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2013-396 Oa TOWN OF QUEENSBURY 742 Ba•Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20130396 Date Issued: Wednesday, August 28, 2013 This is to certify that work requested to be done as shown by Permit Number P20130396 has been completed. Tax Map Number: 523400-295-014-0002-045-000-0000 Location: 27 CROWNWOOD Ln Owner: GEORGE & EILEEN STUART Applicant: GEORGE & EILEEN STUART This structure may be occupied as a: Septic Alteration Residential By Order of Town Board TOWN OF QUEENSBURY 4/..X---- Issuance of this Certificate of Compliance DOES NOT relieve the NP 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 ET 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20130396 Application Number: A20130396 Tax Map No: 523400-295-014-0002-045-000-0000 Permission is hereby granted to: GEORGE & EILEEN STUART For property located at: 27 CROWNWOOD 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: GEORGE &EILEEN STUART 27 CROWNWOOD 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 2013-396 RES. Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,August 21,2014 (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 Town u nsbuWe es.ay,August 21,2013 4 SIGNED BY r for the Town of Queensbury. Director of Building&Code Enforcement Community Development Office r. Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 Al 2 0 2013 Office Use Only TAX MAP NO. t 9 S I - J 1 S PERMIT NO. 13 9(.P PERMIT FEE__ APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: 62eOjC_ S }i± INSTALLER: ••--CA-/vi,•--CA-/vi,/f} "re tie4n sC'/!/�c�' ADDRESS: 7 (1�OG✓//Gt/OYic.12 /lMe ADDRESS:,14.1 ./ Z4',e PHONE NOS. 7" ' — Z f-7 PHONE NOS. 772 -7z r 7 �' 716-3 76. LOCATION OF INSTALLATION: RESIDENCE INFORMATION: YEAR BUILT NO.OF COMPUTATION X = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRINDER 1980 or older / X 150 = 6Q O INSTALLED? ""v 1981 -1991 / X 130 = SPA OR HOT TUB 1992-present X 110 = INSTALLED? Nv PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND_ LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? N/k ✓ 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 /—SJ n-";•" 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: /ate _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? 44 ALTERNATIVE SYSTEM Bed or other type? 2.O 3 ❑ 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 with respect to this application and agree to abide by these and all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL Sanita ew.,!is•osa.• dinance. codes�alqueensbury.net Signatu of Person Responsible Date VISIT OUR WEBSITE FOR MORE INFORMATION www.queensbury.net I L.e S j .- 3 Cies\ Septic Inspection Report Office No. (518) 761-8256 Date Inspection req - cei -•: Queensbury Building &Code Enforcement Arrive: \? '�J •epart: am/pm) 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial NAME: 3 `�r tRMITNO.: ' LOCATION: '7 ( re)(-,;n INSPECT ON: RECHECK: Comments and/or diagram Soil Type: •. oam/ Clay Type of Waters ell Water vet �n Waterline separation distance �� -a \ t. 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 w uft. -t- lb C- Depth of trenches ft. ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Tyne Building to tank LLkt huh an Tank to Distribution Box 4`k Distribution Box to Field/ Pit / L{`` Opening Sealed: V Y N End Cap N Inlet/Outlet Pipes&Baffles Y Manholes 12"or less below grade _Y_N [provide extension collar if Yes] _N Location/ Separations Foundation to tank !,`-v ft. Foundation to absorption –2__L-1 ft. Separation of Pits l 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 Rear 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 L:Tam Whiting\2010\Bullding Codes Forms\1nspection Forms\Septic Inspection Report 03 29 10.doc .y 41. l 1 TOWN Or �UEE►. :Y f ?s', 477 Reviewed C %%, �, 00 � r __ 4. Date: limp .. ___..E.ri Q / �� �` k I , i_,{0a, .eI D G-) I:1i P rf)P i 1 ,,,,, N N O_ zil SEPTA PLOT PIAN �7 nf04`''`� .�•r , ' I HAVE SEEN OR OBSERVED ALL OBJECTS _ :;���.,,A•�G, SUCH AS HOUSES. WELLS. TREES, FENCES, ETC /1.A-/ SHOWN 0 IS DOCUMENT.I HAVE PERSONALLY ,��,v«, ,EASU" HE�;4T ON THIS DIAGRAM. `$IG�a.4I ,RE DATE • CENTER PROJECT SERVICES 73 Sheridan Street, Glens Falls,NY 12801 � Phone-518-796-2515 AV August 16,2013 Project# 175 Dan Drellos Sanitary Sewer Services Luzerne Road Queensbury, NY 12804 Re: Proposed Replacement Septic Stuart Residence—27 Crownwood Lane, Queensbury,NY Dear Dan: At your request we have reviewed your proposed replacement septic system design at the site of the existing 4 bedroom house of at 27 Crownwood 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 600 GPD and a percolation rate of 1 to 5 minutes, you will need 666 square feet of absorptive area. We recommend using a 20 ft wide by 35 ft long absorption bed with 4 — 30 foot long laterals, which will provide 700 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.