2012-566 TOWN OF QUEENSBURY
4/11
742 Bay Road,Queensbuty,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120566 Date Issued: Wednesday, December 05, 2012
This is to certify that work requested to be done as shown by Permit Number P20120566
has been completed.
Tax Map Number: 523400-308-010-0002-006-000-0000
Location: 479 LUZERNE Rd
Owner: DONALD & JOYCE BUTLER
Applicant: DONALD & JOYCE BUTLER
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 (-- J1.
property owner of the responsibility for compliance with Site Plan, /V
Variance, or other issues and conditions as a result of approvals by the 1
Director of Building& Code En orcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20120566 Application Number: A20120566
Tax Map No: 523400-308-010-0002-006-000-0000
Permission is hereby granted to: DONALD& JOYCE BUTLER
For property located at 479 LUZERNE 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. Tyke of Construction Value
Owner Address: DONALD &JOYCE BUTLER
Septic Alteration Residential
479 LUZERNE Rd
QUEENSBURY,NY 12804 Total value
Contractor or Builder's Name /Address Electrical Inspection Agency
SANITARY SEWER
GEORGE DRELLOS 792-7257
PO BOX 224
GLENS FALLS NY
Plans&Specifications
2012-566
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,November 30,2013
(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; Friday,November 30,2012
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
e Community Development Office NOV 2 9 2012
--' z`' Town of Queensbury • 742 Bay Road • Queensbury, New York •12804
Office Use Only I� 1 cG,
TAX MAP NO. 3n(6 •ID- D.' L
`O PERMIT NO. `5(56=1' PERMIT FEE_° C)
APPROVALS: ZONING___ TOWN CLERK___
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS. _ �'LICATION IS SUBJECT TO REVIEW FORE ISSUANCE OF ALc
LID PERMIT.
OWNER:, ‘---7_--Ps v INSTALLER: _�- � _-L[--eierQ JP
--
ADDRESS: LISP ___
ADDRESS: c.� � ADDRESS: � Q ��� 2 dZ� �,
PHONE NOS.'?T 1- V o l PHONE NOS.7 9.( Q J) f
LOCATION OF INSTALLATION:? 9 L.-t.)2_.f 1-r0 12D
— RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRIN
1980 or older X 150 = i 'V 0 INSTALLED?
1981 -1991 X 130 =
SPA OR HOT TUjb
1992-present X 110 = INSTALLED?
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLIN STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND_ LOAM__ CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT PTH?
✓ DOMESTIC WATER SUPLY: MUNICIPALWELL (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: [CO D 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:
C ABSORPTION FIELD (WITH NO. 2 STONE) Total length ft. Each trench X
❑ SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Size?
46LTERNATIVE SYSTEMICInTpir other type?____,r1_a_r4 -0 '
O 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 ..fe r-:d the r tions with respect to this application and agree to
abi.- b these d I equire � s of the Town of Queens ry QUESTIONS? CALL 761-8256 OR EMAIL
Sa ita Sewa , D' p sal OSI/nce. codes(a�queensbury.net
i it2--F 1. ---
Si a ure of Persldn esponsible Date 1WEBTE FOR MORE INFORMATION
www.queensbury.net
h( 2 ndal, I-3 6 ,m
Septic Inspection Report
Office No. (518) 761-8256 Date Ins ion r-• � - -•.
Queensbury Building &Code Enforcement Arrive: �?G�.t, 1 I.rtMW"---2_,-
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: l 67-' n ' ; IT NO.:
LOCATION: r ' L U -SPECT ON: /a -3
RECHECK:
Comments and/or diagram
Soil Ty. yLv-..am Clay
Type of Water: I •- ' - Water
Water i -paration distance ax 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 'i-\ -\,C- ft. E5 'b ‘,z)o��.
Depth of trenches 2 , __. ft.
Size of Stone
SeSizizee: "7C) X /`S.-�
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box ►--�'l c�����7h
Distribution Box to Field/ Pit / qt' h Q g--3 I'D '.:fit i gQ-
Opening Sealed: Y N
End Cap N
Inlet/Outlet Pipes&Baffles ✓ N
Manholes 12"or less below grade _Y_ N
[provide extension collar if Yes] _Y_ N
Location / Separations
Foundation to tank r 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:
Fron ar Left SideRight Side Middle Front Middle Rear
S stem Use S us:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
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SEPTIC PLOT PLAN
I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HO SES, WELLS, TREES, FENCES, ETC
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CENTER PROJECT
SERVICES
73 Sheridan Street, Glens Falls, NY 12801
Phone-518-796-2515
November 28,2012
Project# 167
Dan Drellos
Sanitary Sewer Services
Luzeme Road
Queensbury,NY 12804
NOV 2 9 2012
Re: Proposed Replacement Septic
Butler Residence—479 Luzern Road, Queensbury,NY
Dear Dan:
At your request we have reviewed your proposed replacement septic system design at the site of
the existing 2 bedroom house of at 479 Luzern Road 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 300 GPD and a percolation rate of
I to 5 minutes, you will need 333 square feet of absorptive area. We recommend using a 20 ft
wide by 20 ft long absorption bed with 4 — 15 foot long laterals, which will provide 400 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.