2008-431 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTI F I CAT E C-F COM P L I-A-N- CE
Permit Number. P20080431 Date Issued: Friday, August 27, 2010
This is to certify that work requested to be done as shown by Permit Number P20080431
has been completed.
Tax Map Number. 523400-295-015-0001-052-000-0000
Location: 27 LYNNFIELD Dr
Owner. JOHN & ELAINE HERSEY
Applicant: JOHN & ELAINE HERSEY
This structure may be occupied as a:
Septic Alteration Residential
By Oder 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: P20080431 Application Number. A20080431
Tax Map No: 523400-295-015-0001-052-000-0000
Permission is hereby granted to: JOHN & ELAINE HERSEY
For property located at: 27 LYNNFIELD Dr
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 Value
Owner Address: JOHN & ELAINE HERSEY
27 LYNNFIELD Dr Septic Alteration Residential
QUEENSBURY, NY 12804 Total value
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2008-431
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,August 12,2009
(If a longer period is required,an ap lication for an extension must be made to the code Enforcement Officer
of the Town of before a do to
Dated at the o u x, day,August 12, 2008
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
For an EPA homeowner's guide: http:i/,r~N eo- gov/nodes/Dubs/homeowner Quide Iona custornize pdf
__________ USE ONLY---____:___ __ �._., ----------,f' _ __-------------
OFFICE +
TX�� ^' j� / ry> +
MAP NO/ �PERMIT NO. "�l�J/PERMIT F / % `f +
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: j�;-�h / (1 7 INSTALLER:_ w(jQ v
ADDRESS: -0 / Lylylk r/ �n /; tyt/- ADDRESS: �1.t(;5 71,h3i�3 1 t
PHONE NOS. ���-" �2 77 \ PHONE NOS. �nq �{��
LOCATION OF INSTALLATION: 2/7 �,r/y/V`6A!, - t OR.IL
RESIDENCE
YEAR BUILT BEDROOMS OMS X COMPUTATION= _ ! TOTAL DAILY FLOW INFORMATION:
1980 or older X 150 gallon per bedroom (, Q GARBAGE GRINDER
INSTALLED? _
1981 -1991 ! 0 j X ' 130 gallon per bedroom - F 0
� SPA OR HOT TUB
I 1992-present j l X 110 gallon per bedroom -
{^ INSTALLED?��ii
PARCEL INFORMATION: "IL�C N tA-Wi;,�_.`,�� IN
V-6AVir4 )
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE SLOPE %
✓ SOIL NATURE: SAND X LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?_ � BEDROCK'IMPERVIOUS MATERIAL: AT WHAT DEPTH?. A
✓ DOMESTIC WATER SUPLY:
MUNICIPAL_ WELL (If well:water supply from any septic system absorption is:( ft)
✓ PERCOLATION TEST: RATE IS PER MIINUT ER I �('TET BE COMPLETED BY A LICENSED
PROFESSIONAL E GINEER OR ARC EC
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—16--a— /���
ft. Each trench�_X
❑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 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 Queensburf, 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 QUESTIONS ? CALL 761-8256 OR EMAIL
to abide by these and all requirements of the Town of Queensburj codesCa7gueensbury.net
Sanitary Sewage Disposal Ordinance,
VISIT OUR WESSITE FOR MORE INFORMATION
1 www.gueensbury.net
Sig"t Y re of Pers n Responsible Date t t
VT Imo$ tA C-Ir j tt > 7
Town of Queeptsbury - Conirw uty Devclopnmizt O ice • 7 �, bun, Y 12804
.
-C-1 /
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/ Depart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: A `
NAME: _ PE IT NO.: `
LOCATION: INSPECT ON:
RECHECK:
Comments and/or diagram
Soil T Sand Loam Clay >
Type of Water: Municipal Well Water —/ Z �C1
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: i
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field Pit
Opening Sealed: Y N
End Cap 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 ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built V Y N
ETU Maintenance Contract Y_N
provided
Location of System on Property:
Front ear Left Side Right Side Middle Front Middle Rear
em s:
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
LAPam Whiting\2010Wilding Codes Fonns\Inspecbon Fombs\Sepdc IrSpeCtion Report-03 2910.doc
Septic Inspection Report
Office No. (518) 761-8256 Date Ins ection,retNO.:
d:
Queensbury Building &Code Enforcement Arrive: � apmart: 1 = am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: PELOCATION: 2 r. IN
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
Location Separations
Foundation to tank ft.
Foundation to absorption ft.
Se ration of Pits ft.
orms as perf lot PI Y
n ineer Re - Y N
ion of System on r�opeZ
Front Rear Left Side Right Side Middle Front Middle Rear
System Use7s: pr
Aroved
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
l 2 — !
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart. ` ` am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: AA in -Z/�
NAME: PERMIT NO.:
LOCATION: 2Z INSPECT ON:
RECHECK: '
Comments and/or diagram
Soil T Loam/ Clay
Tpe of Water: un / Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + J - 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:
Stone Size:
Piping Size --I—Type
Building to tank
Tank to Distribution Box
Distribution Box to Field Pit
Opening Sealed: V Y N
End Ca
Inlet/Outlet Pipes&Baffles Y N d'0
Location Separations
Foundation to tank k ft.
