2013-230 e" TOWN OF QUEENSBURY
111
742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
Q rl,
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130230 Date Issued: Thursday, September 11, 2014
This is to certify that work requested to be done as shown by Permit Number P20130230
has been completed.
Tax Map Number: 523400-301-009-0001-037-000-0000
Location: 26 WESTERN RESERVE Trl
Owner: CHRISTOPHER & SUSAN HENDRY
Applicant: CHRISTOPHER & SUSAN HENDRY
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, c �G '
4
Variance, or other issues and conditions as a result of approvals by the Director of Building&Co e En h ement
Planning Board or Zoning Board of Appeals.
Aek TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20130230 Application Number: A20130230
Tax Map No: 523400-301-009-0001-037-000-0000
Permission is hereby granted to: CHRISTOPHER& SUSAN HENDRY
For property located at: 26 WESTERN RESERVE Trl
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: CHRISTOPHER& SUSAN HENDRS
26 WESTERN RESERVE Trl Septic Alteration Residential
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
IBS SEPTIC & DRAIN
ATTN: IVAN BELL
2 LOWER WARREN St
OUEENSBURY,NY 12804
Plans&Specifications
2013-230
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,May 28,2014
(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 Tow eensbu ; T e d ,May 28,2013
SIGNFD BY for the Town of Queensbury.
Director of Building& ode E orcement
Community Development Office
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804
Office Use Only terks. `" �1U
TAX MAP NO. bat'9- l -3 7 PERMIT NO. /3-a30 PERMIT FEE I 1 cy00
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS.INpAP LICATION IS SUBJECT TO REVIEW gEFORE ISSUANCE OF A VALID PERMIT.
OWNER: C�r I 1..ter‘'0 re INSTALLER: '-'+'6 .S
J� n
ADDRESS: J G j -f I\ Orel l"A/P ADDRESS: L- ��I 9 i pc U f'(' \J
34
- -I .
PHONE NOS. 1 ) J PHONE NOS. -1 1 I- `
LOCATION OF INSTALLATION:
RESIDENCE INFORMATION:
NO.OF COMPUTATION
YEAR BUILT X = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINDER
1980 or older X 150 = 1- INSTALLED? IV /1
1981 -1991 X 130 = iV ti( SPA OR HOT wielr
1992-present X 110 0 INSTALLED? iv I
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROI NG STEEP SLOPE\U N %SLOP
✓ SOIL NATURE: SAND LOAM CLAY orOTHER V ft
✓ GROUNDWATER: AT WHAT DEPTH? I UIP\`
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WH DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL NI (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS 'v 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: 1000 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: nn//�� O
❑ABSORPTION FIELD(WITH NO.2 STONE) Total length200 ft. Each trench X
❑SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? hi 4\ Size?
o ALTERNATIVE SYSTEM Bed or other type? ` p 1 ‘
o HOLDING TANK SYSTEM Total required capacity? ,V W Tank size? V IV Number of tanks? ivrN
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 reg :tions with respect to this application and agree to
abide by theSean•.:I equirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sanit.ry � �: • posal Ordinance. L�� y codes{a�queensburv.net
g
Signet e . 'erson Responsible `Date VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburv.net
NYS-Real Property System Subject Property Inventory Summary RPS030/VO4/L001
County of Warren For Current Year File 2013 Date: 5/28/2013
Town of Queensbury Parcel ID:301.9-1-37 Sheet 1 of 1
SWIS Code-523400 Active
Parcel Information - Parcel Land Size , File Maintenance Info
Curr Owner: Hendry Christopher G Acct#: Front: 0.00 Acres: 0.79 ; Created: 02/02/2005
Location: 26 Western Reserve Trl School Cd: 523402 Queensbury Un.fr.: Depth: 0.00 Sq Ft: 0 Modified: 05/01/2013 03:03 PM
Queensbury, NY 12804 Roll Sect: 1 Taxable RS/S: By: Batch FM byteri
Grid Coordinates
Prop Class: 210 1 Family Res East: 696555 North: 1637315 Folder: ASSESSMENT
Site Characteristics
Site No: 1 Nbhd Cd: 173 Newer B to A Site Desire: 2 Typical DC Entry Type: 5 No entry 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: 05/01/2013
Route No: Utilities: 3 Electric Road Type: 3 Improved Reappraisal: 01/28/2011
Residential Building Information
BldgStyle: 01 Ranch No.Bath: 2 Fuel Type: 2 Natural GE Area in Sq. Ft.
