The URL can be used to link to this page

2004-434 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: P20040434 Date Issued: Thursday, June 24, 2004 - - .- This is-to certify that-work requested to be done as shown by_Permit Number P20040434 has been completed. Tax Map Number: 523400-253-003-0001-046-000-0000 Location: 4 KNOLLS RD. NORTH Owner: ROBERT & EILEEN KURTZ Applicant: ROBERT &EILEEN KURTZ 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, 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: P20040434 Application Number: A20040434 Tax Map No: 523400-253-003-0001-046-000-0000 Permission is hereby granted to: ROBF,RT &RTI,F.F,N K1TRTZ For property located at: 4 KNOLLS RD. NORTH 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 &EILEEN KURTZ 4 KNOLLS RD. NORTH Septic Alteration Residential Total Value QUEENSBURY, NY 12804-0000 Contractor or Builder's Name /Address Electrical Inspection Agency OIJEENSBIJRY SEWER NY 12804-0000 Plans&Specifications 2004-434 SEPTIC ALTERATION $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, June 16, 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 To n of Q �s?blV d , June 16, 2004 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: File Permit No. Tax Map No. Fee Paid Owner's Name: �� f- ��[ 1- ......................................................................................................................................: Address: d 2. INSTALLER'S NAME } PHONE NO. ✓C�� 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 f�cp CCEI 1980o der x 150 gal/bdrm = 1980- 1991 2 x 130 gaVbdrm = 20 JUN 1. 4 201 1991 -present x 110 gal/bdrm = TOWN OF QUEENSI Garbage Grinder Installed yes_ Ral BUILDING AND CC Spa or Hot Tub Installed yes_ 4: PARCEL INFORMATION: _(circle applicable information&indicate measurements) Touoi--ranhy Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply lat anW at what depth at what depth m icipal- Rolling loam feet feet well Steep slope clay if well; water supply _%slope other from any septic-system depth: absorption is //6 ft. other Percolation Test: To be completed by licensed professional engineer or architect) Rate: 42 N ( minutg�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. Septi ,sar /d—�—� gallon (min. size 1,000 gal) Tile Field: each trench ft. Total System Length: ft. Seepage Pit(s): number of size of each: ft. by ft. Size of Stone to be used: # / depth or thickness feet i" Bed System Size: A �� j 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. Q - L S.id at re Of responsible person Date 1 177 S( w(:rs and Sewilge Disposal Chapter. AI)pmul^i x C, ` A'11.;;UIt,I'''t ION. SI,'PA LA'i'ION IZI��Zl.J11LI�ttill��N'i';; s r).%tAm POND &t G . E . ( ' Scr•tIC., 1TIIY. .�^�� •...ram • _ter 7. SIGNATURE &INFORMATION FOIL USFU ;SwLd>r��• �•,o�.".""", Septic Inspection Report Office No. (518)761-8256 Date Inspection re e t e . Queensbury Building&Code Enforcement Arrive: 1 p �- 742 Bay Rd., Queensbury,NY 12804 Inspector's Initia NAME: �� j-z PE IT NO.: 7 LOCATION: o-}- V-00-"4 P-0 AD INSPECT ON: RECHECK: Comments and/or diagram Soil T an Type of VVnTe5 a'l/Well tei\ Waterline separation distance ft. LAC Q V--- J Well separation distance ft, -J Other.wells: �7 CiO ft,Absorption Field: Total length p Length of each trench ft. Depth of trenches ft. Size of Stone 3 Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box ld Opening Seale$K Y artial 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: Fron Rear L id Right Si Middle Front Middle Rear System Use Sta sue: V Approved Partial Approved and needs to be re-inspected,please call the Building&Codes Office Disapproved LASueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003 Septic Inspection Report Office No. (518)761-8256 Date Inspection request r c d: Queensbury Building&Code Enforcement Arrive: jZt e rt: °( am/ 742 Bay Rd.,Queensbury,NY 1,2804 Inspector's Initials: NAME: T - P IT NO.: -20 C)y LOCATION: SPECT ON: Z 1 -CH 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: w D PipinR Size Type_ \`` \<ll D64IRgX tank h �Ll , I \� �� Tanlc to Distribution Box " 16CAA 141D. _ Distribution Box to Field/Pit Opening Sealed: Y/N/Partial Location/Se aratio s TP-0\�- -Q�aur- Foundation to t, 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 l' Z S stem Ilse Sta s: Approved Partial Approved and needs to be re-inspected,please call the Building&Codes Office Disapproved LASueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003 i __NACE M P.C. 169 Haviland Road, Queensbury,NY 12804 Phone-518-745-4400, Fax -518-792-8511 June 21, 2004 Project#49139 Mr. Jay Sweet Queensbury Septic PO Box 4283 Bay Road Lake George,NY 12845 Re: Percolation Test 4 Knolls Road North, Queensbury,NY - Dear Jay: At your request, on May 12, 2004, we performed a percolation test at the existing 3 bedroom residence located at 4 Knolls Road North'in Queensbury. The test was performed to the west of the existing residence in the location where construction of a replacement leach field is proposed. The results of the testing are as follows: Percolation Test Stabilization percolation rate - 1" in 12 minute, 41 seconds The test was run in the native sand and gravel at a depth of 24 inches in a 30 inch deep hole. The hole was presoaked with 5 gallons of water and,the test was run 6 times until it stabilized with three consecutive runs of 12:32, 12:42 and 12:45 respectively. With the existing percolation rate, the design application rate for an absorption bed system is 0.60 gal/day/sf. A 3 bedroom residence using 330 gallons per day will require a minimum 550 sf absorption bed at the above mentioned application rate. Please note that 110 gpd/bedroom was used based on the owner replacing all fixtures with code compliant water saving fixtures. Please call me if you have any questions. Sincerely, v Thomas W.Nace, PE tl 169 Haviland Road, Queensbury, NY 12804 Phone-518-745-4400 Fax -51 8-792-8511 May 18; 2004 Project,#.49139 Mr. Jay Sweet 09- C/31 Queensbury Septic RECEIVED PO Box 4283 Bay Road Lake George, NY 12845 ,JUN r ?n014 TOWN OF QUEF-NS13URY Re: Percolation Test BUILDING AND CODE 4 Knolls Road North, Queensbury,NY Dear Jay: At your request, on May 12, 2004, I performed .a percolation test at a residence located at 4 Knolls Road North in Queensbury. The test was performed to the west of the existing residence in the location where construction of a replacement leach field is proposed. The results of the testing are as follows: Percolation Test Stabilization.percolation mate - 1" in'12 minute, 41 seconds The test was run in the native sand and gravel at a depth of 24 inches in a 30 inch deep hole. The hole was presoaked with 5 gallons of water and the test was run 6 times until it stabilized with three consecutive runs of 12:32, 12:42 and 12:45 respectively. Please call me if you have any questions. Sincerely, / Thomas R. Center Jr., EIT 119� "1 have seen or observed, or believe I saw evidence of, ?61 (.bjeCtS S.lC11 as hu'uSe$, 'v�'e11$, i.(CeS, i2r�CCS, etc., I o R 1 al SO i ,t 1 that ! sh�:��t � -n this 3::�rtim.,rt ! a,so ,$,ores;.,�� t;,_,� 1 have onally measured the tlsta ,ces se Tvri1! tin the diagram." (SIGNATURE DATE RECEIVED JUN i. 4. ?004 i TOWN OF QUEENSBURY BUILDING AND CODE , I � 1 r p (D m �1 CO C fl f