2004-376 .410% 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: P20040376 Date Issued: Thursday, June 03, 2004
This is to certify that work requested to be done as shown by Permit Number P20040376
has been completed.
Tax Map Number: 523400-289-006-0001-024-000-0000
Location: 50 NACY Rd
Owner: SLACK PROP MANAGEMENT LLC
Applicant: SLACK PROP MANAGEMENT LLC
This structure may be occupied as a:
Septic Alteration Residential
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, r"-" ,„P4
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
Firm 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040376 Application Number: A20040376
Tax Map No: 523400-289-006-0001-024-000-0000
Permission is hereby granted to: SLACK PROP MANAGEMENT LLC
For property located at: 50 NACY 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: SLACK PROP MANAGEMENT LL
124 BAY St Septic Alteration Residential
Total Value
GLENS FALLS, NY 12801-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
OI TEENSBI TRY SEWER
JAY SWEET
Plans&Specifications
2004-376
SEPTIC ALTERATION
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, June 02, 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 T wn o uee �j :, . 1 ,y, June 02, 2004
avznOuty
/,v'f i
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Elk
Septic Inspection Report
Office No. (518)761-8256 Date Inspection re• est ece. e::
Queensbury Building&Code Enforcement Arrive: .m/p jr-part: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initi Is: I )
NAME: ` J` P✓• IT NO.: )1 "3 7
LOCATION: SPECT ON:
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.
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/Partial
End Cape
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan e Y N
Engineer Report and As-Built _Y N
Location of System on Property:
Front Rear Left Side Right Side
Middle Front iddle Rear
S stem Use Sta s•
Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
Last revised 1/6/05
Application for Permit-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
I. OWNER INFORMATION:
Office Use
Location of installation: 5I Aulcc y %'n4'
File Permit No. 694-3
Tax Map No.oZBT,( / / l
Fee Paid c
Owner's Name: /odor r S7i5E//( .
Address: J2 y y S? ` 4/e0s A J/Vy
2. INSTALLER'S NAME : Jf}r 5veer PHONE NO.3E/-
3. 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 = t.
1991 -present` x 110 gal/bdrm =
14 cr/"se -2,K43r it s fiXr#' s
Garbage Grinder Installed yes_ / no X
Spa or Whirlpool Installed yes— / no X TO l°` C
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
Topography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
Flat at what depth at what depth municipal
Rolling oam 44.4'mow/ feet ___ feet well
Steep slope clay Nv My if/inc if well;water supply
_a,%slope other �� P6 S ewe from any septic-system
depth: 72 absorption is ft.
other / M? e.i or(r
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate:Zrr,,/ /?.see minute per inch
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed
professional engineer or architect(unless incralled 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: 400 gallon(min. size 1,000 gal.)
Tile . ch trench jI Total System Length: _— t
Seepage Pit(s): number of ze of each: A by f
Size of Stone to be / depth or ' ss feet
m Size:
Alternative System: k ,1 -ill A,'r-s length and/or size SI b
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 resconsibl rson Date
r
Septic Inspection Report
Office No. (518)761-8256 Date Ins.ection re est ece• d•
- Queensbury Building&Code Enforcement Arrive: - lb am/.• art: ` t5D am/pm
742 Bay Rd., Queensbury, 12804 Inspector's Initit . /-- _
NAME: 01C r 't . - vi _ P" IT NO.: �C 0 L1 - 3 7(
LOCATION: ? ;\ r..\r` SPECT ON: (p t. —(°
RECHECK:
Comments and/or diagram
Soil Typ: • ' oam/Clay
Type of . : Municipal/Well Water U i\ \oc., .ar
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Absorption Field: Total length i7 to ft.
Length of each trench \A ,,A�,k-c-j 7 9 ft.
Depth of trenches '-&1 ? 7, ft.
Size of Stone c rj C Tt_ -4\i3C,
Seepage Pits: Number
Size: x
Stone Size:
•
Piping Size Type
Building to tank L.\ % ,, L Al'A
Tank to Distribution Box N„ `Lk"
iv(.e-e5Je-p i Cd` 4-b
Distribution Box f .eld/Pit 1i I{
Opening Seale artial I'p Z'` *V\ \d1'5'_isc C)t3
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 Stat s:
Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
L:\SueHenungwayU3uilding.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003
i
11 1WIIIH1+titj///
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49
ACCESS HATCH 692 �`* j \\ �`.• /i/
56
RECOMMEND ALL ACCESS 693 �+
APPROXIMATE CLEANOUT OPENINGS rtst n ::Z:3 g'_—�
FINISH GRADE BE RAISED TO 6 BELOW CONCRETE OR STONE = ,n-C/)=
57
ELECTRICAL FINISHED FINISH GRADE. MARKER ABOVE ALL _ "� �. _
NION
CTRIC GRADE RECOMME RECURIED OMMENDED.
