BOTH-000306-2016 TOWN OF QUEENSBURY
OL 742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000306-2016 Date Issued: Friday, May 20, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000306-2016
has been completed.
Tax Map Number: 309.10-2-39
Location: 2 GARNER ST
Owner: JAMES FISHER
Applicant: IBS Septic
This structure may be occupied as a: Residential Septic Alteration
By Order of Town Board
TOWN OF QUEENSSBBURY
Issuance of this Certificate of Compliance DOES NOT relieve the � I (/ 4 AJ
property owner of the responsibility for compliance with Site Plan, GGG����
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 QUEEN BURY
742 Bay Road, Queensbury, NY 12804-5904 (518)761-8201
Community Development - Building & Cedes (518) 761-8256
IF
BUILDING PERMIT
Permit Number: BOTH-000306-2016
Tax Map No: 309,10-2-39
Permission is hereby granted to: IBS Septic
For property located at: 2 GARNER ST
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other inforrrration hereto fled and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: JAMES f 1S1-IER Septic Disposal $0.00
Owner Address: 2 Garner TER 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 IF E PAID -THIS PERMIT EXPIRES: Sunday, May 14, 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 expiration date.)
Dated at the Town of Iaury, Wh:i y, ay 19, 2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL
PERMIT Office Use QUI
CRATE �_l
Received
Tax Map ID
7AXIVIApIre p ..
Permit Rio.
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LOCATION OF WTA1 LA CION
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Approvals:
St.
APPOON PHONE.✓ E�-mAtL.
ADDRESS
INSTALLERIBuiLt7ER: PHONE/E-MAIL
ADDRESS: Vf
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_:�lOWN ER ' PHONE/P-mAIL P
Address I^
ONTACT PERS' N MjULaDINQ&(20DES COMPLIANCE.- PHONE
RESIDENCE INFORMATION
Year Built #of bedrooms X Gallons per bedroom Total Daily Flow
1984 or older 3 Garbage grinder Installed Y
1981-1991 Spa or helot Tub installed _Y
1992-Present IV
PARCEL INFORMATION' `
Topography — lat rolling Steep slope %slope
Soil Nature Sand Loam Clay Gs:"Z Otho 2016
6 k
Groundwater At what depth"
Bedrock/Impervious Material At wh "t depth? ° ; ` 4
Domestic Water Supply Municipal N4 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 engineering/architect)
P P EI? Y EMF R N w NST CTI N
Tank Size gallons(minimum size 1,000 gallons, add 250 gallons to size for each garbage grinder or spa or hot tub)
System Type Absorption field with##2 stone Total length ft.; Each trench x
Seepage Put with#8 stone How many: ;size
Alternative System Bed or other type?
Molding 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.
QECLARATION: 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 know by or on behalf of an applicant, shall be void. I have read the regulations
and agree to abide theses nd r uirements of the Town of Queensbury Sanitary Sewage Disp sal w:ir mance.
Print Dame: Date:
Signature: DIV Date:
Town of Queensbury Building&Code Septic Disposal Permit July 2014
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