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TOWN OF QUEENSBURY
0 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000153-2016
Tax Map No: 309.9-1-7
Permission is hereby granted to: IBS Septic
For property located at: 39 CONNECTICUT AVE
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: ANNA LEFEBVRE Septic Disposal $0.00
Owner Address: 39 Connecticut AVE Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
IBS Septic
2 WARREN ST
Glens Falls,NY 12801
Plans&Specifications
Residential Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,March 18,2017
(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 ex . ati on da
Dated at the Town*�,2b ) kekrch 23,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL APPLICATION Office Use Only
Received
DATE: Tax Map ID
TAX MAP ID: � 9" 1-�' Permit No. 6TH-0Do.153• �a b
Permit Fee '11D vwo nc, 40�
ZONE:
APPLICANT r �� PHONE/E-MAIL
ADDRESS
INSTALLER/ ---� f )` ` PHONE/E-MAIL /fG L16
B
UILDER /l( Q G U f
OWNER
ADDRESS we 1/'(f C' C'A V
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE:
PHONE/E-MAIL
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older Garbage grinder installed —Yes kNo
1981-1991 Spa or Hot Tub installed Yes No
1992-Present
PARCEL INFORMATION
Topography lat rolling Steep slope %Slope
Soil Nature Sand Loam Clay Other
Groundwater At what depth:
Bedrock/Impervious material At w t-depth:
Domestic Water Supply Municipal Well(if well,water supply from any septic system absorption is_ft.)
Percolation Test Rate: per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size ( gallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total length ft.;Each Trench
Seepage Pit with#3 stone How many: Pize
Alternative System Bed or other type:
Holding Tank System 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&approved. The installed system must match the
septic system 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 Quee bury Sanitary Sewage Disposal Ordinance.
PRINT NAME: V\-k-/ DATE:-
SIGNATURE:
ATE:SIGNATURE: DATE:
Town of Queensbury Building&Codes Principal Structure Application Revised eptember 2014
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73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
March 18, 2016
Project# 224
Ivan Bell
IBS Septic
Queensbury,NY 12804
Re: Proposed Replacement Septic
39 Connecticut Avenue, Queensbury,NY
Dear Ivan:
At your request we have reviewed your proposed replacement septic system design of the
existing 3 bedroom house at 39 Connecticut Avenue, in Queensbury. As per our conversation the
residence has an existing failed septic system.
We have reviewed the proposed replacement septic system design and we agree that a standard
absorption bed is acceptable. Based upon a design flow rate of 330 GPD and a percolation rate of
1 to 5 minutes, you will need a minimum of 367 sf of absorption area. We recommend using 15
ft wide by 30 ft long absorption bed with 3 - 25 ft long laterals. The absorption system can be
constructed with the existing 1,000 gallon septic tank, new distribution box, and 4 inch diameter
perforated pipe and stone.
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.
2016