2000-108 _ • •
A fr
Certificate of Compliance
Town of Queensbury
Warren County,New York
May 4 , 2000
Date
•
200@l08
This is to certify that work requested to be done as shown by Permit No.
•has been completed.
SEPTIC ALTERATION
This structure may be used as a
13 9 PILOT KNOB RD.
Location
Owner GRAY, MARY K.
TAX MAP NO 18. -1-18. 2
By Order Town Board
(T9 OF QUEEN, Y
/ r
Director of Building &Code Enforcement
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518)761-8256
VALUE $ 0 Building Permit No. 2000108
TAX MAP NO. 18 . -1-18 . 2
Permission is hereby granted to GRAY, MARY K.
Owner of property located at 139 PILOT KNOB RD.
in the Town of Queensbury,to construct or place a SEPTIC ALTERATION
at the above location in accordance to 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.
Owner's Address:
139 PILOT KNOB RD.
KATTSKILL BAY, NY 12844
Contractor or Builder's Name:
KRUGER CONCRETE, INC.
Contractor or Builder's Address:
8 HAROLD HARRIS RD
QUEENSBURY, NY 12804
Electrical Inspection Agency:
Type of Construction:
SEPTIC
Plans and Specifications:
SEPTIC ALTERATION AS PER PLOTPLAN SPECIFICATIONS
• Proposed Use:
SEPTIC ALTERATION
•
March 20 2002 •
$ 2 5PERMIT FEE PAID=THIS PERMIT EXPIRES
(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 Town of Queensbury this 20 Day of March
2000
SIGNED BYe ?-Q 14791), , for the Town of Queensbury
o e Enforcement Officer
!u'`'
Application for I'erniit—Septic Disposal System
Tow,:of Queensbury 742 13ay Road Queensbury, NY 12804 (518) 761-8256 . .
1. OWNER INFORMATION:
/�� Office Use
Location of installation: (.bq, 12 to I Kue�`Pet_i/CAi1 skr/l!3/1y NY
File Permit No 0 - 0?
Tax Map No. a / / / /8,v
/' �2Z Fee Paid ,- j• O�
Owner's Name: (14fZY �. is 4y 60-G
Address: S4114 L At llihd rfc:"
2. INSTALLER'S NAME : CT F LG-: / l&u16z. a Cn v,3.t,, cr PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply ifof .
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 /1 x 150 gal/bdrm =
•• : 1980- 1991 x 130 gal/bdrm = •
•
1991 -present y x 110 gal/bdrm = • 9/6. -
Garbage Grinder Installed yes / no' ✓ /
Spa or Whirlpool Installed yes / no Mu Ps('/�4 A y>%i N1AR 2 0 Z0Q0
-eP?t
4. PARCEL INFORMATION: (circle applicable information&indicate measurements) TOWN OF OUE`�NSB__UB
To •_rt!by Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
OOP ' • sand at what depth a!what depth municipal
Rolling loam feet feet well
Steep slope clay if well; water supply.
__%slope other from any septic-system
• depth: absorption is //v ft.
• other
Percolation Test: (To be completed by licensed professional engineer or architect)
• Rate: • _minute per inch c — , 01 ifi-kec cc�):a.v `B6�?/S ,4,i.1 GU lruiaTex Sys'.
-By SGLec€d/l r-c- *roe_ . 3 f20/z000
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 sine
of the septic lank and leach field for each Garbage Grinder, Spa or Whirlpool'Fob.
Septic Tank:/e2 S gallon (min. size 1,000 gal) •
Tile Field: each trench • ft. Total System Length: __fi. •
Seepage Pit(s): number of size of each: ft. by ft.
Size of Stone to be used: It / depth or thickness feet
Bed System Size: 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.
V A/414__/.4/ 1 d/2-
Signature of response'a person ate
--
. .
•
Town of (bieenslairy
gewers mai Sewage Disposal Chaplet-
.
Appendix ('
- .
' .
AM-4)1319'10N FIFA,'/'
. •
- . SEPA RATION REQ1.1 I ItERI I.:NTS
, .
-,... ,
. ........_. S 1 Fkr./.1-1 _..,
_
ir-
j-• -.
POND .
VIELt_ ill liArt,fk-
llortir
• 3. I
. , 7 ..... -
I V"
. 1/0)-- 110OSE_. G __ _____E --.1 . .
1;003E 6 nE /
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i / I fr.ivE
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•
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I 1
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• Dr,Milli Ines,' 1
Lr r W,K Cb
.litt5ORPTIOI I
PI R_LIZ:k
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it
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• ..--,---- •
_______--
i----------- ____------
-----------
•
____----r------- .
•
. .
