2002-681 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020681 Application Number: A20020681
Tax Map No: 523400-290-005-0001-019-000-0000
Permission is hereby granted to: WILLTAM&PENNY UNDERWOOD
For property located at: BARTON PI
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. Type of Construction Value
Owner Address: WILLIAM& PENNY UNDERWOO Septic Alteration Residential
551 DEAN Rd Total Value
HUDSON FALLS,NY 12839
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2002-681
Residential septic alteration
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 16,2003
(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 Tow�n�f Queen
August 16,2002
IGNED BY A A r the Town of Queensbury.
L
Director of Building&Code Enforcement
Application for Permit-Septic Disposal System
Town of Queensbury 742 Bqv Road Queensbur:K AT 12804 (518) 761-8256
1. OWNER INFORMATION: -2-cl 0- 5-- 9
Office Use
Location of installation: 0 2,-6
rmit No.
D File Pe
-A
Tax Map No.Z 0-95
T
/9L
Fee Paid
Owner's Name: .................... ..... ................ ......... ..................
Address: IE 51� I
2. INSTALLER'S NAME kA.1% PHONE NO.-7-1-7--ZfE5_7
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate 4 bedroom(s) and multiply A 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 V--'
Spa or Whirlpool Installed yes_ J no v.--
4. PARCEL INFORMATION: (circle applicable information &indicate measurements)
To 0 ra hn Soil Nature Ground Water Bedrock or impervious Material Domestic Water SMRP-1-Y
t depth at what depth tmunicipal
an at what
loam f
at Rolling
m %C;>jeet el we
slop
to
olling loam IgZ>Jeet -water supply
jfwell,
Steep slope clay from any Septic-system
%slope other absorption is-t ft-
depth: other
Percolation Test: (To he completed 03 licensed professional engineer or architect)
Rate:
minute per inch
Construction: All individual sewage disposal systems must be designed by a licensed
$. PROPOSED SYSTEM: For New Construe 0
planning Board approved subdivisi n). Add 250 gallons to the size
professional engineer or architect(unless instal
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 System Length:
Seepage Pit(s): number o size of each: by f;� ft. k,�:,
Size of Stone to be used: 4 depth or thickness
7 feet
Bed System Size: X
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required) gallons
/ Size Of each: gagons /TOTAL Capacity:
Number of tanks:
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 Sectin 13 6-29 of the Cs granted in ode of the Town
of Queensbury, any permit or approval granted which o is based upon or i
reliance upon any material misrepresentation or failure to make a material fact or
behalf of an applicant, shall be void.
circumstance known by or on
I have read the regulations with respect to this�apptiektion and agree to abide by these and all
I-lu' S e Disposal Ordinance. ry
e�" an ry S 9
requirements of the Town
Da
te
Slonatur onst arson
Septic Insp'ection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm. Depart: am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
7V
NAME: PERMIT NO.:
LOCATION: INSPECT ON: CZ"
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.
Absorption Field: Total length i 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
Foundation to absorption
Separation of Pits
Conforms as per Plot Plan Y N
Engineer Report and As-Built i Y N
Location of System on Property:
Front Rear Left Side Right Side
Middle Front Middle Rear
System Use St s:
Approved
Partial Approved and needs to be -inspected,please call the Building&lodes Office
Disapproved
Last revised 116105
AS 03M31A38
1 903'8 JNICl ne
A n o o
IkAoj
LANDS F
PINE
TAX MAP PARCEL
290.5-1-22 —
LANDS OF
BARBER
CABIN
9
S.P.
TAX MAP PARCEL
290.5-1-24
_ _ — _ —
TAX MAP PARCEL S.P
290.5-1-25
S.
O
CABIN
7
LANDS OF
COONEY
LANDS OF
COONEY
LANDS OF
BILLINGS
d
SUNNYS/DE L
ROAD NORTH
LANDS OF
ORLOW &
ALUND
TAX MAP PARCEL
290.5-1-20
S.P.
rk
TO RIDGE ROAD
P
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Im
it
GP W-2 /
TAX MAP PARCEL a
K
6 290.5-1-19 SA
00
HE j,// c1 SITE LOCATION MAP
, S' 1L SCALE: 1" = 2,000'
.P.
8' 8' DRYWELL MTH
2' STONE RING.
EW (REPLACEMENT)
W-1
O SEE AGE PIT INSTALLED
• SEPTEMBER 2001.
CABIN
B 0
S.T.
APPROXIMATE 8' X
SHED AREA TO RED
AS STORAGE
11 'U 11 EXISTING STORAG
SHED PROPOSED
A
IUjBE RENOVATED
CHLORINATION
TREATMENT
SEE SCHEMATIC BUILDII
W-3
0
CABIN
5
S.P.
O
CABIN
7
S.
E STING
V
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Fhl m ;-r OhOh rived, or believe I saw evide
",uses, Wells trees, fences,
a, Q repr nt that I
c h to es set rth on t.
