BOTH-000390-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201
qW, Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000390-2015
Tax Map No: 301.8-2-52
Permission is hereby granted to: Shirley Howe
For property located at: 21 PROSPECT DR
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
True of Construction
Owner Name: Shirley Howe Septic Disposal $0.00
Owner Address: 21 PROSPECT DR Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Residential Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,November 26,2016
(If a longer period is required,an application for an extension must he made to the code Enforcement Officer
of the Town of Queensbury before the exp. ationnndate.)
ue
Dated at the Town of e /�nsb { / /J d ecember 2,2015
SIGNED BY: (w�►1`/ for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT Office Use Only
DATE 11/20/15 Received
Tax Map ID QOl°J—�7j
TAX MAP ID �s3�62'1=T�#' �JO�.`� `Z-�JZ- Permit No. �'Dl " 'J�10-ZabS
Permit Fee � nyokeQ, 143
LOCATION OFINSTALLATION 21 Prospect Drive. -
Approvals:
APPLICANT ShirleyHowe it�'� a DEC 01 201 PHONE/E-MAIL (518) 792-8727
ADDRESS 21 Pros ect Drive, Queellsbury NY 12804
INSTALLERMUILDER: (TBD) PHONE/E-MAIL
ADDRESS:
OWNER Shirley Howe PHONE/E-MAIL (518) 792-8727
Address 21 Prospect Drive, Queensbury NY 12804
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: Hutchins Engineering PHONE(518) 745-0307
RESIDENCE INFORMATION
Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow
1980 or older 2 110 220 Garbage grinder installed Y _N
1981.1991 Spa or Hot Tub installed _Y _N
1992-Present
PARCEL INFORMATION
Topography X Flat rolling Steep slope %slope
Soil Nature Sand _Loam _Clay Other
Groundwater At what depth?
Bedrock/Impervious Material At what depth?
Domestic Water Supply X Municipal _Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate: per minute per inch(test to be completed by licensed engineering/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION (Septic tank to be of Polyethylene Construction)
Tank Size(Replacement) 1,000 gallons(minimum size 1,000 gallons,add 250 gallons to size for each garbage grinder or spa or hot tub)
System Type Absorption field with#2 stone Total length ft.; Each trench x
Seepage Pit with#3 stone How many: ;size
Alternative System Bed or other type?
Holding Tank System Total required capacity? Tank size #of tanks
Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will no longer
allow systems to be covered until such time as an As-Built plan is received & approved. The installed system must match the septic system
layout on file—no exceptions.
DECLARATION: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or
failure to make a material fact or circumstance know by or on behalf of an applicant, shall be void. I have read the regulations
and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Print Name: Shirley Howe Date: 11/20/15
Signature: P Date:
Town of Queensbury Building icodes Septic Disposal Permit July 2014
T Donovan, Timothy -
T 301.8-2-54 -
1 I 1
Fry, Katharine I
301.8-2-82 L------------------------� I -
1
Murphy, Cheryl A. - -.�
301.8-2-46
1 I
EXISTING 1 I
Serminerio, Richard NEIGHBORING
301.8-2-53 RESIDENCE
1 1
' I 1
Campney, Colby D. I 1
301.8-2-83 ADPAA1N'P.L FROM _-------�
I ��ARREN COUNrY G.LS
I
I Bingham, Robert
EXISTING
EXISTING
I I 301.8-2-47 SITELOCATION-J LOCATION MAP
/ I GARAGE
/ I WASTEWATER SYSTEM DESIGN
/'' I• Flu F l EXISTINGH 2-BEDROOM RESIDENCE
DESIGN FLOW- 110 GPD/BEDROOM
RESIDENCE
2-BEDROOM P� ® I __ SYSTEM DESIGN FLOW- 220 GPD
----__—
�r lmlmr T T �s � r SEPTIC TANK- 1,000 GAL. PRECAST POLYETHYLENE
LEACH FIELD-EXISTING DRYWELL
POTABLE WATER SUPPLY IS MUNICIPAL SUPPLY
1 APPARENT P.L FROM---- MAINTAIN 10'MINIMUM SEPARATION BETWEEN WATER LINE AND
- WARREN COUNTY G.I.B. I WASTEWATER SYSTEM COMPONENTS
I
EXIST.ORYWELL-
Lambert, Joseph R. I rOREMAm Jackson, Roscoe
301.8-2-84 1 EXIST.EFFLUENT- I 301.8-2-48
T I SEWER TO REMAIN
YLENE SYSTEM MATERIAL SPECIFICATIONS
PRP. _
I
.HOUSE SEWER TO
OBEPTTC TANK
1 EFFLUENT SEWER PIPE
\ RECORD DRAWING NOTE: 1 POLYETNBE REPLALE _MAXIMUM 1 PIPING TO BE 4-SDR-35 OR SCH-40 PVC. INSTALL WITH 1/8-
\ A CONCRETE SEPTIC TANK INSTALLED EXTENT_LE1 I PER FOOT MINIMUM SLOPE.
