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2007-643 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number. P20070643 Date Issued: Tuesday, November 30, 2010 This is to certify that work requested to be done as shown by Permit Number P20070643 has been completed. Tax Map Number: 523400-279-018-0001-032-000-0000 Location: 72 SUNNYSIDE EAST Owner: ALISA MARKWITH Applicant: ALISA MARKWITH This structure may be occupied as a: Septic Alteration Residential Test Pit/Perc Test Review By Oder of Town Board. TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the I 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& nfoi ent 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: P20070643 Application Number. A20070643 Tax Map No: 523400-279-018-0001-032-000-0000 Permission is hereby granted to: ALISA MARKWITH For property located at: 72 SUNNYSIDE EAST 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: ALISA MARKWITH 72 SUNNYSIDE EAST Septic Alteration Residential QUEENSBURY,NY 12804-0000 Test Pit/Perc Test Review 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 2007-643 DEEP HOLE/PERC TEST ENGINEER: Charlie Scudder replacement system no wetlands present SEPTIC ALTERATION RESIDENTIAL $225.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday, October 16, 2008 (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 "o f Qu b `� y, October 16, 2007 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement .............................. ►r...................... / �� � _ �_ OFFICE USE ONLY ►► ; i TAX MAP NO. PERMIT N00 ERMIT FEE� � ; '► APPROVALS: ZONING TOWN CLERK_ 1 r r , 10 r , r APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMITI A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID OWNER: ' ' / J INSTALLER: ADDRESS:-� � G y��f 7 � �o� kv—ADDRESS: PHONE NOS. C r PHONE NOS LOCATION OF INSTALLATION: ».».............»........................................,........,................. ..................,........................................................... _........................................,....... . RESIDE E INF ATION: NO.OF t............:. } _.._ YEAR BUILT X COMPUTATION TOTAL DAILY FLOW I BEDROOMS3 I _....;i..............»...,.................,...».......... ....................................,..,..........................................»..».,....,..,...............,,.................,........................... GARBAGE GR{ND 1980 or older ! X 150 gallon per bedroom : I INSTALLED? At D ..........................I.................» ...». ».....:................,..":�......................................... 1981 -1991 i X 130 gallon per bedroom I TUE ;»......................»................. ;.. ................... ......................;...........a............................,,................................................. ! ......... ...............................; S OR HOT I 1992-present X 110 gallon per bedroom = i 3 i INSTALLED? L.....»....._».....»...........»..»..»........,�. .._»»» »..»,.;..».......:..........................................................................:.................................:��................................... .a PARCEL INFORMATION: ✓ TOPOGRAPHY: FLATf�OLLING STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ? 