BOTH-000317-2016 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: BOTH-000317-2016 Date Issued: Monday, October 3, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000317-2016
has been completed.
Tax Map Number: 301.13-2-9
Location: 8 PEGGY ANN RD
Owner: Derek Leo
Applicant: Derek Leo
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.
„mmo TOWN OF QUEEN BUR
a
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
y Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTI-1-000317-2016
Tax Map No: 301.1.3-2-9
Permission is hereby granted tw Derek Leo
For property located at: 8 PEGGY ANN 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: Derek Leo Septic Disposal $0.00
Owner Address 8 Peggy Ann RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name l Address Electrical Inspection Agency
Services Unlimited
213 Maple ST.
Clens Falls,NY 12801
Plans& Specifications
Residential Septic Alteration's
40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,May 20, 2017.
(11'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 Towno bury; Wed ' d� , May 25, 201 G
7
SIGNED BY: P4 for the Town of Queensbury..
Director of Building&,Code Enforcement.
301 -13-2-9_9 B TH 317-20:16
Derek Leo
SEPTIC DISI' SAL APPLICATION 8 Peggy Ann Read
Residential Septic Mteration
DATE:E: Tax Map ID
TAx MAP ID: l�� � � Permit No. 3 '
Permit Fee
ZONE:
1C "
APPLICANT LICANT
PHONE I E-M:AIL
ADDRESS 64
INSTALLER PHONE f E-MAII,
BUILDER 361- d2f7,
OWNER
ADDRESS
CONTACT PERSON FOR BUILDING I CODE COMPLIANCE, Q, i
t
PHONE/E-MAIL
r
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RESIDENCE INFORMATION I
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older Garbage grinder installed "Y"es No
1981-1991 Spa or Hot Tub installed Yes No
1992-Present
PARCEL INFORMATION
Topography fllat rolling Steep slope %dope
Soil Nature r''Sand Loam Clay Other
Groundwater At what depth:
Bedrock/Impervious material At what 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 SYSTEM FOR NEW CONSTRUCTION
Tank size (Lja gallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total length. fl.;Each Trench
Seepage pit with 43 stone How marry: ;Size
Alternative System Bed or other type:
Holding Tank System Total required capacity's 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&approved. The installed system must match the
septic system layout on file—no exceptions.
Declaration: Any permit or proval granted which is based upon or is granted in reliance upon any material representation or failure
to make a material fact or i instance known by or on behalf of an applicant,shall be void.I have read the regulations and agree to
abide by these and all re of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
PRINT NAME: DATE:
SIGNATURE, DATE:
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
i{
E
I' BY I REVISION �e
- -
I
/ SOIL STACK - -
20 MIN VENT STACK CO UPPER FLOORS
COVER .r� I
INLET \ _ _
UNLET
6, -
C . _HOUSE DRAIN
i II
j `l. _ _
• SLOPE 114"PER FT 4"SOLID PVC
I �.K�-1/16'%FT SLOPE
i
LOCATION STAKE 6,
OVER COVER 2"MAX DISTRIBUTION BOX
/-1 -
/ 26' W/LEVELERS
11'4IN� '- ' q-III=III_III-III-III�III� To DIST.BOX
- - III=III=III= III=111611
1 _
6 4"PERF. PVC
HOUSE FOUNDATION J
PLAN VIEW �I ,-,,,-,,, I� I� I� I� I�_� SLOPE AT MIN. ✓� o
I TRAP �1/8"PER FT 1/16'%FT SLOPE .d. .
-3'0"- ` �
LOCATION STAKE L CLEANOUT �4"SOLID.A0 Ho SEPTIC TANK = „ CYD
I PVC PIPE I
4 SOLID PVC
1250 GALLONS 6' ALL ENDS CAPPED
, „ t I SLOPE 1/4/FT(MIN)
III-111-III III= 0 III III III In Ill Ell III lu III lil Ill lil 111 lu III m III lil 111 nl 111 III III III III' �, WASHER _ 1250 GAL ST
-, -� 1 D'MIN. ,. `l �� cc
I 1 l I OUTLET MIN. � -- _, �
2 LOWER 4„SOLID PVC. 14 ® o
I tS� THAN INLET , -I 40' @ 1/8/FT SLOPE �� ca O
CZ
INLETLEVE CAULKED i HOUSE CONNECTION DETAIL �i
N.T.S. , 10'MIN.CAULKED � NITARY SANITARY JOINTS ` 1 ,
JOINTS TEE NEE
20 MIN.
6"STONE j z
C!7
FIELD SCHEMATIC
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-.III=III=III=III=III=III=III=III=III=III=III=III=III= TOPSOIL FOR
SETTLING � q
SECTION VIEW UNTREATED
i. BUILDING PAPER I
SEPTIC TANK DETAILS 6"MIN -
c/] 0
".T,s. I 12"MAX2"1 2"MIN
- - - - i 12"MIN 1 !
