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SEP-003410-2019 06072019TOWN OF QUEENSBURY Nvill,6 M. 742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201 Community Development- Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: SEP-0322-2019 Date Issued: Monday, July 1, 2019 This is to certify that work requested to be done as shown by Permit Number SEP-0322-2019 has been completed. Tax Map Number: 289.7-1-14 Location: 62 REARDON RD Owner: Wassey Family, Inc. Applicant: Herbert Wassey This structure may be occupied as a: Residential Septic Alteration By Order 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 12804-5904 (518) 761-8201 Yry' u G" 4 Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: SEP-0322-2019 Tax Map No: 289.7-1-14 Permission is hereby granted to: Wassey Family, Inc. For property located at:62 REARDON 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 Owner Name: Wassey Family,Inc. Septic Disposal-Residential 0.00 Owner Address: 94 Kent DR Total Value 0.00 Cortland Manor,NY 10567 Contractor or Builder's Name/Address Electrical Inspection Agency Hilltop Construction 51 Crowley RD Hudson Falls,NY 12839 Plans&Specifications Residential Septic Alteration 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES:Thursday, May 21, 2020 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 Town of Queensbury; Wednesday, May 22, 2019 SIGNED BY:for the Town of Queensbury. Director of Building&Code Enforcement Office Use Only g y= SEPTIC DISPOSAL PERMIT APPLICATION Permit#: --0zv22 2sa>c) Permit Fee:$ j ; Invoice#: 15 So Septic Variance? Yes '' No lawn of(iifenrr.Crfry 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.oueensbury.net Tax Map ID#: 289.7-1-14 Project Location: 62 Reardon Road Applicant: Name(s): The Wassey Family Mailing Address, C/S/Z: 94 Kent Drive Cortland Manor, NY 10567 Cell Phone:_( Land Line: _(914 ) 391-6648 Email: wasseyfamily@aol.com. Primary Owner(s): Name(s): Herbert Wassey for The Wassey Family, Inc. Mailing Address, C/S/Z: 94 Kent Drive Cortland Manor, NY 10567 Cell Phone: ( Land Line: _( 914 )391-6648 Email: wasseyfamily@aol.com Check if all work will be performed by homeowner only Contractor: Workers' Comp documentation must be submitted with this application Contact Name(S): Dan Washburn - Hilltop Construction Contractor Trade: Contractor/Builder Mailing Address, C/S/Z: 51 Crowley Rd. Hudson Falls, NY 12839 Cell Phone: ( 518 ) 260-7363 Land Line: ( 518 ) 798-0338 Email: danw@hilltopconstructionco.com Engineer(s): Name(s): Hutchins Engineering Mailing Address, C/S/Z: 169 Haviland Road Queensbury, Ny 12804 Cell Phone: ( Land Line: ( 518 ) 745-0307 Email: tutchins@hutchinsengineering.com Contact Person for Building & Code Compliance: same as owner Cell Phone: ( Land Line: ( Email: Septic Application Revised February 2019 RESIDENCE INFORMATION: Year Built Gallons #of bedrooms: X gallons per =total daily flow per day bedroom Garbage Grinder Yes No 1980 or older 150 Installed? (circle one) 1981-1991 130 Spa or Hot Tub Yes No Installed? (circle one) 1992-Present 110 3 110 330 PARCEL INFORMATION: Topography Flat Rolling Steep Slope Slope Soil Nature SandLoam Clay _Other(explain: 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 1,000 gallons(min.size 1,000 gallons,add 250 gallons for each garbage cylinder or spa/hot tub System Absorption field with#2 stone Total length ft.; Each Trench ft. Seepage Pit with#3 stone How many: Size: Alternative System Bed or other type: Absorption bed of 15'x 25'=375 SF Holding Tank System Total required capacity? tank size of tanks Pump Station: Existing fiberglass tank to remain; replace effluent pump with grinder pump NOTES: 1. Alarm system and 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. 3.As-built drawings must be submitted prior to the inspection, if there has been a change to the submitted plans. 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: r--4 o, e DATE: 0 S f SIGNATURE: DATE: 6cj _ 1 Septic Application Revised February 2019 RX Date/Time 06112/2019 11:41 15182731202 P.002 Jun. 12. 201P11 : 18 MEMO IA No, 9164 P. 2/8 MIDDLE DEPARTMENT INSPECTION AGENCY, INC. le—r that the electrical wiring to the electrical equipment listed below has been examined and is approved asbeinginaccordwiththeNationalElectricalCode, applicable governmental, utility and Agency rules in effect on the datenotedbelowandisissuedsubjecttothefollowingconditions. Owner: Wassey Date: Occupant: 06/09/201.9 Sewage Pumps Location: Occupancy:,62 Reardon Road Angle Family Dwg. Queensbury, Warren Co. NY Applicant: Hilltop Construction Cindy Albrecht 51 Crowley Rd. Hudson Falls,ails, NY 12$39• No. Joseph A.Holmes . 