2003-507 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)'761-8256
TIFICATEO
CERF .
Permit Number: P20030507 Date-Issued:, Friday, July 04;2003
.This is to certify that workrequested.to.be,done as shown by-Perrnit Number T P20030 O7
has been completed
Tax Map Number:
523400.301-008-0001-021-000-0000
Location: 8 MANOR Dr
.Owner: BRYANT BUCKLEY JR
Applicant: BRYAN J.BUCKLEY JR
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential . TOWN OF QVEENSBUEY
Directot of Building&Code Enforcement
TOWN OF QUEENSBUR
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development Building&Codes .(518) 761-8256
BVILDIN,G =PERMIT
Permit Number: P20030501 Application Number:. A20030507
Tax Map No: 523400-3017008-00017027-000=0000
Permission is hereby granted to: _ BRYAN'J.BUCKLEY JR
For property located at: g MANOR Dr'
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans,and other information her filed
and approved and in compliance with the NYS Uniform Building Codes and1he Queensbury Zoning a
Ordinance. Type of Construction' Value
Owner.Address: BRYYAN J. BUCKLEY JR Septic Alteration Residential
P.O. BOX 240 Total value
BOLTON LANDING,NY 12814-
Contractor or Builder's Name/.Address Electrical Inspection Agency
Plans&Specifications
2003-507
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS .
$25.00 PERMIT FEE.PAII3--THIS PERMIT.EXPIRES- Sunday.,July 04,'2004
(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 tb
Towu,,�f Qu4qlns ry; ;July 044,2003 ,
SIGNED BY £or the Towh of Queensbury.
Director of Building&Code Enforcement
J
Application for Permit Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. O)V'IMR INFORMATION:
...........0ffi'e*eUse* ...........
Location of installation: A--1h17V012 Z>AO-21 IA-e
—
File Permit No.
Tax Map No.
Owner's Name: Fee Paid—';�Z
/,7 C
....................... ...................... .............. .............
Address:
2. INSTALLER'S NAME PHONE NO.
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 =
1991 —present x 110 gal/bdrm =
Garbage Grinder Installed yes no
Spa or Hot Tub Installed yes no
4.' PARCEL INFORMATION: (circle applicable information&indicate measurements)
Topography , Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
Flat sand at what depth at what depth municipal
Rolling loam —feet —feet well
Steep slope clay if well;water supply
%slope other from any septic-system
depth: absorption is_ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect
)
Rate: —minute per inch
S. 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 SystemiLength: 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 Ap -
Alternative System: length andlor size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: I 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 responsible person Date
Septic Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am `11
/ am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: 4epart:adcr3 S-6-7
NAME: PERMIT NO.:
LOCATION: INSPECT ON
RECHECK:
Comments and/or diagram
Soil Type: Sand J Loam/Clay
Type of Water: Municipal/Well Water
Waterline separation distance
Well separation distance
Other wells:
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 Caps
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits --A
Conforms as per Plot Plan N
Engineer Report and As-Built Y N_
Location of System on Property:
Front Rear Left Side Right Side
Middle Front Middle Rear
System Use Z
St us:
US Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
Last revised 1/6/05
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queeiisbury Building&Code Enforcement Arrive: am�/ Depart: am/pm
742 Bay Rd.,Queensbu NY 12804 Inspector's Initials:
NAME: rt,Clt— PERMIT NO.: 03
LOCATION: INSPECT ON:
RECHECK:
Comments and/or diagram
Soil T e: Sand Loam C14Y
Type of Water: Municipal/Well Water
Waterline separation distance
Well separation distance ft.
Other wells: ft.
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches
Size of Stone
See e Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field Pit
Opening Sealed: Y/NI Partial
Location/Separations
Foundation to tank
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y_N
Location of System on Property:
Front ear Left Side Right Side
Middle Front Middle Rear
System Use S-hkatus:
Approved
Partial Approved and needs to be re-inspected,please call the'Building&Codes Office
Disapproved
LASueHerningway\I3uiIding.Codes.rnspection.FORMS\Septic Inspection Report.doc January 28,2003
4"PVC 0 1%(MIN X..CUNIHAGIOR IU LXLAMit 10 11 EMN.) bLLIWAOL 11 1IN1111
SOIL CONDITIONS/GROUNDWATER.(ENGINEER TO WITNESS)
/-4"PVC 0 1%(MIN.) INFORMATON:
D-BOX
Cl w
--- DESIGN BASIS
44I� NEW DRYWEL (TYP.) NEWNW YOOFRKQUEENS STATE BURY DEPARTMENT Or HEALTH
TO
-_--------
POTABLE
NO KNOWN WATEER%IS`TUNpGp POTABLE WATER SUPPLY WELLS LOCATED WITHIN
EXISTING SEPTIC4 --EXISTING DRYWELL TO 150 FT.OF PROPOSED WASTEWATER DISPOSAL SYSTEM.
