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SEP-0095-2018 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: SEP-0095-2018Date Issued: Wednesday, January 9, 2019 This is to certify that work requested to be done as shown by Permit Number SEP-0095-2018 has been completed. 308.14-1-52 Tax Map Number: 183 PITCHER RD Location: FOREST PARK MHC, LLC Owner: FOREST PARK MHC, LLC Applicant: This structure may be occupied as a: 2 new septic tanks with a shared leachfield Lot 28 and Lot 30 Woodland Park By Order of Town Board TOWN OF QUEENSBURY Forest Park MHC 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 Director of Building & Code Enforcement Planning Board or Zoning Board of Appeals. Fs TOWN OF QUEENSBURY 742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201 Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: SEP-0095-2018 Tax Map No: 308.14-1-52 Permission is hereby granted to: FOREST PARK MHC,LLC 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 Tyne of Construction Owner Name: FOREST PARK MHC,LLC Septic Disposal-Residential $0.00 Owner Address: 183 Pitcher RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Stone Installations 4305 Route 50 Saratoga Springs,NY 12866 Plans&Specifications 2 new septic tanks with a shared leachfield Lot 28 and Lot 30 Woodland Park Forest Park MHC $ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, March 20, 2019 (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 d to.) Dated at the Town f Quee ury;J 14 Tu re 20, 2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement ' SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury•net Permit#: Tax Map ID#:--W 6 ILI„ i "6 1�_ Permit Fee:$ Invoice#: a- Project Location:# ' r 3L aV1 Septic Variance? Yes No Primary Owner(s) — ,,c f i Mailing Address IS3 t [Ad Phone & Email a("<` Installer/BuilderMailing Address AIL 1, Phone & EmailI Engineer C,LY'I i IAR ) 201"N ' Mailing Address L �, - - � _J L i COi9i1�.� J rt 2URY Phone & Email �� ✓� ��� r � + °}�+�: C,f( Contact Person for Building&Code Compliance: " �y' [�: _ Phone J I RESIDENCE INFORMATION: Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes 0_�O 1980 or older Installed? (circle one) 1981-1991 Spa or Hot Tub Yes Installed? (circle one) 1992-Present © �� PARCEL INFORMATION: Topography )G Flat Rolling Steep Slope %Slope Soil Nature X7 Sand Loam Clay Other Groundwater At what depth? Ilk Bedrock/Impervious material At what depth? �IA Domestic Water Supply ki Municipal _Well (if well, water supply from any septic system absorption is_ft.) Percolation Test Rate: 1,1 per minute per inch (test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size I =gallons(min. size 1,000 gallons,add 250 gallons for each garbage cylinder or spa/hot tub System Absorption field with#2 stone Total lengthy ft.; Each Trench X ft. 