SEP-000436-2017 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-000436-2017 Date Issued: Wednesday, July 26, 2017
This is to certify that work requested to be done as shown by Permit Number SEP-000436-2017
has been completed.
Tax Map Number: 308.18-1-84
Location: 32 REVERE RD
Owner: Mary Kissane
Applicant: Bradley's Septic
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,
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
OL Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: SEP-000436-2017
Tax Map No: 308.18-1-84
Permission is hereby granted to: Bradley's Septic
For property located at: 32 REVERE 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 tiled and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: Mary Kissane Septic Disposal-Residential $0.00
Owner Address: 32 Revere RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Bradley's Septic
47 Hack RD
Corinth,NY 12822
Plans&Specifications
Residential Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 21,2018
(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 expirraa�tion date.)
Dated at the Town of eensb , ( / �id�&for
SIGNED BY: GI�'I("/ /d the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only
742 Bay Road,Queensbury,NY 12504 I
Gai,r nn,on.hup. _..--•----__.._... " S�-(a'JO N3/o-ul�
P:518-761-8256 wwLw. Iueensbu & Permit
Tax Map ID#: 7U� 11u1 D� Permit Fee': $ D Invoice#:
Project Location: 2 l� e �7' JUL 1 9 t7eptic Variance? Yes No
Primary Owner(s)
Mailing Address 32 UILDING €
Phone & Email
Installer/Builder
Mailing Address
Phone & Email C,
Engineer
Mailing Address
Phone & Email
Contact Person for Building&Code Compliance: Phone:
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 C_Fla olling _Steep Slope _%Slope
Soil Nature Sand _Loam _Clay _Other
Groundwater At what dept .
Bedrock/Impervious material At what depth?
Domestic Water Supply _Municipal _Well (if well,water supply from any septic system absorption is_ft.)
Percolation Test Rate: I n.l� per minute per inch (test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: 421ft- Is(01 S
Tank size j ' gallons(min. size 1,000 gallons,add 250 gallons for ea garbage cylinder or spa/hot tub
System Absorption field with#2 stone Total length I ft.; Each Trench ft.
Seepage Pit with#3 stone How many: ;Size:
Alternative System Bed or other type:
Holding Tank System I 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: 1 DATE: 7z—
SIGNATURE: DATE: 7- / ( - 1 7
Town of Queensbury Building&Code Enforcement Revised February 2017
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I HAVE SEEN OR OBSERVEDI ALL OBJECTS
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URED DI TANCE SET NiHIS DIAGRAM
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Quick4.
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INFILTRATOR WATER TECHNOLOGIES,LLC I"INFILTRATOR'1
Typical Trench View Infiltrator Water Technologies,LLC STANDARD LIMITED Dralfifleld WARRANTY
(a)The structural Integrity of each chamber,enticed,EZflow expanded polystyrene and/or other
accessory manufactured by Infiltrator T'Ll s'1,when Installed and operated In a leachfleld of
NATIVE BACKFILL TOPSOIL an onsite septic system In accordance with Infiltrator's Instructions,Is warrented to the original
purchaser)'Holder")against defective materiels and workmanship for one year from the date that
the septic permit is Issued for the septic system containing the Units;provided however,that N a
: septic permit is not required by applicable law,the warranty period will begin upon the dale that
COVER BY ��-.,{':y'..:..;�..:';'Ik Installation of the septic system commences.To exercibe its warranty rights.Hoer must notify
DESIGN P Y9 IY rg Holder
_ Infiltrator in writing at Its Corporate Headquarters in Old Saybrook,Connecticut within fifteen
(15)days of the alleged defect.InfiMator will supply replacement Units for Units determined by
12' % 12' Y G INVERT Infiltrator to be covered by this Limited Warranty.Infiltrator's liability specifically excludes the cast
C� ' removal LI and/or installation 01 the REMEDIES
22• SPACING PER COO 22• 'i THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH(a)ARE EXCLUSIVE.THERE
Px'w•;amwac ARE NO OTHER WARRANTIES WITH RESPECT TO THE UNITS,INCLUDING NO IMPLIED
WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE
(c)This Unni Warranty shell be void If any part of the chamber system Is manufactured by any-
one other than Infiltrator. The Limited Warranty time not extend to incidental,consequential,spe.
Quick4l EqualizerChamber r' i r tial or Indirect damages.Infiltrator shall not be liable for penalties or liquidated damages,Including
loss of production and prolas,labor and materiels,overhead costa,or other losses or expenses
Size 22"W x 53"L x 12"H Incurred by the Holder or any third pard. Specifically excluded from Limited Warranty coverage
(559 mm x 1346 mm x 305 mm) are damage to the Units due to ordinary wear and tear,alteration,accident.misuse,abuse or
neglect of the Units;the Units being subjected to vehicle traffic or other conditions which are not
Effective Length 48" (1219 mm) permlfted by the Installation Instructions;failure to maintain the minimum ground covers set forth
In the Installation Instructions;the placement of Improper materiels Into the system containing the
Louver Height 10" (254 mm) Unite;failure of the Units or the septic system due to Improper ailing or Improper string,excessive
water usage,improper grease disposal,or improper operation;or any other event not caused by
a Capacity
Stora 32 al 121 L Infiltrator. This Limited Warranty shall be void N the Holder fails to comply with all of the terms set
Storage g ( ) forth In this Limited Warranty.Further,in no event shall Infiltrator be responsible for any loss or
Invert Height 6" (152 mm) damage to the Holder,the Units,or any third party resulting from Installation or shipment,or from
any product liability claims of Holder or any third party.For this Limited Warranty to apply.the
Units must be Installed In accordance with all site conditions required by state and local codes;all
other applicable laws;and Infiltrator's installation Instructions.
4 Business Perk Road (d)No representative of Infiltrator has the authority to change or extend this Umited Warmly.No
P.O.Box 768 warranty applies to any party other than the original Holder.The above represents the Standard
Old Saybrook,CT 06475 Umited Warranty offered by Infiltrator. A limited number of states and counties have different war-
UO-577-7000
ar-
N F I LT R AT O R° 1-800-221-44361 880 57 7001 minty Old Saybrorements. Any ok,Connecticut,prior to suchhaser at lts should contact purWse to obtain all otor's Corporate py of the applicabledw�ty in
water technologies www.inRltratorwatercom and should carefully read Met warranty prior to the purchase of Units.
U.S.Parents:4,759.661;5.017,041;5,156,488;5,336,017;5,401,116;5,401.459:5.511,903;5.716,163;5,588,778;5,839,844 Canadian Patents:1,329.959;2,004564 Other patent pending.
Infiltretar,Equalizer.Quick4,and SltleWlnder are reglstereal trademarks of Infiltrator Water Technologies.Innitretor Is a registered trademark In France.Interwar Water Technobgles Is a registered trademark In
Mexico.Contour,MIcmUwhtrg,Poly'ruff,Chamber5pacer,MuNPort,PosiLock,Quli OukkPley Snapt.ock and Smaightt.ock are trademarks of Ini firetor Water Technologies.
PolyWk Is a trademark of Poli Inc.TOF-TRE o a registered trademark of TUF-TITE,INC.Uxra-Rib Is a trademark of IPEx Inc.
020161nfiltrathr Water Tedelologies,LLC.AN rights reserved.Pruned In Ui Opti 0816
Contact - •r Water Technologies' Technical Services Department for :11