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2001-513 v,0 TOWN OF QUEENSBURY 742 eensb NY 12804-5902 518 7 2 Bay Road,Queensbury, ( ) 61 8 Ol Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number. P20010513 Date Issued: Wednesday, January 10, 2007 This is to certify that work requested to be done as shown by Permit Number P20010513 has been completed. Tax Map Number. 523400-266-003-0001-011-000-0000 Location: 977 STATE ROUTE 149 Owner. STEWARTS ICE CREAM CO INC Applicant: STEWARTS ICE CREAM CO INC This structure may be occupied as a: Septic Alteration Commercial 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 s 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 f�� Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010513 Application Number: A20010513 Tax Map No: 523400-266-003-0001-011-000-0000 Permission is hereby granted to: STEWARTS ICE CREAM CO INC For property located at: 3258 STATE ROUTE 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 Value Owner Address: STEWARTS ICE CREAM CO INC Septic Alteration Commercial PO BOX 435 SARTOGA SPRINGS,NY 12866 Total Value Contractor or Builder's Name/ Address Electrical Inspection Agency GALUSHA& SONS PO BOX 4787 OUEENSBURY,NY 12804 Plans &Specifications 2001-513 SEPTIC ALTERTION AS PER PLOT PLAN SPECIFICATIONS $35.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday,July 17,2002 (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 th ow yfQutY, T;f•s t•,_. ,July 17,2001 SIGNED BY \ for the Town of Queensbury. Director of Building&Code Enforcement Application-for Permit—Septic Disposal System • Town of Queensburyy 742 Bay Road Queensbury, NY 12804 (518) 761-8256 1. OWNER INFORMATION: - S%£ -v% 3- rikol' d 2-S Z - Location of installation: /y f• a 2,�iL• Office Use Tax Map No. / / • File Permit No.�00 l J 5' Owner's Name: �� t (,o 06 Fee Paid �� . Address: • f'n c 1 t;}C €Ps J ,NG7ci,*-1-c•,. c1,' , A1 7- . 2. • INSTALLER'S NAME : P4-r (yr- us f 4- •.PHONE NO. 5 i 8 -3 6 3. RESIDENCE INFORMATION': .(circle year of dwelling, indicate #bedroom(s)and multiply 1/ of • bedrooms with applicable gallons per bedroom to equal total daily flow) . Year of House: No. of Bedrooms x Computation = ' Total Daily FIEREC I V 1980 or older x 150 gaVbdrm. = JUL i i 2001 • 1980— 1991 x 130 gal/bdrm = 1991 —present x 110 gal/bdrm _ TOWN OF nt;E_N58URY BUILDING AND CODE Garbage Grinder Installed yes /-no Spa or Whirlpool Installed yes / no 4. PARCEL INFORMATION: (circle applicable information &indicate measurements) • Topog {• . •illitttljx9 Q.LQ W und ater. _1.951.(94.9,ihnimixisUS_Motorial__Pomgslic Wator.Supply Notr sane al what depth at whirl depth' nnclalclpnl Rolling Iva/0 5.0 feet feet well Steep slope c ay • —o?%slope other L""'k"""°`"" if� well; water supply from any septic-system• depth:5 6 . absorption is f7. other Percolation Test:, (To be completed by licensed professional engineer or architect t� Rate: /5-17 minute per inch J ' !'pro '� Ink( l 1 i`s '.,. 6,3, o-sly 5, PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by it licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 25(1 gallons to the size of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub. Septic Tank: /000• gallon (min. size 1,000 gal) l?-) a 7 oay S f -- Tile Field: each trench C00• f. Total System Length: 31, 0 fl. Seepage Pit(s): number of , ti size of each: II. by ft. Size of Stone to be used: 11 Wit' / • / depth or thickness _________feel Bed System Size: x ' Alternative System: '. length and/or size .- 6.' • HOLDING TANK SYSTEM: (if required) Number of tanks: . / Size of each: gallons /TOTAL Capacity: gallons . . Note: Alarm System and associated electrical work must be inspected by a Town approved • electrical inspection agency. 7. .SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queonsbury, any permit or approval:granted which is based upon or is granted in roliance.