SEP-0540-2018
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-0540-2018Date Issued: Monday, January 14, 2019
This is to certify that work requested to be done as shown by Permit Number
SEP-0540-2018
has been completed.
295.19-2-11
Tax Map Number:
231 AVIATION RD
Location:
Joshua Benway
Owner:
Joshua Benway
Applicant:
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,
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 QLJEENSBURY
i. .,, f 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
\-- - Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: SEP-0540-2018
Tax Map No: 295.19-2-11
Permission is hereby granted to: ML Contracting
For property located at: 231 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: Joshua Benway Septic Disposal-Residential $0.00
Owner Address: 231 Aviation RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
ML Contracting
34 Warren LN
Queensbury,NY 12804
•
Plans&Specifications
Residential Septic Alteration
$ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday,August 28,2019
(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 o uee••.ury; ues . , .;1.Di - 28,2018
41
®®®®®®
SIGNED BY: tir- \ for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PER 16.(413 t / Ili WA Use Only
.,-.> 742 Bay Read,Queensbury, g Se-f_.b��C7 "�b l
Town ofQuccnti6mv q y N 9 v uG ^ 1 2018Hit#:
:,��+J8^f6J—a�LJU $9Qid7" �.�]L3�� t Y G' ( �/t�Tax Map ID#: r`T /5i 2-- 1 ( - it Fee:$ 7S DO; Invoice#: 0 g
I OVI/Ny[O�^F C,ZUstt NNSB RY
Project Location: vm i 8 v 0" _ ,�a, ��t`, `M p , Sep c Variance?
Yes No
LI
Primary Owner(s) t k
Mailing Address 3( Av.;a i Sri ® a),e_ev) k >r--LA
Phone & Email 5-I`ag Q l c - — 51(R ios kut"iir)e-ifi a uaA Rt . liti 1 Gann
Installer/Builder PAL Cof i-a-a-yi inC' Cs-)
Mailing Address 3L1 Walfr,e-ra Lop. 0Oeea"Sb 0 rtsi
Phone & Email 6 l 75 q 65 - ?1co S <I
Engineer
Mailing Address .
Phone & Email
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( Nod
1980 or older 150 3 16d H SI) Installed? (circle one) `,..---7.1)
1981-1991 130
Spa or Hot Tub Yes( No
Installed? (circle one) l - '
1992-Present 110
PARCEL INFORMATION:
Topography hC Flat Rolling Steep Slope %Slope
Soil Nature X Sand Loam Clay Other
Groundwater At what depth?
Bedrock/Impervious material At what depth?
Domestic Water Supply• j0 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 SYSTEM FOR NEW CONSTRUCTION:
Tank size )of' 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? ;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 regulations and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage
Disposal Ordinance.PRINT NAME: ® 3✓d LtJ EA/
DATE: O��/i
SIGNATURE: DATE: (F�// /tS
Town of Queensb ii",d ng Code Enforcement Revid March 2018
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