. . 1 d . w E °
z
24"MINI '-� PERFORATIONS •' 'I' f p�
Septic Tattle Notes: � _
L-2,0" 6"MIN
1. The capacity of the septic tank shall be a minimum of i
' GROUNDWATER,
1250-gallons, and 34-sgft of surface area. ROCK OR NOTE: _ _ �- Q0
2. The septic tank covers Shall always be accessible. Where IMPERVIOUS LAYER 1.DO NOT INSTALL TRENCHES
IN WET SOIL
manholes are more than 12-inches below grade and 2.RAKE SIDES AND BOTTOM OF DRIVEWAY I - I
TRENCH PRIOR TO PLACING
extension collar shall be provided over each opening. AGGREGATE. W HOUSE --20'-0°-y�
3.END OF ALL DISTRIBUTOR ' 1
Extension collars shall not be brought up flush with the PIPES SHALL BE CAPPED,
ground unless the cover can be locked. TRENCH DETAIL
j o
3. The construction of driveways, Swimming N.T.S. l Z e
Y , g pools, or other _ b �
EXISTING WELL TO
facilities are not allowed above septic tanks. _ - � ' � a LOCATION OF
4. The following applies to all septic tanks: BE DISCONNECTED I
m PERC& DEEP HOLE
a. The minimum liquid depth shall be 30-inches. The Trench & Installation Notes: + PUBLIC WATER To / LOCATION
1. Absorption fields shall not be built under driveways, parts t BE INSTALLED
maximurnaallowable design depth shall be 60- of buildings, under above ground swimming pools, or other 1250-gal .) LINE 25-ft
Inches SEPTIC TANK,-
areas subject to heavy loading. _ FROM CATCH BASIN
b. The minimum distance between the inlet and the 2. Surface water shall be diverted from the vicinity of the ,
outlet shall be 6-feet ' LINE 10-ft OFF \�1IIl�/i�,� ! EXISTING
c. Tanks shall be watertight. If the tank is a 2-piece absorption field. I PROPERTY LINE o \ BUSHES LINE 10-ft OFF
c 3. Piping:
design it must be leak tested in the presence of the _ P o /NE
' a. Solid pipe shall be between-the house and_the___ P L
local Building Inspector and/or the design engineer ' - - - - TREEI • • • ' ' - ' ' - -
_. _. _ _ _
prior to backfilling 4.. septic tan , the septic tank and the distribution
box, BE REMOVED -
r' g 4 and between the distribution box and the inlet to
`a
d. The tank shall have an inlet and outlet baffle 9 K•�_.�vy
each trench
sanitary tees or other devicesd to prevent the a� TIC PLAT PLAN ; �(
passage of floating solids and to minimize b. Perforated piping shall only be used in the trenches I _1a y ` s -a tl
c. Perforated pipe shall be rigid PVC and labeled as I HAVE SEEN OR r S-c VED ALL OBJECTS - \
disturbance of settled sludge and floating scum SUCH AS HOUSES, N Lt 7 EES, FENCES. ETC PEGGYANNROAD 1. Co
- �
e. There shall be a minimum of 1-inch clearance meeting ASTM standards for use in septic systems. SHOWN ON THIS DOC JB _NT I HAVE PERSONALLYQ�
EXISTING) EXISTING CURBMAY tib
Corrugated, coiled plastic pipe shall not be used for MEASURED THEDISTANCI 'E'T �RTHONTHISDIAGRAM. CATCH BASIN SCUT Lw N Q
between the underside of the top of the tank and all { � rM--
baffles any portion of the septic system N 3t11 E .�8URY
4. The trench aggregate shall be washed ravel or crushed SIGNATURE DATE �,, , .� - ,
BUI1f7IN('' �, ;,'OD S
f. Wanks shall be placed on at least 6-inches of sand g dy - -"
stone % - 'I-1/2" in diameter, Larger material or finer Plot Plan w E ) .