. _
. ,
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name (RIA g1�3/4Rn
Location A:21L15c vyi33 Q-,P
Date — --r Permit # 2cc j —itfe,
SOIL TYP . -
Results of Percolat on Te t-
(if applicable) Rat -Minu e/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: T tal ength fw
Length of each trench. - ^
Depth of tr ches
Size of stone -- _ 6 .
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank A' _ 11' LID
Tank to Dist. Box "
Dist. Box to Field/Pit
Openings Sealed? No Partial
LOCATION/SEPARATION :
Foundation to Tank feet
Foundation to Abso- ption feet
Separation of Pits et
Conforms as per Plot Plan Yes o
LOCATION OF SYSTEM ON PROPER . .
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
NS 7( 7L,
c�� \ �-'�
SYSTEM USE APPROVE) YES NO
Arrive; . ,�
Depa, t�y
_ r
:wilding Ins' ctor
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name CAR R`3 i Rs-C-WIRD
Location \1LEs V c , P_
Date 3 -o Permit
SOIL TYPE: Sand-Loam-Clay-
Results of Percol . ' i .,n Test-
(if applicable) '.te- -inute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Tota Length
Length of each t ench
Depth of trenche•
Size-of stone
SEEPAGE PITS: N mber
Size :\ f' . ft.
Stone si e
PIPING: Size Type
Bldg. to Tank
Tank. to Dist. Box
Dist. Box to Fiels/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIO-S:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot 'Ian Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left S?de - Right Side
Middle Front - Middle/ Rear
COMMENTS:
SYSTEM USE APPROVED: Y. . NO
Arrived: °1� ,
Departed: ii►
4110
Insp-' • �- -
' 1 i
DA5110) OF DESIGN
501L5 IN THE ADSORPTION AREA ARE GRANULAR; SANDY/GRAVEL. 4• - 5' TOP90N. FIN GRADE
STA15ILIZED PERCOLATION TE=5T RATE (3116100) 4.5 MIN/INCH. " '' ' ' " ' ' ' ' ' " ' ' ' '
INLET — - - \ OUTLET .'.'.'.'.'.'.'.'.'.'.'.1e;.l. '.'.'.'.'.':::.'.'.',',',',',',',','IZ
FLOW (4-DR HOUSE) - 4 x 110 - 440 GPD (W/5 FIXTURES).
REQ'D LENGTH - 52 LF; PROVIDE 14 UNIT5 - 56 LF. 4' rERFORA
P FETED
1250-6AL PREGA5T 5EPTIG L L
TANK PROVIDE TWO 26-FOOT ATERA5 A5 5HOWN IN SECTION. LOAMY DAGKFILL bEOTEXTILC
INSTALL EXAGTL.Y IN ACCORD WITH MANUFACTURER'S DANDIN4 STRAPg IN
U IT
PLAN INSTRUGTION5. - - - - - - - - - - - - - - - - - -
. r`
GLEAN MED-COARSE
'CONCRETE' 17AND-
. . . . . . . . . . . . . . . .
y i� i i i� i .r i .ram i� is!► i .c
1,2 12' W12'
Y
INLET , -- -- - 11°'� OUTLET
w»L CASTING NOTES SPEGIFIGATION5
- SECTION
�-
1250 GALLON �,.I„L 1) SET CASTINGS DEAD LEVEL ON A 12 -THICK 1 ) THE QUEENSDURY SANITARY SEWAGE DISPOSAL ORDINANCE SINGLE " IN - DRAIN " MODULE
MU^Cw DAGKFILL BED OF GRU5HED ROCK, 6OVEKN5 THE DESIGN AN9 GONSTRUGTION OF THE 5Y5TEM. NT5
y '"'r'""no % 2) MARK THE REMOVA15LE GOVER5 OF 2) DAGKFILL SAND DELOW AND SURROUNDING 51DE5 OF
GA5TING5 WITH A STAKE VI5IDLE 'IN-DRAIN' UNITS 5HALL MEET NY5DOT 5PEG 703-07.
~�°"""LL"'40'"'°'"011�" Comm ABOVE GRADE AFTER PLAGING DAGKFILL.
e e eovoeooeg�oveg000ae��oeg�voog�000 3) D15TRIDUTION LATERALS 15HALL DE 4' DIAM PERFORATED 3 - q'
,.ti. PVG, 3000* GRUSHING STRENGTH.
6EOTEXTILE
4) EXTEND PERIMETER 6' MIN, ON ALL 51DE5 OF 'IN-DRAIN' UNIT5. : FILTER FADRIG FIN GRADE
SEGTION 6RANULAR 4' MIN TOP501L. 4
5) PROVIDE 6' MIN CONCRETE SAND UNDER 'IN-DRAIN' UNITS. SLOPE < 6% DAGKFILL SEED TO 62RA55
5EPTIG T A N K D TAIL 6) GEOTEXTILE SHALL DE 50E TO 'MIRAFI' 14ON FADRIG.