145262'11,11.22EL Equipment: 1 -Sewage Pump&Control E. CD JUN 12 2019 TOWN. U ENSBURY tlILOi3 3 G&CtJBc o5L2_— ZQL-A This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This cortifirate applies only to the use,occupancy andaboveandtheinstallationInspectedasoftheabovenoteddatebasedonavisualownershipasindicatedherein. Upon a change in the use,occupancy or ownershipinspection. No warranty is expressed or implied as to the mechanical safety,effi. of the property indicated above,this certificate shall be immediately null and void.ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this cartlflcate becomes invalid based upon the above conditions,be valid fora period of one year from the above noted date. Should the eleclr cal this certificate may be revalidated upon reinspection by Middle Departmentsystemtowhichthiscertificateappliesbealteredinanyway,including but not limit- Inspection Agency,Inc. An application for inspection must be submitted to Middleedto,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc.to initiate the inspection and revalidation any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service. INSPECTION WORKSHEET (SEP-003410-2019) Town of Queensbury - Building and Codes - Fire Marshal 742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal Case Number:SEP-0322-2019 Case Module:Permit Inspection Date:Fri Jun 7, 2019 Inspection Status:Failed Inspector:John O'Brien Inspection Type:Septic Job Address:Parcel Number:62 REARDON RD Queensbury, NY 12804 289.7-1-14 Contact Type Company Name Name Contractor Hilltop Construction Primary Owner Wassey Family, Inc. Engineer Hutchins Engineering Granted Permission Wassey Family, Inc. Applicant Wassey, Herbert Checklist Item Passed Comments Building Inspector Notes NO 6/7/19 Septic System Not Approved Remaining Items: Final Electrical Inspection Tom Hutchins Final Report 6/7/19 Septic System Failed Received Engineer's As-Built and Final Report Remaining Item: Final Electrical Inspection Type of Water: Municipal / Well Water YES Well Well separation distance YES All neighboring and own wells are more than 100' from absorption bed. Jun 07, 2019 Page (1) INSPECTION WORKSHEET (SEP-003410-2019) Checklist Item Passed Comments Absorbtion Fields: Total Length YES 70' 15'x25' Absorption Bed Length of Each Trench YES 3 @ 20' Depth of Trenches YES 24" - 36" Stone Size:YES #2 Building to Tank YES 4" sch40 pvc From House To Pumpstation 2" Plastic Forcemain To 4" sch40 pvc at top of hill From Pumpstation to Septic Tank. Tank to Distribution Box YES 4" sdr35 pvc Distribution box to Field / Pit YES 4" sdr35 pvc to 4" sdr35 pvc perforated with end looped End Cap YES End looped Foundation to Tank YES 11' Foundation to Absorption YES 21' Engineer Report and As-Built YES 6/7/19 Septic System Not Approved Remaining Items: Final Electrical Inspection Tom Hutchins Final Report Jun 07, 2019 Page (2) INSPECTION WORKSHEET (SEP-003410-2019) Checklist Item Passed Comments System Use Status NO 6/7/19 Septic System Not Approved Remaining Items: Final Electrical Inspection Tom Hutchins Final Report 6/7/19 Septic System Failed Received Engineer's As-Built and Final Report Remaining Item: Final Electrical Inspection Jun 07, 2019 Page (3) O'Brien, John (Inspector) INSPECTION WORKSHEET (SEP-003379-2019) Town of Queensbury - Building and Codes - Fire Marshal 742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal Case Number:SEP-0322-2019 Case Module:Permit Inspection Date:Fri Jun 7, 2019 Inspection Status:Failed Inspector:John O'Brien Inspection Type:Septic Job Address:Parcel Number:62 REARDON RD Queensbury, NY 12804 289.7-1-14 Contact Type Company Name Name Applicant Wassey, Herbert Primary Owner Wassey Family, Inc. Engineer Hutchins Engineering Contractor Hilltop Construction Granted Permission Wassey Family, Inc. Checklist Item Passed Comments Building Inspector Notes NO 6/7/19 Septic System Not Approved Remaining Items: Final Electrical Inspection Tom Hutchins Final Report Type of Water: Municipal / Well Water YES Well Well separation distance YES All neighboring and own wells are more than 100' from absorption bed. Absorbtion Fields: Total Length YES 70' 15'x25' Absorption Bed Length of Each Trench YES 3 @ 20' Jun 07, 2019 Page (1) INSPECTION WORKSHEET (SEP-003379-2019) Checklist Item Passed Comments Depth of Trenches YES 24" - 36" Stone Size:YES #2 Building to Tank YES 4" sch40 pvc From House To Pumpstation 2" Plastic Forcemain To 4" sch40 pvc at top of hill From Pumpstation to Septic Tank. Tank to Distribution Box YES 4" sdr35 pvc Distribution box to Field / Pit YES 4" sdr35 pvc to 4" sdr35 pvc perforated with end looped End Cap YES End looped Foundation to Tank YES 11' Foundation to Absorption YES 21' Engineer Report and As-Built NO 6/7/19 Septic System Not Approved Remaining Items: Final Electrical Inspection Tom Hutchins Final Report System Use Status NO 6/7/19 Septic System Not Approved Remaining Items: Final Electrical Inspection Tom Hutchins Final Report Jun 07, 2019 Page (2) O'Brien, John (Inspector)