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2013-338 TOWN OF QUEENSBURY Fow742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codcs (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20130338 Date Issued: Wednesday, August 28, 2013 This is to certify that work requested to be done as shown by Permit Number P20130338 has been completed. Tax Map Number: 523400-302-019-0001-019-000-0000 Location: 123 GRANT Ave EXT Owner: GILBERT E DANNENBERG Applicant: GILBERT E DANNENBERG 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, 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. Oisy TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20130338 Application Number: A20130338 Tax Map No: 523400-302-019-0001-019-000-0000 Permission is hereby granted to: GILBERT E DANNENBERG For property located at 123 GRANT Ave EXT 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: GILBERT E DANNENBERG 123 GRANT AVE. Ext Septic Alteration Residential QUEENSBURY,NY 12804 Total Vane Contractor or Builder's Name /Address Electrical Inspection Agency STONE INSTALLATIONS 232-6707 4305 STATE ROUTE 50 SARATOGA NY 12866-0000 Plans&Specifications 2013-338 Res. Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,July 30,2014 (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 f Que bu7 4 Tu: s a /. . ' 30,2013 i SIGNED BY v' \ for the Town of Queensbury. Director of Building&Code Enforcement .. umce use unly Town of Queensbury Building & Codes Received: SEPTIC DISPOSAL PERMIT i� , . LTaxMl�ID: 2 6 2613 3 °a^t -311, A permit must be obtained before beginning con ction 1 I I Permit No.: 3 v� 1 u JUL 26 t1 13 i Permit Fee: $_ 4 O r I ` L ,Approvals: . '` 1 Applicant: sfe�rc r�1/c./!4./✓oej I p� -InstallerBuilder // -. r. , Address: Y5o/� /c 1`' Ca , Address Yq�ill�`" c. a y -r ..°-. a - ,v. .,Z Phone: a3 ` C7.r / Phone 37V- /p/f/ /. - Owner: 6 / -cef jec.d'eatI 1 Location of Installation /25 6", fI irk Address: /2 3 �j/Pau ff /9?t . Err /�/ QuY�56ve7/A t' /2009 Phone " is Contact Person for Building&Code Compliance: ea" /l u g^JcA Day Phone;37-t 7o7 Residence Information: Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow -- 1980 1980 or older x 150 = Garbage Grinder installed? 1981-1991 x 130 = Spa or Hot Tub Installed? J 1992-Present ajj. x 110 = 71O �/ Parcel Information: Topography 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-/,r/fun 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 as Planning Board approved subdivision). C}rr17 Tank size 000 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 1-7° ft. Each trench 3 X_ft . Seepage Pit(S)(with#3 stone) How many? Size? Alternative System Bed or other type? 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 regul:•:.ns with resect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. . Print Name: (aw Veil' C Date: L6 -*L3 Signature: a/ Date: 7�-ZS-/ Town of Queensbury Bu'sing&Code/-pis Disposal Permit 518-761-8256 /6--- 49-13/1-"' Septic Inspection Report Office No. (518) 761-8256 Date Inspectign-req - . -•: -.61___? 