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RPr,MVED
f4U�_", U 2002
),Q0 2-
MAP REFERENCE:
#1) MAP ENTITLED: "MAP OF A SURVEY OF LANDS IN POSSESSION OF
HELEN F. CUTTING", DATED JANUARY 11, 2001 AS PREPARED BY DAVID
J. BOLSTER.
S.P
JEN
ABSORPTION
FIELD G'
C-
LEGEND:
S. T.
DENOTES
SEP TI C TANK
S.P.
DENOTES
SEEPAGE PIT
►`
®
DENOTES
NUMBER OF BEDROOMS
W-#
DENOTES
WELL NUMBER
EXISTING 8'X16' STORAGE SHED
TO BE RENOVATED TO HOUSE
CHLORINATION SYSTEM.
IMPROVEMENTS TO INCLUDE
INSULATION, ELECTRIC HEATER,
AND LIGHTING.
CONTACT TIME STORAGE
CHLORINATION SYSTEM SCHEMATIC
NOT TO SCALE
CHLORINE SOLUTION TANK
WITH PULSE FEED (FLOW
DICTATED) INJECTOR PUMP
ZAW WATER TAP
-ROM SUPPLY OF WELLS
N-1, W-2, AND W-3.
NSTALL GATE VALVES (PRIOR
r0 COMMON PIPE) AND RAW
HATER TAP.
TREATED WATER TO PRESSURE
TANK SYSTEM FOR EACH WELL.
PIPING TO INCLUDE VALVING AND
CONNECTIONS TO ALLOW EACH
WELL DISTRIBUTIONS TO BE
SUPPLIED FROM EACH OTHER WELL.
INISH WATER TAP
PROPOSED WATER SYSTEM IMPROVEMENTS : BARTON PLACE COTTAGES
PROJECT DESCRIPTION: THE EXISTING WATER SUPPLIES SERVING THE APPROXIMATE 12 UNIT COTTAGE CLUSTER ARE
THREE NON -CHLORINATED DRILLED WELLS. ADJACENT PUMP PITS HOUSE THE NECESSARY PRESSURE SWITCH AND TANK
ASSEMBLIES FOR WELLS W-1 AND W-2. WELL W-3 CONTROLS ARE LOCATED WITHIN COTTAGE 10. THE PRESSURE
SWITCH AND TANK ASSEMBLIES WILL BE MAINTAINED IN THE UPDATED SYSTEM. AS THERE IS NO METERING ON THE
EXISTING SYSTEM THE MAXIMUM PUMPING RATE OF THE WELL PUMP WILL BE USED AS THE DESIGN FLOW RATE.
BASIS OF DESIGN: NO RECORD OF WATER USE EXISTS FOR THIS SYSTEM. BASED ON THE PUMP CURVES AN ESTIMATE
OF THE MAXIMUM (COMBINED) PUMPING RATE IS 30 GALLONS PER MINUTE (GPM). AT A REQUIRED CONTACT TIME OF 15
MINUTES, THE VOLUME OF STORAGE NECESSARY IS 450 GALLONS.
OUTLINE SPECIFICATIONS FOR PROPOSED COMPONENTS:
THE PROPOSED TREATMENT SYSTEM WILL CONSIST OF THE ADDITION OF A CHLORINE SOLUTION TANK WITH TOP MOUNTED
CHLORINE INJECTOR PUMP (PULSE FEED - FLOW :ACTATED) AND THE REQUIRED VOLUME OF CONTACT TANKS. THE NEW
EQUIPMENT WILL BE INSTALLED WITHIN AN EXISTING SHED STRUCTURE (8' X 16'±) ADJACENT TO THE THREE WELLS. THE
BUILDING IS A WOOD FRAME STRUCTURE TO BE IMPROVED WITH INSULATION, AN ELECTRIC HEATER, LIGHTING, AND A
MINIMUM DOOR OPENING OF S-0. THIS STRUCTURE SHALL BE RENOVATED BY THE WATER SYSTEM OWNER, BUILT IN
ACCORDANCE WITH ALL APPLICABLE CODES, BUT IS NOT PART OF THE SPECIFIC DESIGN AND APPROVAL OF THIS PLAN.
ALL WIRING AND ELECTRICAL DEVISES REQUIRED TO SERVE THE NEW TREATMENT COMPONENTS SHALL BE PROVIDED.
PROPER VOLTAGES MUST BE CONFIRMED.
CHLORINE SOLUTION TANK: FURNISH AND INSTALL A 50 GALLON RIGID POLYETHYLENE TANK WITH A COVER DESIGNED
FOR A TOP -MOUNTED INJECTOR PUMP - BY LMI OR EQUAL.
