2012-280 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120280 Date Issued: Thursday, June 07, 2012
This is to certify that work requested to be done as shown by Permit Number P20120280
has been completed.
Tax Map Number: 523400-301-017-0002-008-000-0000
Location: 19 CHEROKEE Ln
Owner: KATHLEEN MILLER
Applicant: KATHLEEN MILLER
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
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.
0116k TOWN OF QUEENSBURY
742 Bay Road,Quccnsbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120280 Application Number: A20120280
Tax Map No: 523400-301-017-0002-008-000-0000
Permission is hereby granted to: KATHLEEN MILLER
For property located at: 19 CHEROKEE Ln
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: KATHLEEN MILLER
19 CHEROKEE Ln Septic Alteration Residential
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans&Specifications
2012-280
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 07,2013
(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 Queensbury; Thursday,June 07, 2012
SIGNED BY / for the Town of Queensbury.
I
Direct r o ding C,.V:"n `cement
11
;‘';;` Community Development Office 6 •
— Town of Queensbury • 742 Bay Road • Queensbury, New York •12804
Office Use Only /�
TAX MAP NO. 2b', I PERMIT NO. ! `-- PERMIT FEE it°. v O
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM,pERMIT: A PERMIT MUST BE OBTAINED
BEFORWORK BEGINS. APPLICATION IS SUBJECT TO REVIEW EFORE ISSUANC 79F A VALI ERMIT.
OWNER:_ A-1 L (.,,. t ( 1(4 c C-1--C(1- INSTALLER: - Ni . 2 j eirj-_A__ ( �2 C.1/C
tt
ADDRESS:__ S CJGtP GLS k'a t l./Ali'e- _ ADDRESS: e U O o,C 22 b F _
PHONE NOS. -7 _t__,3= Z- ________ PHONE NOS. 9 ?• 6.,-----.'
LOCATION OF INSTALLATION: t_ IJ_4._
RESIDENCE INFORMATION:
NO.OF COMPUTATION
YEAR BUILT X = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRIfyDFR�
1980 or older i X 150 = 'fS� INSTALLED? ��}}
1981 -1991 X 130 = SPA OR HOT TUB i 1
1992-present X 110 = INSTALLED? I"
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING 7 STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND 1 LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT EPTH?____ _
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL____(If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS _PER MIINUTE 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
architect(unless installed in a Planning Board approved subdivision).
TANK SIZE:4 dO J GALLON(MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,
spa or whirlpool tub.
SYSTEM TYPE:
❑ABSORPTION FIELD(WITH NO.2 STONE) Total length ft. Each trench X _
0 SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? _
ALTERNATIVE SYSTE :ed o other type? Jo °.•c Z`L ' _
0 HOLDING TANK SYSTEM Total required capacity? 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 o' ,respect to is application and agree to
.. •- : these and all r:. ire -nts of - own of Quee sbury QUESTIONS? CALL 761-8256 OR EMAIL
S:nita Sewage Disp aI • • anc: 66-- i Z codes(auueensburv.net
_ — f
A Person Resp.('W.le Date VISIT OUR WEBSITE FOR MORE INFORMATION
'ign- u
www.queensbury.net
NYS-Real Property System Subject Property Inventory Summary RPS030N04/L001
County of Warren For Current Year File 2012 Date:6/7/2012
Town of Queensbury Parcel ID:301.17-2-8 Sheet 1 of 1
SWIS Code-523400 Active
Parcel Information Parcel Land Size File Maintenance Info --
Curr Owner: Miller, Kathleen Acct#: Front: 0.00 Acres: 0.46 Created: 11/20/1984
Location: 19 Cherokee Ln School Cd: 523402 Queensbury Un.fr.: Depth: 0.00 Sq Ft: 0 Modified: 07/06/2011 11:02 AM
Queensbury, NY 12804 Roll Sect: 1 Taxable RS/S: By: teri
Grid Coordinates
Prop Class: 210 1 Family Res East: 699009 North: 1633649 Folder: Improvement
Site Characteristics — -Site No: 1 Nbhd Cd: 162 OldSubdv,Rs,Ri. Site Desire: 2 Typical DC Entry Type: 1 Inter inspec Economic Obs: 0
Site Type: R Residential Sewer Type: 2 Private Nbhd Type: 2 Suburban Zoning Cd: MDR Mod Density Re Data Mailer: No
Prop Class: 210 1 Family Res Water Supply: 3 Comm/public Nbhd Rating: 2 Average Last Phy Insp:
Route No: Utilities: 3 Electric Road Type: 3 Improved Reappraisal: 08/26/2004
-Residential Building Information - - -
Bldg Style: 01 Ranch No.Bath: 1 Fuel Type: 4 Oil Grade Adjust: 0 Area in Sq. Ft.