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 and approved. The installed system must match the septic 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. n PRINT NAME: tc talk 1A DATE: SIGNATURE: DATE: C� Y Town of Queensbury Building&Code Enforcement �- Revised February 2017 ENGINEERING, PLLC . Civil Engineering . Structural Design . Structural Inspection . RECORD PLAN DRAWING SUBMISSION FOR SEPTIC SYSTEM REPLACEMENT Date: January 07, 2019 To: Town of Queensbury John O'Brien Building Department 742 Bay Road UI�T Queensbury,NY 12804 A'j B Re: Forest Park - Mobile Home Park Queensbury,NY 12804 To Whom It May Concern: Find enclosed septic system record drawing (l 1x17) depicting the replacement septic system as it was constructed at the address. Replaced Septic System Lot Numbers: Woodland Path # 28 & 30. Please let me know if you have any questions. ecfEilva, JAN 0 9 2019 If you have any questions please call. TOWN OF QUEENSBURY Sincerely, BUILDING& ODES ZP.-) Ryan K. Riper, P.E. Encl. 225 Ruggles Road Saratoga Springs,New York 12866 Cell:518.817.0099 e-mail:RyanRiper@RKengineering.us INSPECTION WORKSHEET (SEP-009063-2018) Town of Queensbury - Building and Codes - Fire Marshal 742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal SEP-0095-2018Permit Case Number:Case Module: Thu Jan 3, 2019Partial Pass Inspection Date:Inspection Status: John O'BrienSeptic Inspector:Inspection Type: 183 PITCHER RD308.14-1-52 Job Address:Parcel Number: Queensbury, NY 12804 Contact TypeCompany NameName Primary OwnerFOREST PARK MHC, LLC ContractorStone Installations ApplicantFOREST PARK MHC, LLC Granted PermissionFOREST PARK MHC, LLC Checklist ItemPassedComments Building Inspector NotesNO4/3/18 Septic System Partial Approval Remaining Items: -Submit Engineer's Report and As-Built Septic Plan. 1/3/19 Septic System Not Approved - Spoke with Maggie from Forest Park to have her contact Ryan Riper the engineer to submit a final report and as-built for 28-30 Woodland Path. Type of Water: Municipal / Well WaterYESMunicipal Absorbtion Fields: Total LengthYES220' HANCOR ARC24 Chambers Length of Each TrenchYES4@55' Depth of TrenchesYESÿþ Jan 03, 2019Page (1) INSPECTION WORKSHEET (SEP-009063-2018) Checklist ItemPassedComments Building to TankYESÿþ Tank to Distribution BoxYESÿþ Distribution box to Field / PitYESÿþ InletOutlet Pipes & BafflesYESFilter installed Foundation to TankYES10' +/- to MH Foundation to AbsorptionYES10' +/- to MH Engineer Report and As-BuiltNO4/3/18 Septic System Partial Approval Remaining Items: -Submit Engineer's Report and As-Built Septic Plan. 1/3/19 Septic System Not Approved - Spoke with Maggie from Forest Park to have her contact Ryan Riper the engineer to submit a final report and as-built for 28-30 Woodland Path. System Use StatusYES4/3/18 Septic System Partial Approval Remaining Items: -Submit Engineer's Report and As-Built Septic Plan. 1/3/19 Septic System Not