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2008-044 TOWN OF QUE E NSBURY FfN 742 Bay Road,Queensbury,NY128 04-5902 {518}761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number, P20080044 Date Issued: Tuesday, February 19, 2008 This is to certify that work requested to be done as shown by Permit Number P20080044 has been completed. Tax Map Number: 523400-309-011-0001-030-000-0000 Location: 22 MAIN St Owner: NORTH STAR DONUT GROUP LLC Applicant NORTH STAR DONUT GROUP LLC This structure may be occupied as a: Septic Alteration Commercial By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the 4 property owner of the responsibility for compliance with Site Plan, If - sk Variance,or other issues and conditions as a result of approvals bythe pp Director of Building&Code Enforxernent 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: P20080044 Application Number. A20080044 Tax Map No: 523400-309-011-0001-030-000-0000 Permission is hereby granted to: NORTH STAR DONUT GROUP LLC For property located at: 22 MAIN St 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: NORTH STAR DONUT GROUP LL 509 STATE ROUTE 67 Septic Alteration Commercial MALTA,NY 12020-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency IBS SEPTIC &DRAIN ATTN: IVAN BELL 2 LOWER WARREN St QUEENSBURY,NY 12804 Plans &Specifications 2008-044 SEPTIC ALTERATION COMMERCIAL $35.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, February 07, 2009 (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 of ee /4 . . , February 07, 2008 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement OFFICE USE ONLY • • TAX MAP NO S36 ►6 I\'"\ : PERMIT NO. `�`` ' f / ERMIT FEE a • APPROVALS: ZONING TOWN CLERK 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:_�(R c�5T \R 0 )1 I $ L INSTALLER: _PA E-1" 1.I C � \`fit ADDRESS: 5O� I p-�-�t -7! &)1 I7. ADDRESS: 2-- Lo v i A PHONE NOS. PHONE NOS. 7 1 ) Cal f 4 l '�..01--a9 45 LOCATION OF INSTALLATION: '�..�. R f 1.7) Do kC11 I.) t1 Bo U l`A NO.OF RESIDENCE INFORMATION: YEAR BUILT BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW GARBAGE GRINDER 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? PARCEL INFORMATION: V ✓ TOPOGRAPHY: Flat rolling Steep slope %Slope ✓ SOIL NATURE: Sand ✓ Loam Clay Other ✓ GROUNDWATER: At what depth? V2 ✓ BEDROCK/IMPERVIOUS MATERIAL: Atwhat depth? 122- ✓ DOMESTIC WATER SUPLY: Municipal s. / Well (If well: Water supply from any septic system absorption is ft.) ✓ PERCOLATION TEST: Rate is Iv 2-1 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 encOneeror architect(unless installed in a Planning Board approved subdivision). TANK SIZE: 1 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: _41: 14. "Y v N 4 � .47 ": 7:ram ❑ SEEPAGE PIT(S) NO. 3 S • low many _ Ize ❑ 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 INSPECTED BY A TOWN • APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. 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 nr nn hahalf of an annlirant chall hn wesirl Septic Inspection Report Office No. (518) 761-8256 Date Inspection r- e- -d: Queensbury Building&Code Enforcement Arrive: 'Q ► 2-►:rt: <<= ar 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial — NAME: Lb k*t a• fl >T )T' /LIT NO.: O -Ot- q LOCATION: ZZ M .Aft-Q F INSPECT ON: Z—15-0$ RECHECK: 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 Absorption Field: Total length ft. Length of each trench 1, (� ft. Ft$'�ti-- E-C-c3AcbZEI- 3(�; I Flue Depth of trenches ft. L. cLz Size of Stone �E t A`s�EC Seepage Pits: Number tZ I d_.2- 6 1©t3e.. Size: x Stone Size: Piping Size Type 1- Pkt L7‘ t6 PAN ET. — 1461- P t_ Building to tank Tank to Distribution Box Distribution Box to Field/ Pit C 111 Opening Sealed: _Y N End Cap _Y N Inlet/Outlet Pipes&Baffles _Y N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan _Y— N Engineer Report and As-Built Y T N Location of System on roperty: Front ar Left Side Right Side Middle Front Middle Rear S t m e us: Approved Partial 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 Septic Inspection Report Office No. (518) 761-8256 Date Inspectign-reques,t- e Queensbury Building &Code Enforcement Arrive: 6r-,vh a : 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: n v ss br.