or pea gravel substances are not acceptable s��:,"_25'
g. There shall be a minimum of 2-inches in elevation 5. The aggregate shall be covered with a material that s00
between the inlet and the outlet -with the outlet
prevents soil from entering the aggregate after backfilling
being lower. yet must permit air and moisture to pass through. The i9
5. Concrete tanks shall have a minimum concrete strength of g
3000-psi at 28-days. preferred material if a geotextile; however, untreated
6. No non-concrete tanks shall be substituted without the building paper is acceptable. Polyethylene and treated _-
approval of the design engineer prior to installation. building paper shall not be used. General Septic Notes:
6. Trench construction: - REQUIRED FIELD OBSERVATIO
1. If the septic system is not installed within one (1) year from NS
a. The Contractor is responsible for locating ad , the date of the Engineer's stamp the drawings shall be
marking all utilities prior to beginning construction reviewed by a licensed NYS Professional E gineer for an The contractor shall notify the Building Ins ector.and
b. The trench depth shall be not less than 18-inches
- -- -- -- - - - y 9 p the Design
Code changes prior to beginning construction. engineer at least 48-hours in advance for the following
No. DESIGNS deep 2. The percolation test was conducted by Engineering observations. Observa ' °
BAFFLE PER DESIGN g { tions will be conducted Monda T
c. At least 6-inches of aggregate is to be placed below America Com an on April 11 2016 y through
f Company p Friday (except Holidays) during normal Working hours only)
the distribution line and at least 2-inches shall be 3. The stabilized percolation rate is 1-in drop in 1-min 15-sec
g
NOTES:
INLET II I place above the distribution line - °
vo _av�v v�vv o
4. The system has been designed based on rocedures in 7. After the trenches, pipes, et al, have been placed but prior' o
I.PIPE JOINTS SHALL BE SEALED d. The distribution y g p : vym° c rna v °
PLAN VIEW WITHASPHALTIC MATERIAL pipe shall be sloped between 1/16 NYSDoH Publication, "Individual Residential Wastewater to backfill of the system. NOTE.' °'°° °` �'C
oREQuivALENr, and 1/32 inch per foot. Grades shall be determined Treatment systems Design Handbook using the following y { All system components ca(04 v
GL must be visible.) °a"1'1-0 °_'--
2.INVERT ELEVATIONS OF ALL
- - OUTLET PIPES MUST BE EQUAL. by an engineer's level, transit Or laser � criteria: c_ mak. � NEEu
a
atn°vcrn�o v�
e. The earth backfill is to be mounted slightly above a. No. bedrooms - 4 2. After all backfill and final grading has been completed. u°o o E-S
12"MAX 3. THE SLOPE OF OUTLET PIPES � j
n BETWEEN THE DISTRIBUTION the to of the trench to allow for settling b. Required field length - 184-ft {Table6A g°
�I �_O OI BOX AND THE DISTRIBUTION P ) NO TE:A certificate �'3 3 i-v v
LATERALS SHALL BEA f. The entire area shall be graded so as to have C. Fixtures are 1.6- of compliance shall be W-v° ° a
MIN OF 1/32'%FT gpf toilet and 3.0-gpm faucets provided to the Town v �W
surface water run off it. In addition, surface water d. No garbage grinder is included of Queensbury by the Design Engineer for this system indicating 0�
n �14 PEA GRAVEL
° '' from the vicinity shall be diverted from the disposal i '; e. No hot-tub is included that the system has been installed in substantial compliance
r`�4v° IORSAND with ;a o��n�»0,
0=11 nv r. ,��y 1 .
li to or„lir' �, „ „ rl area.
5. The building plumbing shall extend three (3) feet beyond these drawings. This certificate will not be issued unless these : i
n 1 - , ? i`�ey a �.L,.•I'I�. +I
V.
SECTION W.
12 MIN g. he entire surface of the system shall be covered xN 4
the foundation of the house, observations have been completed by the Design Engineer.
