2009-110 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
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Pernut Number: P20090110 Date Issued: Thursday, October 28, 2010
This is to certify that work requested to be done as shown by Permit Number P20090110
has been completed.
Tax Map Number. 523400-309-009-0002-001-000-0000
Location: 200 LUZERNE Rd
Owner. HOMESTEAD VILLAGE L P
Applicant: HOMESTEAD VILLAGE L P
This structure maybe occupied as a:
Septic Alteration Commercial
By Ch+rler 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 Director of Building&Code Enforcement
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: P20090110 Application Number. A20090110
Tax Map No: 523400-309-009-0002-001-000-0000
Permission is herebygranted to: HOMESTEAD VILLAGE L P
For properly located at: 200 LUZERNE 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: HOMESTEAD VILLAGE L P
4294 ROUTE 5 Septic Alteration Commercial
CALEDONIA, NY 14423 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans &Specifications
2009-110
178 & 179 Adirondack St - septic alteration commercial
$35.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday, April 20, 2010
(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 T�w"o ee ry 1 i t Apri120, 2009
w.ve�
SIGNED BY "
_ for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PE T
Permit Number: P20090110 Application umber. A20090110
Tax Map No: 523400-3 09-009-0002-001-000-0000
Permission is herebygranted to: HOMESTEAD VILLAGE L P
For property located at: 200 LUZERNE Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with pl and other' rmation hereto filed
and approved and in compliance with the NYS Uniform Building Aes d the Quee ur Zoning
Ordinance. T e f Cons tru 'o Value
Owner Address: HOMESTEAD VILLAGE L
� Septi Alteration m C mercial
4294 ROUTE 5
CALEDONIA,NY 14 23 Total Value
Cont/ctoror Builder's ame Electrical pection Agency
SA ITARY SEWE
DA DRELLOS
PO BOX 224
GLENS F LS NY
Plans &Specifications
2009-110
178 & 179 Adirondack St alteration o ercial
$35.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,April 20, 2011
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the rwn Quee u � day,April 20, 2009
SIGNED BY ��'$`' V p for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY__________________________% %
01
TA MAP NO. PER NO.67-11C PERMIT FEE. 'f CS 10
;
APPROVALS: ZONING TOWN CLERK 00
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MU T BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJEC TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT. �,,
OWNER:H ��'¢ i 1/ INSTALLER: "7'
ADDRESS: ,e 4 U E �� ADDRESS: P y 9 x z2 y
PHONE NOS. 7 1`'-47 ` -i PHONE NOS. / 1 b — y OC-6 J
LOCATION OF INSTALLATION: fl 7 9 l/ R/C4ClL 4-,�i-<"e
NO.OF RESIDENCE INFORMATION:
YEAR BUILT BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW
GARBAGE GRINDE
1980 or older X 150 gallon per bedroom INSTALLED?_
1981 -1991 X 130 gallon per bedroom = SPA OR HOT TUB
1992-present X 110 gallon per bedroom INSTALLED? I"
PARCEL INFORMATION:
✓ TOPOGRAPHY: Flat rolling r/ Steep slope %Slope
✓ SOIL NATURE: Sand Loam Clay Other
✓ GROUNDWATER: At what depth?
✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth?
✓ DOMESTIC WATER SUPLY: Municipal Well (If well: Water supply from any septic
system absorption is ft.)
✓ PERCOLATION TEST: Rate is 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 Planning Board approved subdivision).
TANK SIZE: a `� ✓ GALLON (MIN. SIZE IS 1,000 GAL.) Add 250 gallons to the size of the septic tank for
each garbage grinder, spa or whirlpool tub.
SYSTEM TYPE:
ABSORPTION FIELD (WITH NO. 2 STONE) Total length �S7 ft. Each trench �� X Z!
❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size?
❑ ALTERNATIVE SYSTEM Bed or other type?
❑ HOLDING TANK SYSTEM Total required capacity?
Tank size? Number of tanks?