TANK COVER—I BE REMOVED 1-'0" DESIGN FLOW
4 BEDROOMS,110 GPD/BEDROOM-440 GEN
(MIN (WATER'EAVER FIXTURES REQUIRED THROUGHOUT APARTMENT UNITS)
T.P. #1 A 1000 GAL. SEPTIC TANK
- Ci SEPTIC TANK
BUILDING SEWER FOR 1]0" MIN (MIN.) 1 250 GALLON(MIN.)CAPACITY REQUIRED
_\ 3-0 1 EX 1000 GAL SEPTIC TANK TO BE SUPPLEMENTED WITH
WESTERLY 2 UNITS ADIDSITTIOGNAL 1000 GAL PRECAST SEPTIC TANK
(4 BEDROOMS TOTAL)
20'--0" .......__I SEPTIC TANK EFFLUENT FILTER
(MIN.) PROVIDE DENI)MODEL A1801-022,"ZABEL-RESIDENTIAL FILTER.
EAST,END OF BUILDING EFFLUENT FILTER TO BE INSTALLED ON OUTLET OF SECOND SEPTIC TANK
BE CONFIRMED LEACHING SYSTEM(FIELD)
440 GPD/0.9 GPD/SO.FT,=488.9 SO.F.REQ'D
UNIT 15 (<10 MINUTE/INCH PERCOLATION RATE SOIL)
PROVIDE 8 FT DIA,.5 FT,DEEP DRYWELLS WITH 4 FT.OF STONE ALL AROUND
16 FT x pi=50.27 SO.FT,/VLF.,5 F.-251.33$0.FT.
251,33 SQ.FT.x 2 DRYWELLS=502.65 SO, 7.TOTAL
GRAPHIC SCALE EFFLUENT DISTRIBUTION
0 41 GRAVITY DOSING/DISTRIBUTION FROM SEPTIC TANK VIA DISTRIBUTION BOX.
TEST PIT RESULTS:
PERMANENT WATEREGN JOINT(TYPI
MARKER
WATERTIGHT MANHOLE FRAME&COVER;
OVERCOVER ) SYRACUSE CASTINGS i I GLQ C R EOUNALIENT;
GRADE TO GRAIN AWAY FROM COVER T.P.#1 -DEPTH-qj Er
TREATED LUMBER MARKER 4'DISTRIBUTION PIPE
ABOVE L
MEDIUM TO COA SE SAND&GRAVEL WITH SOME FINE SAND,
AL BURIED COVERS WATERTIGHT SEALED SET I GRADE MIN, CONCRETE PLUG �FNJSHEG GRADC TRACE OF SILT
ENISHED GRAGE—_. AWAY NO EVIDENCE OF GROUNDWATER
SLOPE
UY,
(,P.) ",..FROM COVER UYIP.) _--PRECAST CONCRETE RISER AS REQUIRED
---_[I- SOIL LINE FROM EXISTING SEPTIC 12 MIN 24•
FORT MILLER DRYWELL 17 SLOPE(MIN.)
NON-WOVEN GEOTEXTILE OR EQUIRALIENT
FOR SEPARATION INLET 3'
N-TO 2R'CRUSHED i I- — .—C,
- -_ -_ V --
H-20 TRAFFIC COVER 5'-0' T-O" STONE:FREE OF FINES THORO NATIVE BACRIFULL 15" 'S" — EFFLUENT UNE
AND STONE DUST UCHUY COMPACTED _T INSTAL NEW OUTLET PIPING
12' AS SHOWN ON DRAWING Cl
----
,.,.,,_FORT MILLER PRECAST
MIN,
D SEPTIC TANK OR DOUNALENT
CRUSHED STONE FOUNDATION SEE NOTE 2. 2'MIN,
AS FIRM NATIVE SOIL
�SFA4ONAL HIGH
GROUND WATER CRUSHED STONE FOUNDATION
ATOP FIRM NATIVE MATERIAL
AB__
I A
TREATED LUMBER MARKER
ABOVE ALL BURIED COVERS: 12/0$W A REVISED PER TOWN COMMENTS
SET ljGGI GRADE 11)29102 /A\ SU6MTERE13 FOR PERMIT TO CONSTRUCT
4"OUTLET TEE GROUT NON-SHRINK DATE REV# ISSUED REVSIONS
A—REMOVAB COVER MODEL A1801-4.18 REGIDENTA__-Z "C" SATF.PLANMFIARs
PROVIDE ADJUSTABLE LEVELING "Wrl'FILTER OR FOUNALENT PIT
INLET ONCE ON EACH OUTLET 'I, C PIPE WASTEWATER REPLACEMENT SYSTEM
GRAVITY DISTRIBUTION LATERAL MAPLEWOOD APAITrMENT.",-UNIT 15 WEST
—0 0.5%MIN.SLOPE MANOR DRIVE
��l 2'MIN,OF C SAND NOTE; QUEENSBURY,NEW YORK
2"MINOR PEA GRAVEL FOUNDATION
IF EX STING ORYWELL CONTAINS A PRECAST CONCRETE TEE OUTLET "Iff
EST AD OF A 4'PTAGPO GARITARY TEE SUBSTITUTE LABEL FILTER
FORT MILLER DISTRIBUTION MODEL A1807-18 FOR MODEL A1801-4.18. H.TFIOMASJAflflEiT
OUTLETS 4'KNOCKOUTS BOX GO CON—ENT RE.#515W 12 EAST WASI INGTOM STREET N IONE:(518)7W-Z
ON— GLENS FAU.S,N.Y. FAX:(618)780.1 1
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