SEP-000759-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: SEP-000759-2016 Date Issued: Monday,November 7, 2016
This is to certify that work requested to be done as shown by Permit Number SEP-000759-2016
has been completed.
Tax Map Number: 289.8-1-18
Location: 63 YORKSHIRE DR
Owner: John Taibe,Jr.
Applicant: IBS Septic
This structure may be occupied as a: Residential Septic Alteration
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the n �J
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
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: SEP-000759-2016
Tax Map No: 289.8-1-18
Permission is hereby granted to: IBS Septic
For property located at: 63 YORKSHIRE DR
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
True of Construction
Owner Name: John Taibe,Jr. Septic Disposal-Residential $0.00
Owner Address: 63 Yorkshire DR Total Value $0.00
Queensbury,NY 12804
Contractor or Buildet's Name/Address Electrical Inspection Agency
IBS Septic
2 WARREN ST
Glens Falls,NY 12801
Plans&Specifications
Residential Septic Alteration
540.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,November 3,2017
(If a longer period is required,an application for an extension most be made to the code Enforcement Officer
of the Town of Queensbury before the expiration
date.)
Dated at the Town of ueensb •j
//I'hu er 3,2016
SIGNED BY: /VJ for the Town of Queensbury.
Director of Building&Code Enforcement
V .k
i" biJd j i LJ 16 l n^ 1
�EP ���• ! Y Revised 4/14/2010
OFFICE USE ONLY T Vh (� rt :VS't;'tiflY D �/
TAX MAP NO. IT FEE l ,
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERM'
uu
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS BIREVIEWQ&WE
ISSUANCEOF A VALID PERMIT. ` 5 BUI: '.FS
OWNER: �/ �/��/1 • INSTALLER:
ADDRESS: �3 /Or r ADDRESS: `LOW C 1�Gr� f� rV r�lA ref
PHONE NOS. 'J I 51 - PHONE NOS. I M— � l
LOCATION OF INSTALLATION:
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS Gallons per bedroom) GARBAGEGRINDER
1980 or older X 150 = INSTALLED?
1981-1991 X 130 = SPA OR HOT TUB
1992-present X 110 = INSTALLED?
7FORMATION: `f
OPOGRAPHY: FLAT ROLLI STEEP
�rtS`rLO1y1PPEIV %SLOPkL
t0 R G OIL NATURE: SAND LOAM V`/ 1 1 CLAY OTHER
9 N 8�GROUNDWATER: ATWHATDEPTH? �—
C d 05 EDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH?
O OMESTICWATERSUPLY: MUNICIPAL_ WELL (If well:water supply from any septic system absorption is:
Z RCOIATION TEST: RATE IS �I PER MINUTE PER INCH[mpi)
Ip (Test to be completed by a licensed professional engineer or architect)
rev-^9120POSE SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a ricensed professional engineer
�— architect unless installed in a Planning Board approved subdivision).
TANK SIZE: �� GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for
each garbage grinder,spa or whirlpool tub.
SYSTEM] E:
1g'ABSORPTION FIELD(WITH NO.2 STONE) Total length V13ft. Each trench X _
❑SEEPAQE PIT(S)(WITH NO.3 STONE) How many? Size? _
❑ALTERNATIVE SYSTEM Bed or other type?
❑HOLDING TANK SYSTEM Total required capacity? Tank size? Numberof tanks?
YE
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
For your protection,please note that pursuant to Section 136-29 of the Code of the Town of Queensbury,any permit or approval
granted which is based upon or is granted in reliance 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 these and all requirements of the Town of Queensbury QUESTIONS? CALL 761.6256 OR EMAIL
Sa�al Ordinance. codesCa2gueensburv.net
.VISIT OUR WEBSITE FOR MORE INFORMATION
Signa t erson Responsible Date www.gueensburV.net
Town of Queensbury` Community Development Office`742 Bay Road, Queensbury NY 12804
I OD f 5 epM44\
a ; r� r .
pECE0VE
NOV 01 2016
D
TOWN OF QUEENSBURY FF=LE OPY
BUILDING 3 CODES
.I
289.8-1-18 SEP-000759-2016
Taibe, John
63 Yorkshire Drive q..a
Residential Septic Alteration `
" .
� dq�
TOWN OF QUE
14- BUILDING & C D E
Reviewed By:
[ Date:
— <-� ez —
f
SEPTIC PLOT PLAN
I HAVE SEEN OR OBSERVED ALL OBJECTS -
SUCH AS HOUSES, WELLS, TREES, FENCES, ETC
SHOWN OWTIJ SDOCUMENT.I HAVE PERSONALLY (l r
I t SUr,ED1fi ITSI'ANCE SET FORTH ON THyS DIAGRAM.
ci��AT49�E DATE