tY YPGrade Adjust: 0 1st Story: 1,800 Fin Bsmnt: 0
No.Stories: 1.0 No.Half: 0 Central Air: Yes 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
Addl Story: 0 Unfin 3/4: 0
Act Yr Blt: 2006 No.Bdrms: 3 Bsmt Gar Cap: 0
1/2 Story: 0 Unfin Rm: 0
Eff Yr Blt: No.Rooms: 0 Overall Cond: 3 Normal
3/4 Story: 0 Unfin Ovr Gar: 0
Yr Remodel: No.Fireplcs: 0 Ext Cond: 3 Normal
Over Garage: 308 SFLA: 2,421
No.Kitchen: 1 Fireplc Type: Int Cond: 3 Normal
Kitchen Qual: 3 Normal Heat Type: 2 Hot air Constr Grade: B Good Fin Attic: 313 Fin Rec Rm: 1,020
Land Breakdowns
Land Soil Wtrfrt Depth Infl Infl Infl 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 150.00 229.00 0.00 0 0 0 64307 428.713
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
RP1 Porch,Open Dimension 4.00 6.00 .00 1.00 B Norm 2006 0 0 0 548 537 0 0
RP2 Porch,Covered Dimension 5.00 27.00 .00 1.00 B Norm 2006 0 0 0 4143 4060 0 0
RG1 Garage, 1 Story Attached SOFT/Mi; .00 .00 528.00 1.00 B Norm 2006 0 0 0 17757 17402 0 0
RP1 Porch,Open Dimension 12.00 20.00 .00 1.00 B Norm 2006 0 0 0 4068 3987 0 0
LS1 Swimming Pool,Metal Vinyl Dollars 5,000.00 .00 .00 1.00 B Norm 2006 0 0 0 22820 22364 0 0
FC1 Shed,Wood Or Machinery Dimension 8.00 12.00 .00 .00 B Norm 2006 0 0 0 1988 1948 0 0
AP1 Fence,Chain Link(Galvaniz Dimension 4.00 120.00 .00 .00 B Norm 2006 0 0 0 143 132 0 0
umce use unit'
Town of Queensbury Building & Codes Received:
SEPTIC DISPOSAL PERMIT Tax Map ID:
Permit No.:
A permit must be obtained before beginning construction Permit Fee:
Approvals:
Applicant: `( �r( / InstallerlBuilder ��. S Si�z C
Address: IP) Co t-f CA---'Pr'r- -5 7 Address `" (p LA c/` (,a n/c^"f/
016
Phone: 7 9 Phone -7Y---,,K191
Owner: C 1 " j /6(c A, circ Location of Installation 26 (,„...( 5 Fer ti f/e /L (
Address: ? 6 6`,<-tf'�iC I.c_ r�r /rvc
Phone rd- 3) - Z S- s'-`
Contact Person for Building&Code Compliance: Day Phone:
Residence Information:
Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow
1980 or older x 150 = Garbage Grinder installed?/
1981-1991 x 130 = Spa or Hot Tub Installed? -
1992-Present C f x 110 = ({Z(Q
Parcel Information: \/
Topography J\ Flat Rolling _Steep Slope %Slope
Soil Nature Sand Loam Clay _Other
Groundwater At what depth?
Bedrock/Impervious Material At what depth?
Domestic Water Supply Municipal Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate- per minute per inch(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 gallon(minimum size 1,000 gallons),add 250 gallons to size of septic tank for each garbage grinder,spa or whirlpool tub
System Type: Absorption Field(with#2 stone) Total length ft. Each trench X
Seepage Pit(S) (with#3 stone) How many? Size? n
Alternative System Bed or other type? gr 6- 7, i 56z /` (
Holding Tank System Total required capacity? Tank size? #of tanks?