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 read the regulations with respect to this application and-agree to abide by those and all requirements of • : Town of Queensbury Sanitary Sewage Disposal Ordinance. N,o9 A i i, • .. //- 0/ . ' Signature.' responsible person . Date 1-1 zro • Septic Inspection Report Office No. (518) 761-8256 Date In pectioj - : Queensbury Building &Code Enforcement Arrive: • - _ ��, D-part: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initia NAME: - P:FIT IT NO.: 2. Co1 57 3 LOCATION: I RECHECK: Comments and/or diagram Soil Type: Sand / Loam/ Clay Type of Water: Municipal/ Well Water �j /0?-__.Waterline separation distance ._. __. .. ft. Well separation distance ft. Other wells: _ _ ft. Absorption Field: Total length ft. Length of each trench ft. w Depth of trenches ft. Size of Stone . Seepage Pits: Number Size: J/ x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit ' Opening Sealed: Y/ N/ Partial End Cap Inlet/Outlet Pipes &Baffles T Y—N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan _-__Y N 1------- �"" Engineer Report and As-Built Y—N L . O V � ��J 7JL "\ Location of System on Property: �� Front Rear Left Side Right ,�J� Middle Fro t Middle :-.r S stem Us-A ' Mr' 'pproved 11Nr,F. Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 021006 Last revised 1/6/05 J.1,190V) TOWN OF QUEENSBURY BUILDING. & CODE ENFORCEMENT.. _i 742 Bay Road Queensbury NY 12804 (518) 761-8256 elek SEPTIC DISPOSAL SYSTEM INSPECTION '91(. Name CA Location 3aSE - Date `, A permit # O / ~O5L3 SOIL TYPE: Sand Loam-Clay- Results of 'ercolation Test- (if applic:b -) Rate--Minute/Inch TYPE OF S ST ' : ABSORPTII FI D: Total Leng.ph Length of rach trench t .. nz, ± Depth of t enc es Size of sto e SEEPAGE PIT, : Number- Size - ft. x ft. Stone size PIP G: Size Type Bldg. to Tan, Tank to Dist Box ' ' 0 Dist. Box to Field/Pi k • N Openings Seal -d? sip No Partia LOCATION/SEPA' 'TION • Foundation to Tank feet • Foundation to Absorption . feet . . Separation of its f Conforms as pe.. Plot Plan Yes No LOCATION OF SYSTEM ON PROP Y: (circle one) • N„�. Front - Rear - Left Side - Right Side Middle F It - Middle Rear COMMENT � «j2 ,02/h/121 Gt� (✓� env46ti(7, n i� ��y /,�sr�c — c'K 11® Dt -) vokktr P6pf/1 SYSTEM.USE APPROVED: YES (10-Pt ) Arrived: 6 Departed: ---t , . . Building Inspector TOWN OF QUEENSBURY BUILDING &_CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804j'(, (518) 761-8256 A!L d1-- SEPTIC DISPOSAL SYSTEM INSPECTION Name6i„sLf., �2 Jcr LoC`a4 n -4-lcRix_ Date 3 d) Permit # cam/-,3 SOIL T PE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) R. Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: • 'al Length Length of each tre Depth of trenches Size of stone 11 SEEPAGE PITS: Numb-- Size - ft. ft. Stone size PIPING: liewA _ Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Field/Pit Openings Sealed? Yes No Partial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption-- ' feet Separation of Pits fee ---Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: 5064A,C I A -► 01Lr R13 ) AMC- 4Pbedk- • Con/ lfrGT -C=S/it/ 614-• � �0 4 .9 ,-nA-(Ai L62-r1-(/( f I Cal' SYSTEM USE APPROVED: YES NO Arrived:, Departed: Building Inspector STATE OF NEW YORK II III DEPARTMENT OF HEALTH Glens Falls District Office 77 Mohican Street,Glens Falls NY 12801 (518)793-3893 Fax(518)793-0427 Antonia C.Novello, M.D., M.P.H., Dr.P.H. Dennis P.Whalen Commissioner Executive Deputy Commissioner July 3, 2001 Ms. Toni Collins Stewart's Ice Cream Co., Inc. • P.O. Box 435 Saratoga Springs,New York 12866 RE: Stewart's Store No. 282 Queensbury(T), Warren County Dear Ms. Collins: I have had the opportunity to review the material you sent me regarding the improvements to the septic system serving.Stewart's Store No. 282 in Queensbury. Based on the setback distances from the store's well to the proposed locations of the septic system's components,the Department of Health does not have reservations about the improvements to the septic system. As we discussed on the phone, the Department of Health requires a minimum setback distance of 100 feet from a well to a leach field. Store No. 282 will have a 200-foot setback distance from its well to its leach field once the improvements are made. If you have any questions regarding this matter, please call me at (518) 793-3893. Sincerely, Karen S. Sklenar, PhD. Research Scientist cc: A. Bugenhagen,Dept. of Ag. &Markets J. Bierce, Dept. of Ag. &Markets DTHadder Town ofQueensbury- K. Sayers A. Gabalski