%d: DC'li,'y3175 PERM "NO.: LOCATION: L2 11.-Wt t, '2 ETV- INSP CT ON: 2— 19--c9 RECHECK: 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 Absorption Field: Total length ft. Length of each trench ft. ' p`'oc c i_ ('`t D 3(r tt C Depth of trenches y ft. _ REA05177R>_LE.17 ti Z 67730E Size of Stone - �Tbt.sF Seepage Pits: Number VAL\ 1 Frmw.AC 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 Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan _Y N Engineer Report and As-Built Y_ N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear S m s t . Approved Partial 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 Septic Inspection Report Office No. (518) 761-8256 Date Inspection r es iv=•. 0 Queensbury Building &Code Enforcement Arrive: 14? k-pa • am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: t:3 NAME: CMC•41t dJ nc.c:l 1 �j PE IT NO.: -` LOCATION: INSPECT ON: Z—t L1— RECHECK: 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 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 -7,1, Location/ Separations Foundation to tank ft. �- Foundation to absorption ft. , jt Separation of Pits ft. Conforms as per Plot Plan _Y N Engineer Report and As-Built Y Location of System on Property: Front Rear Le+ ide Right Side Middle Front Middle Rear system Use S us: •ved �- ial Approved and needs to be re-inspected, please call the Building &Codes Office isapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc Septic Inspection Report Office No. (518) 761-8256 Date Inspection Queensbury Building&Code Enforcement Arrive: = i%'-'rt: 7 � ar '�"ay 742 Bay Rd., Queensbury, NY 12804 Inspector`s Initials: NAME: _U_ 1)0t 1ST\'� ' RMIT NO.: Q j LOCATION: Z M Pt 110 fiT F INSPECT ON: bZ— 1 \—b$ RECHECK: 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 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 �t' " ��L _ End Cap Y N Inlet/Outlet Pipes&Baffles Y N � \ V1 Location/Separations \\� ‘ � Foundation to tank ft. Foundation to absorption ft. Diu\t)�� '"" Separation of Pits ft. Conforms as per Plot Plan Y \�\\ • Engineer Report and As-Built Y N Location of System on Property: Front Rear Le ide Right Side Middle Front Middle Rear -u -i . A,• •ved rtial Approved and needs to be re-inspected, please call the Building &Codes Office isapproved ..}:i Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc Septic Inspection Report Office No. (518) 761-8256 Date Inspection = 1Drt: ived• QueensburyBuilding &Code Enforcement Arrive: i' " . -;e. _ �. 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: Do IA t k) T)o8,-)1TTj 'IA IT NO.: CA—O l- LOCATION: 2-2- t-k At1 t6-1-., ECT ON: Z.- -C RECHECK: Comments and/or diagram Soil T • Sau Clay Type of Wate • unici ater Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - Y N N/A Absorption Field: Total length ft. Q A t_- Length of each trench k @ 50 ft. T MP ®AL Depth trenches Toy ft. Sizeze of Stone --�0 r,�ri�^ `fFI� l l - I l Seepage Pits: Number Size: x Stone Size: 1- u1 F t t_�e,p FRS#fit Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit y f' P3C Tp CCL.eA atJEc J c i 1 zc4 t Opening Sealed:EndCap / _N N Inlet/Outlet Pipes&Baffles Y_ N Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. 0, ', .Conforms as per Plot Plan Y` N Engineer Report and As-Built _Y— N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Sta . Approved Partial 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 Septic Inspection Report Office No. (518) 761-8256 Date Ins ion r-., -st = -ed: Queensbury Building &Code Enforcement Arrive: btpp 14 p •epart: 9:00 am m 742 Bay Rd., Queensbury, `NY 12804 Inspector's Initials:, NAME: n OK RptJ(.3-0 P�' ITNO.: © )-0t- 4 LOCATION: 7 -Z_ M fl t itJ �T—o fit'PI ON: Z.