2012-378 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: P20120378 Date Issued: Wednesday, September 24, 2014
This is to certify that work requested to be done as shown by Permit Number P20120378
has been completed.
Tax Map Number: 523400-308-006-0001-061-000-0000
Location: PETRIE Ln
Owner: SAMUEL & VIOLA WAHNON
Applicant: SAMUEL & VIOLA WAHNON
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 ` D . /-C/5t--
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.
11
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
111110
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20120378 Application Number: A20120378
Tax Map No: 523400-308-006-0001-061-000-0000
Permission is hereby granted to: SAMUEL& VIOLA WAHNON
For property located at: PETRIE 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: SAMUEL& VIOLA WAHNON
39 SARATOGA ROAD Septic Alteration Residential
GANSEVOORT,NY 12831 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2012-378
Septic Alteration - Lots 17 & 19 Petrie Lane
New Site development
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, August 08, 2013
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of Quee2Sbury1)`AWe y;August 08, 2012
•SIGNED BY for the Town of Queensbury.
Director of Building& Code Enforcement
30 10 -1 -- I
Application for Permit -- Septic Disposal System 0 -3
Town of Queensbtuy 742 liny Rood Queellshr ry,''N (518) 761-8256
1, OWNER INFORMATION: 1A ` v`
gereg
Office Use
Location of installation: C T V-1
•
,act I - Filo Permit N, I � ,-
TaxMapNo.� rb/ / �� UG ;17 2012
Foe raid
Owner's Name: , r �c-�-*—� C�
Address: ) 0 `t r/"�k jict` � • A
fl
2. INSTALLER'S NAME : Gvvt t {� PHONE NO. 7 f -
)
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate 11 bedroom(.) and multiply ll or
bedrooms with applicable gallons per bedroom to equal total daily flow)
r of lio'so: NQ.Lof Uodr pnLs Computation Tool Daily Flow
1980 or older _�� " x 150 gnl/bdrm
1980— 1991 x 130 gal/bdrm =
1991 —present x 110 gal/bdrm =
Garbage Grinder Installed yes,^ / no
Spa or Whirlpool Installed yes J / no
•
4. PARCEL INFORMATION: (circle applicable information & indicate measurements)
-.+.V.9Ii pithy .I:t tore__... cltotind.Wnter_. ..Il.cslt.ock,o!'.11npoCV%.V.Uri_I� ttl9.t.1i11_ •nt . Iic_\/ator.$upply
''rrl rr itr! rrl 1./7(11 depth rtl trh,tl depth Mthd r
inti
iltf; � ---fNr.l ----- feel wet
Steep slope clay if well; water supply
%slope other front any septic-system
depth: absolplton Is f1.
other
•
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: Minute per Inch
5, PROPOSED SYSTEM: For New 4onstntcl�n: All Individual sewage disposal systems must be designed by n licensed
professional engineer or architect (unless instrllled in a Planning Board approved sulxlivision), Add 251) gallons/in the suite
of the septic tank and leads field for each Garbage Grinder, Spa or Whilllxwl 'tub,
Septic Tank: 9.—nCS0 gallon (juin. size 1,000 gal.)
Tile Field: each trellc1O, Tfjfl. Total System Length: 1 \7_— fl• E �- �
Seepage Pit(s): number of size of each: ___ It. by ft.
1 t oe K1t
Size of Stone to be wed: li ___ / depth or Ihlckrtt•.xr �_..._._._......._/irel
Bod System Size: x
Alternative System: length and/or size
411
6. HOLDING TANK SYSTEM: (if required)
= / Size of oacl /TOTAL Capacity: gallons= ` gallons
Number of tank . �� _
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE & INFORMATION FOR RESPONSII3LE PERSON (please read)
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 k based upon or is granted in
reliance upon any tnatetial Illi srepresentatiott or frilttte to make a ntatelial fact or
circumstance known by or on bchnlf of an applicant, shalt be void
I have road the regulations with respect to this application and woe to abide by those and all
requirements .fthe Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person Onto
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received:
Name: \) Inspected on: — Z y — 11-{
Location: Il — i 4P0-1-1
0-f- .e Arrive: i AV ... ..m.
Permit No.: / A - 3 ') g Inspector's Initials: W��
C• ents and/or dia•ram
Soil Type: Sand 1 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.
