROUTE 14q ARE SHOWN A5 E5TABLISHED BY N.Y.S.D.O.T.APPROPRIATION IN 2001 5 y
ISI ® �✓•!,•�s �C3-.4—".4 3 s�A _
i ® { ;' � t� � ,v� _a �, DATE:
AND DEPICTED ON MAP NO. 123, PARCEL NO. 150 FOR THE HARRI5GENA-FORT ANN STAT(: HIGHWAY r' w
g35q,DATED JULY 23,2001 AND FILED IN THE WARREN COUNTY GLERK'5 OFFICE ON APRIL 2q,2008 I 1 DRAWING NO. a
IN VOLUME 3538 AT PAGE qb. BOUND5 OF N.Y.5. ROUTE gL HAVE BEEN 5URVEYED TO CONFORM TO {
EXI5TING MONUMENTATION.
SARATOGA SPRIN05, NY 12866 5"'(
18)581-120cl
4. ELEVATIONS SHOWN HEREON CONFORM TO NGVD Ig2q A5 DETERMINED FROM SURVEY CONTROL DATA e FAX 5 +
' TEL. (518 581-1200 FA
OBTAINED FROM THE NEW YORK 5TATE DEPARTMENT OF TRANSPORTATION. i I ALTERATIONS TO THI5 DOCUMENT BY OTHER THAN AN TITLE:
I AUTHORIZED DNNEILLEOAL
T MP® Y SEPTIC SYS /
AND AVIOLATION OFTHE EWYORK 5TATEDUCATIONLAW