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPP(TI=n Rv A Tn%Arkt
Septic Inspection Repo
Office No. (518) 761-8256 Date Ins on r u re iv
Queensbury Building &Code Enforcement Arrive: %� m ,part: am/pm
742 Bay Rd., Quee`nsbury, NY 12804 Inspector's Initials:
NAME: 1-t A tI t L P R NO.:
LOCATION: 1_ ECT ON:
RECHECK: �E
Comments and/or diagram
Soil Type: Sand Loam Clay
Type of Water: Municipal 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 ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field Pit
Opening Sealed: Y N
End Cap Y N
Inlet/Outlet Pipes&Baffles Y N
Manholes 12"or less below grade Y_N
[provide extension collar if Yes Y N
Location Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits Aft.
Conforms as per Plot Plan N
Engineer Report and As-Built Y N
ETU Maintenance Contract Y_ N
provided
Location of System on Property:
Front Re r Left Side Right Side Middle Front Middle Rear
st m Use S
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report-03 2910.doc
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ENVIRONMENTAL DESIGN
PARTNERSHIP,LLP
October 19, 2010
Queensbury Building & Code Enforcement
742 Bay Road
Queensbury,NY 12804
Attn: John O'Brien
Re: Homestead Village Mobile Home Park
Lot 178/179 Adirondack
Dear John:
On October 13, 2010 I visited above referenced Homestead Village Mobile Home Park lots. The
purpose of this visit was to observe the installation of the new septic system designed by EDP
dated May 30, 2008.
Based on my review of the plans and observation of the installation it is my opinion that the
installation of the system is in compliance with the intent of the design plans. I would note that
the positioning of the two septic tanks were modified from that indicated on the original plan.
Enclosed with this letter is a revised plan (2 copies) which reflects the `as-built' condition.
Please contact me should you have any questions regarding this system.
Sincerely,
Dennis MacElroy, PE
Enclosure
cc: Homestead Trailer Park AS BUILT'
900 Route 146,Clifton Park, New York 12065 phone(518)371-7621 -fax(518)371-9540
Septic Inspection Report
Office No. (518) 761-8256 Date Ins n iv
Queensbury Building&Code Enforcement Arrive: rt: _. _n
742 Bay Rd., Queensbury, NY 12804 Inspector's In
NAME: ' IT NO.:
LOCATION: SPECT ON: _�1
RECHECK:
Comments and/or diagram
Soil Ty Sa Loam Clay
Type of Water• Well Water
Wa ration 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
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank �Vt. F
Tank to Distribution Box
Distribution Box to Field Pit Ir
Opening Sealed: Vft N
End Cap N
Inlet/Outlet Pipes&Baffles N.
Manholes 12"or less below grade Y_
1p Y N
Location Separations zi
Foundation to tank ft.
Foundation to absorption 1A ft.
Separation of Pits ft.
Conforms as per Plot Plan Y
Engineer Report and As-Built Y N
ETU Maintenance Contract Y_N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Status•
Approved
Partial Approved and needs to be re-Inspected, please call the Building&Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Farms\Inspectlon Forms\Septic Inspection Repoi#_03 2910.doc
INSPECTION REQUIREMENTS:
BORING AND PERCOLATION TEST:
ENGINEER OF RECORD TO INSPECT TRENCHES PRIOR TO BACKFILLING. ASSUMED CONDITION BASED ON SITE EVALUATION
0-5' MEDIUM FINE SAND
NO WATER OR MOTTLING
NO TE:
1) BASEMAP INFORMATION OBTAINED FROM PUBLICALLY AVAILABLE PERCOLATION RATE APPROXIMATELY ONE MINUTE
RESOURCES AND DOES NOT REPRESENT AN ACTUAL FIELD NOTE: SOIL CONDITIONS TO BE CONFIRMED BY P.E. PRIOR TO BACKFILLING SYSTEM.