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 L--\ i1 k-Ao
Tank to Distribution Box
Distribution Box to Field I 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 f 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 provided _Y___ N
Location of System on Property:
Front R r Left Side Right Side Middle Front Middle Rear
System Use Sta s:
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
t.J eci ,ne sC a ID --(a
Septic Inspection Repert
Office No. (518) 761-8256 Date Inspection Jceiv;d:
Queensbury Building &Code Enforcement Arrive: AllDepart: I arJr
742 Bay Rd., Queensbury, NY 12804 Inspector's I - ea,- --
NAME: Ckih n d n P • IT NO.: I i 3 �'8
LOCATION: /> c- I ' Pf -r i 0, PECT ON: a3 -q--0.
RECHECK:
Comments and/or diagram
Soil Typ-: Sand -loam Clay
Type of Water 'unicipal/ • ell Water \--\ _ �1.-! ��/aE-� b• pZ
WWater!' - _•- - '•• eistance k ft. ±—
Well separation distance ft.
Other wells: ft. A '
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length t ' ! ft.
Length of each trench 7 ft. \� ly�
Depth of trenches ZLI I' ),-.36" ft. :vC�
Size of Stone e..4- A( ._ clmRoC)
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank a csT tom?-5"c•kLEc-,
Tank to Distribution Box 9" hl vkLt
Distribution Box to Field / Pit 741' P\C _ V E�F ---VD ' -- ._.,.7 _A
••-ningSealed:
(y7.,NEnd CapN
Inlet/t • •-s&Baffles N C;f )A:\___
Location / Separations
• Foundation to tank -'-ir ft.
Foundation to absorption . -- ft.
Separation of Pitsft.
Conforms as per Plot Plan Y^ N P, QT,,� _____
Engineer Report and As-Built ^•, Y N
Location of System on Property:
Fro Rear Side Right Side Middle Front Middle Rear
S -1 U - _ •
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
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LA„'DS OF }
13'.;SNBURN ELSIE PA12IS ET AL LANDS OF !
EARL WOOD ET_ AL. LANDS
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GRADE SURFACE
DESIGN DATA: TOWARDS THE SWALE
DESIGN FLOW= 700 GPD FOR TWO UNITS W/THREE BEDROOMS EACH (6 BR TOTAL)
NEW STANDARD FIXTURES, (1.6 GPF& 3 GPM MAX.)
AN ELGIN SYSTEM IS PROPOSED AS A SUBSTITUTION TO PREVIOUSLY APPROVED
SEEPAGE PITS
1-5 MINUTE PERCOLATION RATE W/APP RATE OF 1.7 G/SF o
(28) 843 ELGIN MATS REQ'D, (4) ROWS OF 71
88 OUTLET DBOX W/SPEED LEVELERS
1750 GALL DC TANK
28' I X -7 ..)ix-v7 E� 1
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MIN TOWN OF QU " N- „J,. i
BUILDING & Op, ' r .
Reviewed By: i A ,
/
-13'-6" 13'-6"- / i W
Date:
r-N\ LOTS ORIGINALLY P
CALCULATE ADDITI(
AND SIZE SHALLON
2 BR DOUBLE p CONSTRUCT SWALE RAIN INTENSITY, i=
WIDE MOBILE I -j BETWEEN DOUBLE ADDITIONAL AREA F
HOME N WIDE HOMES. GRADE 1960 SF
SURFACE TO SWALE TIME = 1 HR
1
RUNOFF: 2"X 1961
STORAGE CAPACITY
70' 70' TIME FOR FULL SW
(12j
FOR A 12"DEEP S1
b l(tt rl jed- \C(
toI I
, APPENDIX 75A SET&
^� 28' 28' TREATMENT AREA TO
i-1- TREATMENT AREA TO
I � ' SEPTIC TANK TO WAT
IPARKINGI24'X20' I 'C 1 I PARKINGl24'X20' I \TA
I I I \m \ I I IIm
55.00' I _I I \ I __
SHUT OFF_ SHUT OFF
ACCESS ROAD B
--al r
PLAN - DOUBLE WIDE LOT
SCALE 1"= 20'
TME FORT YIU.ER CO.,INC.