\ INSTEAD OF THE SPOECIFIED POLYETHYLENE S
EXIST.STEEL SEPTIC
-
TANK EANTEELURETO Howe, Lena HOUSE SEWER PIPE
♦ ♦ BE DECOMMISSIONED 301.8-2-51 PIPING TO BE 4" SDR-35 OR SCHEDULE 40 PVC. INSTALL WITH
♦ ♦ ----- 1/4'PER FOOT MINIMUM SLOPE.
-���-
/ SEPTIC TANK
♦ ' ♦♦ 1 1 SEPTIC TANK TO BE ROTH RMT-t000E PREFABRICATED
\ 8POLYETHYLENE 1,000 GALLON SEPTIC TANK OR APPROVED
Clifford, JessaTmyn A. ♦♦ Po301 at�ciag L. EQUIVALENT.
i
301.8-2-85 \
WASTEWATER SYSTEM PLAN
SCALE:
RECORD DRAWING NOTE:
OUR OFFICE PREPARED DESIGN PLANS FOR
EAS 7BLU
T��tTHE SEPTIC TANK REPLACEMENT. BASED 1 UPON OUR FIELD SITE INSPECTIONS AND
APPROXIMATE DISCUSSIONS WITH INSTALLING CONTRACTOR,
FINISH GRADE SUGGESTED:POLYETHYLENE IT IS MY OPINION THAT THE SEP77C TANK
EXTENSION TO GRADE WITH WAS INSTALLED IN ACCORDANCE WITH THIS
TAMPER RESISTANT ACCESS RECORD DRAWING.
COYER(NON-TRAFFIC AREAS)
} i G. THOMAS HUTCHINS,P.E.
TEE BAFFLE JUNE 13,2018
12-t
INSTALLED JUNE 2016 BY ELLSWORTH&SON
- EXCAVATING
4'SCH. 40 PVC II 3• 4'
INLET SCH-40 PVC
i
(- LIQUID LEVEL _I OUTLET
MIN. SLOPE -
_ n
1/4"PER FOOT - MIN. SLOPE D
15' 18-MIN 1/8"PER FOOT
WATERTIGHT-1L-1
SLEEVE AND SEAL 118'LONG
(TYP.) 9'x 51" ..
1, GALLON PREFABRITED
°c, JUN 14 2018
� TAX MAP#157.62-1-14
POLYETHYLENE
-
POLYETHYLENE SEPTICCATANK { ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED PROFESSIONAL
•w
RECORD DRAWING NOTE: ENGINEER IS A VIOLATION OF NYS EDUCATION LAW.
1'� cRY I
A CONCRETE SEPTIC TANK INSTALLED -
TOWN OFQUEENSBU
t
TANKINSTEAD OF THE SPECIFIED POLYETHYLENE BU��LJINV CODES
TANK
6"f SAND, GRAVEL,PEA STONE, OR SIMILAR
SEPTIC TANK NOTES �RECOIR_D DRAWING 6/13/18
INSTALL AND BACKFILL IN STRICT CONFORMANCE WITH MANUFACTURER'S ( 0 ISSM6
INSTRUCTIONS.
No. Revisions Date
SEPTIC TANK REPLACEMENT
prepared for:
Shirley Howe
Dig Safely. 21 Prospect Drive
New York Town of Queensbury,Warren County,NY
®call Weans TPp Oig MAP REFERENCE:
El wan The Regalrea Time
El confirm Denny R.."- BASE MAP INFORMATION FROM WARREN Drown:IRS Checked.C7H Scola:NOTED Date: 17/5/2015
B R.. TM1e Narks SEPTIC TANK DETAIL COUNTY GIS AND AERIAL PHOTOGRAPHY,ALL 169 HOvilond Road
p0110`ncare LOCATIONS ARE APPROXIMATE. CONTRACTOR Queensbury, NY 12804 29979-01
800.962.7962 NTS TO FIELD VERIFY ALL SETBACKS PRIOR TO
www.aiywrerynewy-,x.-•,a (518) 745-0307 PhoBEGINNING INSTALLATION. Hutchins neerng
(518) 745-0308 Fax