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 ComP liance 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: 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. T"e 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 Builders 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.
0Director of Buildin8t Ce Enforcement'
OFFICE U,
6P�NO. (/VERM
e, ,1—6
Wo! IT FEE
\ APPROVALS: ZONING TOWN CLERK 14
APPLICATION FOR SEPTIC DISPOSAL ^° " ~°""—M PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT T0 ftEVAEVV B—EF-0�Rs
ISSUANCE 0FA VALID PERMIT.
PHONE NOS. PHONE NOS.-12)a��-s6n Spa � ,rinab
LOCATION OF INSTALLATION:
RESIDENCE INFORMATION:
YEAR BUILT NO.OF COMPUTATION TOTAL DAILY FLOW
BEDROOMS X (Gallons per bedroom) GARBAGE GRINDER
1981-1991 x 130 SPA OR HOT TUB
PARCEL INFORMATION:
TOPOGRAPHY: FLAT.ROLU --XSTEEP SLOPE %SLOPE
V' SOIL NATURE: SAND 7— LOAM CLAY OTHER
/ *r WHAT DEPTH?
_________
'
• aT WHAT DEPTH?
/ MUNICIPAL_��_ vvsLL ____(If well:water supply from any septic system absorption is: fd
/ RATE IS PER m||wuTs PER INCH[nnU
(Test mu000mpmteauva licensed professional engineer u,architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional engineer
o,architect(unless installed mo Planning Board approved ovudiwown).
TANK SIZE: GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for
000h
garb aso grinder,spa or whirlpool tub.
SYSTEM TYPE:
o ABSORPTION FIELD(WITH NO.2STONE) Total length ft. Each trench______X
��EEPAGEP|T(G)ON|THNO.5STONE) How many? ���� Size?''
o ALTERNATIVE SYSTEM Bed or other type?
oHOLD|NGJ7\NKSYSTEM Total required capacity?_Tank size? Number cf 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 orapproval
gnomud which is based upon or in granted in m|ionoa upon any mo0ohal misrepresentation or failure m make u mooaha|fact or
circumstance known byoron behalf ofun applicant,shall bovoid.
|have read the regulations with respect tv this application and agree
to abide by these and all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
San' Sewage Disposal 0 dinan::�
/� VISIT OUR WEBSITE FOR MORE INFORMATION
//
,. S -TNUS
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection-mque ecelved:
Queensbury Building &Code Enforcement Arrive: 1 �7� ar Be. = a m
742 Bay Rd.,Queensbury, NY 12804 Inspector's Initials: � 11
a NAME: R eLwAAg
PERMIT NO.:
LOCATION: 3.b WatAl2t n A INSPECT ON:
RECHECK:
Comments and/or diagram
Soil Type: Sand/ Loam Clay
Type of Water: Munici al/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 Ca Y_ N
Inlet/Outlet Pipes&Baffles Y N Ax\10
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:
4Frontar Left Side Right Side Middle Front Middle Rear
S stem pproved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Fortes\Inspection Forms\Septic Inspection Report-03 2910.doc
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury,NY 12804
Phone-518-745-4400 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
,is
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RV rlpl
- . NE W 0- '+y
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3 l3 A 1
Septic Inspection/rrNO.:
Office No. (518)761-8256 Date In " on
Queensbury Building&Code Enforcement Arrive: 1rt: y
742 Bay Rd., Queensbury, NY 12804 Inspector's Initi
NAME: PLOCATION: 2� \� I —
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. oL2 Z>t3
Well Casing Length 50'+/- I Y N N/A
150'to well required if NO
Absorption Field: Total length
Length of each trench ft.
Depth of trenches ft. \`J
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size T
Building to tank 1 F may- ®�
Tank to Distribution Box � e—
Distribution Box to Field Pit
Opening Sealed: Y N
End Cap 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 Status:
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 Inspecdon Report-03 2910.doc
Cornmunitu Develo meat O "ice
1 vzv�i of Queensbury • 742 Bu}/rct,
Queensbury, New York •128U4
PLOT PLAN
Show all existing and proposed structures.Indicate the setbacks of all structures nd buildings from.all property lines.
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