2008-046 TOWN OF QUE EN SB URY
FoN742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20080046 Date Issued: Tuesday, December 09, 2008
This is to certify that work requested to be done as shown by Permit Number P20080046
has been completed.
Tax Map Number: 523400-303-016-0001-008-000-0000
Location: 437 DIX Ave
Owner: WILLIAM BARRETT
Applicant: WILLIAM BARRETT
This structure may be occupied as a:
Test Pit/ Perc Test Review
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
owner of the responsibility for compliance with Site Plan,
property p tY p
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 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080046 Application Number. A20080046
Tax Map No: 523400-303-016-0001-008-000-0000
Permission is hereby granted to: WILLIAM BARRETT
For property located at: 437 DIX Ave
in the Town of Queens bury,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 Value
Owner Address: WILLIAM BARRETT
PO BOX 142 Test Pit/Perc Test Review
GLENS FALLS, NY 12801-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2008-046
deep hole/perc test
$200.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday, December 09, 2009
(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 T of ee /` / 3 December 09, 2008
SIGNED BY ✓ \ for the Town of Queensbury.
Director of Building&Code Enforcement
° —04
D (� L . TINNY etsbury • Building&Codes Enforcement Office•742 Bay Road■ Queensbury,NY 12804
L,1-, �Vj 1J DEEP HOLE/PERC TEST
FEB 0 8 2008 Request for Town Engineer Review
TOWN OF QUEENSBU�RY" , ` /� '] 1
P dritEca .sic = s '3, 7,re Tj Phone: f / - 7 2-3
Property Owner's Address: `f- 3 '7 ,0,."/ i?ve �a p
Location of Test: 5,m.e ff 54-care.5 5 Tax ID#: 3 v 3 r /6--/
'Applicant's Engineer: A/4 n) 5 Phone:
Applicant's Agent: / 0/41 (�'-1"1 'j f Phone: 7 6 —Z. S7 5
Additional Notes:
1. Reason for Request? New Septic System Replacement Septic System Failed Septic System
Subdivision Site Plan Review
2.Are Wetlands present? YES X NO UNKNOWN
*Note: Applicant is required to engage an engineer for design and testing of the system. The Town
Engineer's responsibility is to witness system testing only.
PLOT PLAN: Plot plan, to scale, to be submitted with application
FEE SCHEDULE:
a. $ 200 Flat Fee Date Paid: 2 g �a
Check No.: '��1�®
b. OR Fee to be determined during To Be Determined:
Site Plan / Subdivision review process
SIGNATURE:
In carrying out the provisions of Article IV, the Local Board of Health or the enforcement officer may
engage the services of a qualified professional consultant for expert review and recommendation arising
from the carrying out of the provisions of Art. IV, including but not limited to the review of plans,
specifications and reports, attendance at inspections, dye tests, deep hole test pits, septic related deep
hole and percolation tests, system installations, and any other aspect of any matter contained in this Art.
IV, and any costs incurred in such review shall be paid to the Town by the owner of the property before
any approval can be granted under this Art. IV shall become effective within 30 days of presentment of an
invoice for same, whichever is sooner. Such costs shall not exceed $1,500 without prior written notice to
the party to be charged with same.
My signature below indicates I have thoroughly read and understand the instructions, agree to the
submission requirements and have completed the application. I also fully understand that additional
engineering fees may be necessary per Town of Queensbury Local Law 136-14D.
SIGNATURE OF APPLICANT: Date: 2 2 "
SIGNATURE OF AGENT: Date: /�/
Original (B &C File) Canary (Planning) Pink (Applicant) Gold (Town Clerk)
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury, NY 12804
Phone- 518-745-4400 Fax -518-792-851 ciy_027,
January 16, 2008
Project # 49267
Dave Hatin
Code Enforcement Officer
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
Re: Barrett Property - 437 Dix Avenue— Out of Season Test Pit Request
Dear Dave:
We are currently working with Jim Barrett to design a new septic system for his property at 437 Dix
Avenue in the Town of Queensbury. (See map attached). As you can see on the map provided, the
property is located in an existing commercial area.
We would like to schedule this work as soon as possible so that we can complete our design, submit
to the Town of Queensbury Building Department for a Septic System Permit and start construction
as soon as possible.
Please feel free to contact me at 796-2515 if you have any questions and that you for your assistance
with this request.
Sincerely,
Thomas R. Center Jr, P.E.
Cc w/encl.: Dan Drellos