INSTRUMENT SURVEY
SEPTIC DESIGN :
APPLICATION RATE = 1 .2 GAL./SF/DAY
LOT 178
3 BEDROOMS AT 100 GALLONS/BEDROOM
=300 GALLONS
/VpR7-H
LOT 179
3 BEDROOMS AT 100 GALLONS/BEDROOM
=300 GALLONS
TOTAL
6 BEDROOMS AT 100 GALLONS/BEDROOM
(2) AS—BUILT 1,000 = 600 GALLONS
GALLON SEPTIC TANKS
USE 1250 GALLON PRECAST TANK
USE 5 LINES AT 50 FT. EACH (SPACED 6 FT. ON-CENTER)
AS—BUILT 4" PVC AS—BUILT 4" PVC
SCH 40 AT 2% MIN. SCH 40 AT 2% MIN. CONSTRUCTION NOTES:
1) CONSTRUCTION OF ABSORPTION FACILITIES SHALL NOT OCCUR WHEN THE GROUND /S FROZEN OR
THE SOIL MOISTURE CONTENT IS HIGH. IF A FRAGMENT OF SOIL FROM APPROXIMATELY NINE INCHES
15. BELOW THE SURFACE CAN EASILY BE ROLLED INTO A RIBBON INSTEAD OF CRUMBLING, THE
4' 25.7" �6.5 MOISTURE CONTENT IS TOO HIGH FOR CONSTRUCTION PURPOSES. OBVIOUSLY, SOME SILT OR CLAY
MUST BE PRESENT FOR A RIBBON TO BE FORMED. r
PROPOSED WYE AND 4" PVC SDR 2) TRENCH LOCATIONS AND DEPTHS SHOULD BE MARKED BY STAKES BEFORE TRENCHES ARE
I —35 (GASKETED BELL) AT 175 MIN. EXCAVATED. THE NATURAL SURFACE SHALL NOT BE SIGNIFICANTLY DISTURBED. IF THE SITE IS
REGRADED OR SIMILARLY DISTURBED, THE SOIL SHALL BE ALLOWED TO STABILIZE (I.E., SETTLE
NATURALLY FOR A PERIOD OF AT LEAST SIX MONTHS, INCLUDING AT LEAST ONE FREEZE—THAW e
CYCLE) AND NEW PERCOLATION AND DEEP HOLE TESTS CONDUCTED. HEAVY EQUIPMENT USE IN THE
EXISTING DESIGNATED ABSORPTION SYSTEM AREA SHOULD BE MINIMIZED TO PREVENT SOIL PERMEABILITY
MOBILE I I I I I REDUCTION DUE TO COMPACTION PLUS POSSIBLE TRENCH CAVE—IN AND DISTRIBUTION PIPE
HOME I I I I MISALIGNMENT/BREAKAGE.
AS—I I I I BUILTEXI 3) AFTER A FINAL GRADE CHECK, TRENCH EXCAVATION MAY BEGIN. TRENCH DEPTH SHALL BE AS
I I I I I MOBILE SHALLOW NG DISTRIBUTION BOX #2 SHALLOW AS POSSIBLE, BUT NOT LESS THAN 18 INCHES. TRENCHES SHALL BE EXCAVATED TO
HOME DESIGN DEPTH WITH BOTTOMS PRACTICALLY LEVEL.
F
4) FOLLOWING EXCAVATION, THE TRENCH BOTTOMS SHOULD BE GRADED BY HAND. THE BOTTOMS OF
THE TRENCHES SHOULD BE CHECKED BY A TRANSIT, ENGINEER'S LEVEL, OR CARPENTER'S LEVEL TO
LOT 180 LOT 179 I I I I I ASSURE THAT EACH /S PRACTICALLY LEVEL. TRENCH BOTTOMS AND S/DEWALLS SHOULD BE
LOT 178 LOT 177 IMMEDIA TEL Y RAKED AFTER FINAL GRADING AND AT LEAST SIX INCHES OF AGGREGATE PLACED /N
THE TRENCHES.
5) GRAVITY DISTRIBUTOR PIPE SHALL BE CAREFULLY INSTALLED AT A SLOPE OF �6 TO Y32 INCH PER 4
I FOOT. PRESSURE OR DOSED DISTRIBUTOR PIPE SHALL BE INSTALLED LEVEL. GRADES SHALL BE
�— —L DETERMINED BY AN ENGINEER'S LEVEL, TRANSIT OR CARPENTER'S LEVEL. AN EASY METHOD OF
MEASURING THE '6 INCH PER FOOT SLOPE FOR DISTRIBUTOR PIPE IS TO TAPE A Y4 INCH BLOCK TO
ONE END OF A STRAIGHT FOUR FOOT BOARD. BY PLACING THE BLOCKED END WITH THE BLOCK
FACING DOWN ON THE DOWNSTREAM TOP OF THE DISTRIBUTOR PIPE, A CARPENTER'S LEVEL CAN BE
USED TO DETERMINE THE %6 INCH PER FOOT SLOPE. A Ya INCH BLOCK SIMILARLY USED WOULD
AS—BUILT RESULT IN A Y32 INCH PER FOOT SLOPE. ANOTHER METHOD USED TO ESTABLISH THE GRADE OF
DISTRIBUTOR PIPE IS BY BATTER BOARDS. AGGREGATE SHALL BE INSTALLED IN THE TRENCHES TO
ABSORPTION FIELD A DEPTH OF AT LEAST TWO INCHES ABOVE THE TOP OF THE DISTRIBUTOR PIPES. ADDITIONAL
5 LINES AT 50 FT. AGGREGATE MAY BE REQUIRED TO BRING THE TOP OF THE AGGREGATE TO WITHIN SIX TO 12 INCHES
EACH TO SERVICE OF FINAL GRADE.
