2004-821 TOWNQUEENSBURY
.
OF
Vara
742 Bay Road, ueensbu NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20040821 Date Issued: Thursday, November 04, 2004
This is to certify that work requested to be done as shown by Permit Number P20040821
has been completed.
Tax Map Number: 523400-253-000-0001-012-000-0000
Location: 2109 RIDGE Rd
Owner: ROBERT & JENNIFER METIVIER
Applicant: ROBERT & JENNIFER METIVIER
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
r(k"
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
A16/4` � 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201.: v
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040821 Application Number: A20040821
Tax Map No: 523400-253-000-0001-012-000-0000
Permission is hereby granted to: ROBERT & JENNIFER METTVIER
For property located at: 2109 RIDGE 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 Value
Owner Address: ROBERT & JENNIFER METIVIER
2109 RIDGE Rd Septic Alteration Residential
Total Value
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-821
SEPTIC ALTERATION
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, October 20, 2005
(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 Queensbu�r; We nesday, October 20, 2004
SIGNED BY %� r. . for the Town of Queensbury.
arm tvm
Director of Building&xR ode Zto.forcement
Application for Permit-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
OWNER INFORMATION: --- -
Office Use
Location of installation: 2 I D 7 R,�c -cot cl ,z�
File Permit No. V "I 'C
Tax Map No.Z S3. / I / 12- �,;
Fee Paid c'-3
Owner's Name: oh r ft Q t`/ t I Cr
Address: a 10 9 (2.1 Are 4.8 ate e ti s bu
INSTALLER'S NAME : k Nit c(u i ( . PHONE NO. 778-s8 2-
RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s) and multiply# of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: No. of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdrm =
1980-1991 x 130 gal/bdrm =
�49T presen 3 x 110 gal/bdrm = 3 3 0
Garbage Grinder Installed yes_ / no M..
Spa or Whirlpool Installed yes— / no i
PARCEL INFORMATION: (circle applicable information&indicate measureme> )T 1 9 2004
a�
Topography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
Flat sand at what depth at what depth municipal w-
Rolling edam) A'_Jfeet feet el
Steep slope clay if well;water supply
slope other from any septic-system
S`-I 0 depth: absorption is/004'ft
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: minute per inch 7 toe ?°�o r�ned c��-�2� "ecr c edl
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: 1000 gallon(min. size 1,000 gal.) 6 v-.44`^f
Tile Field: each trench 40 ft. Total System Length: 200
Seepage Pit(s): number of °" size of each: by fr
Size of Stone to be used: # / depth or thickness — feet
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)
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 Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person
Date
--r
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received: 0' o,
Queensbury Building&Code Enforcement Arrive: am/p e art: < &3 am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: 1A4�T 1 V V- PERMIT NO.: O7
LOCATION: 7—( ram R 1.Jr V INSPECT ON: If (r
RECHECK:
Co • i ents 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.
Absorption Field: Total length
Length of each trench t.
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/Paxrkial
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms asper Plot Plan ^Y N
Location of System on Property:
Front Rear Left Side Right Side °
Middle Front Middle Rear APPX6U0-L d AJ
S stem Use Statu .
Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
L:\.SueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003
OCT 29 2004 4: 44PM HP LASERJET 3200 P. 1
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NACE ENGINEERING Y.C.
169 Haviland Road,Queensbury,NY 12804
Phone-518-745-4400 Fax -518-792-851 1
October 29,2004
Job#49047
Mr.Dave Hatin VIA FAX—745-4437
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
RE: Replacement Septic System
Robert Metivier—2109 Ridge Road
Dear Dave:
This is to inform you that on October 27th I performed a percolation test in the fill material placed
for the replacement septic system at the Metivier residence at 2109 Ridge Road in Queensbury.
The percolation test was located in the middle-western portion of the system. The test was run at
20 inches in a 30 inch deep hole which was presoaked with 10 gallons of water. The stabilized
percolation rate was 5 minutes 15 seconds which is within the range specified on the approved
drawings.
Please call me if you have any questions.
Si cerely,
Q �
Thomas W. Naze,P.E. 1/—
cc: Robert Metivier C�
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received: Q /e C
Queensbury Building&Code Enforcement Arrive: am/ epart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: iv
NAME: tKiPERMIT NO.: C)C ' - I
LOCATION: ' 1 INSPECT ON: O C -4:00
fdyx-
�CHE�'fi�
•
Comments and/or diagram
Soil T e: Sand/Lo C
Type of Water: unicipal/Well Water
Waterline s aration distance ft.
Well separation ft.
Other we f}.
Absorption Field: Total length v l/ ft.
Length of each trench _ft.
Depth of trenches
Size of Stone .ri'"
Seepage Pits: Number
Size: x
Stone Size:
•
Piping Size T
Building to tank � (, 571j11(?
