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2013-036 011111W TOWN QUEENSBURY - OF 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20130036 Date Issued: Tuesday, February 12, 2013 This is to certify that work requested to be done as shown by Permit Number P20130036 has been completed. Tax Map Number: 523400-308-014-0001-052-000-0000 Location: 183 PITCHER Rd Owner: ARC COMMUNITIES 14 LLC Applicant: ARC COMMUNITIES 14 LLC This structure may be occupied as a: Septic Alteration Residential By Order of Town Board 7 3 Ca r 6 Q(,3 cad ( t-A TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the ` f j 4 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. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20130036 Application Number: A20130036 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: ARC COMMUNITIES 14 LLC For property located at 183 PITCHER 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 Value Owner Address: ARC COMMUNITIES 14 LLC Septic Alteration Residential PO BOX 61102 Total Value CHICAGO IL 60606-0000 Contractor or Builder's Name/Address Electrical Inspection Agency SANITARY SEWER DAN DRELLOS PO BOX 224 GLENS FALLS NY Plans&Specifications 2013-036 73 Gregwwod Circle Res. Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,February 01,2014 (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 To of Qu sbu /J F ' y ary 01,2013 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement 11 Community Development Office Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 FEB 0 1 2013 Office Use Only 11 TAX MAP NO,.3f1 g.HA -5. PERMIT NO. I 3 'b3l� PERMIT FEE '1 rI APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM RMIT: A PER IT MUST BE OBTAINED BEFORE WORK EEGINS. APPLICATION IS SUBJECT TO REVIEW /�FORE ISSUANCE i FF A VALID PERMIT. OWNER:P1'�C • i r ' PAiL(L INSTALLER: � 14J � )---19. C (...A_- ADDRESS: . _- ADDRESS: I c pi.) C ck 4, b ADDRESS: p J - -.1y... a y / b F PHONE NOS. PHONE NOS.79 J'J' O LOCATION OF INSTALLATION:?3 6-i-,2 `•GU:)`?) C / (c--(..e RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT X = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRINp7R. 1980 or older X 150 = INSTALLED? NV 1981 -1991 X 130 = SPA OR HOT TUB A 1992-present X 110 = INSTALLED? /" PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLL G ' STEEP SLOPE %SLOPE_ ✓ SOIL NATURE: SAND LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ 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: 100 u 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 ❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many?_ Size?______ _ ALTERNATIVE SYSTEM Bed 2 r other type? 0'x �4l ! ❑ 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 read the re lata. with respect to this application and agree to ide by these d all r . ement the Town o QueensburyQUESTIONS? CALL 761-8256 OR EMAIL a 'ary Se a Disp..- • din codes(a�queensbury.net VISIT OUR WEBSITE FOR MORE INFORMATION Signature of Person Responsible ate www.queensburv.net Septic Inspection Report Office No. (518) 761-8256 Date Inspection r4.1..6=-:- -- - ed: Queensbury Building &Code Enforcement Arrive: = _ Mas depart: I = armor m 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: 4 NAME: ARCe ) PE•J NO.: l3--0—* LOCATION: 73 GP...E u C '0 ( CL_ IN'.• CT ON: 2_—I 1-13 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 lengthft. 