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2007-001TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Community Development -Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20070001 Application Number. Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: HOMESTEAD VILLAGE L P For property located at: 200 LUZERNE Rd a20070001 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. Tvne of Construction Value Owner Address: HOMESTEAD VILLAGE L P 4294 ROUTE 5 CALEDONIA, NY 14423 Contractor or Builder's Name /Address SANITARY SEWER DAN DRELLOS PO BOX 224 GLENS FALLS NY Septic Alteration Commercial Total Value Electrical Inspection Agency Plans & Specifications 2007-001 septic alteration commercial lots 35 & 36 $35.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, January 02, 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 T o eens ry;~ a ay, January 02, 2007 SIGNED BY ~/~f for the Town of Queensbury. Director of Building & Code Enforcement ~h ~ .. ."..".._,.~ `~~ OFFICE USE ONLY ~¢' ~ r""" """" ~'-2 ~ TAX MAP N0. PERMIT N0.O -DO PERMIT FEE ; + I~r : a ~' ~..f~;; .~~~ ry~y~1~URY ; ~duvly APPROVALS: ZONING TOWN CLERK ~ ~ aUILDIN4 ANR CODE APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT; A PERMIT M~lS BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJEC T REVIEW BEFORE IS NCE OF A VA PERMIT. OWNER: ~ ~ INSTALLER: / 1 vl cam, ADDRESS:, L y -? ~~~~ ~J ~ l ~ %~ ~~ Q-^~ .~^~ r' ADDRESS: ''~f Q J~ PHONE NOS. ~ / Z ` 2 r ~ J r PHONE NOS. / l ~ '~ ~ ~~~ LOCATION OF INSTALLATION: __~T (' ~J ~`'~ ~, EAR BUILT """"""""'°°'••°°°•°•°•°••°°••••••••: RESIDE E INFORMATION ~ X COMPUTATION= i = i NC ; ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, BEDROOMS ,TOTAL DAILY FLOW 1980 or older ..,..........,...... ......... I X .................•......................................... 0 gal Ion per bedroom ~ ' , GARBAGE GRINDER .............. 1981-1991 X •• . , , .,..... , . . ..... ...=....L .............. i .....................•.....................................1 INSTAL LEO? ..................»...............,.. ,...,....i .................•................. ...................... 130 gallon per bedroom .................... . ~ = 1992 -present ~ ..............__.......,.......... X . ............................................. 110 gallon per bedroom ....•.a...........i....................................................•............•........ ~ : , SPA R HOT O TUB INSTAL ........... .......................•.........• LED? PARCEL INFORMATION: / TOPOGRAPHY: FLAT R iNG ~ EEP SLOPE %SLOPE / IL NATURE: A S N~ LOAM CLAY OTHER / GROUNDWATER: WHAT DEPTH AT WHAT DEPTH? BEDROC /IMPERVI OUS MATERIAL: AT / DOMESTIC WATER SIIPLY: MUNICIPAL / WELL (IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT ) / PERCOLATION TEST: RATE IS 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: ~j GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH~~.] FT. / TOTAL SYSTEM LENGTH: ~~' FT. SEEPAGE PIT(S): HOW MANY? / SIZE OF EACH FT, X FT. / SIZE OF STONE TO BE USED: # ~~ /DEPTH OR THICKNESS ~L FT. / BED SYSTEM SIZE: X / ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE / HOLDING TANK SYSTEM: (If required) NO.OF TANKS: /SIZE OF EACH / GALLONS. /TOTAL CAPACITY.• GAL. NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY'A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. STATE OF NEW YORK DEPARTMENT OF HEALTH s District Office 77 Mohican Street, Glens Falls NY 12801 (518)793-3893 Fax (518) 793-0427 Antonia C. Novello, M.D., M.P.H., Dr.P.H. Commissioner September 7, 2006 Amended October 17 2006 to include lot 35) James Mitchell, P.E. Environmental Design Partnership, LLP 900 Route 146 Clifton Park, NY 12065 Dennis P. Whalen Executive Deputy Commissioner ~~ T~ RE~~~~,/E~ ~ ~, ~-'~ ~ ; ~'' fi©WN ur ~~~"v~tsURY BUILpING AND GOQE Re: Letter of Approval Homestead Village Mobile Home Park, Lots 35.36, 84,78,79 Town of Queensbury, Warren County Dear Mr. Mitchell, We have, this day, approved the plans for the construction of the on-site wastewater treatment systems for the Homestead Village Mobile Home Park on Lots 36, 84,78,79. The approved plans were designed by James Mitchell, P.E. of Environmental Design Partnership, LLP, titled Septic Design prepared for Lots 78 and 79, Septic Design prepared for lot 35 and 36 and Septic Design for Lot 84. These plans are all dated August 15, 2006. This approval is conditional upon the following items. • That the proposed facilities shall be installed according to the approved plans. • The design engineer must inspect construction. • When complete, the design engineer must certify in writing to the Town of Queensbury, Building and Code Office, and this office that construction was completed according to the approved plan. • This approval will expire two years from today. After that time if construction is not complete, plans must be resubmitted to this office for approval. Enclosed you will find one set of the approved plan. Your office is responsible for distribution of the approved plan to the Town of Queensbury, the applicant, and the contractor. This office will retain one copy in our file herein Glens Falls. If you have any questions, please call me. S inc~rel y, C~~ ,/~'v n~ Mike Shaw Senior Sanitary Engineer cc: Homestead Village MHP, Applicant Town of Queensbury Building Office Anita Gabalski Kristen Sayers s ~/~ ~~ ~~ Septic Inspection Report 2~v Office No. (518) 761-8256 ~~ In w n ~ part:-~ am/ Queensbury Building & Code Enforcement Arrive: _ , __ 742 Bay Rd., Queensbury, NY 12804 Ins NAME: 5~ LOCATION: RECHECK: NO.: " ON: '" "' ~~~~ ~~ D ~\a~ QF~ ~ `~.~'~- r~ m approved ~ ~ re-inspected, please call the Building & Codes Office Partial Approved and needs Disapproved Last revised 021006 Last revised 1/6/05 Location of System rope Front R r Sid Right Side Middle Front Middle Rear