BOTH LOTS
178 & 179 6) AFTER THE UPPER AGGREGATE IS PLACED IN THE TRENCHES, THE GEOTEXTILE, UNTREATED BUILDING
PARKING 3 3 PARKING AREA AREA PAPER, HAY OR STRAW IS TO BE IMMEDIATELY INSTALLED ON THE AGGREGATE AND THE TRENCH
BACKF/LLED WITH EXCAVATED SOIL. IF THE TRENCHES CANNOT BE IMMEDIATELY BACKFILLED, THE
TRENCHES SHOULD BE TEMPORARILY COVERED WITH AN IMPERVIOUS MATERIAL, SUCH AS TREATED
BUILDING PAPER TO PREVENT SIDEWALL COLLAPSE AND SILTATION INTO THE AGGREGATE.
7) THE EARTH BACKFILL IS TO BE MOUNDED SLIGHTLY ABOVE THE ORIGINAL GROUND LEVEL (I.E., NOT
CO PLCTED) TO ALLOW FOR SETTLING. FOLLOWING SETTLEMENT, THE ENTIRE AREA SHOULD BE
E.o.P. ADED WITHOUT THE USE OF HEAVY EQUIPMENT AND SEEDED WITH GRASS. HEAVY EQUIPMENT
ALL NOT ENTER THE ABSORPTION FACILITY AREA OR THE PROPOSED EXPANSION AREA AFTER THE
BSCPPFACE SEWAGE TREATMENT SYSTEM HAS BEEN CONSTRUCTED.
A DI RONDA CK STREET IMU HORIZONTAL SEPARATION OF 10 FEET SHOULD EXIST BETWEEN THE HOUSE SEWER AND
Y WATERLINE.
LINES WHERE LINES MUST CROSS, THE WATER SERVICE LINE SHALL BE AT LEAST 12
r NCHES ABOVE THE HOUSE SEWER. IF A WATER LINE MUST PASS BELOW THE HOUSE SEWER, THE
�fy 1(ERT/CAL SEPARATION MUST BE AT LEAST 18 INCHES.
ROOF, FOOTING, GARAGE, CELLAR AND SURFACE WATER DRAINAGE MUST BE EXCLUDED FROM THE
SYSTEM. WATER SOFTENER, WATER RECHARGE AND BACKWASH WASTES NORMALLY ARE NOT TO BE
DISCHARGED TO THE SYSTEM UNLESS A SEPARATE SUBSURFACE DISCHARGE TO AN AREA 250 FEET
FROM WELLS OR WATER COURSES IS UNAVAILABLE.
n A S—BUI L T SEPTIC REHA BILI TA TION
PREPARED FOR
LOT 178 & 179 ADIRONDACK STREET
EXISTING SANITARY STRUCTURES HOMES TEA D VlL L A GE
INCLUDING SEPTIC TANK AND SEEPAGE
DEVICES ARE TO BE CRUSHED IN PLACE > >
AND FILLED WITH NATIVE MATERIAL. AS ILT TOWN OF QUEENSBUR Y WARREN COUNTY, NEW YORK
SCALE: 1 " = 20' OCTOBER 18, 2010
NOTE: ENVIRONMENTAL DESIGN PARTNERSHIP, LLP
900 ROUTE 146 CLIFTON PARK, N.Y. 12065 (518) 371-7621
MOBILE HOME UNITS TO BE PLACED WITH A MINIMUM 10 FT. HORIZONTAL SEPARATION. ENGINEERING LANDSCAPE ARCHITECTURE LAND SURVEYING
JAMES E. MI TCHELL P.E. 530 337