2012-249 .1116%. TOWN OF QUEENSBURY
i
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120249 Date Issued: Thursday, October 31, 2013
This is to certify that work requested to be done as shown by Permit Number P20120249
has been completed.
Tax Map Number: 523400-295-018-0001-006-000-0000
Location: 23 SYCAMORE Dr
Owner: GARY BRAHAM
Applicant: DONALD & JACQUELINE BROWN
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
a ! 14
property owner of the responsibility for compliance with Site Plan, 'P '1
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
AO`
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120249 Application Number: A20120249
Tax Map No: 523400-295-018-0001-006-000-0000
Permission is hereby granted to: DONALD &JACQUELINE BROWN
For property located at: 23 SYCAMORE 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 Value
Owner Address: DONALD &JACQUELINE BROWN
23 SYCAMORE Dr Septic Alteration Residential
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
BRADLEY'S SEPTIC SERVICE
654-6318
47 HACK Rd
CORINTH NY 12822-0000
Plans&Specifications
2012-249
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, May 17, 2013
(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 sbury; hu . al May 17,2012
SIGNED BY 4 for the Town of Queensbury.
t
Director of Building&Code Enforcement
6i4d: f�n45 OF I VIte .Sbk. 8 Pgg •�/ U
UOFFICE USE ONLY ' '
TAX MAP NO. PERMIT NO. `a- pl 17 PERMIT FEE I //i 'D It ([,, rt ji \','.0. i.
APPROVALS: ZONING TOWN CLERK FI !
t/
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: . a= du% ti Baa:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VA1:ICDD= -
PERMIT.
OWNER: • I 7" 0
, I INSTALLER: ,6 f/ ' . .
ADDRESS: • Gt/L � f_c�.+• _,4/f./ /,'RESS:
PHONE NOS. 307•- 36 /3 PHONE NOS. l AI .1 ,
LOCATION OF INSTALLATION: 023 S/ U lore l __-
-
NO.OF T - — - RESIDENCE INFORMATION:
YEAR BUILT BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW
1980 or older X 150 gallon per bedroom = GARINSTAAGE GRINDER
ALLED?
1981 -1991 V- X 130 gallon per bedroom = 52_0
SPA OR HOT TUB
1992-present X i 110 gallon per bedroom = INSTALLED?
PARCEL INFORMATION:
/ TOPOGRAPHY: Flat rolling p Steep slope %Slope
/ SOIL NATURE: Sand Loam ClayOther
er
✓ GROUNDWATER: At what depth? t1N---
✓ BEDROCK/IMPERVIOUS MATERIAL: At wh depth?
/ DOMESTIC WATER SUPLY: Municipal Well (If well: Water supply from any septic
system absorption is ft.)
/ PERCOLATION TEST: Rate is minutes per inch [MPI]
(Test to be completed by a licensed professional engineer or architect.)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by
a licensed professional engineer or archi ect(unless installed in a Planning Board approved subdivision).
TANK SIZE: 1 QA O�`N (MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for
each garbage grinder, spa or whirlpool tub.
SY EM TYPE:
SORPTION FIELD (WITH NO. 2 STONE) Total length g 1,5D ft. Each trench
❑ EEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size?
ALTERNATIVE SYSTEM Bed or other type? b LW )
P'S? .9
❑ HOLDING TANK SYSTEM Total required capacity? .\ E_t
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 behalf of an applicant, shall be void.
I have read the regulations with respect to this application and
agree to abide by these and all requirements of the Town of QUESTIONS? CALL 761-8256 OR EMAIL
Queensbury Sanitary Sewage Disposal Ordinance. codes a(�queensburv.net
/1VISIT OUR WEBSITE FOR MORE INFORMATION
.� y www.queensbury.net
Si:nature of Person Resp•n •Ie Date
Town of`Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
B 5-LGL 6.,06
(\z• Q\
Septic Inspection Report
Office No. (518) 761-8256 Date Ins•-ctio Ted:
Queensbury Building &Code Enforcement Arrive: :` i rt:
742 Bay Rd., Queensbury, NY 12804 Inspector's In . s: /1.
NAME: t'7 R Pt-k \'\ L-(9
LOCATION: Z , �`iC I1�C �� INSPECT ON: f
RECHECK:
Comments and/or diagram
Soil T . . / Cla
Type of Wa_agigrallirr ell-Water
Ir.',separation distanceft.
Well separation distance _ft.
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length 1 2 D ft.
