SEP-000140-2017 x 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-000140-2017 Date Issued: Monday, April 10, 2017
This is to certify that work requested to be done as shown by Permit Number SEP-000140-2017
has been completed.
Tax Map Number: 301.12-1-45
Location: 25 HELEN DR
Owner: Neil Iverson
Applicant: IBS Septic
This structure may be occupied as a: Residential Septic Alterations
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
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
"r► Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: SEP-000140-2017
Tax Map No: 301.12-1-45
Permission is hereby granted to: IBS Septic
For property located at: 25 HELEN 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
Type of Construction
Owner Name: Neil Iverson Septic Disposal-Residential $0.00
Owner Address: 25 HELEN DR 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 Alterations
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,April 7,2018
(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 a ury; Fri a , ,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
vy\y Community Development Office
miry<�`
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804
Office Use Oniy
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TAX MAP NO. PERMIT NO. PERMIT FEE nw -sJ
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.
OWNER: V eo lo'-\ INSTALLER-Z5_ L
ADDRESS: n ADDRESS._ I ow Q(' \jyw Cn,
PHONE NOS. 3 PHONE NOS._ DTQ_p 1 1�•
LOCATION OF INSTALLATION:
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS Gallons per bedroom GARBAGE GRINQVR
1980 or older X 150 = INSTALLED?
1981 -1991 X 130 = SPA OR HOT
1992-present X 110 = INSTALLED?
PARCEL INFORMATION: E C E 0 p�� ^�
✓ TOPOGRAPHY: FLAT RO ING STEEP SLOPE %SLOPE D �j �YJ
✓ SOIL NATURE: SAND LOAM CLAY T Ef " 4 2011
✓ GROUNDWATER: AT WHAT DEPTH?
✓
BEDROCK/IMPERVIOUS MATERIAL: AT WH T DEPTH? IV TOWN OF QUEENSBURY
RI In niklf;R t^ DES
v' DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS_ PER MIINUTE PER INCH[mpi] (Test to be completed by a licensed professional
engineer or architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All it d=vidual sewage disposal systems must be designed by a licensed professional engineer or
architect(unless installed in a Planning Board approved subdivision).
TANK SIZEe-�A)Ttt 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 TYPE:
11AB ORPTION FIELD(WITH NO.2 STONE) Total lenit:
ft. Each trench X
❑ EPAGE PIT(S)(WITH NO.3 STONE) How many? Size?
ALTERNATIVE SYSTEM Bed or other type? 1
❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks?
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 be of an applicant,shall be void.
I have read the regulations ith respect to this application and agree to
abide by these a II r irements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sanita I Ordinance. , codesla.aueensburv.net
7
VISIT OUR WEBSITE FOR MORE INFORMATION
Sig a Pe o esponsible Date www.pueensburv.net
Pipeline Specialists JOB:
SHEET
301.12-1-45 SEP-000140-2017
PNO.: Iverson, Neil
4 CALCULATED 25 Helen Drive
Everett J. Prescott; Inc. BY: Residential Septic Alteration
SCALE:
SEPTIC PLOT PLAN
I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HOUSES, WELLS, TREES, FENCES, ETC U
D
SHOWN ON THIS DOCUMENT.I HAVE PERSONALLY
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D T E DI CE SET FORTH ON Ty1 DIA RAM.
`rt_ -I� APR 0 4 2017
S!.:
DATE
TOWN OF QUEENSBURY
BUILDING&CODES
FILE COPY
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TOWN OF QUE
BUILDING & C D
Reviewed By: _
Date:
s
CENTER PROJECT
SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
March 31, 2017
Project# 245
Ivan Bell
IBS Septic
Queensbury, NY 12804
Re: Proposed Replacement Septic
25 Helen Drive, Queensbury,NY
Dear Ivan:
At your request we have reviewed your proposed replacement septic system design of the
existing 4 bedroom house at 25 Helen Drive, 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 440 GPD and a percolation rate of
1 to 5 minutes, you will need a minimum of 489 sf of absorption area. We recommend using 15
ft wide by 35 ft long absorption bed with 3 - 30 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.
D
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