2015-359 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: P20150359 Date Issued: Monday, November 28, 2016
This is to certify that work requested to be done as shown by Permit Number P20150359
has been completed.
Tax Map Number: 523400-308-014-0001-052-000-0000
Location: 183 PITCHER Rd
Owner: FOREST PARK -- 65 GREGWOOD CIRCLE
Applicant: FOREST PARK 21 & 23 BRIWOOD CIRCLE
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QQUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the �J4A
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.
TOWN OF QUEENSBURY
0,0 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150359 Application Number: A20150359
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: FOREST PARK 21 & 23 BRIWOOD CIRCLE
For property located at: 183 PITCHER 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: FOREST PARK-- 65 GREGWOOD C Septic Alteration Residential
31200 NORTHWESTERN Hwy Total Value
FARMINGTON HILLS MI 48834-00
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-359
Residential Septic Alteration
21 & 23 Briwood Circle
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 13,2016
(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 ex iration date.)
Dated at the Tow of Qu a sbu 4 T4/ ,, • ugust 13, 2015
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL APPLI ." 117, (E, E Use Onl
1 ' 1e ved
DATE: $ I I I S 2tC A"r 1 1 I �� i ap ID
' hwu "ermi` No. n-
„uEENsBTAX MAP ID: 3t�`�S, I�� - I - J oZ Rl�ermi FeeZONE. TOBptGODE' -
APPLICANT Oce -i- Vac
,)c_ m -1c, L.L L PHONE/E-MAILt ( a$, 7(.�5.-7-7 -7(p
ADDRESS 1%3 9 i-+c he.c 1 . GY O ul-i3 'J U fLI ��r I D S()L L04- Off► '� D3
INSTALLER/ J PHONE/E-MAIL
BUILDER r1 �i ong (sl )d3)"1x01
OWNER Ca1105
Q �' l
ADDRESS L1 3b Q")- 5'O J�1-c - )c NN/
►�c6a9
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE': ���im 3 0- cd,t
PHONE/E-MAIL CSI$, �3a- L-7 C"7
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older Garbage grinder installed _Yes _No
1981-1991 3 11 0 3 3 O Spa or Hot Tub installed _Yes _No
1992-Present 3 1 1 0 3 3 D
PARCEL INFORMATION 0
Q Q aockxthe d pian
n�
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: per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size I O0j') gallons(min. size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total length 1.9C) ft.;Each Trench x 55
Q � � Seepage Pit with#3 stone How many: y ;Size
JC m ,e5 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 known 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: � . iQ ay) (�
Y y1 DATE: YI I 1115-'
SIGNATURE: ��'y,'„ i - , C� DATE:
� Y� / •
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
Town of Queensbury Building &Code Enforcement Z — V 1
Office No. (518)761-8256
Septic Inspection Report
Inspection request received: 2 '1//S
Name: w4iec 1" 4! "�' 6L r'- H petted on: g, a
C 4-
Location: 3 r, wb U.C`C. Arrive: A,�m. p.m.
Permit No.: i I , Inspector's Initials: ��
C• • ents and/or dia•ram
Soil Tyr6siaillace4-Glay r
Type of Wat . Municipal/)Well Water
Waterline separation distance 10 ft. "r' —^ Z— v3 ..uJ \o oO GAll1)1
Well separation distance ft. �� \
Other wells: ft. C2_5
Well Casing Length 50'+/- Y N_N/A
[150'to well required if NO] �—`Ev_ \�t�V 'J.
Absorption Field: Total length 2—Zo ft.
Length of each trench AQ'tWft.
Depth of trenches 71—Z'_ft.
Size of Stone N,a _ aec._z4 Ltd
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank LA 11 ,t't tiO
Tank to Distribution Box 4 '1 /c `,1/4 yo
Distribution Box to Field/Pit L1 'k P\)(-- i--u ,R Q . 2^1-4
Opening Sealed: 2( N
End Cap N
Inlet/Outlet Pipes&Baffles _s2( N
Manholes 12"or less below grade _ N
[provide extension collar if Yes] N
Location/Separations
Foundation to tank ft. SEC - _L�
�
Foundation to absorption ft. �� ��
Separation of Pits ft. gbit-
Conforms as per Plot Plan _Y
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 1/
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report ��
0
N
F-
lo 0
aa -
DESIGN
INFORMATION SOILS INFORMATION:
DESIGN ELOW DESIGN PERC. REO'D LENGTFI OF PT - PERCOLATION TEST (LOCATIONS, SEE PLAN)
�M DTP - DEEP TEST PIT
TEST PERFORMED ON 6-05-15 WITH STONE INDUSTRIES AND NYSDOH
6 660 GAL/DAY 1-5 MPI 275°-25X 206° REPRESENTATIVE IN PROPOSED TREATMENT AREA.
