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2004-227 ,T TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building & Codes (518) 761-8256 IFI:CA'I' -OF COMPLI��NCE Permit-Numb& P200,40227: .. -Date Issued: Thursday, April 28, 2005 This,.is-ta=certify-that work requested_toF be-done as shown by Perriiit Number P20040227 has been completed. _ - Tax MaP.Number:. 523400-290-005-0001=050-000-0000 Location:'_ _ - .- 168 SUNNYSIDE Rd - Owner: :-_ HARS PARS, INC. . - . A 'cant - -_ PP PAR 3 GOLF COURSE — _-This structure may be occupied as a: Septic Alteration Commercial By Order of Town Board -- - E SBU Y _ Issuance-of-this-Certificate-of Compliance DOES NOT relieve the 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&Code Enforcement 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: P20040227 Application Number: A20040227 Tax Map No: 523400-290-005-0001-050-000-0000 Permission is hereby granted to: PAR 3 GOT,F C OURSE For property located at: 168 SUNNYSIDE 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. I I c 1' ' Type of Construction Value Owner Address: BRIAN P JACOBS TRUST 13 OWEN Ave Septic Alteration Commercial Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name /Address Electrical Inspection Agency OITEENSBURY SEWER JAY SWEET Plans&Specifications 2004-227 SEPTIC ALTERATION $35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, April 27, 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(late.) Dated at the T o ueen a Aprils 27, 2004 SIGNED BY for the Town of Queensbury. r .Y 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: Af SC( v,0 41, i I File Permit No. Qq c2a7 Tax Map No. / / ©v : Fee Paid Owner's Name: c Address: 2. INSTALLER'S NAME : Serv. - PHONE NO. -7— 3. RESIDENCE INFORMATION: (circle year o 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 = 621) 1980—1991 x 130,gal/bdrm = 1991 —present x 110 gandrm = Garbage Grinder Installed yes_ Spa or Hot Tub Installed yes^./ 4: PARCEL INFORMATION: (circle applicable information&indicate measurements) ToQoeraphy Soil Nature Ground Water Bedrock or Impervious Material Domestic Water.Supply s at what depth at what depth municipal -Rolling loam feet feet wel Steep slope clay if well;water supply slope other from any septic-system depth: absorption is/,2,ft. other Percolation Test: (To be c3mpleted by licensed professional engineer or architect) Rate: 'ule per inch 5. 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: �gallon (min. size 1,000 gal) Tile Field: each trench _ ft. Total System Length: SZ ft. 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 '61 PP , Alternative System: length and/or size a Ilyn_� 6. HOLDING TANK SYSTEM: (if required) Iv G��Ry 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. Si nat re f responsible person Date • •�1,��1v�t ��i �.�,1j(��'��1�1f1��•v S( wors :t»tl Sewsige Dusi sal t.li:cttirr l�Itlti�tttli x (• PON • SI��I'1�itA'1'I4)1N ItI�(,ZZ.JIILI�[�l l�.f�l'I';i • L"J Y'JELI. IN �l�lfl�i�• fit u'w•1 . *Off CA51,16 ........ c, .�,• �••' c 00, G • .�✓1I T�.)u� •�I " A cpar . Z .J •, '� 7l� 7• SICFI�I�A,TURE &1NFbp,14P►TIS�T,'`i'10 I .� 1�V1�1►`��fisl+tr x'��wvt.�xv,��..•.�•••y' M COMMONWEALTH ELECTRICAL'INSPECTION SERVICE,INC. 0 Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Permit No........................................Cert. N® 7 6 0 4 9 ut-in Card No...................�...../x Owner........ Location...............cr.�01JIv.Y ... y................................®�L� .. Installation Consisting of...��..'�� >� "'�d' �/U C� °........../9�� ..... ................................................................................................................................................................................... .................................................................................................................. .............................................................. Installed By..... .�.1..�.... �l-.. Ltc.No. ........................................... ................................................. The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon thi introduction of additional equipment or alterations,application shall be promptly made for inspection.. Inspectors of this Company shall have the privilege of makin i pections at any time, and if it rules are violated,the Com any shall have the right to rev kY ertificate. Date......'z." �...d.................. INSPECTOR....'a ............................................................. Member N.F.P.A.,I.A.E.1. Septic Inspection Report Office No. (5.18)761-8256 Date Inspection re est r Ned: Queensbury Building&Code Enforcement Arrive: a p D art: 1>2 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: E ITNO.: 7 00tA — 77�j LOCATION: 60 3�b1 OF V) `I SPECT ON: r—2-5A—(,,y RECHECK: Comments and/or diagram Soil Type: andy Loam/Cla Type of Water: Municipal/ ell Water Waterline separation distance ft• Well separation distance ©Q ft. Other wells: ft. Absorption Field: Total length t` ft• ' Length of each trench ft. Depth of trenches --ft. - Size of Stone J Seepage Pits: Number 10 Size: x Stone Size: Pi in Size Type Buildin to tank t 1 to Distribution Box Zti ` _ L �Z� Distribution Box to Field/Pit Opening Sealed: N/Partial Location/Separation 1] Foundation to tank — ft• pr� (�� t Foundation to absofbtion Separation of Pits ft. Conforms as per Plot Plan Y N Location of System on Property: Fro Rear eft Side Right Side Middle Front Middle Rear System Use Status: Approved dartial Approved and needs to be re-inspected,please call the Building&Codes Office isapproved . LASueHemingway\Building.Codes.hispection.FORMS\Septic Inspection Report.doc January 28,2003 COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.09 Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVALr Permit No........................................Cert. N 0 9.0066 Cut-in Card No................................/ Owner......PAX...I�.....5 :4� .....