y
55
65
41
INLET BAFFLE 12 A11 STRUCTURES59 sa /�' N 1111111�
BMERSi �„ �1�p r* r asTRlBunoN eox
4~ PVC PUMP O4 7"' 3 BY FORT MILLER OR '
_-• / E®
MIN. SLOPE LIQUIDAL 40
62 /
ALARM ON ,E t/��" PER FOOT s ^•� ,
— — 1�� FORCE MAIN MIN.
' SLICE TO DRAIN 8 20,34
67 63
1/8" PER FOOT r �PUMP ON BACK TO PUMP STATION o � -•
SYSTEM #2 - 3 „ a ALL OUTLET INVERTS 10 Y sa nap _- 37 - INN OF n
(USE 2-t/2 PIPE IF SYSTEM #1 - 1500 GAL SEPTIC TANK a� oo TO BE SET AT - - , �7 KEENS
I PUMPING INTO SEPTIC TANK SYSTEM PEA -- 95 U(!,�'jlf,Ir�A q)r��RY
PUMPS OFF CHECK VALVE; �12 - 1000 GAL SEPTIC TANK EXACTLY THE SAME --_ j
EIY FORT MILLER OR GRAVEL ELEVATION. a '- -.
1 :• INLET rk OUTLETA USE OF SPEED LEVELERS --
N
EQUAL BAFFLES DISTRIBUTION BOX
1 ENCOURAGE )
,
N.T.S.
• SEPTIC TANKS � . . � >.,ebn�p a 34
a • • • • • ' • CONCRETE TO BE i. ALL UNITS SHALL COMPLY MATH THE REQUIREMENTS OF THE NEW YORK �z
TROWEL FINISHED STATE DEPARTMENT OF HEALTH AND SHALL BE PRECAST CONCRETE c� , 23 el
4'-0' I.O. PRECAST CONCRETE AS MANUFACTURED BY FORT MILLER OR EQUIVALENT.
MANHOLE WITH INTEGRAL B MERCURY FLOAT EFFLUENT PUMP Z ALL STRUCTURES TO BE PLACED ON FIRM, COMPACT SAND OR \ i �\
in
AND FLAT SLAB TOP, VVMGTHHT (TYYP (USE SEWAGE PUMP GRAVEL FOUNDATION. WHEREVER EXISTING FOUNDATION CONDITIONS
AS MANUFACTURED BY FORT MILLER ( ARE UNSUITABLE, CRUSHED STONE SHALL BE PLACED AS MINIMUM 2x MADTH �t7,y
OR EQUIVALENT IF PUMPING INTO NECESSARY TO ACHIEVE A STABLE FOUNDATION. MAXIMUM 4x WIDTH
(NO LADDER RUNGS) SEPTIC TANK)
3. SEPTIC TALCS INSTALLED IN TRAFFIC AREAS SHALL � EXTRA HEAVY
CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING. ` PROJECT LOCATION
PROVIDE Y SAND OR--- -�O��o o
SEWAGE PUMP STATION FOR SYSTEM #2 PEA GRAVEL UNDER TANK SEPTIC TANK • _;N.T.S.