TRENCH SYSTEM WITH ADS HANCOR ARC 24 CHAMBERS
TOTAL NUMBER OF LATERALS = 4
LENGTH OF EACH LATERAL = 55'—Oa
TOTAL LENGTH OF LATERALS = 220'
* PER NYSDOH APP. 75—A(FEB 3, 2010). A 20X REDUCTION IN
TRENCH LENGTH IS ALLOWED WITH USE OF GRAVEL.LESS CHAMBERS
WITH 1.6SF/FT OF BOTTOM AREA & VOLUME OF 7.5GAL/FT & OPEI
SIDEWALLS. TABLE 6C OF NYSDOH 'GREEN' HANDBOOK.
i
O
O
I
PARKING
4 LATERALS AT 55' EACH.
ADS HANCOR ARC 24 CHAMBERS.
SEE DETAILS.
LOCATE WATER LINE AND MAINTAIN 10'
HORIZONTAL SEPARATION TO SEPTIC.
TYP. i
AS—BUILT TIE—IN DIMENSIONS FT
A B C D
D—BOX
L1 BEGIN
L1 END
L4 BEGIN
L4 END
DTP 10 (SEE SITE PLAN FOR LOCATION)
09-139 DARK SANDY TOPSOIL
89-27' LIGHT BROWN SAND
279-67' TAN/BROWN SAND
NO GROUNDWATER OR MOTTLING NOTED
PT #1 STABILIZED PERCOLATION RATE: 1:10 MPI
PT J22 STABIUZED PERCOLATION RATE: 1:15 MPI
PARKING
I
SITE INFORMATION:
TOPOGRAPHY AT TREATMENT FIELD IS RELATIVELY LEVEL
DWELLI!YG SUPPLIED WITH MUNICIPAL WATER.
NO ACTIVE NEIGHBORING WELLS NOTED/VISIBLE WITHIN 100°
OF TREATMENT AREA.
NORTH
M R 1 N C'
1. SEE NOTE SHEET. CALL ENGINEER TO
CLARIFY ANY DESIGN DETAILS.
2, USE DIMENSIONS GIVEN: DO NOT
SCALE DRAWINGS.
3• ALL PERMITTING/VARIANCES TO BE
OBTAINED BY CONTRACTOR AND/OR
PROPERTY OWNER.
EXISTING FAILED. SEPTIC SYSTEM CONSISTS OF COMBINED LOTS I,
21,23,25,27,29&31 FLOWING INTO A 1500 GALLON SEPTIC TANK THEN TO A
DRYWELL. PROPOSED PLAN IS TO PROVIDE EACH 3 BEDROOM LOT WITH
SEPTIC__I?.I
INDIVIDUAL 1000 GALLON SEPTIC TANKS AND A TREATMENT AREA DESIGNED '
FOR TWO LOTS WHICH EQUALS S BEDROOMS TOTAL B � HAVE SEEN QR O�3 S� � J�� ��(: 0 I�CrT�
`�JCH AS HOUSES, kNELI ! r;l S I Ellt�c E 1"0.
,.'1GWN ON THIS DOCUlN _N I: I I-,,�Vr � EI�St . IAkLY
S (l D THE DISTANCEtT ORTH G�!'f HlLv5� DD AG -�, NI.
Irl, DATE
2 y 0 SIGNKTURE
Lor INFORMATIoN
rn TAX MAP #: 308.14-1-52
s�
TOWN OF QUEENSRURY
rmn
EXISTING 3 g °
LOT X23 BEDROOM
DWELLING W ,,
J ° IeWI.I
L1
NEW 9 000 OGALLO� oO�dCR�TE � •` �
3
i l\i��lk
PROJECT — - —
d
NOT
' TANK WITH
FILTE .SEEi'LWILS t • ter: " '
-VVYE
SHED
D -BOX 1
EXISTING 2 NEW 1000 GALLON CONCRETE
LOT #21 BEDROOM TANK WITH FI TERISEE DETAILS.