�yQ.7.{. ...`.... .—. ................................................................... 124 Location................SP..AJ. ............. '..................................e :...t�......... Installation Consisting of..��...........................................:(:.......................................................................... .................................................................................................................................................................................... .................................................................................................................................................................................... Installed By...... ...�2�............................Lic.No................................................... The conditions following governed the issuance of this certificate,and.any certificate previously issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of makin inspections at any time, and if its rules are violated,the Company shall have the right to r voke t ' ce ficate. Date......../..' ....fi ....(J ......... INSPECTOR i:..... .:.......................... ............................ Member N.RP.A..I.A.E.I. F- Z . SITE NOTES SOILS DATA e 1. IT IS THE SOLE RESPONSIBILITY OF THE TEST PIT U Z �, CONTRACTOR TO COORDINATE THE FIELD LOCATION OF 0-12" TOP SOIL a CL ALL UTILITIES WITH THE UTILITY OWNERS. �7 �i ,.F U 12-30" FINE LOAMY SAND (COMPACT) L 2. IT IS THE RESPONSIBILITY OF THE CONTRACTOR TO PROTECT 30-76 FINE SAND LOAMY SAND W ALL EXISTING UTILITIES FROM DAMAGE DURING EXCAVATION, GRADING ROOTS CAD 36"+/- � .� ,.,� ,r 1 OO � AND CONSTRUCTION. STABILIZED PERCOLATION RATE - 1 MINUTES 08 SECONDS PER INCH :o �; c 3. THE CONTRACTOR SHALL DISPOSE OF ALL DEBRIS AND EXCESS TEST PIT AND PERC TEST BY NACE ENGINEERING - 4/14/04 7 LATERALS WITH 6 INFILTRATORS EACH ,�? o MATERIAL OFF OF THE PROJECT SITE IN A LEGAL MANNER. TOTAL LINEAR FEET OF INFILTRATORS = 350 LF50% REPLACEMENT AREA PROVIDED, WHICH WILLco USE 4 LATERALS WITH 5 INFILTRATORS EACH. °' 4. THE CONTRACTOR SHALL STAKE THE LOCATION AND GRADES qi qi OF ALL NEW WORK IN THE FIELD PRIOR TO STARTING WORK. ANY ORBROUGHTRTO THE EATTENTION SOFO NS THE ENGINEER FORSHOULD BEEDIATELY R SOLUTION SEPTIC SYSTEM DESIGN BEFORE PROCEEDING WITH THE WORK. =Cil � n th � O 4 Q DESIGN FLOW - EXISTING 6 BEDROOM HOUSE WITH POSSIBLE FUTURE BEDROOM 5. THE CONTRACTOR SHALL PUMP OUT AND BACKFILL THE EXISTING ABOVE GARAGE. SEEPAGE PITS AND DISCONNECT PIPING FROM THE HOUSE. Lwu a - NEW FIXTURES TO BE INSTALLED IN EXISTING RESIDENCE.. 