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2009-452 TOWN OF QUEENSBURY FoN 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number. P20090452 Date Issued: Monday, November 29, 2010 This is to certify that work requested to be done as shown by Permit Number P20090452 has been completed. Tax Map Number. 523400-253-003-0001-014-000-0000 Location: 25 KNOLLS RD. NORTH Owner. BRUCE MANDOLARE Applicant: BRUCE MANDOLARE This structure may be occupied as a: Septic Alteration Residential Test Pit/Perc Test Review By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the owner of the res onsibili for com liance with Site Plan ` Y //;r/_— property responsibility P , 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: P20090452 Application Number. A20090452 Tax Map No: 523400-253-003-0001-014-000-0000 Permission is hereby granted to: BRUCE MANDOLARE For property located at: 25 KNOLLS RD. NORTH 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: BRUCE MANDOLARE 25 KNOLLS Dr Septic Alteration Residential QUEENSBURY, NY 12804 Test Pit/Perc Test Review Total Value Contractor or Builder's Name/Address Electrical Inspection Agency STEVENSON EXCAVATING NY 12804-0000 Plans &Specifications BP 2009-452 Septic Alteration&perc test $225.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, October 08, 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 theTowof Queensbury; / ;� T u, day, October 08, 2009 SIGNED BY( /J rS-° tflAtzzl for the Town of Queensbury. Director of Building&Code Enforcement JNLY r R Bruce Mandolaro BP 2009-4520,r ,Cti -`-�- ERMIT FEE C ,G' f � 25 Knolls Road North de Ur' ; Residential Septic Alteration TOWN CLERK : ri°'.. ' ' 4 , V?: APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.OWNER: Q � I7flyQ INSTALLER: C.V:4'1 V-;r. 6 X CA U 0,4;vA) ADDRESq k0i i S Pc. iq ADDRESS: it t V�-1\s (� r, �q y A. >Ann PHONE NOS. `I Cp.� :=2... iv) NOS, J �b `�q LOCATION OF INSTALLATION: a' .c i A11 YEAR BUILT NO.OF X COMPUTATION= RESIDENCE INFORMATION: BEDROOMS = TOTAL DAILY FLOW 1980 or older X 150 gallon per bedroom = GARBAGE GRINDER INSTALLED? ;`, , 1981 -1991 X 130 gallon on per bedroom = 39 0 SPA OR HOT TUB 1992-present X 110 gallon per bedroom = INSTALLED? J1,)Q PARCEL INFORMATION: ay, ✓ TOPOGRAPHY: Flat rolling Steep slope %Slope 3) ✓ SOIL NATURE: Sand i\ Loam /. Clay Other ✓ GROUNDWATER: At what depth? 2 ✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth? i ✓ DOMESTIC WATER SUPLY: Municipal Well `' (If well: Water supply from any septic system absorption is ft.) -67✓ PERCOLATION TEST: Rate is C- E �S6%,J�C^�11 LoC, (Test to be completed by a licensed professional engineer or architeper minute per inch. ct.)) MC, VoMD`k 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: 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 1t) ft. Each trench A X S (--) ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? h 64 2_ Size? C,ALTERNATIVE SYSTEM Bed or other type? 1'I C IQ F.v TR at Oil S SV.5.4,y` ❑ HOLDING TANK SYSTEM Total required capacity? Tank size? l(300 Number of tanks? I ii NOTE: ALARM SYSTEM AND ASSOCIATED APPROVED ELECTRICAL INSPECTION AGENCY.PLIEASE REVIEW LIST PROVIIDEDED BY A TOWN ii • 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 QUESTIONS? CALL 761-8256 OR EMAIL Queensbury Sanitary Se age Disposal Ordinance. codes@queensburv.net VISIT OUR WEBSITE FOR MORE INFORMATION PO' www. ueen s�-�. 00, q sburv.net Signature of son Responsible Date 01Z- . Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 B 5-LGL 6/06 v VISION Engineering SOIL BORING & DEEP TEST HOLE FIELD LOG .14441111S4(10000 Project: 247-TOQ Deep Test Holes 2009 Location: side slope b/w hill &flat area w/trees Date: 10/05/09 Temperature: 60 °F Weather: Partly Cloudy Test Hole#: 1 Address: Bruce Mandolare, 25 Knolls Road North Queensbury, NY 12804 Soil Survey Map Designation: 1 2 County: Warren i 1 Soil Series: 2 Slope Class: Remarks: (site description,usage,anticipated daily wastewater flow,etc.) 1 Percolation at 24 inches: 2:46/2:56/3:25 Depth (in) Boundary Color Soil Soil Consistency Stickiness Moisture Condition Matrix Mottling Texture Structure State 0-10 tan silty sand extremely firm non-sticky moist clear 10-17 olive-gray ---- fine sand granular firm dry abrupt 17-32 dark brown gravely. loamy medium ediam granular firm dry clear 32-66 light orange medium fine sand granular firm dry 1. Describe and record the average thickness.of each horizon. 