NOT TO SCALE �+
0
r>4
I. PUMP TO BE EFFLUENT PUMP RATED AT A MINIMUM OF 20 GPM
HOC MDN--MM�-
AT Cf P„in`18 I SSW CVi(�811CC' 0 15 FEET TOTAL DYNAMIC HEAD. PUMP TO BE 1/3 HP GOULDS
all O17.: S It r 5, ict'GPS, etc., Z V1
MODEL 3885WE03L OR EQUAL 4)
1 r se + 1 'A
2. IF PUMPING INTO SEPTIC TANK PUMP TO BE RATED FOR RAW SEWAGE. � � //�� SIiOWIf =.' 1I.� i 1. i a I h�`aP
PUMP TO BE 1/2 HP GOULOS MODEL 3886WS05 OR EQUAL. INSTALLATION OF DISPOSAL FIELDS � f Jis0.�„��� set fo zt; �I, t�4 �; � � a �
SOILS DATA SEPTIC SYSTEM 0
3. PUMP CONTROL PACKAGE TO BE SUPPLIED BY MANUFACTURER. �'l
AUDIBLE AND VISIBLE ALARM TO BE ACTIVATED BY ALARM FLOAT V
1. CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING, -
�A'URE DFiT
AND SHALL BE IN ACCORDANCE WITH THE N.Y.S. TEST PIT SYSTEM #1 �- W
DEPARTMENT OF HEALTH INDIVIDUAL HOUSEHOLD SYSTEMS, AND 0-31" MISC. GRANULAR FILL DESIGN FLOW - 4 BEDROOM HOUSE ASTM F481-76 INSTALLATION OF THERMOPLASTIC PIPE AND 31-36" ORIGINAL TOPSOIL - 4 BEDROOMS 110 GAL./DAY/BDRM = 440 GPD Ix
CORRUGATED TUBING IN SEPTIC TANK LEACH FIELDS. 36-72" SAND W/ GRAVEL & COBBLES TRACE SILT
2. NO HEAVY EQUIPMENT SHALL BE ALLOWED WITHIN THE LIMITS SYSTEM #2 f�
OF THE DISPOSAL FIELDS AFTER PIPE INSTALLATION HAS BEGUN. W
3. AFTER EXCAVATION OF 4' WIDE TRENCH TO THE DEPTHS REQUIRED DESIGN FLOW - 3 BEDROOM HOUSE
THE WALLS AND FLOOR OF EACH TRENCH SHOULD BE CLEANED NO MOTTLING OBSERVED - 3 BEDROOMS ® 110 GAL./DAY/BDRM = 330 GPD
A
AND RAKED TO ACHIEVE AN EVEN SURFACE AND TO LOOSEN PERCOLATION RATE - 2 MINUTES 17 SECONDS PER INCH w �Cyy� 4)
SMEARED SECTIONS OF TRENCH. SEPTIC TANK - USE 1250 GAL TANK FOR SYSTEM #1 & 1000 GAL TANK FOR SYSTEM #2 = 3
4. PLACEMENT OF CONCRETE SAND IN-DRAIN UNITS, PERFORATED PIPE, TEST PIT AND PERC TEST BY NACE ENGINEERING - 5/1/04
AND GEO TEXTILE SHALL BE AS SHOWN AND IN ACCORDANCE WITH ^
o F+y
ELJEN IN-DRAIN DESIGN MANUAL AND NYSDOH APPROVAL CONDITIONS. ABSORPTION FIELD - TEST PIT SHOWS MISC. FILL & TOP SOIL TO 36"
5. THE PIPE AND LA DRAIN UNITS SHOULD BE LAID AT THE GRADES - CONTRACTOR SHALL REMOVE MISC. FILL & TOP SOIL COMPLETELY AND
AND TO THE RELATIONSHIPS SHOWN ON THIS DRAWING, MAINTAINING
STRAIGHT CONTINUOUS GRADES WITHOUT SAGS, HUMPS, SEPARATED TO 5' OUTSIDE NEW SEPTIC SYSTEM & REPLACE WITH GRANULAR FILL.
JOINTS OR OTHER UNSUITABLE CONDITIONS. THE PIPE SHALL BE LAID NEW GRASSED AREA E4
WITH THE HOLES DOWN IN ALL CASES. - PERCOLATION RATE OF FILL MATERIAL SHALL BE BETWEEN 1 MIN/INCH
6. ALL DISPOSAL FIELDS SHALL BE GRADED TO SHED RAINFALL / MINIMUM AND 5 MIN/IN MAXIMUM.
AND TO DIVERT SURFACE RUNOFF FROM ADJACENT AREAS AWAY - ELJEN IN-DRAIN SYSTEM PROPOSED DUE TO SITE CONSTRAINTS.
FROM THE DISPOSAL FIELD.
7. NO PART OF THE DISPOSAL FIELD SHALL BE INSTALLED UNDER DRIVEWAYS. f 100 SYSTEM #1 - AT NYSDOH APPLICATION RATE 52 L.F. OF ELJEN TRENCH REQUIRED.
4" PERFORATED PIPE GEO-TEXTILE COVER (� - USE BED WITH 2 LATERALS EACH 28' LONG = 56 L.F. TOTAL.
_ ! Cy_ TYPAR 3401 OR EQUAL SYSTEM #2 - AT NYSDOH APPLICATION RATE 39 L.F. OF ELJEN TRENCH REQUIRED.
17" MAX. no
I SLOPE 1/16--1/32- PER FT. LIMITS OF EXISTING "�I-' - USE BED WITH 2 LATERALS EACH 20' LONG 40 L.F. TOTAL.
