2002-938 A TOWN OFQUEENSBURY
Fors
A ,1�r 1 N
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20020938 Date Issued: Friday, August 15, 2003
This is to certify that work requested to be done as shown by Permit Number P20020938
has been completed.
Tax Map Number: 523400-289-017-0001-011-000-0000
Location: 84 ASH Dr
Owner: SUZANNE KING HUNSICKER
Applicant: SUZANNE KING HUNSICKER
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
(... eW/P 4
«\
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020938 Application Number: A20020938
Tax Map No: 523400-289-017-0001-011-000-0000
Permission is hereby granted to: ST JZANNE KING HI JNSICKER
For property located at: 84 ASH 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. Type of Construction Value
Owner Address: SUZANNE KING HUNSICKER
60 STATE RTE 149 Septic Alteration Residential
Total Value
LAKE GEORGE,NY 12845
Contractor or Builder's Name /Address Electrical Inspection Agency
CUTTING EDGE GROTJP_ 1,1,C
NY 12804-0000
Plans&Specifications
2002-938
Residential septic alteration per plot plan and specifications.
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, November 12,2003
(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 To Queens ry; ay,November 12,2002
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Permit—Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION:
Office Use
Location of installation: $4 As Dr• (,t jam, /n„ i Ail I
File Permit No. L -"-- / ✓,
Tax Map No.281. 17 / / i1 .�.
'/•
Owner's Name: -T'.� g See ILNs:glu-<^ Fes Paid
Address: 430 St e4 149 L411. Crea7- Aly lzgfr --?q Ss
I ar\AD
2. INSTALLER'S NAME CNW e (T1'6ap , LLC PHONE NO. 718 -'��
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply# of
bedrooms with applicable gallons per bedroom to equal total daily floo �
Year of House: No. of Bedrooms x Computation = Total Daily Flow v ED
1980 or older x 150 gal/bdrm = NO v () 8 2002
1980—1991 x 130 gal/bdrm = TOWN OF
1991 —present (o x 110 gal/bdrm = CEa() BUILDING UEFNSB�RY
See A144 1 Lem Jell jy sJer• Nfrbe5 ANO CODE
Garbage Grinder Installed yes / no
Spa or Whirlpool Installed yes / no 7
4: PARCEL INFORMATION: (circle applicable information&indicate measurements)
Flat
osz C
raphv an oil Nature Groundatwhat Wdepthater Bedrockatwh
ort d Imperviousepth Material Domeisticpal Water Supply
g munic
Rolling loam )Zo feet ' : NIA feet EC>
Steep slope clay well; water supply
< 4 %slope other from any septic-system
depth: 7 S' absorption is too ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: 4s SZt Allitu to per inch
5. PROPOSED SYSTEM: For Nev Constni ti9n: 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: 2 0 gallon (min. size 1,000 gal.)
Tile Field: each trench fl. Total System Length: fir
Seepage Pit(s): number of size of each: ft by ft.
Size of Stone to be used: # / depth or thickness feet
Bed System Size: x
Alternative System: length and/or size 80 LF
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.
Signa ure o responsi e person D e
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7. SIGNATURE &INFORMATION FOR R1.SVONausi. rn1;\.D.,r,, ww,...+..,....,
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building& Code Enforcement Arrive: yi am/ m Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: �'-
NAME: i rh ^-,c%- PERMIT NO.: 5.3(1'
LOCATION: cr y� r J
INSPECT ON: ��o
RECHECK:
Comments and/or diagram
Soil Type: n 1`Loam/Clay
Type of Water: Municipal/ ell Wate
Waterline separation distance ft.
Well separation distance /(o ft.
Other wells: /t, ft.
Absorption Field: Total length J 2,0 ft.
Length of each trench J(� ft.
Depth of trenches _ Z.- 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 4/4 f
Opening Sealed: Y/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 Property:
Front Rea Left Side 'ight Si:-
Middle Front Middle Rear
System Use Status:
}(J 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
s L
II 7
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: it 36 am/pm Depart: arn/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: ¶fr
NAME: t;\tr rk`mil c. PERMIT NO.: C 9 '- 3
LOCATION: ISy INSPECT ON: 7 / l '.3
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.
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft. 5-0,Ate/_ dir4(')/`) 7�
Size of Stone
Seepage Pits: Number rL 'rcr)M -fy l
Size: x '7
Stone Size: hi)//1" AAjb
Piping Size Type occroZ 0.66/ S IL
Building to tank _
Tank to Distribution Box /J ‘06erlie
Distribution Box to Field/Pit
Opening Sealed: Y/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 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
7 Disapproved
L:'\SueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003
Septic Inspection Report
Office No. (518)761-8256 Date Insp ction request received:
Queensbury Building& Code Enforcement Arrive: P.2A( am/ m Depart: am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: 1M `s '\c- }C)S PERMIT NO.: 0 0-c J C�
LOCATION: "T INSPECT ON:
RECHECK:
-�j Comments and/or diagram
Soil Type. a�S /Loam/Clay
Type of Water: Municipal/ke11 Wa
Waterline separation distance i,. ft.