Foundation to absorption
Separation of Pits ` l ✓ `—
Conforms as r Plot Plan
Engineer Re rt and As-Built Y V N
Location of System on Property:
Front ear Left Side Right Side Middle Front Middle Rear
System 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
S45°25'15'E
100.00, LOT OPTIONAL: POLYETHYLENE
APPROXIMATE EXTENSION TO GRADE WITH TAMPER
147
FINISH GRADE RESISTANT ACCESS COVER
SHED ° 15,000 sq.ft. 2" MIN. DROP
16" PINE 0.34 acres �d — BETWEEN INVERTS
� 12" MIN. COVER
6" MAPLE
ROPOSED PIPE-IN-STONE ABSORPTION ; . 12" MIN. COVER
9
i 16 PINE TRENCHES, 4 REQ D, 40 LONG EACH 4" PVC SDR-35 2" DISTRIBUTION BOX
6" MAPLE p ROPOSED DISTRIBUTION BOX INLET
4" PVC SDR-35
ro MIN. SLOPE LIQUID LEVEL OUTLET 2" MIN.
p ROPOSED 4" SDR-35 EFFLUENT 1/4" PER FOOT ti MIN. SLOPE
SEWER, 1/8" PER FT. MIN. SLOPE q 1/8" PER FOOT BAFFLE '_
16"
18"MIN. USE SPEED LEVELERS TO
0o ROPOSED 1000 GAL PRECAST WATERTIGHT SLEEVE ASSURE ALL OUTLETS ARE AT
CONCRETE SEPTIC TANK AND SEAL (TYP.) _
t- EXACTLY THE SAME ELEVATION
" 14 CHERRY w z x
8 MAPLE <
ROPOSED 3- SDR-35 HOUSE SEWER, 4" PVC SDR-35 SOLID HEADER
EXISTIN 1/4" PER FT. MIN. SLOPE PERFORATED TRENCH PIPING,o= a TO P
EEPAGE PIT 1000 GAL PRECAST 1/8" PER FOOT MIN SLOPE
CONCRETE SEPTIC TANK
W
'� ry c3lo MINIMUM 2X WIDTH
MAXIMUM 4X WIDTH
M O �•.;
"o TEMPORARY EFFLUENT o
8 , . �. . . ".._ SITE
z TREE ' • -
It' DATA
SEWER FROM NEW SEPTIC SEPTIC TANK NOTES TEST PITS:
I TANK TO EXISTING ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK STATE TP-1: 08 OS 08, BY T HUTCHINS
SEEPAGE PIT TO BE USED °
8" MAPLE DEPARTMENT OF HEALTH AND SHALL BE OF PRECAST CONCRETE AS / /
DURING CONSTRUCTION MANUFACTURED BY FORT MILLER OR EQUIVALENT.
1.75' OF PROPOSED ADDITION 3 0-12" - TOPSOIL
ALL STRUCTURES SHALL BE PLACED ON FIRM, COMPACT SAND OR GRAVEL BASE. 12-48" - MEDIUM BROWN SAND
p c WHERE EXISTING SOIL CONDITIONS ARE UNSUITABLE, CRUSHED STONE SHALL BE 48-72" - BROWN MEDIUM AND COARSE SAND
EXISTING SEPT] Q U.) o' PLACED AS NECESSARY TO ACHIEVE A STABLE BASE. NO WATER EVIDENCE TO 72"
TANK SETBACK CH a' SEPTIC TANKS INSTALLED IN TRAFFIC AREAS SHALL BE OF EXTRA HEAVY PT-1: 08/08/08, BY T. HUTCHINS
CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING. STABILIZED PERCOLATION RATE: 2 MIN 10 SEC PER INCH
SHED 20'-7" 20'-0" O ALL JOINTS MUST BE SEALED.
1
10' SEPTIC SEPTIC TANK DETAIL WASTEWATER SYSTEM DESIGN
_ 3 BEDROOM RESIDENCE
EXISTING TANK SETBACK NTS
PROPOSED PATIO EXISTING FIXTURES ARE WATER SAVING
ADDITION !o DESIGN FLOW - 110 GPD/BEDROOM BASIS (WATER SAVING FIXTURES)
2.06'
(NO BASEMENT) 22.5' OFFSET= SYSTEM TANK 1000
FLOW 1 00 - 30 GPD
FITTINGS IF
16'-0" -- ; - - _ NECESSARY 6" MIN TOPSOIL OVER THE ENTIRE ABSORPTION
RELOCATE EXISTING HOUSE FIELD; SEED AND ESTABLISH TURF LEACH FIELD - NYSDOH ABSORPTION TRENCH CRITERIA
SEWER OUTLET INSIDE BASEMENT FILTER FABRIC TENCATE DESIGN PERCOLATION RATE IN NATIVE MATERIAL= 1-5 MIN/IN
I MtRAFI 140N OR EQUIVALENT APPLICATION RATE= 1.2 GPD/SF
ABSORPTION TRENCH LENGTH REQUIRED: 138 LF
12" MAX. I USE FOUR TRENCHES AT 40'
