2014-139 ` r�` TOWN OF QUEENSBURY
ra742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140139 Date Issued: Monday, May 05, 2014
This is to certify that work requested to be done as shown by Permit Number P20140139
has been completed.
Tax Map Number: 523400-301-012-0003-016-000-0000
Location: 38 COTTAGE HILL Rd
Owner: JOHN FRENCH JR
Applicant: JOHN FRENCH JR
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 N
Director of Building&Cote En ement
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: P20140139 Application Number: A20140139
Tax Map No: 523400-301-012-0003-016-000-0000
Permission is hereby granted to: JOHN FRENCH JR
For property located at: 38 COTTAGE HILL 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: JOHN FRENCH JR Septic Alteration Residential
38 COTTAGE HILL Rd Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
SANITARY SEWER
GEORGE DRELLOS 792-7257
PO BOX 224
GLENS FALLS NY
Plans& Specifications
2014-139
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, April 28,2015
(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 sbury J Mo s t ayj A t ri128, 2014
SIGNED BY - for the Town of Queensbury.
Director of Building&Code Enforcement
pECELIV
Community Development Office D
Town of Queensbury • 742 Bay Road • Queensbury, New Yor iJill 4 6PR 2 4 2014
N vI
Office Use Only vvvlLtUEENSBURY
�___—BUIL9!NG& CODES
`
TAX MAP NO. 61. las 3-/lc PERMIT NO. It/ —I 3 ' PERMIT FEE 7�
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFOREgWORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCEc f OF A VALID PERMIT.
/
OWNER: DA's Fre:'cA INSTAIIFR S..---c711-/r /ff- ,/GG/ recce
ADDRESS: 3i- OSI,3e `l/ //AN ADDRESS: • &?t 022 (f c ^tel /e/4
PHONE NOS. -5 p / PHONE NOS. ` 7f 2 - 72 r7
LOCATION OF INSTALLATION: aJF1C� y/9-rd
NO.OF COMPUTATION RESIDENCE INFORMATION:
YEAR BUILT X = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINDER..
1980 or older 3 X 150 = ys—t� INSTALLED? /'��_
1981-1991 X 130 = SPA OR HOT TUBt✓Q
1992-present X 110 = INSTALLED?
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING X STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY OTHER -
✓ GROUNDWATER: AT WHAT DEPTH? ra
✓ BEDROCK IMPERVIOUS MATERIAL: AT WHAT DEPTH? r71-
✓ DOMESTIC WATER SURLY: MUNICIPAL X WELL (If well:water supply from any septic system absorption is: It
I PERCOLATION TEST: RATE IS AC(4- PER MIINUTE PER INCH[mpg (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: f1/49ry GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,
spa or whirlpo I tub.
SYSTEM E:
AB RPTION FIELD(WITH NO.2 STONE) Total length B n ft Each trench � X 7 0(
o EPAGE PIT(S) (WITH NO.3 STONE) Flow many?
Size?
TERNATIVE SYSTEM Bed or other type? old A .2-s- /
❑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 a and all requirements of the Town of Queensbury QUESTIONS? CALL 7614256 OR EMAIL
Sanewag I ante. codes( queensburv.net
4,-zi-/y
VISIT OUR WEBSITE FOR MORE INFORMATION
Sign re of Person Responsible Date www.queensburv.net
•
Town of Queensbury Building & Code Enforcement I h a� / — to
Office No. (518) 761-8256 J
Septic Inspection Report
Inspection request a t /�
r
Name: n r, 9r rr" '°.. _t _ Inspected on: /Alt / /
Location: 1� I IL¢ . -• Arrive: L ,,' '' a.m.l p.m.
Permit No.: /y—`3! •
Inspector's Initials: �t
Comments and/or diagram
Soil Type: afi Loam/Clay
Type lioWs er: atonidist /Well Water ��
Waterline separation distance ft. f/y \✓_e_ fal
Well separation distance ► �J
deC
Other wells: �f7(v/ 7% _ 3760 7 /,
Well Casing Length 50'+/- °< Y V N NIA / V
[150'to well required if NO]
Absorption Field: Total length Ir ft.
Length of each trench .2-0 ft. n1554:25
C54:2S A- /
Depth of trenches ft.
Size of Stone *� .1-
/
Seepage Pits: Number \---____" l
Size:
PtiQr
Stone Size'
Piping Size Type
Building to tank /1[ 4
Tank to Distribution Box '6�E
Distribution Box to Field/Pit �t atv IT-
_ il2 '
Opening Sealed: N
_VY
End Cap N Qf�j, q/�° ��
Inlet/Outlet Pipes&Baffles N - � yD .a. LAi
Manholes 12"or less below grade Y_N c 7. t rat 4�a�
q-5-
[provide extension collar if Yes] Y N ��✓� rU1—�
Location/Separations
Foundation to tank 17 ft.
•
Foundation to absorption _ ft.
Separation of Pits At r'.
Conforms as per Plot Plan ASN
Engineer Report and As-Built _Y N
ETU Maintenance Contract provided Y N
Location of Syston perry:
Front Rear Left Side Right Side Middle Front Middle Rear
S stem Use Stat
Approved •
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
• 6 P/ 7--071
�'I C PLOT PLAN
I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HOUSES, WELLS, TREES, FENCES, ETC
SHONM S DOCUMENT.I HAVE PERSONALLY
SiEASUe' D.4 SETFORT HO RAM.
V SIGNAT E DATE
TOWN OF QUEEs'S", '
BUILDING & Cr f/
Reviewed By: %' tiad �ts,�
Date: ' -0 ,� ,`
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CENTER PROJECT
SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
April 23, 2014
Project# 180
George Drellos
Sanitary Sewer Services
Luzeme Road
Queensbury,NY 12804
Re: Proposed Replacement Septic
French Residence—38 Cottage Hill Road, Queensbury,NY
Dear George:
At your request we have reviewed your proposed replacement septic system design of the
existing 3 bedroom house at 38 Cottage Hill Road 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 450 GPD and a percolation rate of
1 to 5 minutes, you will need 474 square feet of absorptive area. We recommend using a 20 ft
wide by 25 ft long absorption bed with 4 — 20 foot long laterals, which will provide 500 sf of
absorptive area The absorption bed can be constructed with a new 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.