SEP-0329-2018 TOWN OF QUEENSBURY
742 Bay Road, QueensburY,NY 12804-5904 (518)761-8201
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Community Development - Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: SEP-0329-2018 Date Issued: Thursday, June 14, 2018
This is to certify that work requested to be done as shown by Permit Number SEP-0329-2018
has been completed.
Tax Map Number: 295.13-1-30
Location: 8 AVIATION RD
Owner: Wendy Abbott
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
property owner of the responsibility for compliance with Site Plan, 4t
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.
T � 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-0329-2018
Tax Map No: 295.13-1-30
Permission is hereby granted to: IBS Septic
For property located at: 8 AVIATION RD
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: Wendy Abbott Septic Disposal-Residential $0.00
Owner Address: 8 Aviation RD 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
$ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,June 7,2019
(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 ate.)
Dated at the To Qu ;:P4 *,Tu—ne7,2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
f....._..,,
SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only
742 Bay Road,Queensbury,NY 12804
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P:518-761-8256 trrww�ueens�u�q�°f Permit#: 2cb It)
Tax Map ID#: D` Permit Fee: $ ; Invoice#:
Project Location: Septic Variance? Yes ✓ No
Primary Owner(s) e
Mailing Address i
Phone & Email
Installer/Builder l S 5
Mailing Address "
ulu
Phone & Email L
Engineer i'��. Fz1=CtYsU€ Y
Mailing Address
Phone & Email y
Contact Person for Building &Code Compliance: Phone:
RESIDENCE INFORMATION:
Year Built Gallons #of bedrooms X gallons per = total daily flow
per day bedroom Garbage Grinder Yes o
1980 or older 150 Installed? (circle one)
1981-1991 130 Spa or Hot Tub Yes o
Installed? (circle one)
1992-PresentI � %110 C'1
PARCEL INFORMATION:
Topography Flat Rolling Steep Slope %Slope
Soil Nature V Sand Loam Clay Other
Groundwater At at depth?
Bedrock/Impervious material At khat 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 SYS EM FOR NEW CONSTRUCTION:
Tank siz a70tW gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or spa/hot tub
System Absorption field with #2 stone Total length ft.; Each Trench ft.
Seepage Pit with #3 stone How many: ; Size:
Alternative System Bed or other type: '
Holding Tank System Total required capacity? Aank 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 and approved.
The installed system must match the septic 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 Queensbury Sanitary Sewage
Disposal Ordinance. -
PRINT NAME: 5 Pr G DATE: H
SIGNATURE: DATE: b.
Town of Queensbury Building&Code Enforceme Revised hoar.`.2__3