THE FORT YiLLER CO.,I . PO BO%9B
SC BOX 96 __�II
` SCNUYLEfMIIE,NT 12671
SC141rLERNLLE.N1.12871 , PHONE:(518)895-5000
.. ..Y
PHONE:(516)695-5000 #2 DISTRIBUTION BOX 1 FAx (518)695-4970
Mc: (518)695— 970 www.fortmiller.com
FORT7 www,forlmiller.COm (8) OUTLET FORT MILLER
MILLER
CONCRETE: 4000 PSI CONCRETE: 4000 PSI
REINFORCEMENT:ASTM A615-GRADE 60 REINFORCEMENT:ASTM A615 - GRADE 60
ASTM A185-GRADE 65 ENTRAINED AIR: 5.0% -9.0%
ENTRAINED AIR: 5.0%- 9.01G
-MEETS ASTM CB90-
-MEETS ASTM C890-
16"
/ 25'
1810 OPENING(TYPICAL}-
EFFLUENT FILTER W/24"0 PRECAST CAP
CARTRAGE
1
EFFLUENT FILTER
HOUSING
EFFLUENT FILTER
<r. PIPE AOAPTERi
441 ZABEL A100 i:TF.".
/ , 13' OUTLET SCREEN FILTER
i
i
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1 I I I I I I I I I 11'..''''.''.1141111114141111% 11°°°°%1111 I I I 1 I 11111
2"
1 1�" Br INLET 111111110 „.
1 // NOTES;
/ •BAFFLES ARE 2 THICK AND 24"HIGH
� •CO HIGH DENSITY POLYETHYLENE
0000PIPE SEALS PROVIDED AT ALL PIPE
CONNECTIONS SHOWN.
NOTES 'CONFORMS TO CURREN'NYSDEC STANDA
ON THREE SIDES FOR 4•PIPE.
•OPTIONAL LIQUID LEVELLER PIPE OUTLETS-(8)4"
•DESIGN CASE 4,NON-TRAFFIC
INSERTS(SPEED LEVELERS)AVAILABLE UPON REQUEST. KNOCKOUTS WITH
•TOP,�OTTOM,AND SIDES �� HIGH DENSITY POLYETHYLENE
ALL 12 THICK. PIPE SEALS.
•DESIGN CASE 2(TRAFFIC) SLAB TOP BOTTOM TOTAL
(LBS) (LBS) (LBS)
50 144 194
HOUSE PIPING TO BE PVC 4" SDR-38 PVC
VENTS, CLEANOUT AND
TRAP PER CODE.
T r )6"/FT. MIN
Y4"/FT. MIN 1750 DC GAL 22- / 4
�� ��SEPTIC TANK
8" COMPACTED GRAVEL 8 OUTLET 0-BOX
OR SAND BASE SPEED LEVS CAULI
ALL OUTLETS
PROFILE - SEPTIC SYSTE
NO SCALE
GENERAL NOTES:
1. DESIGN AND ALL WORK FOR TREATMENT SYSTEM
PER NYSHD APPENDIX 75-A
2.ALL ROOF OR HOUSE DISCHARGES SHALL BE
12'-0" DIRECTED AWAY FROM THE TREATMENT AREA.
3. OWNER/CONTRACTOR RESPONSIBLE FOR
ASBUILT SKETCH OF ACTUAL LOCATION OF
COMPONENTS.
SEED TO 4. PRIOR TO EXCAVATING CONTACT NYS DIGSAFE AT
GRASS 1-800-962-7962.
5. PERCOLATION RATES TAKEN FROM APPROVED
SEEPAGE PIT DESIGN BY VDS,3-16-93.
7.TREES AND ROOTS SHALL BE REMOVED IN
L-\---IN-SITU SAND
---"\_/' 8.
AREAS.
8.SEAL UNUSED INLETS OF SEPTIC TANK.
10.ALL COMPONENTS TO BE SET ON A LEVEL 12"
SWALE CROSS SECTION STONE BASE.
11.D-BOX TO BE 8 OUTLET W/SPEED LEVELERS,
SCALE: 1/2"= 1' CAULK OULTET SEALS.
12. SEPTIC TANK TO BE FM OR EQUAL W/4000 PSI
CONCRETE AND 5-9%ENT.AIR
13.WATER SUPPLY IS MUNICIPAL.