NOTE: 1)Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agency-see Certified Electrical form
on Town website; 2) Effective as of March 23, 2006 Septic System-As Built Plot Plan: The Building Department will no longer allow systems to be
covered until such time as an As-Built Plot Plan is received and approved by the Building Inspector. The installed system must match the septic system
layout on file. There will be no exceptions.
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 Queensbury Sanitary
Sewage Disposal Ordinance. /
Print Name: ((Jo, /lam ( - Date: / / d /.(
Signature: (12l � Date: d
) )0/
Town of Queensbury Building&Codes Septic Disposal Permit 518-761-8256
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Septic Inspection Report
,
Inspection request received:
Name: -fie(Id r-%_ Inspected on: C///
Location: at, up e,s t`et-n R S car' Arrive: a.m.!p.m.
Permit No.: / 3—a3E) Inspector's Initials: (Di-
Comments
Comments and/or diagram
Soil Type: Sand I Loam I Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50'+I- 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
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 4,Y N
Engineer Report and As-Built Y N
ETU Maintenance Contract provided Y N
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
S stem Use Stats:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report
V1v Helm I--3
n pro)
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart:/_,LE�-- am/pm
742 Bay Rd., Queensbury,rLNY 12804 Inspector's Initials
�7 / `
NAME: 6(1C1- r PERMIT NO.: /3-',-D1.�diPt
LOCATION: t g Li K.Stt?s r) i 6.-S -F 9C NSPECT ON: ' / I3
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 L Ce 0 ft.
Length of each trench 40 ft. 13.- --1) 9-05-1-29-k,
Depth of trenches ft.
Size of Stone --4; r% .
Seepage Pits: Number # L
Size.
Stone Size: L
Piping Size Type
Building to tank ---7._-.— -V._t.
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: _Y_N
End Cap 14-Y_____fl
Inlet/Outlet Pipes&Baffles Y—/N
Manholes 12"or less below grade _Y_ N
[provide extension collar if Yes] . _Y_ N '- --3-"Ji•- -
Location / SeparationsR ..-c9--c,"17:. --
""
Foundation to tank /OA ft.
Foundation
o absorptionfPis ft. eG �� � Tv
Separation of Pits ft.
Conforms as per Plot Plan _Y______)4 .T7> \,^ (eC."- 4. r ��
Engineer Report and As-Built Y
ETU Maintenance Contract _Y_ N
provided
Location ystem 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 request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart r am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: L
NAME: d PERMIT NO.: / .3- .3 C)
LOCATION: 1'P iJ rrf--t'1 AcG..s -4"VE, INSPECT ON: % -"/.3 --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 lengthje—
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size:
Stone Size:
Piping Size Type
Building to tank i` •
Tank to Dis�aox V �"- 56-61/4 1/4 V h
D' / Pit Ca -- f l a k-dj et-A- 4,J
Opening Sealed: =v N
End Cap ‘77 N
Inlet/Outlet Pipes& Baffles ' Y
Manholes 12"or less below grade
[provide extension collar if Yes] N
Location / Separations
Foundation to tank MT* ft.
Foundation to absorption • .
Separation of Pits _ ft.
Conforms as per Plot Plan —_Y ,IV
Engineer Report and As-Built Y N Z-- \ R O,N — L'
ETU Maintenance Contract _Y_ N r rte,
provided CLe-c--01-3T _ 1�j`�d
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
system Use Statu-.
Partial • •••• and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report03 29 10.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: - ) , lPERMIT NO.:t ' � '2 U
LOCATION: ..,_..,:, s -�_r-rL (� INSPECT ON: .1
RECHECK:
Comments and/or diagram
Soil Type: Sand/ Loam/ Clay
Type of Water: Municipal / Well Water
Waterline separation distance ft.
Well separ ro distance ft.
Ot -r wells: ft.
Well Casing Le gth 0' + /- N N/A
[150'to w I requir-,� if NO]
Absorption field: Total ength ft.
Length of each ench _ ft. �p --�U��� 1���--� --
Depth of tre ches ft.