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 ear Left Side Right 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 L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report 03 29 10.doc NACE ENGINEERING, P.C. 169 Haviland Road, Queensbury,NY 12804 Phone-518-745-4400 Fax -518-792-8511 February 11, 2013 Job#49335 Ms. Kristine Wheeler New York State Dept. of Health 77 Mohican Street Glens Falls,NY 12801 1 y RE: Forest Park Community—Queensbury, Warren CountyFEB � 2013 73 Gregwood Circle—Replacement Septic System Gentlemen: This letter is to inform you that we inspected the completed replacement septic system for 73 Gregwood Circle in the Forest Park Community on 2/4/2013. The septic system as installed was for a 3 bedroom trailer and consisted of a 1,000 gallon septic tanks and 400 sf of absorption bed constructed with stone and 4 — 35 ft long perforated pipe laterals. The system conforms to the requirements of the approved replacement design drawings. Please call me if you have any questions or concerns. Sincerely, Thomas R. Center Jr., PE cc: Dave Hatin, TOQ Building Dept. P. U r,�L Marty Mancini, ARC 0 9cn cow z J ^ c� 08 Amo azo a #0 9 n zg aF k \ N [Q+ mQ .2`a wvgqn _a aO H< R� F. d wrd a Q x cKi gg wi V) - rw €F ��=d ee�Zo z �rW� omZa a�� a r� � < z •I a LL U4 0W mCjj � �E �(/{ Q NN p p O o��w <a oaz $�n wos3 3 �� o� zap_ wo I x m < � m oz z a a oN < o O Z maN NN I� 3b m# <� Q zWQ� a� o12a� Ba a 9 Q 0. —� dTwM �"o' >Td'acFi I��o pa�z sQi w'o x z�$ tt <g i Q �S—j as 0��go ao�3 .60 �o� �� r mp�jw V) O� wok �� wi3oo� o�� o °a as U 8 $ zI� SWI as o F-mun Z � c7 r.i .p N •u ri m a ,��� °p m � Fy W o N m o w O� N a r3 M io o m I Z [V S J xa W Q r 1 q z gI<� � 3r� i bid w 63i 62, z alo tc 14. $ Ca q < U {.•r iii Ci N vD;•L; z2 LIJ Lu � r N Zis a g` lZ< ��_ � w o $ j • fir eat MA; M� 6 a � Ld 0 s _ 0 0 < a 1 ry 0 van i m m m W CYS Of 3 Svs z F F p 0 W 6e g 7Y11 09 w m d ?¢ b 'NIDI,(M J O J O � Q N V)I<� Z Q Q d W 3 g 7H'i, �Pi .= N Septic Inspection Report Office No. (518) 761-8256 Date Inspectio - "led: 'Queensbury Building &Code Enforcement Arrive: '-L . •r�, 0 epart: \2-tt a /p 742 Bay Rd., Queensbury, NY 12804 Inspector's Ini . , / NAME: A RC(-roR_- RY-N) P.' NO.: \�-C:40 LOCATION: (3 (2 REC.uCtO CAROL F •ECT ON: 2-Lk -`'j RECHECK: Comments and/or diagram Soil Ty • San loam/ Clay Type of Waterlunici al ell Water Waterline separation distance 1 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 lengthCc)-LE-1-1 ft.Length of each trenchJ ft. / r y l_c�?CDepth of trenchesft. 6Size of StoneSeepa a Pits: Number t.Ec \ c ED h SV -t-\ Size: x 7Stone Size: -� Piping Size pe Building to tank ''k " 6C.1\ -\n Tank to Distribution Box k--\`k hnR 75 Distribution Box to Field/ Pit / \ '1 ,/ n R ?).?--i- TO 1/4-:t1t5 DR3 Peggy Opening Sealed: ,/7__._ N End Cap .,/Y_ N ----> GcNE9 Inlet/Outlet Pipes&Baffles / N Manholes 12"or less below grade ,/fir [provide extension collar if Yes] _Y ✓N Location/ Separations K Foundation to tank t Z. ft. IA\A Foundation to absorptionft. Separation of Pits -ft. i Conforms as per Plot Plan Y DF! Engineer Report and As-Built Y_./N 'Q E2.EV C c . 1 ETU Maintenance Contract _Y_ N ,oC� g-- ce._:‘, provided Location of System on Property: T ront Rea eft Side Right Side Middle Front Middle Rear System Use Stat : 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 -••--, ei • • Queensbury Building &Code Enforcement Arrive: tZ,=3o; 'pm /_. 'd-•• : l7,1hU a /pm 742 Bay Rd., Queensbury, NY 12804 Inspector' Initia : /! NAME: C GC • _ t& R P 'MIT NO.: V-.)T n -JIo LOCATION: !