6 ( � ¢ �� 6. THE CONTRACTOR SHALL NOTIFY THE ENGINEER AT LEAST 24 HOURS Lu - DESIGN FLOW REQUIRED 770 GPD �✓ ct Off' o u , PRIOR TO REQUIRED INSPECTIONS. REQUIRED INSPECTIONS ARE: PRIOR TO z N COVERING PUMP STATION & SEPTIC TANK, PRIOR TO BACKFILLING OF LATERALS SEPTIC TANK - USE NEW 2000 SEPTIC TANK O�o=u N �, a AND UPON COMPLETION OF WORK. { N CLUB `L 3 H 7. THE CONTRACTOR SHALL KEEP RECORDS DOCUMENTING ANY CHANGES FROM ABSORPTION FIELDS - FAILURES OF EXISTING SEEPAGE PITS MAKE HOUSE o o *- THE CONTRACT PLANS AND SPECIFICATIONS. THESE DOCUMENTS SHALL BE EXISTING SYSTEM UNUSABLE. _ o PROVIDED TO THE ENGINEER AT THE COMPLETION OF THE WORK FOR THE a PURPOSE OF PREPARING AS-BUILT PLANS. - INSTALL NEW PUMP STATION AND ABSORPTION FIELD. - SOIL PERCOLATION RATE OF SOIL = 1" IN 1 MINUTE 08 SECONDS 2,000 GALLON - 770 GAL./DAY/1.20 GAL/DAY/SF = 642 SF OF ABSORPTION AREA REQUIRED SEPTIC TANK - 642 SF / 2 FT (WIDTH OF TRENCH) = 321 LF OF ABSORPTION TRENCH REQUIRED FORT MILLER OR EQUIVALENT z w -CD • y�7.L SITE OTECTION & RESTORATION 1. PROTECT ALL AREAS OF THE SITE FROM UNNECESSARY Z c c DISTURBANCE. 5 CEO � om 2. PROTECT EXISTING TREES FROM SKINNING AND FILLING m 8- AROUND BASE. 9 00 C 3. PROTECT ALL ASPHALT ROAD AND DRIVEWAY SURFACES GARAGE MN (Y I1 z o `n w 0 FROM DAMAGE BY CONSTRUCTION EQUIPMENT. I 8 8 4. UPON COMPLETION OF SEPTIC SYSTEM INSTALLATION, W/ FUTURE I �� w oc �` } W w BEDROOM tit GGo aZ 'JO-4 ROUGH GRADE DISTURBED PORTION OF SITE AND PLACE , Mini o o rV^1 t►� R MINIMUM OF 4" OF TOPSOIL IN ALL DISTURBED AREAS. I NEW PUMP STATION m c a o 5. FINE GRADE TOPSOIL, FERTILIZE WITH STARTER FERTILIZER �P (SEE DETAIL) f zLJJ 0 or (5-10-5 AT 40 Ibs. PER 1,000 sf, SEED WITH LOFT'S TRIPLEX �� o � Z GENERAL MIX OR APPROVED EQUAL AT 5 Ibs. PER 1,000 sf AND I ��'P q_ APPROX. LOCATION OF O MULCH WITH STRAW - OR HYDROSEED. SEEPAGE PITS TO BE v ABANDONDED cp 0 r I SEQUENCE OF WORK I Foy LL a m [� � O a z � 1. PUMP OUT EXISTING SEPTIC PITS AND DISCONNECT INFLUENT PIPING. � �. �9�, '��', Z W w � w w a H _ W Ix 3. INSTALL NEW SEPTIC TANK, PUMP STATION, REPLACEMENT ABSORPTION SYSTEM � � � � C � a ram, AND PIPING AS SHOWN AND NOTED. 0 �C F+Ay m w o w 4. RESTORE AND MAINTAIN ALL DISTURBED AREAS AS NOTED. HOUSE I }+ W/ 6 BEDROOMS GARAGE z I �.. rn z w � W � w o z I z a � a � E I w � 2'-0" 4'-0" -- 21-WI Ri a 1,W9 SS S�OPE OVERFILL TO ALLOW N SLOPED sITEs SUNNYSIDE ROAD N FOR SETTLEMENT W W O PLAN co _ EAR 12" TO 19" NOT TO SCALE FILL INFILTRATOR CHAMBER SYSTEM EQUALIZER 24 OR EQUIVALENT. M o cu cn W � 4 O Z Z PROVIDE SOLID CONCRETE � BLOCKSPLASH PAD UNDER ¢ INLET PIPE OF EACH TRENCH N PROVIDE OWNER WITH AS—BUILT MAXIMUM SEASONAL HIGH — MEASUREMENT'S TO ALL BURIED COVERS GROUNDWATER ELEVAT16W FROM AT LEAST 3 FIXED, PERMANENT APPROXIMATE OBJECTS SUCH AS BUILDING CORNERS. FINISH GRADE LEAVE 6" LONG IRON REBAR BURIED INFILTRATOR ABSORPTION TRENCH SECTION 2" BELOW SURFACE TO MARK COVER ACCESS HATCH N.T.S. INLET BAFFLEGRO O COVER � NONu SHRINK T WITH 1 ALL STRUCTURES .�� �EyUNCT�IONAL GR�D D ( #2 DISTRIBUTION BOX BOX e0� GROUT TYP.) BY FORT MILLER OR EQUAL y = V'v NLIQUID LEVEL . SLOPE--- . L .�< 0�5�` .