2011-186 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: P20110186 Date Issued: Friday, May 13, 2011
This is to certify that work requested to be done as shown by Permit Number P20110186
has been completed.
Tax Map Number: 523400-295-019-0001-058-000-0000
Location: 6 WESTMORE Ave
Owner: LINDA ROGGE
Applicant: , LINDA ROGGE
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the �.
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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: P20110186 Application Number: A20110186
Tax Map No: 523400-295-019-0001-058-000-0000
Permission is hereby granted to: LINDA ROGGE
For property located at: 6 WESTMORE Ave
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: LINDA ROGGE Septic Alteration Residential
6 WESTMORE Ave Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
SANITARY SEWER SERVICE
Plans&Specifications
2011-186
septic alteration residential
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,May 11,2012
(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 To n Tenslry; eild3y,May 11,2011
wf/
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
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Town of Queensbury • 742 Bay Road • Queensbury, N k • 4
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TAX MAP NO.. v f `J(<-9. PERMIT NO. PIF= QO
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM ERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS. PPLICATION IS SUBJECT TO REVIEW FORE ISSUANCE A VALID y RMIT.
OWNER:/( 43A� _ INSTALLER:
ADDRESS: ADDRESS:
PHONE NOS. PHONE NOS. 7 / i PAD
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 = J INSTALLED?_"
1981 -1991 X 130 = SPA OR HOT TUB tjQ
1992-present X 110 = INSTALLED?
PARCEL INFORMATION:,
✓ TOPOGRAPHY: FLAT ROLLS STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND / LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCMMPERVIOUS MATERIAL: AT WH DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft)
✓ 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: Ali individual sewage disposal systems must be designed by a licensed professional engineer or
architect(unless installed in a Planning Board approved subdivision).
TANK SIZE:1 060—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 —_
❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many?------___ Size?
ALTERNATIVE SYSTEM ed r other type? L�,O'
❑ 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.
e read the r ulations 'th respect to this application and agree to
a d by these n II re ments of the Town o uee sbury CQUEION 761-8256 OR EMAILa ary Se �e ,i pos Ordinance. ensbury.netignature of Person Responsible Date R MORE INFORMATION
sbury.net
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection req i ed:
Queensbury Building&Code Enforcement Arrive: a epart: am
742 Bay Rd., Queen ury, NY 12804 Inspector's Initials:
NAME: PE IT NO.:
LOCATION: c ��2__. IN PECT ON:
RECHECK: /
Comments and/or diagram
Soil Ty am/Clay
Type of Water uroci ll Water
Wate-rTifi—eseparation distance V, ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50'+/- Y N N/A
150'to well required if NO
Absor tion Field: Total length ft.
Length of each trench
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size: _--
Piping Size Type
Building to tank 9
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: N
End Ca _ N
Inlet/Outlet Pipes&BafFles N
Manholes 12"or less below grade _
[provide extension collar if Yes Y N
Location Separations
Foundation to tank ft L�
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan N
Engineer Report and As-Built N
ETU Maintenance Contract Y_ N
provided
Location of System on Property:
Qnt R ��LeSide Right Sid Middle Front Middle Rear
stem Use S s:
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
L:\Pam Whiling\2010\Building Codes Forms\InspecBon Forms\Septic Inspection Report-03 2910.doc
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SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
May 4, 2011
2t# 139
Dan Drellos
LS 0
Sanitary Sewer Services MAY
Luzerne Road 09 2011
Queensbury,NY 12804 r
BUIL CF QUEE
Re: Proposed Replacement Septic DING& COp ESRY
Rogge Residence—6 Westmore Avenue, Queensbury,NY
Dear Dan:
At your request we have reviewed your proposed replacement septic system design at the site of
the existing 3 bedroom house of at 6 Westmore Avenue in Queensbury. As per our conversation
the residence has an existing failed septic system.
We have reviewed the proposed replacement septic system design and we agree that a standard
absorption bed is acceptable. Based upon a design flow rate of 450 GPD and a percolation rate of
1 to 5 minutes, you will need 500 square feet-of absorptive area. We recommend using a 15 ft
wide by 35 ft long absorption.bed with 3 — 30 foot long laterals, which will provide 525 sf of
absorptive area. The absorption bed should be constructed with the existing 1,000 gallon septic
tank,new distribution box,4 inch diameter perforated pipe and stone.
Please feel free to contact me at 796-2515 if you have any questions and that you for your
assistance with this request.
Sincerely,
Thomas R. Center Jr, P.E.