Approved - Spoke with Maggie from Forest Park to have her contact Ryan Riper the engineer to submit a final report and as-built for 28-30 Woodland Path. O'Brien, John (Inspector) Jan 03, 2019Page (2) GENERAL NOTES: Df$IGN INFORMATION SOILS INFORMATION: %a INFQRMATION: 1. SEE NOTE SHEET. CALL ENGINEER TO DESIGN FLOW I DESIGN PERC. REo'D LENGTH OF PT - PERCOLATION TEST TOPOGRAPHY AT TREATMENT FIELD IS RELATIVELY LEVEL. CLARIFY ANY DESIGN/LAYOUT DETAILS. tS. gsg i ATrau c DTP - DEEP TEST PIT r DWELLING SUPPLIED WITH MUNICIPAL WATER. 2.USE DIMENSIONS GIVEN: DO NOT TEST PERFORMED ON B-18-15 WITH STONE INDUSTRIES AND NYSDOH — a= e. 6 660 GAL./DAY 1-5 MPI 275'-25X0-206' REPRESENTATIVE ON SITE. SCALE DRAWINGS. fill,0"-121 DARK SANDY TOPSOIL. NO ACTIVE NEIGHBORING WELLS NOTED/VISIBLE WITHIN 100' 3,ALL PERMITTING/VARIANCES TO BE 12'-66' TAN/BROWN SAND. SOME ROOTS OF TREATMENT AREA. OBTAINED BY CONTRACTOR AND/OR `p' �� . '• *" PROPOSED INSTALLATION: NO GROUNDWATER OR MOTTLING NOTED PROPERTY OWNER. TRENCH SYSTEM WITH ADS HANCOR ARC 24 CHAMBERS TOTAL NUMBER OF LATERALS 4 o'-8' DARK SANDY TOPSOIL. 8'-32' BROWN SAND. LENGTH OF EACH LATERAL = 55'-0" 32'-72' LIGHT TAN/13ROWN SAND "# a ` ' �'�LOG11M NO GROUNDWATER OR MOTTLING NOTED t d /3' TOTAL LENGTH OF LATERALS = 220' PT /t STABILIZED PERCOLATION RATE: 1:10 MPI PT /2 STABILIZED PERCOLATION RATE: 1:09 MPI N 0 R TH • PER NYSDOH APP. 75—A(FEB 3. 2010); A 25% REDUCTION IN <•r ';' - TRENCH LENGTH IS ALLOWED WITH USE OF GRAVELLESS CHAMBERS D OF 1#/1L PROJECT LOCATION PLAN WITH 1.6SF/FT OF BOTTOM AREA & VOLUME OF 7.5GAL/FT &SIDEWALLS. TABLE 6C OF NYSDOH 'GREEN' HANDBOOK. W NOT TO SCALE �Z117 E. P. It is a violation of NYS education law for any person. \l unless he Is acting under the direction of a licensed professional engineer, to alter any item in any way. � EXISTING/3 SOLID 4"0 SCH40 AT �" / LOT #30 / PER FOOT, TYP. / BEDROOM / LOT INFORMATION: DWELLING PARKING TAX MAP #: 308.14-1 -52 I r '- 4_ - - TOWN OF QUEENSBURY A O L1 ,+ LOT SIZE: 48.9 ACRES I � 55' 6' > TREE II � C APPROVAL STAMP / NOTES NEW 1000 GALLON CONCRETE TANKS WITH FILTER.SEE WYE rT;21 ; INSTALLER TO LOCATE ALL UNDERGROUND DETAILS. UTILITIES PRIOR TO CONSTRUCTION. N I 4 LATERALS AT 55' EACII. pY I Bim, L4 ADS HANCOR ARC 24 D C4 I D=60X CHAMBERS. SEE DETAILS. o ° __-I __ p FILE COPY W C PURPORTED j I -I-O y OF QU U E C � a N I ELECTRIC LINE. / LOT #28 EXISTING 3 / D I LOCATE IN / BEDROOM / I BUI ING & O _ I FIELD. ///////////////////////// DWELLING PARKING = Revi wed B MAR 14 2018CU a) ti I � % I Date Y '� A � .�.. ._���„ 0 ( TOIIJN O. , &S3URY L 0 L I ACTUAL SEPTIC COMPONENT LAYOUT ////////////� COMMU • �:t+— Tto � r, a o I MAY VARY DUE TO BURIED UTILITIES. LOCATE WATER LINE AND I e SE C REPLACEM DES GN / GRA VEC____ _... ...