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2011-176 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: P20110176 Date Issued: Friday, February 21, 2014 This is to certify that work requested to be done as shown by Permit Number P20110176 has been completed. Tax Map Number: 523400-308-014-0001-052-000-0000 Location: 183 PITCHER Rd Owner: FOREST PARK MHC, LLC Applicant: ARC COMMUNITIES 14, LLC This structure may be occupied as a: Septic Alteration Residential By Order of Town Board TOWN OF QU NSBURY 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. N TOWN OF QUEENSBURY a 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20110176 Application Number: A20110176 Tax Map No: . 523400-308-014-0001-052-000-0000 Permission is hereby granted to:. ARC COMMUNITIES 14, LLC For property located at-. 183 PITCHER 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. Tyke of Construction Value Owner Address: ARC COMMUNITIES 14, LLC Septic Alteration Residential 900 Total Value PO BOX-790830 SAN ANTONIO,TX 78279-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2011-176 repolacement drywell between 29 Briwood&30 Woodland $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,May 13,2012 (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; Friday,May 13,2011 SIGNED BY �� for the Town of Queensbury. t�rry /V k Director of Butldinc Ce Enforcement F rE qi, RevisedT4/14/2010� OFFICE USE ON Y TAX&O, / SPZ-rT NO. ERMIT FEE I'''ih;ice✓' ��i 1 4� APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT" A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.1L �y� !� 1^ OWNER: (7r1��P \\ ��1�\ 1 1 I • INSTALLER: �`1//��(.I M Ofld `M.V�) ADDRESS: `� P 1 U Y' OC��. ADDRESS: P7 c 1X �OGI n^ PHONE NOS. c 9 PHONE NOS. )a�tckn Sq, w 1 DU j Qn LOCATION OF INSTALLATION: RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW BEDROOMS Gallons per bedroom GARBAGE GRINDER 1980 or older X 150 = INSTALLED? 1981-1991 X 130 = SPA OR HOT TUB 1992-present X 110 = INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLL[ STEEP SLOPE F %SLOPE ✓ SOIL NATURE: SAND LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? tJ ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (if well:water supply from any septic system absorption is:_t) ✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpi] (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). TANK SIZE: GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,spa or whirlpool tub. SYSTEM TYPE: ❑ABSORPTION FIELD(WITH NO.2 STONE) Total length ft. Each trench X ar SEEPAGE PIT(S)(WITH NO.3 STONE) How many? I Size? ❑ALTERNATIVE SYSTEM Bed or other type? WI Sioa�� ❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. 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 QUESTIONS? CALL 761-8256 OR EMAIL Santry_ Sewage Disposal O dinance. I codes(ftueensburv.net \� I' VISIT OUR WEBSITE FOR MORE INFORMATION Signature of erson Responsi le Date www.gueensbury.net Town of Queensbury* Community Development Office* 742 Bay Road, Queensbury NY 12804 � RUS Septic Inspection Report Office No. (518) 761-8256 Date Inspection-mque eceived: Queensbury Building &Code Enforcement Arrive: '1 =Zh arBepart: a �742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: 13 NAME: PERMIT NO.: 1 l—/?I-0 LOCATION: b Waaal Cz A INSPECT ON: — -2-1- --t- 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. Well Casing Length 50'+/ - Y N N/A 150'to well required if NO 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 End Cap Y_ N .Inlet/Outlet Pipes&Baffles Y N Manholes 12",or less below grade Y N [provide extension collar if Yes Y_N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan _ _N Engineer Report and As-Built Y N ETU Maintenance Contract Y_N provided Location of System on Property: Front ar Left Side Right Side Middle Front Middle Rear System Use S us: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report_03 2910.doc i 169 Haviland Road, Queensbury,NY 12804 Phone-518-7454400 Fax -518-792-8511 March 6,2013 Project#49335 Mr. John O'Brien HAND DELIVERED 742 Bay Road Queensbury,NY 12804 Re: Septic System Repair 27, 29 &31 Woodland Path&28-30 Briwood Circle Forest Park Mobile Home Park Queensbury,NY Dear John: As discussed in the field with Mr. Hatin, we observed the existing drywells serving the above mentioned mobile homes and confirmed that the owner had installed a new distribution box and 4"PVC laterals between the existing 2,500 gal septic tank and the existing drywells. It appears from our observations that one of the existing laterals had collapsed and unequal flow was distributed to the existing drywells. At the time of repair the owner was systematically replacing existing systems and the plan was to replace systems that were in failure or closer to failure and this repair was a temporary fix. Please find a sketch of the work observed. Please feel free to contact me at 796-2515 if you have any questions. Sincerely, Thomas R. Center, Jr., PE . Cc: American Residential Communities J • f 4 I woo NEV 0_- If% 1000 I`` -f J i 3 13 A 1 A � �L �, Septic Inspection Report Office No. (518)761-8256 Date Ins ' on a ed: Queensbury Building &Code Enforcement Arrive: epart: 742 Bay Rd., Queensbury, NY 12804 Inspector's Initi ° NAME: PE IT NO.: _ LOCATION: 2 tJ \�� I PECT ON: — RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/Clay Type of Water: Municipal Well Water Waterline separation distance Well separation distance ft. Other wells: ft. Well Casing Length 50' +/- Y N N/A 150'to well required if NO Absorption-Field: Total length ft. r �� —'C� LsEv Length of each trench ft. Depth of trenches Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Building to tank ` 1 J\ Tank to Distribution Box `�_ (2 Distribution Box to Field/ Pit Opening Sealed: Y N End Cap _Y_N Inlet/Outlet Pipes&Baffles Y N Manholes 12"or less below grade Y_N [provide extension collar if Yes Y N Location Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N Engineer Report and As-Built _Y N ETU Maintenance Contract Y_N provided Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use S tus: Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection ReporL03 2910.doc REAR PROPERTY LINE ! : i : ! { t ! 3 ! 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