DWELLING
—SOLID 4"0 SCH40 AT J" PER FOOT
ACTUAL SEPTIC COMPONENT LAYOUT INSTALL AS SHALLOW AS POSSIBLE. TYPICAL.
MAY VARY DUE TO BURIED UTILITIES. /
INSTALLER TO LOCA-TE-TE—Ui�C�ERCaR�TJND
IUTILITIES PRIOR TO CONSTRUCTION. &
r
4�
SEP11C SITE PLAN
PLOT PLAN INFORMATION OBTAINED FROM WARREN COUNTY GIS m
AND AS PURPORTED BY PROPERTY MANAGER.
THIS DRAWING DOES NOT REPRESENT A LAND SURVEY AND MUST
NOT BE CONSTRUED AS SUCH. �s� � 95®z� �
oppss1®,�A�
LOT SIZE: 48,9 ACRES
APPROVAL STAMP / NOTES
a
AIPPHI )VI ()
TOWN OF QUA-F�
BUILDING 0
Reviewed By.
Oates
PRo,IEcl:
SEPTIC REPLACEMENT DESIGN / GRAVELLESS CHAMBER
FOREST PARK — LOT #21 & #23
163 PITCHER ROAD, 9UEENSBURY, NY (TOWN OF QUEENSBURY)
DRAWINGRKn
ENGINEERING, P66C SITE PLAN
225 RUGGLES RD., SARATOGA SPRINGS, NY
518.581.3893 FILE NAME S1TF
SUBMITTAL / REVISION
ISSUED FOR REVIEW/APPRC
SCALE
APP'D. DATE
DATE
AL RKR a/S/15
REVISION
C-001
ov
�0
aiL
SEE PLAN FOR NUMBER
OF LATERAL LINES
ONE CHAMBER
LONGITUDINAL SECTION
FROM SEPTIC TANK
4' DIA. SOLID PVC
OUTLET
— 2' MIN.
—CLEAN SAND, PEA
GRAVEL OR AGGREGATE
(3/4' - 1 1/2')
1. PIPE JOINTS TO BE SEALED LIQUID TIGHT.
2. SPEED LEVELING DEVICES SHALL BE USED ON ALL
OUTLET PIPES.
3. SEPTIC TANK TO D -BOX: 4' PVC OR SDR21, LIQUID
TIGHT .HINTS, MIN. SLOPE 1/8' PER FOOT.
4. THE SLOPE OF OUTLET PIPES BETWEEN THE
DISTRIBUTION BOX AND DISTRIBUTION LATERALS
SHOULD BE SLOPED AT LEAST 1/32" PER FOOT
AND CONSTRUCTED OF 4" PVC SCH. 40 OR SDR21
WITH LIQUID TIGHT JOINTS.
5. USE DOUBLE SIDED STICKING RUBBER BUTYL FOR
DOSED SYSTEMS.
NEW CONCRETE
DISTRIBUTION BOX
SCALE: NONE
MOUND TOPSOIL FOR SETTLING.
SEED AND COVER WITH STRAW.
6' 6°'
TYP. 1 F— MIN.
V_ ,1W,
ADS - N O.7 —R 2 --
DUE TO GRADE CHANGE
BURIAL DEPTH WILL VARY.
INSTALL LATERAL END VENTS
IF TOP OF CHAMBER >3' DEEP.
�— PROPOSED GRADE, SLOPE TO
DRAIN. SEED AND MULCH.
INSTALL LEVEL. REMOVE
nFRRIS. RAKE FLOOR & WALLS.
GROUND WATER, BEDROCK OR
IMPERMEABLE STRATA
�JION
24" DIA
— OUTLET
PROVIDE EFFLUENT
FILTER. SEE NOTES.
FILTER (POLYLOK PL -1 22)
NISHED GRADE
'11ARaft, SEED & MULCH
'�'WATERPROOF SEAL
POLY RISER
OUTLET
CAULKED
JOINT
SANITARY TEE W/
EFFLUENT FILTER
3' MIN
IF DESIGNED TO USE EXISTING SEPTIC YANK; P13MP OUT AND INSPECT
EXISTING TANK. PROVIDE WRITTEN REPORT IO ENGINEER.
