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SEP-0464-2018 - 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-0464-2018 Date Issued: Wednesday, October 10, 2018 This is to certify that work requested to be done as shown by Permit Number SEP-0464-2018 has been completed. Tax Map Number: 296.13-1-36 Location: 16 WINCREST DR Owner: Bill Gibbons Applicant: Dean Burdick 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 rinj 4 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-0464-2018 Tax Map No: 296.13-1-36 Permission is hereby granted to: Stone Installations For property located at: 16 WINCREST 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 Tyne of Construction Owner Name: Bill Gibbons Septic Disposal-Residential $0.00 Owner Address: 16 WINCREST DR Total Value $0.0.0 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications Residential Septic Alteration $75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,July 18,2019 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town of ry; ed e a ,2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement EEF1 SEPTIC DISPOSAL PERT > PLICATION off I se Onl Taws ofQaeensb 742 Bay Road,Queensbury,NY Iio JUL 16 2018 r P:518-761-8256 wwwu a et it#: �a �' �c� Tax Map ID#: � (� f�� OWN Off'QUEENS UMI& Peymi Fee:$ �° Invoice#: ®CP�7 Project location: �� "f10A�'�J� �J, e —� Septic Variance? Yes No Primary Owner(s) _ k1cA Mailing Address e 14d Phone &Email ,, 5- installer/Builder S Mailing Address t '� '� 1 _ J � Phone &Email 2 z- Engineer Mailing Address Phone &Email Contact Person for Building&Code Compliance: Phone: RESIDENCE INFORMATION: Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes o 1980 or older Installed? (circle one) 1981-1991 Spa or Hot Tub Yes Gy Installed? (circle one) 1992-Present PARCEL INFORMATION: Topography Flat Rolling Steep Slope %Slope Soil Nature S nd Loam Clay Other Groundwater At what depth? Al® 7 Bedrock/impervious material At yjhat depth? A®ter Zfc„ Z, Domestic Water Supply unici al _Well(if well,water supply from any septic system absorption is_ft.) Percolation Test ate: per minute per inch(test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size 00 gallons(min.size 1,000 gallons,add 250 gallons for each garbage cylinder or spa/hot tub System Xbsorption 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? ;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 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 regul tions and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME: DATE: SIGNATURE: DATE: 13 N Town of Queensbury B 'ding&Code Enforcement Revised February 2017 uo��eia}I�d ©0 pnxasposat3 a�9 a 8a�3� ��ogg98 .. 8►.OZ'i�9�0'd3S g��d��a�g6Z - ... �y�"per} .,..-... :. u ,... b .'lam .0 o . .. , - ..., \,,......, r �` �+ _ „ _ „3 -NR5 • , , . .... „.......,„. _\_____ i... --7-\- - I\14.. ...0 ...,Azh ,,„ ,4_,_ ‘....., 1 „.... . ,. . , =4) of _ • .1 S3aoo 'R SiNialine . .•`> ` EA .. I ��Yae1 �:I OOaa'lY C JO N�elV0cfa..- X. • . ,l'o EIGpCe, P'.:; ;:- 4, '01+ w'oue9idwo0 11171. _ .. - --u! �a suoireoJgoeti:� pun sueiki �� 3u`}eo@hut `' se p nisuOD ec;-:ls;an al:, moenuo in®tip J. eouelldwoo`uo eui`!4:e(o pew inc uo peseg SEPTIC PI.©T P -a. . ,t� �``,- � a SUCHSEEN p "''� ` - �S r�VD Ai.� Of3J�CS . . �„ r „ .fie SES, ..5, TREES, FENCES, ETC � �c-'‘ �' SHOWN N T IS DO ENT.1 HAVE PERSONALLY 1 MEASU D TH D!STA ' SET FO ``'�.,%,. --,„ N 1..---. SIGN T -. - a3 .. a AT q- s