2003-551 TOWN OF QUEENSBURY
742 Bay Road,Queensbm7,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF
COMPLIANCE
Permit Number: P20030551 Date Issued: Tuesday, July 29,2003
This is to certify that work requested to be done as shown by Permit Number P20030551
has been completed.
Tax Map Number: 523400.253-003-0001-039-000-0000
Location: 11, KNOLLS Rd
Owner: DONALD WEAVER
Applicant: DONALD WEAVER
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
10,
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20030551 Application Number: a2003O551
Tax Map No: 523400-253-003-0001-039-000-0000
Permission is hereby granted to: DONALD WEAVER
For property located at: 11 KNOLLS Rd
in the Town of Queensbury,to constrctct'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. �•` { ' 4 'd `"e of Construction Value
Owner Address: DONALD WEAVER
11 KNOLLS Rd Septic Alteration Residential
Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency-
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Plans&Specifications
a2003-551
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
s
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 24,2004
(If a longer period is required,an application for an extension miist be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)* 4„r
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Dated at the Town of Queensbury; Thursday,July 24,2003
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
1,"
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Application for Permit Septic Disposal System
Town o,f Queensbury 742 Bay Road.Queensbury,NY 12804-(518) 761-8256
1. OWNER INFORMATION:
_................ ;
Location of installation:
I�f 1 O Office Use
File Permit No.
Tax Map No. / !
�" Fee Paid ���A
Owner's Name:i A) U),--oL U e
Address: 41
2. INSTALLER'S NAME PHONE NO. L J,611,7' ,
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply-.#of
bedrooms'with applicable gallons per bedroom to equal total dailyflow)
Year of House: No. of Bedrooms x' Computation = Total Daily Flow
1,980 or�a 3 - x 150 gal/bdrm = Tl
1980— 1991 x 130 galtbdrm = �� �
1991—present x 110 gal/bdrm =
Garbage Grinder Installed yes____ /0 JUL Z,,? 2003
Spa or Hot Tub Installed yes_ / TOWN OF OUEENSBURY
BUILDING AND CODE
4: PARCEL INFORMATION: (circle applicable information&,indicate measurements)
Tol3op-ranhv Soil Nature Ground Water. Bedrock or impervious Material Domestic'Water Su 1
Z sand at what depth at what depth municipal
o ling oa feet feet well -
Steep slope clay if well;water supply
_%slope other front any septic-system
depth: I_absorption is ft.
other
Percolation Tesp (To be-completed by licensed professional engineer or architect)
Rate: c c minute 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.
Septic Tank: 1,24-� gallon(min. size ],000 gal.)
Tile Field: each trench 5o 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
Bed System Size: a f x
Alternative System: Sd — U ' length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: ! Size of each: gallonss !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.
Signat of re ponsible person Date
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received: A- 1)
Queensbury Building&Code Enforcement Arrive: am/
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: art: UIJ am/pm
NAME: A V F PERMIT NO.: -z
LOCATION: INSPECT ON:
RECHECK:
Comments and/or diagram
Soil DTe: Sand LLOA cw----)
Type of Water: Municipal Well Wat
Waterline-separation distanc ft.
Well separation distance ft.
Other wells:
Absorption Field: Total length 1 45 -
Length of each trenches ft. r Lei to-5
Depth of trenches
Size of Stone
Seepage Pits: Number
Size: X
Stone Size:
Piping Si7,e Type
Building to tank
Tank to Distribution Box 5,04 :r.
" cscP ' Distribution Box
Opening Sealed: Y/NI Partial
Location/Separations
Foundation to tank
Foundation to absorption t.
Separation of Pits ft.
Conforms as per Plot Plan N
Location of Syste o Property:
Front rea�)rLeft Side Right Side
Middle Front Middle Rear
System Use Status:
pproved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
NACE
, Oa �
169 Haviland Road,;Queensbury, NY,12804
Phone-518-745-4400 Fax -518-792-8511
June 23, 2003
Project:#,49109. .
Mr. Jay Sweet
Queensbury Septic Tank ,
PO Box 4283
Bay Road
Lake George, NY 12845
Re: Percolation Test
Don Weaver Residence, l 1 Knolls Road, Queensbury, NY
Dear Jay:
At your request, on June 21, 2003, 1 performed a percolation test at the Dori Weaver residence on-
Knolls Road in Queensbury. The test was performed to the'west of,the existing shed 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- P' in 6 minute, 05;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 G gallons.of water and.-the test was. run 3 times untifit`stabilized with
three consecutive runs of 5:48, 5:56 and 605 respectively.
The design flow rate.for an absorption bed system serving a 3 bedroom residence is 450 gallons
per day which would require a minimum 565 sf absorption bed at Ahe above mentioned
-
percolation rate.
Please call me if you have any questions.
Sincerel
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-,Thomas R. Center Jr., EIT
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