1'-7- WHAT DEPTH? BEDROCK/IMPERVIOUS MATERIAL: AT ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL S4�,/t (IF WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS � FT. ) ✓ PERCOLATION TEST: RATE is 2- Wow PER MIINUTE 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). Add 250 gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub. ✓ SEPTIC TANK: 4PW GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH THE CH FT. ✓ TOTAL SYSTEM LENGTH: FT. SEEPAGE PIT(S): HOW MANY? ✓ SIZE OF EACH Z FT. X 4�.FT. ✓ SIZE OF STONE TO BE USED: #_�/DEPTH OR THICKNESS__,� _FT, ✓ BED SYSTEM SIZE: X ✓ ALTERNATIVE SYSTEM: LEA jNG HAND/OR SIZE ✓ HOLDING TANK SYSTEM:(If required N0. OF TANKS: ^f /SIZE OF EACH ✓ GALLONS.ITOTAL CAPACITY: GAL. NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN I! `' 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 or on behalf of an applicant, shall be void: l 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 Sanitar Sewage Disposal Ordinance. codes®aueenOurv.net VISIT OUR WEBSITE FOR MORE INFORMATION f/ �� l www.aueensburv.net Signature of Perso Responsible Date >lJ , wl Town of Queensbury - Community Development Office • 742 Bay Road, Queensbury, NY 12804 07-61-13 Town of Queensbury• Building&Codes Enforcement Office■742 Bay Road• Queensbury,NY 12804 DEEP HOLE/PERC TEST Request for Town Engineer Review Property Owner: 4G 1-5A 1 A Phone: Property Owner's z ,SL/,4l�!/s/0� L�7s/ , 42lf��J/641,e Address: rr Location of Test: ri?S�.�CI�#41W J �CL,�,L�• ®� � Tax ID#:Q 9 , �2- *Applicant's Engineer: ' /tr $ • /pp�� , • Phone: Applicant's Agent: Phone: Additional Notes: 1.Reason for Request? El New Septic System Im Replacement Septic System Failed Septic System El Subdivision El Site Plan Review 2.Are Wetlands present? YES FA NO UNKNOWN *Note: Applicant is required to engage an engineer for design 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: a. $ 200 Flat Fee Date Paid: Check No.: _�� 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. I also fully understand that additional engineering fees may be necessary per Town of Queensbury Local Law 136-14D. SIGNATURE OF APPLICANT: Date: /© d SIGNATURE OF AGENT: Date: Original (B &C File) Canary (Planning) Pink (Applicant) Gold (Town Clerk) Septic Inspection Report Office No. (518)761-8256 Date InW'# aqnmu/est received: Queensbury Building&Code Enforcement Arrive: Depart: am/pm 742 Bay Rd., Queensbury, NY 12 Q4 Inspector's Initials: NAME: R ' PERMIT NO.: LOCATION: _ — INSPECT ON: / z 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: 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: Pi pi Size Type Building to tank Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: Y N � � End Ca Y N In 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 Plat 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 5ystem Use t —L Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved L:\Pam Whidng\2010\Building Codes FomrsVnsped ion Forms\septic Irspection Report_03 2910.doc 12 . 7113 Septic Inspection Report , Office No. (518) 761-8256 Date Ins est received: Queensbury Building&Code Enforcement Arrive: ri epart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's NAME: V1 PERMIT NO.: LOCATION: _ INSPECT ON: RECHECK: Comments and/or diagram Soil T nd G Type of Water: Municipal f Well Water Waterline separation distarkeft. Well separation distance ft. Other wells: ft. 