Well separation distance `j ft.
Other wells: _ f ft.
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft. i ` s"
Size of Stone LI /
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box 4.e S'f)/L
Distribution Box Field/Pit if* 10k
Opening Sealed N/Partial � ;$ e J fete ler)
v
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 Property:
Front Re.' Left Side •ight Sid
Middle Front Middle Rear
System Use Status:
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
A A
BAFFLE
INLIrET
4' TOPSOIL — - - - — _
i
4' 0 PERF. PVC PIPE
OF ,y 9L GEOTEXTILE COVER HOLES POSITIONED 10'-17' _
�S F OUTLETGROUT UNUSEDOOPENINGS AT 5 & 7 O'CLOCK 30' MAX.
� BINDING STRAPS
PO2 1 165
92� ELJEN INDRAIN UNIT ,
PLAN VIEW -7�
TPl 0� CONCRETE SAND
6 N
�� 3 4' MIN UNDISTURBED SOIL
�C
DRA AGE GRADIANT — 4' _
CAPP X. 4%) MIN, 12' COVER 2' MIN. TO IMPERVIOUS LAYER O HIGH GROUNDWATER LEVEL '
f2 _ _
X T LEACH IELD _.._.._.._.._.._.._.._.._...
EISI L
XISTING 2000 GAL SEPTIC TANK
INLET, 4' SCH 40
OUTLET, 4' SDR35 PVC
PVC MN. SLOPE #'/FT O O MIN. SLOPE J'/FT
MIN, 9' CRUSHED STONE
t/� f WELL
tr •
�� � SECTION A—A YC
CELJ[E�] 0HO � ° M 711M. ]C H C ROO20 2 C 70 [� ,
vL yG NOT TO SCALE
NOT TO SCAL
a
WELL
• WELL
s52
3'-6'
GLEN LA E
2'-6'
L IX .837 NCB 8 TE PLAN �C AL E 1 °° 4 0'
LIMITS OF LEACH FIELD EXCAVATI❑Nit j
I LANDS OF DERBY/STEIN _
4' MIN, OF UNDISTURBED SOILS BETWEEN TRENCH WALLS j
INLET OUTLET
WELL }
END CAPS (TYP.) j
I.
I 4' DIA. PERF. PVC PIPE
/ WATER WELL INFLUENCE SLOPEi J'-�'/FT
LINES (100' RADIUS)
t PLAN VIEW
L>J / ±2S 1 • � � 24' MANHOLE FRAME AND GRATE. __ - _. __ _ r-
� ,� (NEENAH 1754 OR EQUAL) I
_ L� FINISH GRADE
EXISTING 2000 GAL SEPTIC TANK LL l.,_
/ PROPOSED �LTERING MANHOLE
ry PAVED DRIVEWAY / -'/ (� Co O W
Q / PROPOSED ELJE INDRAIN - v CATCH
LEACH FIELD/ 0i
P 1 �DDRAIINAGZ ZABEL FILTER
MODEL A-100
4' SCH 40 PVC
GRADIAIJT LLJ W W 4 SCH40
(APPROX. 4%) LANDS OF HU SICKER Z Z Z FROM SEPTIC TANK DISTRIBUT
(MIN SLOPE J'/FT) (MIN SLOP
� PR❑P❑SED DISTRIBUTION BOX
J J J
TP1 Z Z z
/ LLJ W LL
MIN 9' CRUSHED STONE
WOOD FENCE ±240
10' SETBACI: LINE
DISTRIBUTI❑N BOX SECTI❑N VIEW
4' SCH40 PVC FROM SEPTIC TANK
I c e e o e
a_
LEL�JEH PHRO H LFAGa FE LDD PLM
LANDS ❑F GRAVES WELL N DSCALEFOL1�ITERRHO CMIQLI�N LI�C
TOWN or QUEEN l�RY
NOT TO SC
pG�30pOSED S0TE PLAN SCALE: �I °°
1 s p�'.