D
CRUSHED STONE
f
10" MIN. ; I eee� W
''•'''• "�'�°�°�•• :•.:•. .....• .. . .". • SLOPE / i .. �_ '- _ - w ,-� :
co
MAP REFERENCE:
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•
.• .. .•. .. . •. `� p � 41.85` RIM � � .
:....
:
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i B I LC O I--�
Y - -
I
S: SYSTEM M S E #i 2 2 F MAP 8 L LATERALS F ERA 0 LS F I A SURVEY
O SUR� E MAD FOR
_ E 0
l0 { _ CHRISTINE BERGERON o
' ' " ' ' • -' • ��••'' "•' ELJEN IN DRAIN UNITS = 56 LF TOTAL �E� -
MIN
TYPE B IN-DRAIN UNIT 10 ., �� PN J - BY: VAN DUSEN & STEVES
BY ELJEN CORPORATION CONCRETE SAND I � W �
NYSDOT ITEM #703-07 � I ` - � DATED: OCTOBER 31, 1996 0
' \ NEW 1500 GAL. SEPTIC TANK UPDATED: APRIL, 2004 III� z
EXISTING WELL
c0 00 a
B I O—M A NOTES: �FROMAPROPERTTER N LINE I � � , � `; � LACAB AN A
T ABSORPTION SYSTEM , I RESTAURANT
1. END OF ALL DISTRIBUTOR PIPES MUST BE TOP OF CRO
PLUSTANDARD TRENCH PROFILE 2. ALL GLATERALSSTO BEOFOEQUALELENGTH. ,)D. ELEV. = 98,5 CIRF , 010' +� I 'R°�
SYSTEM #2 - 2 - 20 LF LATERALS OF t p FF=99.96 T01
ELJEN IN DRAIN UNITS = 40 F TOTAL
N.T.S. ' 100 - I I NEW IT F n & 0
' PARKING AR s 4 BEDROOM BUILDING
lot•
HOUSE
� / REVIEWED 8Y
BENCHMARK: NAIL 1 DATE
IN 6" CEDAR CRUSHED ! QA
ELEV.=100.00' 105� I -� STONE 1 F
�' p 1v _ ..
r - PARKING
NEW SEWER i xp
FORCE MAIN L5
4" MIN. TOPSOIL, I,}; ' J } 1 TOWN OF QUEENSBURY BUILDING DEPARTMENT
OVERFILL TO ALLOW SEED AND MULCH ;t r` , W
0011 ,
FOR SETTLEMENT � - Based On our limited examination
. i`;I �, !_ _- O 0 comppliance with our comments shall
BACKFILL WITH SUITABLE MATERIAL not Er construed as indicating the y
t ;; plans and specifications are In full a�
./ f``��:, `` �• ��-- gS DATUM — ASSUMED compliance with the Building Codes
NEW GRASSED of New York State. to
� a ti,• � , AREA CONTOUR INTERVAL — 1 FOOT �•
-, z
o 4"0 PERFORATED PIPE 105 `� � J -,�; /,, ' -_ W y
MIN. 1 GEO-TEXTILE COVER ' • ` , / 1 f .�
TYPAR 3401 OR EQUAL ',-
-'r ,Sri TWT �
f r r V M
: .°.°. "•'•.•.'' .•. ..•._.. I P 95 STONE & HOUSE LEGEND
••• •e•• • • 4• • ^• • • °• ° ••� °ILj • 4°,— - -
'9�l F
CONCRETE Z
• - � - • STAIR PROPERTY LINE
...: . . ... ... :. >;.:,.. TYPE B IN-DRAIN UNIT
EXISTING CONTOUR Data1 MAY,2004
4' MIN. BY ELJEN CORPORATION _ „�„
4' MIN �o f
3 BEDROOM
UNDISTURBED SOIL "' CONCRETE SAND
PROPOSED CONTOUR
NYSDOT ITEM #703-07 HOUSE
2 STORY
MAXIMUM SEASONAL HIGH --r _ WOOD FRAME
GROUNDWATER ELEVATION
HOUSE
NEW 1000 GAL. SEPTIC TANK & CIRF® = CAPPED IRON ROD FOUND $caul AS NOTt®
PUMP STATION (SEE DETAILS)
PLAN
IPF® = IRON PIPE FOUND
B10— MAT ABSORPTION SYSTEM �RF® = IRON ROD FouND
STANDARD TRENCH SECTION acwv r '20' 49131
LANDS N/F OF � = UTILITY POLE •
N.rs. I�ORCORAN
*NET 1 OF 1