2. Record each horizon boundary in terms of distinctness. Designate as Very Abrupt(<0.5 cm),Abrupt(0.5-2 cm),Clear(2-5 cm),Gradual(5-15 cm) or Diffuse(>15 cm). 3. Record the topography of the horizon boundary. Designate as Smooth, Wavy,Irregular(undulating boundary),or Broken(discontinuous or intermingled horizons or irregular pockets). 4. Indicate the color of each horizon. The matrix color is the majority color within the peds,and the mottle color is the minority color within the peds. Record ped surface color where colors existthat are associated with an organic coat/claytilm/carbonate mass/etc. Record the percent ofmottles as Few(<2%),Common(2-20%),or Many(>20%). Record the mottle contrast as Faint,Distinct,or Prominent. 5. Soil texture:Designate as Sand,Loamy Sand,Sandy Loam,Loam,Silt Loam,Silt,Sandy.Clay Loam,C/ayloam,Silty Clay Loam,Sandy_Clay, Silty Clay,or Clay. Sand,loamy sand,and sandy loam may be further classified into coarse,medium fine,fine,and very fine. 6. Soil Structure:Designate peds as Granual,Blocky,Prismatic, Columnar,Platy,Single-Grained,or Massive.Structure grade shall be described for peds as Weak,Moderate,or Strong. 7. Soil Consistency: Designate as Loose,Friable, Firm,or Extremely Firm. Indicated NDformt determinable,if too wet for test. 8. Record stickiness as Non-Sticky(little or no soil adheres to fingers after release of pressure),Slightly Sticky(soil adheres to both fingers with little stretching upon separation),Moderately Sticky(soil adheres to both fingers and stretchessome on sepamfinrl),or Very Sticky(soil adheres and stretches greatly). 9. Record the moisture state of each horizon._Designate as kv or Moist. 10. Roots: Record the quantity,size,and locations of roots. Record quantity as Few,Common,or Many. Record size as Very Fine(<1 mm),Fine(1-2 mm),Medium(2-5 mm),Coarse(5-10 mm),-or Very Coarse.(>10 mm). Location shall be noted to be Between Peds,In Cracks, Througbaud,In Mat at Top of Horizon,or Matted Around Rock Fragments. Boundary Condition Observed_atDepth: Bedrock: N/A ft. Groundwater: N/A ft. Impervious Strata: N/A ft. Mottling: N/A ft. Slope of Site: 5-10 % Giound Cover: ® Grass ❑Wooded ❑ Barren ❑ Crops El Shrubs Landscape Position: El Depression ❑Hill Top ®Side Slope El Foot Slope Describe Roots: (Quantity, Size,and Location) grass roots to 2 inches, fine, common 16 Pearl Street•Suite 200•Glens Falls, NY•12801 •P:518.792.9264•F: 518.792.9282 'NOV www.visionengineering.org 07 --i/7/5— ...._ 140 Town of Queensbury■ Building&Codes Enforcement Office■742 Bay Road■ Queensbury,NY 12804 DEEP HOLE/PERC TEST Request for Town Engineer Review _ tel Property Owner: ��332 �� �C` Q ��(�, �� ,.� _ Phone: �- Property Owner's Address: . ,4 L //f )c( iV Location of Test_ n O t i$ ( A Tax ID#: *Applicant's Engineer , r-- Phone: Applicant's Agent: c el ,,,-1) _ Phone: Additional Notes: 1. Reason for Request? New Septic System 1 Replacement Septic System Failed Septic System Subdivision Site Plan Review 2.Are Wetlands present? 1 YES NO UNKNOWN *Note: Applicant is required to engage an engineer for desiqn and testing of the system. The Town Engineer's responsibility is to witness system testing only. PLOT PLAN: Plot plan, to scale, to be submitted with application FEE SCHEDULE: 1 a. $ 200 Flat Fee Date Paid: 7-2/�7 Check No.: CA-5 b. OR Fee to be determined during To Be Determined: Site Plan / Subdivision review process SIGNATURE: In carrying out the provisions of Article IV, the Local Board of Health or the enforcement officer may engage the services of a qualified professional consultant for expert review and recommendation arising from the carrying out of the provisions of Art. IV, including but not limited to the review of plans, specifications and reports, attendance at inspections, dye tests, deep hole test pits, septic related deep hole and percolation tests, system installations, and any other aspect of any matter contained in this Art. IV, and any costs incurred in such review shall be paid to the Town by the owner of the property before any approval can be granted under this Art. IV shall become effective within 30 days of presentment