MOUND TOPSOIL TO
ALLOW FOR SETTLEMENT
6-12"TOPSOIL
WHITE \ . lip
ANTI-SILTATION
FABRIC
843 ELGIN MAT r. I
N
IT IS A VIOLATION OF THE LAW FOR ANY PERSON,
o UNLESS ACTING UNDER THE DIRECTION OF THE
LICENSED ENGINEER,TO ALTER ANY ITEM OR
IN-SITU SAND - PORTION OF THIS DOCUMENT IN ANY WAY.
THE ENGINEER HAS NOT BEEN RETAINED TO
PERFORM OR PROVIDE INSPECTIONS OR
4"PERFORATED PIPE CERTIFICATIONS ASSOCIATED WITH THIS PROJECT.
Z IF IN THE COURSE OF THIS PROJECT A CONDITION
L-.\---IN-SITU SAND
EXISTS WHICH DISAGREES WITH THAT AS
�/ `v REPRESENTED ON THESE PLANS.THE CONTRACTOR
SHALL STOP WORK AND NOTIFY THE ENGINEER OR
GROUNDWATER OR IMPERVIOUS LAYER ASSUME ALL RESPONSIBILITY ARISING THEREFROM.
IT IS THE RESPONSIBILITY OF THE
OWNERTO ENSURE THAT ALL
ELGIN DETAIL MATERIAL ORD REDOR COMPLIES WITH PROJECT
SCALE: 1/2"= 1' REQUIREMENTS.
SINGLE WIDE HOMES,
=OR DOUBLE WIDE HOMES c �z -•�ys s{ .+� r+ ti Top 3.
;� s ,.. �38f g S ,L .y t 1 ' .,Gem• .,..':''.,',..A w - ,�„r' Br! OF Ml/��
�'n�S�•H , .• 12 bks • Rye !
FOR 100 YEAR STORM i ,1���`> otl� t.�74+N4. r p( 1 I SiM (:Go ., 'L'1., G -41 1'-
980
980 SF/ UNIT X 2 = �c ' r c• 0 sit ,• an Del' r.4-,„...4.;;;;;.:
s .. CO <i SIL Q�9 r
,.:,;E:.1'4',.nom a 4v Ip r • Qr9 q t'- "" * Ntt/ tP
z VS.`'y::a: Y N _ t ...fart 51■1•Pat 4'1-15.t I
(100 YR STORM) « ti /,f �;
x p r~ 11 1Ylluern�fepr�r r r_�ty,
7 SF/FTX 55' = 385 CF '� � �' • . f s e °"'' n 1 t ,,', .
AT 5 MIN /IN IS 1 HOUR :...','"::!..`ii''.
: .t,.?4rA r y� a: . ,- c'.1' t i.':.--‘431:7.:: t.. rif.gr •
itlakp, Vice 1e+1& �, i 9 1 )t ` 1 • 1n OWY Q Q �?
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ill
. P2 RYAN M. BURNS, NYS P.E. LICENSE No.084062
_s� /k-4 l ,, „?•e DESTROY PREVIOUSLY DATED DRAWINGS
a�� t.,a nH \ }, r.•
V • large 1 v_�z�CPo4K Al-t1
S; —, Elrod Cf SI� .! Mt a : 1 12/14 RB ENG. COMMENTS
�, 1 Th `Rivo _Ai, -$J1/1 ' t,• :J - 1�*
i'^"'_ ', f - NO. DATE BY REVISIONS
1 , ��R �'•. - fe T° 'Mao" ' UPSTATE DESIGN ASSOCIATES
./-
,t
tµt;t� << :A.:‘,..:/ic RESIDENTIALDESIGNAND CIVILENGINEERINGi ,r_ / L� $ RYAN M. BURNS. P.E. IRA S.ADLER, P.E.
•
180PLEASANTSTREET1OMADELINEDRIVEt�. ' KEESEVILLE, NY 12944 SARATOGA SPRINGS NY
t Nanrnnn S % iP: 518-572-0256 518-573-2549 12866
' OaM•IatOwn y ,, /e wooF: 518-536-9058
i CAI1. �} \ ,f ;f t OUEENSBURY VILLAGE MHP
xlnthl 1'<. Raynol' PROJECT: ELGIN SEPTIC/RUNOFF DESIGN •
LOCATION: PETRIE LANE. QUENSBURY NY
LOCATION MAP. SCALE: 1 " = 3 MILES DATE: 10/10/07
DRN.BY: RMBSHEET NO. —
CONSTRUCTION NOTES:
1.HEAVY CONSTRUCTION EQUIPMENT SHALL NOT
1750 GALLON BE ALLOWED WITHIN THE BASAL AREA.VEHICULAR
PARKING SHALL NOT BE ALLOWED ON ANY PORTION
SEP TIC TANK OF THE SEWAGE TREATMENT SYSTEM.