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 Distributim Box n Distribution Box o Meld Pit OpeninQ Sealed N Partial End Ca Inlet/Outlet Pipes&Baffles Y N Location Separations Foundation to tank Q t / Foundation to absor ti AC� Separation of Pits ft. Conforms as per Plot Plan Y Engineer Report and As-Built Y N 045 — Location of System on Property: Fron(rRq Left Side Right Side Middl ront Middle Rear System Use Status: proved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 021006 Last revised 1/6/05 rage 1 vi 1 Dave Hatin From: Dave Hatin Sent: Wednesday, October 17, 2007 2:19 PM To: 'Daniel W. Ryan, P.E.' Cc: Pam Whiting Subject: Request for Town Engineer Review DEEP HOLE/PERC TEST Request for Town Engineer Review Name: Alisa Marknith Phone: 761-0054 Address: 72 Sunnyside East Location of Test: 72 Sunnyside East Applicant's Engineer: Charles Scudder Phone: 793-1475 Applicant's Agent: Phone: Additional Notes: Reason for Request: = New System Replacement System Failed System Are WETLANDS present? = YES FTI NO UNKNOWN David Hatin Town of Queensbury Director of Buildings&Codes 761-8253 10/17/2007 7 y��-3 �U�N�AID E Ep"c Al-ISA MARKWITH 72 5UNNY51PE EAST WAFtLES H.SCUDDER,PE ConsuKitig Engineer P.Q.Box 792 [glans Falls.NY 12801 OE516N STANDARDS EXIST 6RADE PROVIDE 24' 'TUF-TITS' RihER SYSTEM ON THIS VO'AhTEVIATER 5Y5TEM 15 DE516NED IN ACCORD WITH APPENDIX SEPTIC TANK INLET AND OUTLET ENDS 75-A, PHL 201 (1) (1), NY5 DEPARTMENT OF HEALTH 5TANDARDh FOR OF GA5TIN6. I TOP501L INDIVIDUAL RESIDENTIAL WA5TEVATER TREATMENT 5Y5TEM2. O --- IN5TALL 50HED 40 PVG `TUF-TITS EF-(# GOMDO' EFFLUENT,FILTER 4 FINE 'v DAFFLE O T-DAFFLE MEETING AN51/N5F STD 46 DRY SAND CONSTRUCTION NOTES loon �►L - 2.2' . THE EXISTING CE55POOL SHALL DE REMOVED AND REPLACED WITH 7 1/2' PROVIDE INLET AND OUTLET 5ANITAR A 1000-6ALLON PREGAST CONCRETE SEPTIG TANK A5 5HOWN ADOVE. O TEES OR DAPPLES. IF OKAN6EDVR6 NEWER PIPE EXI5T5 IN THIS SYSTEM, IT SHALL DE O REPLACED WITH SGHEDULE 40 PVC PIPE. O THE NEW hY5TEM WILL DE RELATIVELY SHALLOW. CONTRACTOR 1000 - GAL COARSE SHALL INSULATE THE LON6 EFFLUENT LINE, FROM SEPTIG TANK TO DAFFLE - SEPTIC TANK DRY SAND AD5ORPTION SYSTEM, FROM FREEZIN6 IN GOLD WEATHER. rin . 10-09-07 2 DEEP TEST PIT WITNESSED DY DANIEL RYAN, P.E. 24' PREGA5T 015TRIDUTION DOX 46 ...................................................................................... ROCK NO EVIDENGE OF R 7• OR GROUNDWATER D-DOX - - - - - - - - - - - - - - - - - ......:.................................................:.......... SDIL LOG tDY G. H. SGUDDER, P.E.) ....................... 6 . :........................................................................................ ...: DETAIL TRENGH LATERAL SYSTEM i NT5 FINISHED 6RADE 4' PERFORATED 'FMIHRAFI 160 NIC TOPSOIL 50HEDULE 40 PVC ;4 W - 015TRIDUTOR - - - • A66RE6ATE GARAGE - - /100 REMOVE GE55POOL 24' 4' MIN. 24' 4' MIN. 24' PLANT Z DEL 101 N TOWN C F QUEENSBURY IOOo-GAIT BUILDIN & POBWAPT. SEPTIG TANK GROUNDWATER, DEDROCK OR IMPERMEADLE 501L Revial y: 5TONE WALL SECTION ' 1ti�71 0 14 MAPLE / #/!-tic loo TRENGH LATERAL 5Y5TEM WAY qq ,. 0 18' PUJE SPRUGE ADSORPTION RATE DA515 OF DE5I6N TRENGH AD50RPTION THE AD5ORPTION 5Y5TEM SHALL DE BUILT IN DAILY 0: 3-DR OD110 - 330 GPO SYSTEM THE TOPM05T 18 INGHE5 OF 5011.— GOAR5E 5AND5 5TADLE PERGOL.ATION RATE: 2 MIN / INCH DELOW THE 2' TO 2.5' DEPTH ARE TOO POROU5 DE516N AD50RPTION RATE: 1.2 GPD / 5F 417 D-DOX FOR EFFECTIVE DIOLOGICAL TREATMENT. A155ORP. TRENGH LENGTH: 330 / 1.2 x 2 - 138 LF q6 . AL15A MARKWITH o 12• DIRCH 72 SUNNYWE EAST QUEEN5DIJ9Y, NY ............. .. ....................... ......................., 0000 FFFL. AGEMENT q5 q5 °G�a��00 WAc.� TFWATEK SYSTEM 51TE PLAN 5GALE I' - 20' OGTODER 26, 2007 i • 5GUDDER A550GtATE5 SITE PLAN 40�4 � •. GON5ULTIN6 ENGINEERS �., �� � . I' - 20' GHARLE5 H. 5CUDDER P.O. BOX 7q2 GLEN5 FALLS, NY 12601 516-7q3-1475 MA"Mff•i a/ui07