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2014-239 ,� TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20140239 Date Issued: Monday, June 30, 2014 This is to certify that work requested to be done as shown by Permit Number P20140239 has been completed. Tax Map Number: 523400-301-017-0001-012-000-0000 Location: 535 WEST MT. Rd Owner: GORDON & BEVERLY KILTS Applicant: AMBER PATTEE 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, Gf/ Variance, or other issues and conditions as a result of approvals by the Director of Building&C n cement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 14 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140239 Application Number: A20140239 Tax Map No: 523400-301-017-0001-012-000-0000 Permission is hereby granted to: GORDON & BEVERLY KILTS For property located at: 535 WEST MT. 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: GORDON & BEVERLY KILTS 535 WEST MT. Rd Septic Alteration Residential QUEENSBURY,NY 12804-0000 Total Value Contractor or Builders Name /Address Electrical Inspection Agency SANITARY SEWER GEORGE DRELLOS 792-7257 PO BOX 224 GLENS FALLS NY Plans&Specifications 2014-239 Res. Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 19,2015 (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 f Que bury 4Th. .d . : :a 19,2014 SIGNED BY -1'- \ for the Town of Queensbury. Director of Building& Code Enforcement • 5 m— Office Use Only Town of Queensbury.Building & Codes h a Received: L)) r Tax Map ID: SEPTIC DISPOSIL PERMIT " li o ll t Permit �� A permit must be obtained before f egin{3iitt cangru?i }f} permit Fee: $ o r o ITOWN OF QUEENSBURY Approvals:/� BUILDING&CODES Applicant: IQiyi. e'r� PA f t et Installer/Builder 5ANv4A-r §w ea_ Se/gel/cc Address: 53S ttt.<S* mi--. Ron1 Address Po . €0.,e tizzy ificteers!!(..,-,-),_ 6'/en lam-/!r XIV /reoy Phone: Phone 792 -725-7 CZ••'- 796-796-376.0G' Owner: Location of Installation 5;3r est-/n1. Ed Address: Phone /n1 �� /f/ yc� Contact Person for Building&Code Compliance: (9eOCyC a5"�`•«J Day Phone: 7$6 3760 Residence Information: Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow 1980 or older x 150 = Garbage Grinder installed? /110 1981-1991 x 130 = 5642 Spa or Hot Tub Installed? NZ) 1992–Present 5 x 110 = Parcel Information: Topography DC Flat Rolling _Steep Slope %Slope Soil Nature Sand Loam Clay _Other Groundwater At what depth? Na Bedrock/Impervious Material At what depth? N el Domestic Water Supply k Municipal Well(if well,water supply from any septic system absorption is ft.) Percolation Test Rate- /`S 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 Plpgning Board approved subdivision). Tank size d/ 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?) temative System Bed or other type?fO X ZS 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. /6 Print Name: t7 ebre-11-7 Date: p4/- //!� Signature: .se, Date: Town of Queensbury Building&Codes Septic Disposal Permit 518-761-8256 J Town of Queensbury Building & Code Enforcement I /leg M id Office No. (518) 761-8256 ( i 11 3°?) Septic Inspection Report / Inspection request received: Name: I Q4te CK I -1-g ; ) Inspected on: Location: 535 Aq/ 111 Arrive: 01•• a.m.1 p.m. Permit No.: I i —.9) 39 Inspector's Initials: .— Comments andlor diagram Soil Type. San /Ly Type of WWell er' unicip 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 a ft. Length of each trench ft. Y .CV) Depth of trenches j $' ft. Size of Stone Seepage Pits: Number Size. Stone Size: Piping Size Type Building to tank N_. A (7t3 — Tank to Distribution Box Distribution Box to Field/Pit rt r �r�I) 3 C Ply Opening Sealed: Y . JJ End Cap Inlet/Outlet Pipes&Bathes —fj✓ Manholes 12"or less below grade _Y ✓ r [provide extension collar if Yes] Location/Separations Foundation to tankft. i Foundation to absorption S. ft. Separation of Pits Conforms as per Plot PO r N Engineer Report and s-Bu _N ETU Maintenance Contract provided Y N Location of S ste •n • o'e : Front Left Side Right Side Middle Front Middle Rear S stem Use Sta . : Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved Septic Inspection Report ursialy 1 -3 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: / lram/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: # c "`/�IIIIj NAME: 4 I m PERMIT#: I J a 3 / LOCATION: /023 C ^ INSPECT ON: 9-a-e4-144 TYPE OF STRUCTURE: tee! Comments N N/A `Footings=—=- __1 Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. Foundation/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building &Codes Forms\Building &Codes\Inspection Forms Foundation Inspection Report.doc Last printed 12/18/2013 2:44:00 PM CI acj '/-L&+ +sw1 _ Z. itt1.N __......-- WI r•.• t I t. i O ( SEPTIC PLOT PLAN / :a}ea (c?":” I HAVE SEEN OR OBSERVED ALL OBJECTS N SUCH AS HOUSES, WELLS, TREES, FENCES, ETC '/ : lea �18Ma'/1aj iv1: V SHO n i IS DOCUMENT.I •ERSONALLY `Lc0 +� 1� °NICl�iffl� IF UR �T �� ON THIS DIAGRAM. DATE -s- s- s z' rte-- -/-, A —7j TURE o LL1 014 i I Vi 1 -)f .ja9w9ei CENTER PROJECT SERVICESsm,a3'9 73 Sheridan Street, Glens Falls,NY 12801 Phone-518-796-2515 June 13,2014 Project# 188 George Drellos Sanitary Sewer Services Luzeme Road Queensbury,NY 12804 Re: Proposed Replacement Septic Amber Patte—535 West Mt. Road, Queensbury,NY Dear George: At your request we have reviewed your proposed replacement septic system design of the existing 3 bedroom house at 535 West Mt. 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 I to 5 minutes, you will need 500 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 1,250 gallon septic tank, new distribution box, and 4 inch diameter perforated pipe and stone. The replacement system has been designed to accommodate a future additional bedroom as long as all fixtures are upgraded to water saving devices. 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.