2.BED TO BE COVERED WITH 6'TOPSOIL MINIMUM.
3.DWERSION DITCH SHALL BE CONSTRUCTED TO
DIRECT RUNOFF WATER AWAY FROM THE BED.
24'
MAINTENANCE NOTES:
1. CONTE OF THE SEOR H TANH SHALLPBE
PUMPEDimir EVERY YEAR OR WHEN THE DEPTH OF
SLUDGE EXCEEDS)S OF THE LIQUID LEVEL. TANKS
p. i �•� SHALL BE INSPECTED WHEN PUMPED.
WGT: 120 LBS. 2. ENSURE THAT EXCESSIVE AMOUNTS OF
DETERGENTS AND HOUSEHOLD CHEMICALS DO NOT
ENTER THE SYSTEM.
3.AVOID DISPOSAL OF SANITARY NAPKINS, DIAPERS
163
ETC.
4. NEVER ENTER A SEPTIC TANK
TOP SECTION 5. NEVER USE ABSORPTION AREAS FOR VEHICLE
PARKING.
6.CHECK ABSORPTION AREAS FOR SURFACE
)0/1
PONDING.
7, INSPECT AND CLEAN OUTLET SCREEN FILTER AT
LEAST ANNUALLY.
111 IT IS A VIOLATION OF THE LAW FOR ANY PERSON,
UNLESS ACTING UNDER THE DIRECTION OF THE
LICENSED ENGINEER, TO ALTER ANY ITEM OR
PORTION OF THIS DOCUMENT IN ANY WAY.
oo THE ENGINEER HAS NOT BEEN RETAINED TO
PERFORM OR PROVIDE INSPECTIONS OR
• CERTIFICATIONS ASSOCIATED WITH THIS PROJECT.
BOT SECTION IF IN THE COURSE OF THIS PROJECT A CONDITION
EXISTS WHICH DISAGREES WITH THAT AS
REPRESENTED ON THESE PLANS.THE CONTRACTOR
SHALL STOP WORK AND NOTIFY THE ENGINEER OR
ASSUME ALL RESPONSIBILITY ARISING THEREFROM.
IT IS THE RESPONSIBILITY OF THE
OWNER/CONTRACTOR TO ENSURE THAT ALL
MATERIAL ORDERED COMPLIES WITH PROJECT
REQUIREMENTS.
I TANK WEIGHT,LBS
I SIZE '
I GALLONS I TOP ;BOTTOM'i TOTAL OF ��� .\\
;SECTION;SECTION WEIGHT I
�-`1�'� ' M•
I 1750 13,140 16,320 33,925 ! P� '`�' �L1it, 9�
Y
� �Ai•
a 08406
9° FSS I Ota�'��
/ /7
(4) 28' 4" PERF PVC LEACH LINE 316"
SLOPE W/ END CAPS
RYAN M. BURNS, NYS P.E. LICENSE No. 084062
DESTROY PREVIOUSLY DATED DRAWINGS
/%//////////////////////////ff///////% i 1 12/14 RB ENG.COMMENTS
NO. DATE BY REVISIONS
UPSTATE DESIGN ASSOCIATES
ELGIN 843 MATS, 28'LONG)56" SLOPE RESIDENTIAL DESIGN AND CIVIL ENGINEERING
W/ANTI SILTATION FABRIC AND 12" RYAN M. BURNS, P.E. IRA S.ADLER, P.E.
CLEAN SAND BELOW 180 PLEASANT STREET 10 MADELINE DRIVE
KEESEVILLE,NY 12944 SARATOGA SPRINGS NY
P: 518-572-0256
518-573-2549 12866
F:518-536-9058 QUEENSBURY VILLAGE MHP
PROJECT: ELGIN SEPTIC/RUNOFF DESIGN
LOCATION: PETRIE LANE, QUENSBURY NY
DATE: 10/10/07
DRN.BY: RMB SHEET NO. 2