Construction Notes: Leach Field System Notes:
9. Contractor to verity all utility locations and contact UFPO prior to any Flows: 6 bedroom residence, all lum in fixtures have been have scram .r ` or 'eve I say evidence
of, RECEIVED
1. Sewerage o s. op g I
1. Sawcut and remove paved areas as necessary to install new leach field excavation. ss i;ooe;, 11s, frees, fence °to
system, structures and piping as shown on the drawings. No paving will
modified to low flow units to reduce daily design flows. As per 1 ONYCRR ail, ehiect
„ 10.Contractor must at all times allow access to the driveway for occupants. Appendix 75-A, daily design flow per bedroom = 110 gal/day. sl,,wri on t;i1� �:_';,��ir,ent. I also represent that I have r NOV 0 8 2002 �
(ibe placed over the new leach field system, this area to receive 4 topsoil, - k ;a;ed the iStances set forth on the diagram.MTE �Oo C�Q��ON UVUG�1Lf seed, and mulch. All other disturbed paved areas to be replaced in kind. 11.Construction fencing shall be provided and maintained throughout (6 bedrooms x 110 gal/day) = 660 gal/day personal TOWN OF QUEENSBURY
construction. �! 8 �- BUILDING AND CODE _
2. Existing 2000 gal. septic tank to be utilized, remove existing outlet piping 2. Septic Tank: 1.5 x design flow = 1.5 660 = 990 gal
„ ATE
12.Survey and site information taken from previously completed site plans = !n
? ;"" +: AffaondackPark M1 and replace with 4 SCH 40 PVC C /< /ft to filtering manhole. Y P Y p P Minimum required tank capacity 1000 gal �Jllt
developed b VanDusen and Steves Land Surveyors, Glens Falls, NY '
P Y Y Existing 2000 gal tank is acceptable for reuse. --•-----
, 3. Install filtering manhole as shown Dn the contract drawings. Install SCH
• � ,, t ,I �f ',• r` : .�? , ;, , (Sept 15, 1997). Limited measurements were taken for plan preparation
• V. r " x u! 40 PVC pipe between filtering manhole and new distribution box @ / /ft 3. Leach Field Design Criteria: As per ELJEN Corporation Design and
1 R by CEG. Contractor to verify all measurements
:`.
slope. Installation Manual for NY and in accordance with 1 ONYCRR Appendix
,,, Percolation T
� a 4. Erosion Control shall be maintained throughout the duration ofTest Results. — 75-A, the minimum trench length is 79 LF. This is based on a percolation
'onl - 1 ,
Qa construction and shall be in accordance with the New York Guidelines for rate of 1-5 minutes per inch for modified site soil conditions. Indrain units TWOTHYAND SUZANNE
Urban Erosion and Sediment ContrDL Minimum are available in 4' lengths, so use 80 LF. There should be a minimum of
, . P•
e A�,o�, t u,,3,, : . ", :,, No. Perc. Rate Depth o
_ 4 of existin undisturbed soils between each trench. Trench len the are o 0 0 0
x ( LakeGe6fw NY,,26�5 ,;� 5. All work to conform to all local, state, and federal regulations. g g d d D d 0 o a
s, 1 1 follows II w for proper setback and well influence separation 84 ASH Dtl §V (MAID QD9 289. 17I 1l 1 �1)
�� PT1 45 sec./in. 36 as to allow p p p F N
, tl 6. Septic tank to be pumped clean prior to and during all construction.
P p p p 9
r+T r requirements: �0 E..
s ' ,., PT2 60 sec./in. 36 �Q�oN 'r TOWN F UEENSBURY WARREN COUNTY STATE F YOR9C
Ir5 ry, 7. Soils shall be improved in the leach field area to allow for a percolation �. O O Q O NEW
•B°@` rate between 1 and 5 minutes. In no case shall the percolation rates
Trench line #1: 32 LF s
Percolation Tests Performed By SS, AA. Trench line #2: 28 LF Q�� �Qcc��O Q� cc� �� a
exceed 5 minutesfinch. Soils stall be improved by either mixing the D�� w D� Jv ��Q��1 ����D
Trench line #3: 20 LF , w
existing soils with fines to achie\e slower pert. rates or complete soil Test Plt Results: 2 t o d D d
s G3G�I�,1C3�UTATIOnNI
replacement to a depth of 2 f,'et below the leach field elevation. 4. Contractor to at all times comply with requirements set forth in the F
p
4p79736 ��
1 ,i 1. µno; • , . ..
r., n er to 7 - Wastewater
Percolation tests shall be performed by the engi a verify validity of in D n tion NYSDOH Design Document 10NYCRR Appendix 5 A, Waste ate R , ipN o p °
Y,I No. esc p DRAWN ��. �� APPROVED ��° SCALE: �I°° e ®° FILE: HUNSICKER.DWG
place percolation rates for either iTethod. Mechanical compaction should Treatment Standards for Individual Household Systems & Individual
1[K12 Msxoiofi tap 014ap Na uTecfifTiOF"Mc andFx C„Inpurmc .'• "�'` -: - TP1 0 -4 Topsoil with organics [� ���� N /A '
be used in place of vibratory methods to avoid segregation. Soils not g Residential Treatment Systems Design Handbook and the ELJEN DATE: 10/15/02 � ® O° III
passing perc. requirements shall be modified until proper rates can be 4%4' CM Brown Sand with some cobble (fill) Corporation Design and Installation Manual for NY.
obtained. no ground water observed
no mottling observed C UTTE eS EDGE GROUP, LL� _
8. Contractor shalt provide as-built drawings of the system. no rock or impervious layer observed PE LISCENCE NO:079736 si•rsEr of