1 Queensbury Building &Code Enforcement Arrive: W0,9 - ••rt: am/pm 742 Bay Rd., Queensb ry, NY 12804 Inspector's Initials: d nJ NAME: 4 \ /A 0,4 . r/ NO.: �i3 - 33 �5 LOCATION: , - - O.1:_rt_ ' r I 4. ON: W a 3/?-r)7 3 g_P bed( RECHECK: / J Comments and/or diagram Soil Ty . Sa m/Gay Type of Water: unici If Well Water ¶9 r.JT --k#4.) Wa potation 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 J c Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank t-; " L= Tank to Distribution Box 14" ht_,Ft..tf\ Distribution Box to Field/ PitzLi" V c'c- . t\l .C)c t L INZ� Opening Sealed: 1 N End Cap N Inlet/Outlet Pipes&Baffles ✓Y N Manholes 12"or less below grade N [provide extension collar if Yes] Y N Location/ Separations Foundation to tank lEaicra R. epi, co, Foundation to absorption z,r`-'i"ft. Separation •W ,. ., lot Plan - gineer : --. • • -:uilt ✓Y_N • '-nonce Contract Y N provided — — Location of System on Property: Front Rea Left Side Right Side Middle Front Middle Rear stem U S Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved LAPam Whiling\2010\Building Codes Forms\Inspection Fom�Septic Iron Report_03 2910.doc ir I + • G.Peter Jensen 17 West Road South Glens Falls New York 12803 (518) 798—3859 August 23, 2013 To Whom It May Concern: For the Gilbert Dannenberg residence septic system replacement(plan 13-0503), 120 Lin. Ft. of Hancor ARC 24 chambers will satisfy the requirements for a 3 bedroom residence, The residence is located at 123 Grant Avenue Extension, Queensbury,New York Sincerely, / 41 G. Pet Jensen ,AspEO ARcy', it _sitehicks 14„ i .; iti,i _K t ►. r oteotc q AS BUILT TOWN OF QUE-1d' / L BUILDING & .D' ;• JJ Reviewed By �� ll/ Date: &gnu, V t �' I AES✓�Zt I�GN TRENC;4 � y" EX 1S"!'{NG GftA(Jkz ;q:VEMbED Or; NT IN PEMOVEA8i_E COVET{ ,o low CRUShIEL7 STON9 /4` A»Sp,r'`T"1;'�^1 qi�.�, SE✓TlCN �'?!�,>' ;'�.• ` ,80x ��4 TIDr�t - N TS t I F�EStUENGE } R/�I T AVENDE r�aXTENS10N FL©`F FLAN to JiL 2 2813 -- 8AFFLE Zi Dl 7 F�If3E1 � tf�Ne.Ox FLAN N r� - SEED AREA AFTER INSTALLATIOtV UNTREATED MUfLDING PAF'ER X1 SFW EP PIPE P11:14 r�"i�f?PER FOOT N _c Q0 CRusii£ '=' SroNEii �" I :507" >M GF T74C1 2i`4Es MINIMUMZ'AEOVE SEA50NIAL HIGH GROUNI3 2_O - % WATER `)R IMFE:RVIW `i LjYL Fi, ?h'l rYLHES D,a,WfTg4't1.SEAPSi_F': OIL Re OOrRr;T> t3E'I'Vviw�:'iF' TR'ENGNES N Y$ lilt E COPY / 8fiGl! F1 LL - 01S7RI15UT/ON PIPE SLOPE -"- i,;:ER FOOT __— AW_ .Y l-L-VCL "TKC'NCN PJOTTOM.. LONIG I-rU0i INA L. ISE6:7_1044 NT5 6e1/�, 33q EpED A,4 it is a Violation of the Law for any Persson,^ Unless Acting Under the Direction of a j ` Licensed Architect, to Alter any Portion of This Document in any way. Ii any Portion of this Document is so Altered, the Altering Architect ! Shall Affix to the Portion so