Length of each trench 3g,. eft. d,
Depth of trenches `= y�`�_ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank b
Tank to Distribution Box X1-1
Distribution Box to Field / Pit `` pie-,
Opening Sealed: Y N �
End Cap N t_�c�
Inlet/Outlet Pipes &Baffles Y N
Location/ Separations
• Foundation to tank rft,—
Foundation to absorption 2/ft. -ate r Chc)
Separation of Pits ft. 17�M
Conforms as per Plot Plan V Y N
Engineer Report and As-Built -_-_Y N
Location of System on Property:
Front lirLeft Sid Right Side) Middle Front Qliddle Rear
S -I Us-
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: f (D up (' PERMIT NO.: / 'A4/6?
LOCATION: 3 S �t0.l�rc� tar e tt�er' INSPECT ON:
RECHECK: J
Comments and/or diagram
Soil Type: Sand / Loam / Clay
Type of Water: Municipal / Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N._ N/A
1150'to well required if NO]
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: _Y_ N
End Cap _Y_ N
Inlet/Outlet Pipes&Baffles __Y N
Manholes 12"or less below grade _Y_ N
[provide extension collar if Yes] _Y_ N
Location/ Separations
Foundation to tank ft.
Foundation to absorption _ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built _Y N
ETU Maintenance Contract _Y_ N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Status:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report 03 29 10.doc
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection r-• e"wed:
•Rueensbury iuilding k Gde Enforcement Arrive: .��� art: a m
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials• ;•�
NAME: L')Rd Pr'MIT NO.: Iz- 'sFz„ N
LOCATION: SIPCP rr ►r , SPECT ON: 5-Ito-1 7
RECHECK:
Comments and/or diagram
Soil Type: Sand/ Loam / Clay
Type of Water: Municipal / Well Water
Waterline separation distance ft.
Well separation distance ft. �
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
[150'to well required if NO]
Absorption Field: Total length ft. De b ‘6,‘1, L RC .v),
Length of each trench ft.
Depth of trenches ft. f\�i c Y t
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box j• ICO9
Distribution Box to Field/ Pit r'
Opening Sealed: _Y_N
End Cap Y N
Inlet/Outlet Pipes&Baffles _Y_ N
Manholes 12"or less below grade _Y_ N
[provide extension collar if Yes] Y_ N
Location/ Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan _Y, N
Engineer Report and As-Built _Y_ N
ETU Maintenance Contract _Y_ N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Status:
/Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Repor_03 29 10.doc
CENTER PROJECT
SERVICES
73 Sheridan Street, Glens Falls, NY 12801
Phone-518-796-2515
May 10, 2012
Project# 157
Bill Bradley
Bradley Septic Services
Corinth,NY
Re: Proposed Replacement Septic
Brham residence—23 Sycamore Drive, Queensbury, NY
Dear Bill:
At your request we have reviewed your proposed replacement septic system design at the site of
the existing 4 bedroom house of the Brham residence at 23 Sycamore 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 500 square feet of absorptive area. We recommend using a 15 ft
wide by 45 ft long absorption bed with 3 — 40 foot long laterals, which will provide 750 sf of
absorptive area. The absorption bed 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.
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Septic Inspection Re ort
Office No. (518) 761-8256 Date Ins ion request received:
Queensbury Building &Code Enforcement Arrive: r c a m Depart: :3%4F-70 am pm
742 Bay Rd., Queensbury, NY 12804 Inspector'sInitials a
NAME: 01 �1 P: — 1C PERMIT NO.:
LOCATION: R1\JC_ INSPECT ON: -1)--'2:7-1-2_
RECHECK:
Comments and/or diagram
Soil Type: Sand / Loam / Clay
Type of Water: Municipal / Well Water
Waterline separation distance ft.
Well separation distance ft. C-Ui3TR.iALTUjZ E
Other wells: ft.
Well Casing Length 50' + / - Y N N/A 1 pG b Eft\C F))K
[150'to well required if NO]
'FALL bF LiC), ) 1D
Absorption Field: Total length ft. � FFL
Length of each trench ft. J . v\E-gE
Depth of trenches ft. P06 E‘) n E CC OF
Size of Stone
Seepage Pits: Number bi\ ( J?O USD. 1U
Size:
Stone Size: E PLIA.CE �E k..1
Piping Size Type L E P\CA F r ELO
Building to tank
Tank to Distribution Box () U FO
Distribution Box to Field/ Pit
Opening Sealed: Y N ._ r\—\\ F (-)\kv
End Cap Y_ N _
Inlet/Outlet Pipes & Baffles Y N P,�� v Pt 0 Ek -T �t3 0�
Manholes 12"or less below grade _Y_ N I--OC _
•
[provide extension collar if Yes] Y N � E e `C U OU uV F11
Location/ Separations b D R-TV lJ C OE_
Foundation to tank ft. ,
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan _Y_ N
Engineer Report and As-Built Y_ N
ETU Maintenance Contract _Y_ N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Status:
pproved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Repor _03 29 10.doc
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