�p,N'� ►--N TV TOPSOIL (6" min.), SEED AND = " G �y UBM S�IBLE , 1/8 PER FOOT =. . c MULCH SEPTIC SYSTEM AND ALL ALL OUTLET INVERTS VC N PUMP OR O DISTURBED AREAS IMMEDIATELY 2,000 GAL. SEAMLESS 'g` ` 12 MUST BE ggET AT r // AFTER INSTALLING SYSTEM u INLET & �' PEA EXACTLY Tl-IE SAME ALARM ON41L SLOPE 1 2" PIPE04 SEPTIC TANK BY FORT �� OUTLET �,� GRAVEL ELEVATION. LEVEL BOX ON PUMP ON �•'. � �� w FINISHED GRADE MILLER OR EQUALa BAFFLES DISTRIBUTION 80X BACK TO PUMP STATION 'd o ►+ o Nor scuE PEA GRAVEL AND USE SPEED I Qs 60" MAX. c LEVELERS ON ALL OUTLETS;. PUMPS OFF .i:: c�v CH CK 'V VE h—� ADJUST SPEED LEVELERS _ LIQUID DEPTH WITH WATER. 1r:.::•:• ^, . .....•. .� 19" MAX 1—��( - _ '•.: .'• .,• . . .. . . TROWEL FINISHED .11 I I I i I•,� . . , . INSTALLATION OF DISPOSAL FIELDS 4'-0" I.D. PRECAST CONCRETE w c�12 MIN. �� MINIMUM 2x WIDTH MANHOLE WITH INTEGRAL BA MERCURY FLOAT EFFLUENT PUMP ,x MAXIMUM 4x WIDTH—, AND FLAT SLAB TOP. SWITCH WITH (USE SEWAGE PUMP 1. CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING, AS MANUFACTURED BY FORT MILLER WEIGHT TYP. IF PUMPING INTO w �j INFILTRATOR CHAMBERS PROVIDE 3" SAND OR o0 00� AND SHALL BE IN ACCORDANCE WITH THE N.Y.S. OR EQUIVALENT ( ) SEPTIC TANK) CO PEA GRAVEL UNDER TANK—'$°� SEPTIC TANKS DEPARTMENT OF HEALTH INDIVIDUAL HOUSEHOLD SYSTEMS, AND (NO LADDER RUNGS) my IQ ASTM F481-76 INSTALLATION OF THERMOPLASTIC PIPE AND SEWAGE PUMP STATION BOTTOM OF TRENCH TO BE LEVEL CORRUGATED TUBING IN SEPTIC TANK LEACH FIELDS. BOTTOM OF TRENCH 1. ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS 017 THE NEW YORK 2. NO HEAVY EQUIPMENT SHALL BE ALLOWED WITHIN THE LIMITS NOTES: STATE DEPARTMENT OF HEALTH AND SHALL BE PRECAST CONCRETE OF THE DISPOSAL FIELDS AFTER PIPE INSTALLATION HAS BEGUN. 1. IF PUMPING INTO SEPTIC TANK, PUMP TO BE RATED FOR RAW SEWAGE. 1. BOTH ENDS OF INFILTRATOR CHAMBERS MUST BE AS MANUFACTURED BY FORT MILLER OR EQUIVALENT. PUMP TO BE 1/2 HP GOULDS MODEL 3886WS05 OR EQUAL. 3. AFTER EXCAVATION OF 2' WIDE TRENCH TO THE DEPTHS REQUIRED, PUMP CONTROL PACKAGE TO BE SUPPLIED BY MANUFACTURER. Date: APRIL 23 2004 CAPPED WITH END PLATES SECURED TO CHAMBERS 2. ALL STRUCTURES TO BE PLACED ON FIRM, COMPACT SAND OR THE WALLS AND FLOOR OF EACH TRENCH SHOULD BE CLEANED 2. AUDIBLE AND VISIBLE ALARM TO BE ACTIVATED BY ALARM FLOAT 2. ALL LATERALS TO BE OF EQUAL LENGTH. GRAVEL FOUNDATION. WHEREVER EXISTING FOUNDATION CONDITIONS AND RAKED TO ACHIEVE AN EVEN SURFACE AND TO LOOSEN 3. MAXIMUM TRENCH LENGTH IS 60 FEET. ARE UNSUITABLE, CRUSHED STONE SHALL BE PLACED AS SMEARED SECTIONS OF TRENCH. NECESSARY TO ACHIEVE A STABLE FOUNDATION. Scale: AS NOTED 4. THE PIPE SHOULD BE LAID AT THE GRADES AND TO THE RELATIONSHIPS INFILTRATOR ABSORPTION TRENCH PROFILE SHOWN ON THIS DRAWING, MAINTAINING STRAIGHT CONTINUOUS GRADES WITHOUT SAGS, HUMPS, SEPARATED JOINTS OR OTHER UNSUITABLE N.T.S. CONDITIONS. THE PIPE SHALL BE LAID WITH THE HOLES DOWN IN ALL CASES. 5. ALL DISPOSAL FIELDS SMALL BE GRADED TO SHED RAINFALL (1, s2 AND TO DIVERT SURFACE RUNOFF FROM ADJACENT AREAS AWAY e�7, e> FROM THE DISPOSAL FIELD. 6. NO PART OF THE DISPOSAL FIELD SHALL BE INSTALLED UNDER DRIVEWAYS. BFEET 1 OF 1