1. MINIMUM TANK CAPACITY AS FOLLOWS:
— FOR 3 BEDROOMS OR LESS TANK SHALL BE 1,000 GALLONS, WITH
27 S.F. SURFACE AREA.
— 4 BEDROOMS SHALL HAVE A 1,250 GALLON TANK WITH 34 S.F.
SURFACE AREA
— FOR EACH ADDITIONAL BEDROOM ADD 250 GALLONS & 7 S.F.
SURFACE AREA.
- FOR HOT TUR/SPA AND/OR GARBAGE GRINDER ADD 250
GALLONS TO TANK SIZE FOR EACH.
2. BUILDING TO SEPTIC TANK: 4' PVC SOH. 4O PIPE, LIQUID TIGHT JOINTS,
MIN. SLOPE 1/4' PER FOOT.
3. SEPTIC TANK TO D -BOX OR . PUMP TANK:. 4� PVC SCH. 40 PIPE OR
SDR21, LIQUID TIGHT JOINTS, MIN. SLOPE 1/�' PER FOOT.
4. SEPTIC TANK TO CONSTRUCTED PER NYSDOH GUIDUNES.
FOR EACH MOBILE HOME UNIT PROVIDE
NEW 1000 GAL CONCRETE SEPTIC TANK
SCALE: NONE
m
,A
`-' - s-
PROJECT NOTES•
1. SYSTEM DESIGNED IN ACCORDANCE NTH 2010 NYSDOH APPENDIX 75-A.
SEE NYSDOH'S "APPENDIX 75-A, WASTEWATER TREATMENT STANDARDS
INDIVIDUAL HOUSEHOLD SYSTEMS"& "NYSDOH — (GREEN) DESIGN
HANDBOOK" FOR ADDITIONAL DESIGN AND INSTALLATION GUIDELINES. NO
GUARANTEE ON SYSTEM PERFORMANCE OR LONGEVITY.
2. INFORMATION ON THESE DRAWINGS IS FOR SEPTIC SYSTEM DESIGN
PURPOSES ONLY.
3. CONSTRUCTION SHALL BE AS SHOWN ON THESE DRAWINGS AND
IN ACCORDANCE WITH ALL NYSDOH AND SYSTEM MANUFACTURER'S
REQUIREMENTS.
4. ALL WORK MUST COMPLY WITH LOCAL, STATE & FEDERAL SAFETY
REGULATIONS, (NYSDOH, OSHA, NYSDOT). PERMITTING REQUIREMENTS ARE
THE RESPONSIBILITY OF THE OWNER.
5. HEAVY EQUIPMENT SHALL BE KEPT AWAY FROM THE TREATMENT FIELD.
NO VEHICLES ALLOWED ON TREATMENT FIELD.
5. SMEARED TREATMENT AREA FLOORS AND WALLS ARE f0 BE RAKED.
7. TREATMENT FIELD SHALT. BE GRADED TO SHED RAINFALL AND TO
DIVERT SURFACE RUNOFF FROM ADJACENT AREAS.
B. RECOMMENDA71ON: DOWNSLOPE OR SHALLOW WELLS SHOULD HAVE
UV TREATMENT OR CHLORINATION AND FILTRATION SYSTEM INSTALLED.
WELL WATER QUALITY SHOULD BE TESTED PERIODICALLY.
9. INSTALL EFFLUENT FILTER IN SEPTIC TANK, (POLY-LOK PL -122) WITH
A RISER OR EQUAL.
10. GARBAGE GRINDERS AND WATER TREATMENT SYSTEM SHALL NOT ATTACH
TO SEPTIC. NO SUMP PUMP DISCHARGE ALLOWED. LEAKING FIXTURES WILL
CAUSE FAILURE OF SEPTIC SYSTEM.
APPROVAL STAMP / NOTES
'TIC REPLACEMENT DESIGN / GRAVELLESS CHAMBER
FOREST PAR LOT #21 & +423
183 PITCHER ROAD, QUEENSBURY, NY (TOWN OF QUEENSBURY)
ENGINEERING, PLLC
225 RUGGLES RD., SARATOGA SPRINGS, NY
518.581.3893 FILE NAME
SCALE
t
_ NO. T SUBMITTAL / REVISION PP'D. DATE DATE
A ISSUED FOR REVIEWW/APPROVAL RKR 6/5/95 RAN
DRAWING TITLE
DETAILS
DETAILS
AS NOTED
JUNE 2015
A
C-100 If/ 4F
2