Altered his Seal and 1the Notation 'Altered By" Followed by his �28Dt�' b Signature and the Date of Such Alteration, arxf a Specific Description n+ the Alteration. iL TOWN OF C ' BUILDING ' GILSERil DANNENBERG RBVI@W0 ? G. PETER JENSEN i. Date. 1 17 WEST ROAD PLAN ! SOUTH GLENS lay FALLS -- - -- —{ NEW YORK 12803 PERCOLA'1­101`4 RATE WAS LESS THAN ONE MINUTE PER INCH. REMOVE 501E TU A DEPrN OF 4' In ARSORP'T'/ON ARTA AND 2' ZLZY01�0, AMENL` _arL To A 5-1 MINUTE PERWLATIDN RATE - OR F,EPiL.ACE !U>IL— Nt=W SOIL TO HAVE A S'-7 MINUTEBATE 4T SOKROVy PIT. COMPACT REPLACteMENi (AMENZWD e7P, NEW)IN &` L/F-M. ZiSIFOROOM RtA ITOE.-41,n-Z4oG'P0 FLOW PA75 1N SOIL WITH A 5-7 MINUTE i`ERCOI_AT/L>N 'FA _r6 t�EQUIF?E�a 110LIN,FT. Ai?SORPTION TRENCH- ___."__� zO LbN,Fr PROv=DED(3 RUNS E 401 WAaN�, 2, CONNEC"f GRAY WATER PIP)Nv tv SC.P*r#e_ SYSTEN4 .S. PEJA,?Ve ANYCDNTAM!NAT,vD SOIL ENCOUNTERGV, � r'R C1V1€�[.". 2ANI'TAR'i rEar;, uv ExLSTING SEPTIC ?'2 A' 2'.4 2`L• i TANK -1,F FEnC.%IFF,0- ENDCAP 7YP!:!A4 S• SET' DISTRIBUTION eOA LEVE!_, IN STA LL SPEE'LU LEV£L RS IN VIST-RISU77014 F.'AX. 1► 1 Ae= or;rnr�N TRr 17, U5E o1v_Y s7L 11) PlKIF� WITH TtGNT JC�tni� SEnKGEty p �-� 1 1Tk` oil WANK AND DISTR!$tJTIDh! SOX AID 8E7WL5EN i�IST}7'SfJTlG*Pl ',d;JX ANBD ESE[,.IIVNIN;� of A8.,ORr'TIOnr 1 4 `Q t 11. ; 1 �C moi. NO �ORTIt?tl OF SEPTA-` SYSTEM SHALL Si5 ' i 6 � ytF7f /N IQ QF AN'( p`RC> >= 14'FV LIN€'". NO 0M.11,;'f'Of?TION - D1.STZ't OU7 .6A OR ASC�5 101v 1 ARBA at -+A" ENP i ts1N 14 ANY WELL)LAKt:1 }t STREAM PONrDI R 1\/ER OP WE-ri ANV, I!( 16, INS7AI.LATt0N MU57 e 5 l NSf GTGD-P(Z?Of `t COVERl,'4.'a- 73Y THL $U1LD11VG tNSf'C-sG.7"Or> DISTRISU?7UtilE�>< _ /�F HC UP, Y, n 4 SOL ID P: f ;� EXI9TIIV� s�YTSc T F;.vr: I I F�EStUENGE } R/�I T AVENDE r�aXTENS10N FL©`F FLAN to JiL 2 2813 -- 8AFFLE Zi Dl 7 F�If3E1 � tf�Ne.Ox FLAN N r� - SEED AREA AFTER INSTALLATIOtV UNTREATED MUfLDING PAF'ER X1 SFW EP PIPE P11:14 r�"i�f?PER FOOT N _c Q0 CRusii£ '=' SroNEii �" I :507" >M GF T74C1 2i`4Es MINIMUMZ'AEOVE SEA50NIAL HIGH GROUNI3 2_O - % WATER `)R IMFE:RVIW `i LjYL Fi, ?h'l rYLHES D,a,WfTg4't1.SEAPSi_F': OIL Re OOrRr;T> t3E'I'Vviw�:'iF' TR'ENGNES N Y$ lilt E COPY / 8fiGl! F1 LL - 01S7RI15UT/ON PIPE SLOPE -"- i,;:ER FOOT __— AW_ .Y l-L-VCL "TKC'NCN PJOTTOM.. LONIG I-rU0i INA L. ISE6:7_1044 NT5 6e1/�, 33q EpED A,4 it is a Violation of the Law for any Persson,^ Unless Acting Under the Direction of a j ` Licensed Architect, to Alter any Portion of This Document in any way. Ii any Portion of this Document is so Altered, the Altering Architect ! Shall Affix to the Portion so Altered his Seal and 1the Notation 'Altered By" Followed by his �28Dt�' b Signature and the Date of Such Alteration, arxf a Specific Description n+ the Alteration. iL TOWN OF C ' BUILDING ' GILSERil DANNENBERG RBVI@W0 ? G. PETER JENSEN i. Date. 1 17 WEST ROAD PLAN ! SOUTH GLENS lay FALLS -- - -- —{ NEW YORK 12803