__' ' a M N MAINTAIN 10' HORIZONTAL FOREST PARK — WOODLAND PATH ap >` 0a cu SEPARATION TO SEPTIC, TYP. I LOT #28 & #30 t M LL 04 V) 183 PITCHER ROAD. OUEENSBURY. NY (TOWN OF OUEENSBURY) SEP IC PLOT PLAN DRAWING nTLE: AS-BUILT TIE-IN DIMENSIONS (FT) I HAVE SEEN 0 OBSERVED ALN. OBJECTS RKENGINEERING9 PLLC SITE PLAN A B Ci D SUCH AS HOUSES, LLS,TREES, FENCES, ETC 225 RUGGLES RD.,SARATOGA SPRINGS,NY SEPTIC SIZE PLAN SHOWN ON THIS D UMENT.I HAVE PER 518.581.3893 FILE NAME SITE 9D MEASU D THE DISTA E SET FORTH ON THIS DIAGRAM. SCALE t• - 20'-0' E; D—BOX NO. SUBMITTAL / REVISION APP'D. DATE DATE JANUARY 2016 N L1 BEGIN PLOT PLAN INFORMATION OBTAINED FROM WARREN COUNTY GIS 4 () /��"1 A ISSUED FOR REVIEW/APPROVAL RKR 12/12/15 4k AND AS PURPORTED BY PROPERTY MANAGER. 1 ATURE DATE REVISION B Ll END THIS DRAWING DOES NOT REPRESENT A LAND SURVEY AND MUST a REVISIONS TO DESIGN INFO TABLE RKR 4/11/16 � L5 BEGIN NOT BE CONSTRUED AS SUCH. a a L5 END C-001 1 2� PROJECT NOTES: i MOUND TOPSOIL FOR SETTLING. 1. SYSTEM DESIGNED IN ACCORDANCE WITH 2010 NYSDOH APPENDIX 75-A. 6' SEED AND COVER WITH STRAW. DUE TO GRADE CHANGE SPACING OF SEE NYSDOH'S -APPENDIX 75-A, WASTEWATER TREATMENT STANDARDS - 6" BURIAL DEPTH WILL VARY AND INDIVIDUAL HOUSEHOLD SYSTEMS•dc -Nr - (GREEN) DESIGN TYP' OK•MIN. EXCEED 24". INSTALL LATERAL ABSORPTION HANDBOFOR ADDITIONAL DESIGN AND INSTALLATION GUIDELINES. NO TRENCHES = 6' O.C. GUARANTEE ON SYSTEM PERFORMANCE OR LONGEVITY. GRAVELLESS ��NATIVE END VENT >3' DEEP. 2. INFORMATION ON THESE DRAWINGS IS FOR SEPTIC SYSTEM DESIGN CHAMBER BACKFILL EARTH 0 PURPOSES ONLY. I r ( I I I 3. CONSTRUCTION SHALL BE AS SHOWN ON THESE DRAWINGS AND Imo- I I IN ACCORDANCE WITH ALL NYSDOH AND SYSTEM MANUFACTURER'S I�I� � I�Iall� ��12" CHAMBER I_ I- �5r, ONE CHAMBER REQUIREMENTS. HEIGHT z PROPOSED GRADE, SLOPE TO LONGITUDINAL SECTION AFETY DRAIN. SEED AND MULCH. 4. RREEGULLAATTIONS,(NYSDOH YOSSHA. NYSWITH DOT)TPERMATE �ITTIrnNGG REQUDERAL IREMENTS ARE THE RESPONSIBILITY OF THE OWNER. DO NOT SMEAR SOILS DURING C INSTALL LEVEL. REMOVE EXCAVATION. _ DEBRIS, RAKE FLOOR & WALLS. Mpg04W 5. HEAVY EQUIPMENT SHALL BE KEPT AWAY FROM THE TREATMENT FIELD. — For NO VEHICLES ALLOWED ON TREATMENT FIELD. GROUND WATER, BEDROCK ORNrtAK IMPERMEABLE STRATA �NEAL7H SMEARED TREATMENT AREA FLOORS AND WALLS ARE TO BE RAKED. PER NYSDOH APP. 75-A(FEB 3, 2010); A 257L REDUCTION IN TRENCH LENGTH IS ALLOWED WITH USE OF / P E9. TREATMENT FIELD SHALL BE GRADED TO SHED RAINFALL AND TO GRAVELLESS BERG T 11..66SF OFFBBOTTOM AREA ADS -HANCOR AR.0 24 CHAMBER MODEL Y�l�;�/ZGJ6 DIVERT SURFACE RUNOFF FROM ADJACENT AREAS. & VOLUME OF GRAVELLESS CHAMBER TRENCH TREATMENT SECTION (,4i* 8. RECOMMENDATION: DOWNSLOPE OR SHALLOW WELLS SHOULD HAVE UV TREATMENT OR CHLORINATION AND FILTRATION SYSTEM INSTALLED. SCALE: NTS WELL WATER QUALITY SHOULD BE TESTED PERIODICALLY. FROM SEPTIC TANK r TZ - , I 1 24• DIA 9. INSTALL EFFLUENT FILTER IN SEPTIC TANK, (POLY-LOK PL-122) WITH 4• DIA. SOLID PVC 1 I I I I A