--7—p RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/ Clay Type of Water: Municipal/Well Water Waterline separation distance ft. PA p‘Pr L Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - Y_N_N/A `g 0t t1/4„\a_ET Absorption Field: Total length ft. 01/ TG ORCY- F1,LLD PA R"Cl p Length of each trench 5—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 Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y_N Engineer Report and As-Built _Y_ N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear S Approved Partial 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 \..)04 ). BELL_ Vim\ � --(61Oy Septic Inspection Report Office No. (518) 761-8256 Date Inspection r-•u-. - ei --•: Queensbury Building &Code Enforcement Arrive: \k ice" � � `epart: ‘Z-tom a /pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: _ NAME: D t.) 01A RMIT NO.: Y01 tVC*-©t t-1) LOCATION: NSPECT ON: Z — —v RECHECK: VC-6TATU-1) Comments and/or diagram Soil Type: Sand/ Loam/ Clay Type of Water: Municipal/Well Water RI-,Mo ( kT 1 OF1 Waterline separation distance ft. L`�E v�l Lt_ . C,1_E'PV- v�Well separation distance ft. Other wells: ft. RE 1 r TR Well Casing Length 50' + / - Y N N/A t ikeR—C45 Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. i �� E- --�EC� , � � Size of Stone e Seepage Pits: Number 0-1—CO$ o 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 Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N Engineer Report and As-Built _Y N 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 Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc 1,� a 1 ENTRANCE �r EXISTING PARKING r 1 • I CURB '--4 4 t i u: . :r^.. ', . :J Imo. t BUILDING & C D E i. f I REVIEWED BY DATE u .� i I Z I CONCRETE WALK z o 1 EXISTING DUNKIN• DONUTS SHOP r ( —1' I EXISTING SEPTIC TANK I WITH RE1111LU SANITARYfl, ORNE THRU LANE .xa CATCH BASIN OUTLET TEE I EXISTING EFFLUENT FILTER BASIN • I v • : LEACMIa LA 'b TO BE REMOVED; EFFLEENT FILTER TO BE ABANDONED (BACK s a+� TION � TO BE RELOCATED TO OUTLET OF O �. i' .ER 36" WITH CLEAN SAND WITH i=, i1.4. PVC SEPTIC TANK NFI LEACHING RATE OF 1-5 MINUTES }.. .NC LATE (TYP•) Laia -t coNCRETE ��� 1 > //////./ �/f�/ 1a'O.�O.'�:"'"..�J Cr..46+.:VI7.+'O...97.'I'59v:LSfO... ��'O...fl�: O.Oi9.'/ s•-a I)P_T. #2 TYP f •PVC EDWILIZAr• N'IPI Trilr r %///_451%//////%/407,77 r/�117,62:� .1:�o���� --r ,, T.P. IIIAIII %///////,S%'i'4'A%////W i✓J7 I" Al //i's7% Mik P.T. 1 : ` _ ■,�.r_� � a A� :_ a i ■ a ©4• CARBON � a y�TE LOCAT PVC VENT PI' NEW OISTRIBUT•ti ; PVC DISTRIBUTION / CARBON FIL '® WING; 0.5X MIN. SLOPE .F. ❑WASTEWATER PLAN Scab SEE GRAPHICAL ' GRAPHIC SCALE 10 0 5 10 20 r.,) 'i 'r a' n;z'T i s s ., � SCAM 1'-10' li I � x y ,,S, 041V. , \ , 1 /''L '' ''-'41... APPROXE LOCATION 1 //g h OF EXISTING SHRUB LINE AP/ PFTIONROX9MTE E C .EXISTING PAVED d It.SURFACE ,.:,.. I ".. 6-0" I i � � \ �vim � e"14 / / / / / / /\///\\� \/� // i ='� //%/ /\/\/\ \ \ \/\/\ \�/ // '. $ #//4 - •' �\\�\/ /\/ / c; er 0 ,„ \ I 2.* ' / //. /1 NOTE: \ \\\�\ 1 I EXISTING GROUND TO BE GRADED TO DAYLIGHT SURFACE WATER "EQUALRER 38" EXISTING SOIL •RUNOFF AWAY FROM LEACHING SYSTEM. INFILTRATOR CHAMBER r (TYP,) I A ®LEACHING SYSTEM SECTION t 9 SCJLLE.N.T.S. Y h EXISTING CAST IRON FRAME do COVER RELOCATE EXISTING EFFLUENT FILTER FROM FILTER BASIN TO OUTLET OF I EXISTING SEPTIC TANK 1 TREATED LUMBER MARKER ABOVE ALL BURIED COVERS: I E2 4" PVC SET 1/2'ABOVE GRADE OUTLET PIPE n��TO DISTRIB @IQON_ ///\�/.\//��\8` MIN.) \ ?'� 4" INLET � \ PIPE ..........e=,..............-..-1 REMOVABLE COVER I .. i 1 PROVIDE ADJUSTABLE LEVELING DEVICE ON EACH OUTLET 1 i 4" GRAVITY DISTRIBUTION LATERAL j SUPPORT POST 4" INLET TEE CUT OS MIN.) 2" HOLES IN a 0 O 0.57[ MIN. SLOPE •..r• .....+......•B A .�' 12' MIN. OF CLEAN SAND 2' MIN, " r%t •..-----OR PEA GRAVEL FOUNDATION i FORT MILLER DISTRIBUTION EXISTING SEPTIC TANK OUTLETS — 4' KNOCKOUTS BOX OR EQUIVALENT A ©SEPTIC TANK EFFLUENT FILTER REFIT DETAIL DISTRIBUTION BOX DETAIL o SOME:N.T.S. 2 -SCALE:Na.S. • 1