of an invoice for same, whichever is sooner. Such costs shall not exceed $1,500 without prior written notice to the party to be charged with same. My signature below indicates I have thoroughly read and understand the instructions, agree to the submission requirements and have completed the application. Ily understand that additional engineering fees may be necessary per Town of Queensb o I Law 136-14D. c' SIGNATURE OF APPLICAN _ - SIGNATURE OF AGENT: Date: Original (B&C File) Canary (Planning) Pink (Applicant) Gold (Town Clerk) Community Development Office — Town of Queensbury • 742 Bay Rd. Queensbury, New York •12804 PLOT PLAN Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property lines. SIDE PROPERTY LINE t __ v v, r . ri • { I i "„ • : I 2• 1 _- : • j -...d • f ..j : ! . '''... ! ! 1 i C.: -.." :••••-, ! • i .....(,) r _, ., . .,,,, , !. ;a) ••••••• ":- ; 1 : 1 • ; 1 ; . 1 . ; • : I : : i • :, ; ; 1 '.›- CC I a) 1 a) .L • I i` 4/ 0 T y ,O ' i 0 DO -< 1 r— ) : 1! ,:.,i ,, _ : i 1,, ,,,12 E-.E.: „9,-__,. : 7, !. ! : 1 1 , H ' 1 , .I. (41r4,10 . , ),ji,,,...1, i i : , ; . . .-- : : 1 cn _ ; 9 v 0 - cv cn. �, D 4. • i : Bruce Mandolaro BP 2009-452 s'ccr-\' 25 Knolls Road North B€ PROPERTY LINE 1 SQUARE = ) Residential Septic Alteration FT. (rep,+ potio). s 1-1e5d • Septic Inspection Report Office No. (518) 761-8256 Date Inspection reques ive . Queensbury Building &Code Enforcement Arrive: i=4t a pa • 17,h ti a pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial NAME: " rti Cf/2p a r IT NO.: —26 LOCATION: 2- / 1 0/(5 /t/o-f( . SPECT ON: Q� RECHECK: Comments and/or diagram Soil Type: Sand 4-Glay Type of Water: Munici ell Water) Waterline separation distance ft. Well separation distance ft.Sri— Other wells: ft. Well Casing Length 50' + / - Y N N/A =Iv Absorption Field: Total length _ ft. Length of each trench c ft. Depth of trenches Size of Stone -*--Z4C7 Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank 4" i'Lt-t Tank to Distribution Box t-t° ‘)v Distribution Box to Field / Pit PZC_ Opening Sealed: ✓Yf N End Cap ✓YN Inlet/Outlet Pipes &Baffles N Location/ Separations Foundation to tank 1-±% ft. :kii.1-1 ,6 Foundation to absorption ,,C;, Separation of Pits ,' ft._ Conforms as per Plot Plan VY_N \� � Engineer Report and As-Built _Y - Location of System on Property: Front ear eft Side Right Side Middle Front Middle Rear ; stem U t t • _ Approved artial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc "s Community Development Office • Town of Queensbury • 742 Bay Rd. Queensbury, New York •12804 PLOT PLAN Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property lines. SIDC PROPERTY LINE - i I � i I ) ' F I �� �I s r I 1- . ! 1 ! ' I l i I I I I i , . I ,I I i : , I I ' i i i i I 1 I i K r. .•:ati . „ i � i ' I 1 ! . i c)Ca I . , •C)• , 7 'C7 r I i 1 i s a .c Is i . 1 1, - I� ! i i i i i I • ;ai I W I .� , ! a t._ I _ I 1 *� i _ a. , T ' V ; e, TI I � �. Co • i • _ '4 - - • : > a� • I I w !A ..._,t._.y.........ry-_ - I t•I-12. ..:•.•c,-1 •' n .' .. i 1 1 - - - i _ • .., - 'T ICJ �'" "k-.- ..._ -.. �' m ' i 1 I { ; i 1 I i I• 1 ' , I I 1.. I I ch - I ; .n 1 "-I 1 , ! T , , O ! I i.. i' � E f -a a I i 1 • ! + _ . - - — ' �-a..k, i „ row. ! .1 r" Bruce Mandolaro BP 2009-452 c::;.- 25 Knolls Road North PROPERTY LINE 1 SQUARE = )0 FT. Residential Septic Alteration 11. 13/2009 15:37 5187928511 VAN DUSEN AND STEVES PAGE 01/01 NACt ENGINEERING, P.C. 169 Haviland Road, Queensbury, NY 12804 Phone-518-745-4400 Fax -518-792-851 October 13, 2009 Project#49303 FAXED— 745-4437 Dave Hatin Code Enforcement Officer Town of Queensbury 742 Bay Road Queensbury, NY 12804 Re: Mandolare Residence—25 Knolls Road North—Replacement Septic System Dear Dave: This letter is to inform you that we inspected the completed septic system for the Mandolare Residence at 25 Knolls Road North in the Town of Queensbury on October 13, 2009. The septic system as installed was for a 3 bedroom house and consisted of the existing 1,000 gallon septic tank, a new distribution box and 4 —50 ft long absorption laterals constructed with stone and perforated pipe. The system conforms to the requirements of the approved design letter. Please call me if you have any questions. Sincerely, / 1 ' L� Thomas R. Center Jr, P.E. Cc: Mandolare (Owner)