2 STORY .
TOTAL TRENCH LENGTH TO BE PROVIDED: 160 LF
I WOOD FRAME
HOUSE ( 6" MIN. POTABLE WATER SUPPLY - EXISTING TOWN WATER SUPPLY
i 2" MIN. O&0 ,000"o SLOPE
OP` 00 ��O I
21'-0"
n n n nliQ n n n ^ n ^ t1l e% n ri e% e% n f% e% e% n e, SYSTEM INSTALLATION NOTES
Oboe 0 Li 0 CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING AND IN
IL — �� °0 �0 " ACCORDANCE WITH THE N.Y.S. DEPARTMENT
OF
� 4 PERFORATED SDR-35 PVC LATERAL, HEALTH INDIVlDUAL
C�v �0 SLOPE 1/16 - 1/32 PER FT. 08143 I HOUSEHOLD SYSTEMS AND ASTM F481 INSTALLATION OF THERMOPLASTIC
I MEETING ASTM STANDARDS FOR PIPE END CAP R-R ..,. x _. PIPE AND CORRUGATED TUBING IN SEPTIC TANK LEACH FIELDS.
3/4" TO 1 1/2" USED IN SEPTIC SYSTEMS rr
WASHED CRUSHED STONE AFTER EXCAVATION, THE BOTTOM AND SIDES OF THE BED SHALL BE HAND
RAKED TO REDUCE SOIL SMEARING.
f a L0 0 8 }
ABSORPTION TRENCH PROFILE _ ALL DISPOSAL FIELDS SHALL BE GRADED TO SHED RAINFALL AND DIVERT
NTS
L_ SURFACE RUNOFF AWAY FROM THE DISPOSAL FIELD.
'ES
�! DO NOT USE HEAVY EQUIPMENT WITHIN THE ABSORPTION AREA AFTER
ABSORPTION BED HAS BEEN INSTALLED.
w 6" MIN TOPSOIL OVER THE
EN71RE ABSORPTION FIELD,
ASPHALT
DRIVE SEED & ESTABLISH TURF OVERFILL TO ALLOW � s FOR SETTLEMENT s; � SE UENCE OF INSTALLATION
BACKFILL FREE OF
I 1 1. SET NEW SEPTIC TANK. INSTALL NEW HOUSE SEWER & TEMPORARY
STONES OVER 3" 9 EFFLUENT SEWER FROM NEW SEPTIC TANK TO EXISTING SEEPAGE PIT.
I
` 2. PUMP & REMOVE EXISTING SEPTIC TANK & HOUSE SEWER.
100.00, FILTER FABRIC m 3. CONSTRUCT PROPOSED ADDITION. CONSTRUCTION AND DELIVERY
N45°25'15'W IPF M/RAFI 140N
OR EQUAL 6-12" ei VEHICLES SHALL NOT DRIVE OVER NEW SEPTIC TANK.
IPF -.-- 2 TRENCH WIDTH T
CO CD 4. UPON SUBSTANTIAL COMPLETION OF PROPOSED ADDITION, ABSORPTION
2" IN. °e FIELD SHALL BE INSTALLED.
=� � ;tea
12" MIN. � 5. PUMP EXISTING SEEPAGE PIT, CRUSH, & BACKFILL WITH SAND PRIOR TO
6" JUDO 0�� 3 ID 2 INSTALLATION OF ABSORPTION FIELD.
cY)
CD C)
TO 1-112" m
WASHED CRUSHED STONE
i - ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED PROFESSIONAL
,Cf RE ENGINEER IS A VIOLATION OF NYS EDUCATION LAW.
LYNFIELD DRIVE ABSORPTION TRENCH SECTION
NTS '
T I� 0 ISSUED 8/11/2008
TO
' . No. Revisions Date
E3, 1 IN, WASTEWATER SYSTEM REPLACEMENT
WASTEWATER SYSTEM REPLACEMENT PLAN VIEW ' : I= �, g, �¢
prepared forSCALE: 1" 10'
John & Elaine Hersey
27 Lynnfield Drive
MAP REFERENCE Town of Queensbury,warren County,New York 12804
PROPERTY LINES AND BOUNDARY INFORMATION TAKEN FROM Drawn: CCw Checked: GTH Scale: NOTED Date: 08/11/08
"MAP OF A SURVEY FOR JOHN HERSEY* PREPARED BY VAN 169 Haviland Road
DUSEN AND STEVES LAND SURVEYORS, 169 HAVILAND ROAD, Queensbury, NY 12804 2g345-01
QUEENSBURY, NY 12804. DATED FEBRUARY 24, 2003. Hutchins Engineering (518) 745-0307 Phone
g g (518) 745-0308 Fax