2013-560 • ' TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130560-40507 Date Issued: Tuesday, March 21, 2017
This is to certify that work requested to be done as shown by Permit Number P20130560-40507
has been completed.
Tax Map Number: 308.19-2-8
Location: 34 ESSEX CT
Owner: Kurt Daubenschmidt
Applicant: IBS Septic
This structure may be occupied as a: Residential Septic Alteration
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, r
j4 4
Variance,or other issues and conditions as a result of approvals by the Director of uilding&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: P20130560 Application Number: A20130560
Tax Map No: 523400-308-019-0002-008-000-0000
Permission is hereby granted to: KURT& ELLEN DAUBENSCHMIDT
For property located at: 34 ESSEX Ct
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: KURT& ELLEN DAUBENSCHMID" Septic Alteration Residential
6 FINCH Rd Total Alteration
alue
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
IBS SEPTIC & DRAIN
ATTN: IVAN BELL
2 LOWER WARREN St
OUEENSBURY,NY 12804
Plans&Specifications
2013-560
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,December 10,2014
(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 sbu Tu: a/ December 10,2013
SIGNED BY ,i for the Town of Queensbury.
Director of Building&Code Enforcement
- P6,0t )(1,.
Office Use Only
Town of Queensbury Building & Codes
Receivdl__, . 0 2013
SEPTIC DISPOSAL PERMIT Tax Mary1D.
Permit No.: / 3— 5 /e70
A permit must be obtained before beginning construction Permit Fee:
Approvals:
r --T6 S eic
Applicant:
16) 5 /+ f Installer/Builder
Address: 2 i 0 ww \W/e/' ,�. Address ,c c!r W S y
Phone: 1 J Y-Y! 9'f Phone Pi y CibI Tt\
Owner: Kr Location of InstallationS L'-P C4-'
Address: i14 E5Sei:. CI`.
Qi,, ef,-,,i6,1 IV 7
Phone 21.--O () .
IV(h/\ x� 61J46
Contact Person for Building&Code Compliance: ' Day Phone:
Residence Information:
Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow 1.
1980 or older x 150 = Garbage Grinder installed? i`f
1981-1991 x 130 = Spa or Hot Tub Installed? %i'
1992—Present .---75 x 110 = 3-) [`1
Parcel Information:
Topography V tat Rolling _Steep Slope _%Slope
Soil Nature ✓Sand Loam Clay _Other
Groundwater At what depth? Iv,r
Bedrock/Impervious Material At w depth? N I�
Domestic Water Supply Municipal f1/, ,Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate- Ni k- 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 100(") 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?
Alternative System Bed or other type? 2.0 Y Zq
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.I •
Print Name: C t t? v`I^ i- �t, (I Date: I 1-10 v f)
Signature: e /lif4 Date: / ..1° _)3
Town of Queensbury Building&Codes Septic Disposal ermit 518-761-8256
Town of Queensbury Building & Code Enforcement f J 3 ( ? 1
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received:
Name: Oa A SCO1rc\ I c1-Ei Inspected on: /, -3
Location: 3 'y Fi&A.,9, Arrive: Air a.m..
Permit No.: / 3-f•(0 Inspector's Initials: _
Comments and/or diagram
Soil Typ . Sa o. lay
Type of Water unicipal A.,ell Water
Waterline sepa . 'on •istance \-D 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 70 ft.
Length of each trench Z. ft.
Depth of trenches .340if ft.
Size of Stone
Size: 10` x `41-)I LEAD\ P,EZ>
Stone Size:
Piping Size Type
Building to tank Htt I,C 'AD NC...-
Tank to Distribution Box
Distribution Box to Field/Pit hO R2)5 NC, 1-1"6 ?E
Opening Sealed: ✓Y N
End Cap 4 N
Inlet/Outlet Pipes&Baffles ✓' N
Manholes 12"or less below grade ✓Y_N/
[provide extension collar if Yes] Y N i\nO EST 1)3 I CA- �K__
Location/Separations — DE7 M-hlCA) Feb 0\
Foundation to tank 'p ft. EtJG‘,).\CES
Foundation to absorption 7 0 ft.
Separation of Pits ft.
Conforms as per Plot Plan ,// N
Engineer Report a i As-Built �/Y N
ETU Maintenance Contract provided Y_N
Location of System on_Property:
Front 6,f) " Left Side fight Si Middle Front Middle Rear
System Use Statu . cA�— RCLAEc OF
_Approved E431- 1►J UPT\ its)
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
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OBJECTS
1 HAVE SEEN OR O6SERVED S,FENCES,ETC --:3
SUCH AS HOUSES,WELLS,TREED, ��, r
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SHOWN ON THIS DOCUMENT.l HAVE PERSONALLY
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Date:
Esse Li.
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury,NY 12804
Phone-518-745-4400 Fax -518-792-8511
December 8, 2013
. til 2113 Project#49369
Ivan Bell
IBS Septic
2 Lower Warren Street
Queensbury,NY 12804
Re: Proposed Replacement Septic
Daubenschmidt Residence—34 Essex Court, Queensbury,NY
Dear Ivan:
At your request we have reviewed your proposed replacement septic system design at the site of
the existing 3 bedroom house of at 34 Essex Court 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 330 GPD and a percolation rate of
1 to 5 minutes, you will need 347 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.
,lE,
Septic Inspection Report
Office No. (518) 761-8256 Date Ins.- io r-' est reo' ed;•' ,
Queensbury Building &Code Enforcement Arrive: • ' itt�i D_•.rt: arr m
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: -
NAME: koc-2EOhC -1 I 01 RM1T NO.: \,
LOCATION: CVA lj F ��� �l;INSPECT ON: I
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 1
[150'to well required if NO]
Absorption Field: Total length __ft.
Length of each trench ft.
Depth of trenches ft. �.��
Size of Stone WILL
Seepage Pits: Number
Size: x E t6b1t,3
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 Rear Left Side Right Side Middle Front Middle Rear
System Use Status: ./
pproved
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
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Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received:
Name: � rn d Inspected on:
Location: e - C 9 i5v, Arrive: a.m./p.m.
Permit No.: 201' `-Dtc D Inspector's Initials:
Comments and/or diagram
Soil Type: Sand I Loam/Clay
Type of Water: Municipal 1 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 ft. o
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 provided Y_N
Location of System 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
Septic Inspection Report
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
Inspections per Permit
Permit# P20130560
Inspection Date Inspection Type
Approved/Denied Comments Permit Type Person Responsible
12/05/2013 Miscellaneous Septic Alteration Residential STAFF
Misc 2013-560
permit app rec'd&entered
12/06/2013 Miscellaneous Septic Alteration Residential JOHN O'BRIEN
Misc 2013-560
Septic System layout w//van Bell
Stone bed will be best option
12/06/2013 Miscellaneous Septic Alteration Residential STAFF
Misc 2013-560
revised septic plan rec'd
12/06/2013 Miscellaneous Septic Alteration Residential STAFF
Misc 2013-560
permit issued
12/31/2013 Septic Septic Alteration Residential JOHN O'BRIEN
Partial 2013-5690
-add vent w/charcoal filter
-need revised design from engineer