SEP-0788-2018
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-0788-2018Date Issued: Thursday, January 3, 2019
This is to certify that work requested to be done as shown by Permit Number
SEP-0788-2018
has been completed.
240.6-1-30
Tax Map Number:
4 HANNEFORD RD
Location:
GARNER PROPERTIES LLC
Owner:
IBS Septic
Applicant:
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
' i'. '
,,. . ,- 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: SEP-0788-2018
Tax Map No: 240.6-1-30
Permission is hereby granted to: GARNER PROPERTIES LLC
For property located at: 4 HANNEFORD 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: GARNER PROPERTIES LLC Septic Disposal-Residential $0.00
Owner Address: PO Box 341769 Total Value $0.00
Tampa,FL 33694
Contractor or Builder's Name/Address Electrical Inspection Agency
IBS Septic
2 WARREN ST
Glens Falls,NY 12801
Plans&Specifications
Residential Septic Alteration
$ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday,December 17,2019
(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 o uee , /�vlo .,.,, r -. ,er 17,2018
1.
SIGNED BY: 1r \ for the Town of Queensbury.
Director of Building&Code Enforcement
v- :" Community Development Office DEC 12 201$ J
a
- ,• Town of Queensbury • 742 Bay Road • Queensbury, New York •7 z-
OF QUEI':NSBURY
-,-VET OPMMENT
Office Use Only
TAX MAP NO. '40: CI 1 `50 PERMIT NO. PERMIT FEE
5 77
APPROVALS: ZONING TOWN CLERK 1j1/g
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MliST BE OBTAINED
BEFORE W RK pEGI S. APPLICATION IS SUBJECT TO REVIEW LEF RE ISSUANC OF A VALID PERMIT.
OWNER: I If V INSTALLER: S S e � , _
,.._ ,
ADDRESS: . /' Vr ADDRESS: 0 e( (At I^(SAD -I -.-I -.r
PHONE NOS. .3 `- r9 PHONE NOS.
LOCATION OF INSTALLATION: 1" t 0 ifv^P I ord kqd "
e\L) - v--` _ RESIDENCE INFORMATION:
��� NO.OF COMPUTATION
�i% YEAR BUILT , X TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) ! GARBAGE G IN ER
\� u 1980 or older X 150 = O) INSTALLED?\
1981 -1991 X 130 = SPA OR HOT T
1992-present X 110 = I INSTALLED?
PARCEL INFORMATION:
/ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE
/ SOIL NATURE: SAND LOAM CLAY OTHER h
✓ GROUNDWATER: AT WHAT DEPTH? �n r�l`�"O 01 1 (N)
/ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? t 0( r l
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL 1 (If well:water supply from any septic system absorption is:
✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mph] (Test to be completed by a licensed professional
engineer or architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All it cividual sewage disposal systems must be designed by a licensed professional engineer or
architect(unless installed in a r lanninpfl8oard approved subdivision).
I, ),"()° e—rCArN TANK SIZE: ;,),- GALLON (MIN. 5I7 IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,
spa or whirlpool tub.
SYSTEM TYPE:
❑ABSORPTION FIELD (WITH NO. 2 STONE) Total length (� htifd6ii trench X
O SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Size?
❑ALTERNATIVE SYSTEM Bed or other type?
❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks?
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL
INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval
granted which is based,upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or
circumstance known by or on behalf of an applicant, shall be void.
I have rea regulation with respect to this application and agree to
abide b an all re it ments of the Town of Queensbu QUESTIONS? CALL 761-8256 OR EMAIL
ani 7syrdinance.
41 codes(aqueensburv.net
Signa r ofnnsible ate y VISIT OUR WEBSITE FOR MORE INFORMATION
www.pueensbury.net
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