CHLORINE INJECTOR PUMP: FURNISH TWO (2) AND INSTALL ONE (1) LIQUID CHEMICAL FEED PUMP - LMI LIQUIPRO SERIES
A OR EQUAL FOR TOP MOUNTING ON THE SOLUTION TANK. PROVIDE A 4-WAY VALVE WITH DEGASSING FEATURE - BY
LMI OR EQUAL TO BE INSTALLED ON THE DISCHARGE SIDE OF THE PUMP. THE SECOND PUMP SHALL SERVE AS A SPARE
AND SHALL BE KEPT ON SITE.
CONTACT TANKS: FURNISH AND INSTALL CONTACT TANKS FOR WATER TREATMENT WITH A MINIMUM 450 GALLON TOTAL
CAPACITY. THE TANKS SHALL BE WELLMATE UT SERIES OR EQUAL WITH TOP AND BOTTOM SYSTEM CONNECTION
FITTINGS.
PIPING, VALVES, GAUGES, ETC.: FURNISH AND INSTALL ALL REQUIRED PIPING, VALVES, GAUGES, UNIONS AND CONNECTION
DEVICES TO ASSURE EFFICIENT OPERATION OF THE COMPLETED SYSTEM. ALL NEW PIPING IN TREATMENT BUILDING TO BE
PVC-SCH.80. WELL PIPING TO BE HDPE-SDR 9.
CHLORINE TEST KIT: FURNISH A CHLORINE TEST KIT BY HACH OR EQUAL FOR REQUIRED READINGS OF CHLORINE
RESIDUAL. PROVIDE ENOUGH TABLETS FOR ONE YEAR'S TEST.
FLUSHING, DISINFECTION AND TESTING: ALL NEW EQUIPMENT MUST BE FLUSHED AND THEN DISINFECTED PRIOR TO
TESTING. THE WATER SYSTEM MUST BE FILLED WITH WATER WITH A FREE CHLORINE RESIDUAL OF NO LESS THAN 25
MILLIGRAMS PER LITER (MG/L). THE HEAVILY CHLORINATED WATER MUST REMAIN IN CONTACT WITH ALL COMPONENTS OF
THE NEW WATER SYSTEM FOR AT LEAST 24 HOURS. TEST THE FREE CHLORINE RESIDUAL OF THE WATER AFTER IT HAS
BEEN IN THE SYSTEM FOR AT LEAST 24 HOURS. IF THE FREE CHLORINE RESIDUAL OF THE WATER IN THE SYSTEM IS
LESS THAN 10MG/L AFTER 24 HOURS, REPEAT THE DISINFECTION PROCEDURE UNTIL THE FREE CHLORINE RESIDUAL AFTER
24 HOURS CONTACT IS AT LEAST 10MG/L. THE SYSTEM MUST THEN BE FLUSHED UNTIL A STANDARD FREE CHLORINE
RESIDUAL IS ACHIEVED. THEN TWO CONSECUTIVE DAYS OF NEGATIVE BACTERIOLOGICAL ANALYSIS MUST BE ACHIEVED.
CONSTRUCTION NOTES:
THE WATER TREATMENT BUILDING MUST HAVE A LOCKABLE DOOR TO SECURE IT FROM UNAUTHORIZED ACCESS.
THE WATER SYSTEM DESIGN CANNOT INCLUDE BYPASSES AROUND REQUIRED TREATMENT. THE DRAINS FROM CONTACT
TANKS CANNOT BE CONNECTED.
ALL NEW AND EXISTING HOSE BIB CONNECTIONS AT THE FACILITY MUST INCLUDE APPROVED VACUUM BREAKER FITTINGS.
GENERAL NOTES:
1. PROPERTY BOUNDARY INFORMATION FOR THE LANDS OF UNDERWOOD AS PER MAP REFERENCE #1.
2. REPRESENTATION OF EXISTING SEPTIC SYSTEMS TAKEN FROM SKETCH PLAN PREPARED FOR PREVIOUS VARIANCE
APPLICATION - DATED 5/11/99. INFORMATION PROVIDED BY DICK CUTTING, PRIOR OWNER OF BARTON PLACE. SOME
FIELD CONFIRMATION MADE BY CURRENT OWNER WILLIAM UNDERWOOD.
3.THE EXISTING WATER SYSTEMS SERVING THE BARTON PLACE CABINS CONSIST OF THREE DRILLED WELLS WITH
INDEPENDENT PLASTIC PIPE DISTRIBUTION SYSTEMS. THE INDIVIDUAL WELLS SERVE AS FOLLOWS:
WELL# CABINS
1 5,7,8,12,14,16,18
2 4,6,7,9
3 10
THE WATER SUPPLIES ARE CURRENTLY UNTREATED
4. CHLORINATION DISINFECTION OF THE THREE WATER SUPPLY WELLS SERVING THE 12 CABINS IS HEREIN PROPOSED.
REFER TO SYSTEM SCHEMATIC AND OUTLINE SPECIFICATIONS ON THIS SHEET.
DATE ISSUED
AUG 0 8 2002
SHE ENVHUNmENTAL
DESIGN PARTNERSHIP
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