1st Story: 1,092 Fin Bsmnt: 0
No.Stories: 1.0 No.Half: 1 Central Air: No Pct Good: 0
2nd Story: 0 Unfin 1/2: 0
Ext Wall Mtrl: 03 Alum/vinyl Bath Qual: 3 Normal Bsmt Type: 4 Full Func Obs: 0
Act Yr Blt: 1973 No.Bdrms: 3 Bsmt Gar Cap: 0 Addl Story: 0 Unfin 3/4: 0
Eff Yr Blt: No.Rooms: 5 Overall Cond: 3 Normal 1/2 Story: 0 Unfin Rm: 0
Yr Remodel: No.Fireplcs: 0 Ext Cond: 3 Normal 3/4 Story: 0 Unfin Ovr Gar: 0
No.Kitchen: 1 Fireplc Type: Int Cond: 3 Normal Over Garage: 0 SFLA: 1,092
Fin Attic: 0 Fin Rec Rm: 0
Kitchen Qual: 3 Normal Heat Type: 2 Hot air Constr Grade: C Average
Land Breakdowns
Land Soil Wtrfrt Depth Intl Infl Intl Intl Land Unit Dim
Type Front Depth Acres Sq Ft Rating Type Factor Pct Cd 1 Cd 2 Cd 3 Value Price Code
01 Primary 135.00 150.00 0.00 0 0 0 34675 256.852
Additional Improvements
Structure Measure SQFT Overall Act Eff Yr Pct Func Sry Unit Bld Bld
Code Code Dim1 Dim2 MISC Qty Grd Cond Yr Built Gd Obs Life RCN RCNLD No. No. Sec
RG1 Garage, 1 Story Attached Dimension 24.00 26.00 .00 1.00 B Good 1973 0 0 0 17740 14724 0 0
LS1 Swimming Pool,Metal Vinyl Dollars 5,000.00 .00 .00 1.00 B Good 1984 0 0 0 16810 15129 0 0
RP3 Porch, Screened Dimension 16.00 10.00 .00 1.00 C Norm 1990 0 0 0 4390 4083 0 0
RP1 Porch, Open Dimension 3.00 5.00 .00 1.00 C Norm 1973 0 0 0 240 194 0 0
I (oSc -(- 0 ( fol f r),____
Septic Inspection Report
Office No. (518) 761-8256 Date In pection °'•u - eived. U ( c /i Z
Queensbury Building &Code Enforcement Arrive: a D:.art: IcIL1i: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia��r , .___..
NAME: I-\'" ti I � ' ' RMIT NO.: -, DO.
LOCATION: i ( ( /i y- c, j/e-e L- 'ft-N C INSPECT ON: , Nil
RECHECK:
Comments and/or diagram
Soil Ty . San m/ Clay
Type of Water unicip ell-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 \r,k---; ft.
Length of each trench i:-/6J-2,1_,_2____ft. 1.-_--4:0 LoPE)
Depth of trenches Z- _ft.
Size of Stone -TrZ--
See Pr's;--Number C271 '______
Size: 7,i' x Zi
Stone Size:
Piping Size Type
Building to tank W :r '. (ei LID
Tank to Distribution Box L/ d %,/42 -77;4--
Distribution
77hDistribution Box to Field/ Pit r j-/ '< <� � tic- --
Opening Sealed: N
End CapN - —'- ti0 L �_
Inlet/Outlet Pipes & Baffles Yf_ N
Manholes 12"or less below grade j'_ N
[provide extension collar if Yes] _Y N
Location / Separations
Foundation to tank i°i ft., . i
Foundation to absorption �-{ , . ‘---L- \-=-1-" M, ��• .
Separation of Pits _ ft. E Cp
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 Re.r Left Side Right Side Middle Front Middle Rear
S stem Use Sta +s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
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CENTER PROJECT
SERVICES
73 Sheridan Street,Glens Falls,NY 12801
Phone-518-796-2515
June 5,2012
Project# 158 •
Dan Drellos
Sanitary Sewer Services
Luzerne Road
Queensbury,NY 12804
Re: Proposed Replacement Septic
Miller Residence— 19 Cherokee Lane, Queensbury,NY
Dear Dan:
At your request we have reviewed your proposed replacement septic system design at the site of
the existing 3 bedroom house of at 19 Cherokee Lane 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 450 GPD and a percolation rate of
1 to 5 minutes, you will need 500 square feet of absorptive area. We recommend using a 20 ft
wide by 25 ft long absorption bed with 4 — 20 foot long laterals, which will provide 500 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 Thomas`xRm" asee
Enginno
Center `���.06 «'`�
Thomas R. Center Jr,P.E.
TOWN OF QUE. : 41
BUILDING & • P 4 D
Reviewed By / dry
Date: Aiwyg
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