Tank to Distribution :ox H 4e-0 Zd
Distribution Box eld/Pit IA-
Opening
Seale• /N/Partial
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan _Y!N
Location of System on P perty:
g "atripe .A)& . A -A'1< 7-ST /-5 Ae
Fron Rear eft ide Right Side
Middle Front Middle Rear
System Use Status: O l< �6 /'„ON
proved `�
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
L:\SueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003
1
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MAP REFERENCE:
MAP OF A SURVEY MADE FOR
ROBERT AND JENNIFER METIVIER
DATED NOVEMBER 23, 1999
BY VAN DUSEN & STEVES
LAND SURVEYORS
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LANDS N\F OF W U H
ROBERT & SHIRLEY HAUSLER a 4 wPIP 10.1 W
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°32'10"E W a
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583.09
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w � cr a
2'-0" 4'--0.' 2'-0" 157. MAXIMUM
O
GROSS SLOPE
OVERFILL TO ALLOW ON SLOPED SITES W F
FOR SETTELMENT
6" - 18" F�LLTM GEOTEXTLE FABRIC
2" MIN.
4" PERFORATED
12" MM. LATERAL
o°O
i9 �°Oo 0 3/4" TO 1 1/2" �r AREA
WASHED
0 0 5.30 Acres
E2MN. CRUSHED STONE N O
MAXIMUM SEASONAL HIGH -� r
GROUNDWATER ELEVATION O
OR IMPERVIOUS SOL OR ROCK z cv
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a
5T,4NDARU AS50RPTION TRBGH SECTION
NOT TO SCALE O
DRILLED O �
WELLCd
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APPROXIMATE LOCATION ~ O '�,,�
OF DIRT DRIVEWAY — p
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BARKER MATERIAL d-
18' MAX. =llil, „II , ,,_, , .���►_ , — o ~' Co
w �-
30' MAX. w MN. 0
1s' MN. 2' MN. cx�od7oo SLOPE 0
p o00 0 '� O COul
= REPLACEMENT ABSORPTION FIELD. 04
REMOVE EXISTING LEACH FIELD AND �
f% r% e,. rs n n e% n n I'll" ======
MIN. 3' OF SOIL UNDER FIELD. IN LOWER ocbcA 0 0 04 437.0' LY_ Lil '
O 0 4' PERFORATED PVG LATERAL.
�- 0 AREA BEYOND EXIST. FIELD. REMOVE
SLOPE IAA'-1/32' PER FT.��� � �£� I"'" Q _ — TOPSOIL PRIOR TO PLACING NEW FILL �
(� _ TO BRING AREA UP TO LEVEL OF t
TO BE LEVEL yEND OF ALL DISTRIBUTOR
PS MUST BE LS-- EXIIXSTING LAWN. NEW FILL TO BE 1 V
N r M OF MEDIMUM TO FINE SAND WITH
PLUGGED UNL£S5 HTERGONNECTED.
2 ALL LATERALS t0 BE OF £CWAi. LENGTH. E IST G I SMALL AMOUNT OF SILT. FILL TO ,
LE CH FIE D HAVE AN IN-PLACE PERCOLATION
STANDaIZU �350RPTIDN T���.IWn PROFILE — — _ RATE OF BETWEEN 5 AND 8 MINUTES .
-In PER INCH.
NOT TO SCALE
NEW DISTRIBUTION GR E 5 LATERALS '
BOX TO RA • 40' LONG
EACH
REPLACEMENT 5EFTI6 5Y5TEM DE516N
DESIGN FLOW - EXISTING 3 BEDROOM HOME = 330 GPD to Data OCTOt;3ER i�, 2004
SEPTIC TANK - EXISTING 1.000 GALLON TANK pRAI�pGE
AROUND FIELD OCT 1 9 2004
�+IAINTpIN SIDE
AB50RPTION FIELD - EXISTING TOPOGRAPHY IN THE AREA OF THE REPLACEMENT gWA►-E Sifl�
A PTION FIELD REQUIRES FILL TO LEVEL AREA AT A flF pgSflRP
BSOR
GRADE JUST BELOW ADJACENT LAWN AREA.
- STRIP TOPSOIL IN AREA OF FIELD AND PLACE NEW FILL
WITH IN-PLACE PERCOLATION RATE OF 5 TO 5 MINUTES PER INCH.
- WITH 501L PERCOLATION RATE OF FILL = 1" IN 8 MIN. MAX. °3 0"W
NEED 330 GPD/ 1.0 GPD/SF= 330 SQ. FT, OF TRENCH S$2 ��
- USE 5 LATERALS @ 40' EACH = 400 SQ. FT, 571.14
ENGINEER TO PERFORM PERCOLATION TEST OF FILL 1N NEV ABSORPTION v I LIk 1 Al 3��f.`¢�`� ._ r�, I ,AREA TO CONFIRM THAT IT MEETS THE REQUIREMENTS OF THIS DESIGN. �---- 49047
LANDS N\F OF ��
FLORENCE MURPHY PLAN `'� ' -
SURVEY N0. 94265
SCaw r-20'
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