RISER OR EQUAL. INLET III kr 4,1 M t I OUTLET 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. INLET OUTLET PROVIDE EFFLUENT FILTER. SEE NOTES. APPROVAL STAMP /NOTES INSTALL RISER & EFFLUENT FILTER (POLYLOK PL-122) • LOCKABLE COVER, TYP It is a vitiation of NYS education law for any person, unless he is acting under the direction of a licensed 1-1 2 PRECAST professional engineer, to alter any item in any way. C CRETE BAFFLE BAFFLEpN gBACK�FIpLL�WpIT�Hp�gA.E�EApN //,-FINISHED GRADE OR EQUAL REMOVABLE VABLE COVER IN 8 INCH�IJFTS ANO TAMPED EFFLUENT FILTER / TOP SOIL. SEED do MULCH C VER�� J l WATERPROOF SEAL - 124' MIN . . . . . . . . . : T POLY RISER / INLET INVERT ABOVE U INLET ) WET MINVERT OUTLET INLET ! CAULKED—J/ 74-41 CAULKED OUTLET JOINT / z JOINT SANITARY TEE W l u SANITARY b LEVETEVIM / 2• MIN. TEE 4 j EFFLUENT FILTER r - N eeo °^ / 3• MIN 12' MIN -,° x ° 3' -, ^LEAN SAND. PEA q� GRAVEL OR AGGREGATE Jn•'=ai=i%'i !I1I_!= (3/4• - 1 1/2-) IF DESIGNED TO USE EXISTING!SEPTIC TANK, PUMPOUTAND INSPECT EXISTING TANK. PROVIDE WRITTEN REPORT TO ENGINEER. SYSTEM COMPONENTS SHALL BE 1. MINIMUM TANK CAPACITY AS FOLLOWS: MAINTAINED. TANKS SHALL BE PUMPED SEPTIC REPLACEMENT DESIGN GRAVELLESS CHAMBER EVERY 2 YEARS PROJECT, 1. PIE JOINTS TO BE SEALED LIQUID TIGHT. - FOR 3 BEDROOMS OR LESS TANK SHALL BE 1,000 GALLONS, WITH OR LESDFORPECTED OPTIMAL PERFORMANCE; FOREST PARK WOODLAND PATH 27 S.F. SURFACE AREA. EFFLUENT FILTER (IF INSTALLED) SHALL 2. SPEED LEVELOUTLET ING DEVICES SHALL BE USED ON ALL - SURFACE �BEDROOMS ALL HAVE A 1,250 GALLON TANK WITH 34 S.F.REA BE CHECKED AND CLEANED LOT #28 & #30 - FOR EACH ADDITIONAL BEDROOM ADD 250 GALLONS & 7 S.F. REGULARLY. OTHERWISE PREMATURE 3. SEPTIC TANK TO D-BOX: 4• PVC OR SDR21, LIQUID SURFACE AREA. FAILURE COULD OCCUR . 183 PITCHER ROAD, QUEENSBURY, NY (TOWN OF QUEENSBURY) TIGHT JOINTS, MIN. SLOPE 1/8• PER FOOT. - FOR HOT TUB/SPA AND/OR GARBAGE GRINDER ADD 250 GALLONS TO TANK SIZE FOR EACH. 4. THE SLOPE OF OUTLET PIES BETWEEN THE DRAWING TITLE: DISTRIBUTION BOX AND DISTRIBUTION LATERALS 2. BUILDING TO SEPTIC TANK: 4• PVC SCH. 40 PIPE, LIQUID TIGHT JOINTS, OF NEw SHOULD BE SLOPED AT LEAST 1/32• PER FOOT MIN. SLOPE 1/4• PER FOOT. �4' g _ yO RKEINGINEERING, PLLC DETAILS AND CONSTRUCTED OF 4• PVC SM. 40 OR SDR21 eS �P� 225 RUGGLES RD.,SARATOGA SPRINGS,NY 3. SEPTIC TANK TO D-BOX OR PUMP TANK: 4• PVC SCH. 40 PIPE OR r� 518.581.3893 FILE NAME DETAILS WITH LIQUID TIGHT JOINTS. �'J 4` SDR21, LIQUID TIGHT JOINTS, MIN. SLOE 1/8• PER FOOT. r 04 5. USE DOUBLE SIDED STICKING RUBBER BUTYL FOR CONSTRUCTED �. w SCALE AS NOTED PQ O. DOSED SYSTEMS FOR EACH 4, SEPTIC TANK TO MOBILE HOME PROVIDE f1 '�o NA ISSUEDSFOR REVIEW/APPROVAL RKR 1/12A5 �� NEW CONCRETE f � R��oN JANUARY 2016 n W DISTRIBUTION BOX NEW 1000 GAL CONCRETE SEPTIC TANK `dA 07 50& ti} SHEET a a SCALE: NONE SCALE: NONE ��l'ESSID�P C-100 2 OF 2