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