Size of one �1r (-2-- --- 6v'f-TZ__
See,-ge Pits: Nu •-r
Sire: x
Stone Siz: ,t5- 4 ('cam_
-'
Cr-
Piping Size Type
Buil.'ng to tank k'CL-1 --
Tank to Distri•ution Box
Distribution Box t• Field/ Pit
Openi Sealed: _Y
End Ca Y N �.`-- --'--
f' F _ �V`. t C�-�5 5 P
Inlet/Outlet Pipes : Ba' -s Y N j,L ` .
Manholes 12"or less beim gr.de Y— N
[provide extension collard es] 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 otem on Property:
ro Rear Left Side Right Side Middle Front Middle Rear
S stem Use S t .
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Form\Septic Inspection Report_03 29 10.doc
..00111 ills 0111104100
THE NEW PRESSURE BED IS TO BE PLACED IN THE AREA OF THE EXISTING TILE FIELD
ACCORDING TO THE TOWN RECORDS THE EXISTING TILE FIELD IS A GRAVITY SYSTEM
THAT WAS INSTALLED APPROXIMATELY 7 YEARS AGO. THE CURRENT OWNER HAS LIVED IN
THE RESIDENCE FOR THE LAST 3 YEARS. BASED ON TEST PIT OBSERVATION PERFORMED 29 MAY 2013
WITNESSED BY JOHN O'BRIEN FROM THE TOWN OF QUEENSBURY. THE SOIL IN THE AREA OF THE
EXISTING TILE FIELD IS SUSPECTED TO BE IMPORTED FILL MATERIAL AND IS UNSUITABLE FOR THE
CURRENT SYSTEM. THE EXISTING MATERIAL IS TO BE REMOVED AND NEW STONE ABSORPTION BED
MATERIAL IS TO BE INSTALLED ALONG WITH A NEW EFFLUENT PUMP AND TOP SOIL MATERIAL. THE
NEW SYSTEM 1S TO BE INSTALLED AT OR JUST BELOW EXISTING GRADE AND THE NEW TOP SOIL
MATERIAL IS TO BE GRADED SO THAT POSITIVE DRAINAGE IS PROVIDED AWAY FROM THE NEW SYSTEM
IN ALL DIRECTIONS. ASSUMED PERCOLATION RATE OF PLACED FILL AND EXISTING MATERIAL TO BE
11-15 MIN. PER INCH.
EXISTING 4 BEDROOM RESIDENCE AT 110 GAL/DAY/BEDROOM = 440 GPD
440 GPD DIVIDED 0.80 GPD\SF = 550 SF OF PRESSURE BED REQUIRED
USING 15 LF OF TOTAL BED WIDTH REQUIRES 40 LF OF BED LENGTH = 600 SQ. FL
3" SOLID MANIFOLD WITH 3" PERFORATED PRESSURE LATERALS AT 5'-0" O.C. SET LEVEL WITH END CAPS
ENTIRE AREA OF PRESSURE BED (44'x19') TO HAVE 12" WASHED CRUSHED STONE 3/4" TO 1-1/2" SIZE
BELOW FORCE PIPING WITH A MINIMUM OF 6" WASHED CRUSHED STONE ABOVE THE PIPE LATERALS.
ENTIRE BED AREA TO BE COVERED WITH PERMEABLE GEOTEXTILE OR UNTREATED BUILDING PAPER PRIOR TO
PLACEMENT OF TOPSOIL. TOPSOIL LAYER TO BE 6" MAX. IN DEPTH.
PUMP SIZING 40'FOOT LATERALS x 4 LATERALS + 25 LF OF MANIFOLD = 185 LF OF PIPE x 0.589 PIPE AREA x 85% = 93 GAL FIELD CAPACITY
PUMP TO BE SET SO THAT MAXIMUM 95 GAL PUMP CYCLE AT 1.0 PSI PRESSURE IN THE PIPE AT THE FIELD.
GENERAL NOTES
INFORMATION SHOWN ON THIS DRAWING IS TAKEN FROM
A SURVEY DRAWING PREPARED BY VAN DUSEN & STEVES
LEGEND
---------- PROPERTY LINE
-------- -------- PROPERTY LINE SETBACKS
----------330---------- EXISTING CONTOURS
330 NEW CONTOURS
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