with a minimum of 6-inches of topsoil, and seeded 6. Roof, footing, cellar, and surface water drainage shall not
v� }Qy r•
DISTRIBUTION BOX DETAILS with grass go into the septic system or into the septic system area. ' ' P z ' F I
".Ts. h. The soil being placed above the existing grade is to
waterTOWN OF QUEENSBURY
7. Water
not be d�scharr ed to thechar a and backwash wastes shall
- - - - be placed in 6- 9-inch lifts and compacted by one g
- -- --- -- BUILDING DEPARTMENT
(1)
and only one (1) pass of a tracked or wheeled g septic system or the septic Based on our lirnited examination com lianve �� ' "�� �4 r'°°'
vehicle. system area. with our comments shall not be construed as COPY '�,�
indicating the plans and specifications are in �.IL �,� �� �aa����
8. House sewer construction, including materials shall full compliance with the Building Codes of , 3,10
Distribution Box Notes: conform to the requirements � "
q nts of all the Codes of NYS, and New York State. QJ b,
for this site shall be PVC. s i £s d
1. The distribution box shall be not more than twelve (12) 9. A minimum horizontal separation of to 3
inches below grade and have a removable cover. Where
P n (10(feet shall exist � s ° W
Re wired Separation Distances between the house sewer and any water line. If they must N ° ° a °
° p d N-F�U d}'
due to site conditions the distribution box must be greater cross, the water service shall be a minimum of 12-inches 301 .13-2-� BOTH 317-2416 °
g System Co�tf Component
� :� � � U
than 12-inches below grade and extension collar shall be p well stream, et al( 2) Dwelling Property Line I Drainage Ditch(*2) d .N � �, d °
House Sewer(watertight joints) 1 25(*1) 1 25 3 10 above the sewer line. Suction water lines from wells shall Derek Leo d -0° s U i
installed to within 12-inches of the surface. I [ 10 never cross under house sew v F, CO i
Septic Tank j 50 50 10 , 10 sewer lines. 8 Peggy Ann Road , .3 P°° ai c
2. The distribution box shall be set on a 12-inch thick bed of � 10 10. The Contractor is responsible for
sand or pea gravel. Efffuerct Line to D. Box j 50 10 10 p locating and marking all
50 10 Residential Septic Alteration o a-0+1 U £Z U-P Z
3. All outlets from the distribution box shall be at the same ! I 100 utilities prior to beginning construction.
Distribution Box � 100 � 20 I 10 I 20 11. Soil Data: DRAWN gy
level. Outlet levelers are acceptable. Absorption Field j 100 1 100 I 20 10 20 a. Verified b EACo 0
4. There shall be a minimum of 2-inches clearance between Y n 4/11/16 Site Observation DATE
b. Soil data: April 16, 2016
the inverts of the outlets and the bottom of the distribution *1- 25-ft if cast iron or PVC with O-ringjoints -otherwise 50-ft i. 0 - 10" Lo
Loam
P
box. *2-this dimension is from the mean high water mark ii. 10 -40" CO I r.r
Coarse tan sand �� N ®� Qui (�, U PROJECT NO.
5. Concrete distribution boxes shall have a minimum concrete * ` . 40 - 56" Coarse
3-for all systems involving the placement of fill these separation distance are measured from the toe of slope for i gray sand o% Dra win 6-0034
strength of 2500-psi at 28-days. iv. 56 - 61" Coarse light tan sand � �U1LD11'dC c� 'a ',':� �':•�. �:
g Reviewed By- For Construction
'
V. 61 -84" Coarse gray sand `®
SHEET No.
Deed _
I �
septic system -1
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Engineering America Company .. '
8 Fielding Street
Glens Falls, NY 12801
518-615-0201 1�
Georgevas3@vahoo.com u OCT 0 3 2016
September 27,2016 TOWO Q ENSBURY
BUILDING&CODES
Re: Record Drawing&Certification
Leo Residence
Peggy Ann Road
Town of Queensbury, NY AS BUILT
Building Inspector
Dear Sir:
This letter is to certify that the septic system was installed in substantial compliance with the drawings
provided for this system.
I observed the system being installed on September 27, 2016,and:
1. The system was installed in a different location from that shown on the submitted drawing.The
reason for this is that it Interfered with the driveway off Peggy Ann Rd.
a. The soil conditions at the installed location are the same as the soil conditions at the
initial location,and all separation distances were able to be maintained.
2. The system was installed in substantial compliance with the provided drawings,as shown on the
attached Record Drawing
3. Photos are also attached
If you have any questions regarding this letter or the attached Record Drawings please contact me.
Sin ;ely;: r ,.yr ,Y•t,.
y;;S
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DRIVEWAY HOUSE
PIPE FROM
0 HOUSE TO S.T.
LO
° 4'-7,
2j 9. N
CZ
�4 33�1,•
CIRCULAT
Q — D. BOX
—LINE 10-ft OFF
1111
PROP– LINE
PEGGYANN ROAD /STING EXISTING CURB
CATCH BASIN CUT
Record Drawing
6 Peggy Ann Rd. " Record Drawing
Scab.1,25' � F1 9/27/17
a� By Engineering America Co,
8 Fielding Street
s Glens Falls, NY
615-0201
George Yasenchak, PE
i � r
e ,
1 1
F
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D. Box With Levelers
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S �� .o-rl y n Ufa
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Typical Line Installed Typical End Capped
Pictures—Page 2
6 Peggy Ann Rd
Septic System