............................. ...... ..... ........ ..........................:....I.......................... .
7) QUEEN55URY REGULATIONS REQUIRE A VERTIGAL SEPARATION CONCRETE SAND 4' PERFORATED X
OF THREE (3) FEET FROM DOTTOM OF ADSORPTION TRENCH TO PVG PIPE
5EA50NAL- HIGH GROUNDWATER TADLE OR BEDROCK.
NIDRIf. N
6' MIN —F—
FIN. GRADE 3' MIN TO 6WT, ROGK
OR IMPERVIOUS 5TRATUM
TOPSOIL III=III=III=III=III=III III III 111 III III III III III III 111 III III III III III III
0.5'
NOTE
SECTION
THE DISTRIBUTION BOX SHALL GENERAL NOTE 5 BU I L {BESET DEAD LEVEL ON 12'
r OF CRUSHED STONE. ABSORPTION BED ;
1) DE516N PERGOLATION TES -T RATE 5 MIN/INCH. ^ :�-
l.lj
PERCOLATION 2) SOIL TESTS PERFORMED 15Y C:HARLE5 H. SCUDDEK 3/1NOO. NT5 - 3,`
. ,
r-r
' TEST DEPTH SANDY-LOAM 3) SOILS IN THE ADSORPTION AREA ARE 5ANDY/LOAM.
4) ONE 1,250-6AL 5EPTIG TANK 15 REQUIRED.
2.2 _ _ I 1 have seen or o
0 5) DE51GN DISGHARGE (4 BR HOME P05T lggl FIXTURES) 15 440 PP. +, 1 ,orbelfel�e�
(a) GROUND 5URFAGE SLOPE IN A135ORPTION AREA IS 1.E55 THAN 1%. objects such as houses, wek hm 6ftsk skq
7) THE IN-DRAIN ELJEN 5Y5TEti1, NOW APPROVED DY NY5DOH, IS
wn on this document. I also represent gw 1 hm
PRORIETARY. INSTALL AGGORDING TO MANUFAGTURER'5 DIREGTION5. 4-111dIly measured the distances Set bf1 on „
DISTRIBUTION BOX DETAIL EL.GEN 'IN—DRAIN' AB50RPTION - W '
5Y5TEM; I_ s+rnl�ru�� A E
3.5' 14 UNITS PROVIDED.
ors 501E LOG 5Y5TEM PIMEN51ON5: 10' x 30'
NT9
NOTE .......'............ .:...:..........:...:.. ' .:...:...:..........'. _' .....................- ---................... ' .....'................. ' ............---.......'
N 512.8430E CONFIRM THAT DEPTH TO ROCK OR GWT FROM p =
WI ' I - - = - - --_ - - — = - - - --- - - --;- - - - - -
TRENCH BOTTOM OF IN DRAIN U NITS �L B E � I
A MINIMUM OF 3—FEET. 7 "IN=DRAIN' UNITS
' 5 04-21-00 W
00, 5q.2q' :...:...:.......:...:..:...:...:...:...:..:...:...:...:.....:.......:...............................................................................................
........ ...................... ........................
7 IN=DRAIN UNITS
\s.. . ' :
10' x 30' 'IN-DRAIN' `�` 30'
�Z�o ADSORPTION SYSTEM .\ MAR 2 0 2000
PLAN
TREE 17' Pam, ABS RPTION BED
o.TAX MAP N 16-1-18.2 AW CORNER of O .\
/ TIMBERS P
24, 11' DD � NT5
2000108 18. -1-18 . 2
/ - GRAY, MARY K.
.'
4-DR S 31-40-30 W 22• 4' PVG 139 PILOT KNOB RD.
HOB SEPTIC ALTBflATION
B Q 47 q5• 16 1% MIN 5LOPE
OQ' IN
20' 1,250-6AL
.� 10' 5EPTIG TANK RICHARD W . and MARY K . GRAY
-'�----�►__ GARAGE � 5 34-37-00 W 4' PVG 139 1ILOT KNOB ROAD KATTSKILL BAY, NY 12844
"---N 8�,30 Y� 64.57' 110' TO WELL 2% MIN 51-OPE •. • ' ' • ' •. 1
NEW6A
— .M _ o N. WASTEWATER SYSTEM
P L, O T FLAN - - HOUSE SCALE NOTED DATE M
1' - 50' •• 'Q�` � SCUDDB>R ASSOCIATES ARCH 20, 2000
•••. f nA��; •'• CONSULTING ENGINEERS
J1 _2O• INSET P.O. BOX 792
PE 40g04 TEL: 793-1475 GLEN$ FALLS, NY 12801 FAX: 798-3747