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2011-566 TOWN OF QUEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201 OS Q rY, Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20110566 Date Issued: Friday, February 21, 2014 This is to certify that work requested to be done as shown by Permit Number P20110566 has been completed. Tax Map Number: 523400-279-017-0001-033-000-0000 Location: 121 SUNNYSIDE RD. NORTH Owner: MALCOLM & KAREN NICHOLS LIFE USE & TRUST Applicant: MALCOLM & KAREN NICHOLS LIFE USE & TRUST 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 ("‘c" .,)(,,,,,,v7,fr. 4 f 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. 41111 \ TOWN OF QUEENSBURY IG4 rt/iTS 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20110566 Application Number: A20110566 Tax Map No: 523400-279-017-0001-033-000-0000 Permission is hereby granted to: MALCOLM&KAREN NICHOLS LIFE USE&TRU For property located at: 121 SUNNYSIDE RD. NORTH 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: MALCOLM&KAREN NICHOLS LI 121 SUNNYSIDE RD.NORTH Septic Alteration Residential QUEENSBURY,NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency SANITARY SEWER DAN DRELLOS PO BOX 224 GLENS FALLS NY Plans&Specifications BP 2011-566 Septic Alteration: 2 lots 279.17-1-33 (1,000 gallon tank)and 279.17-1-46 (distribution box and absorption beds) $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,November 15, 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 Q eensb ; �sda ,; i1 e i i i er 15,2011 SIGNED BY J for the Town of Queensbury. Director of Building&Code Enforcement ` a iiEcErivE Community Development Office Town of Queensbury ® 742 Bay Roads Queensb ry, ew York -128(.74- 1 , . tib:. • Office Use Only a-� 7.1_3 3 BUILDING& CODES TAX MAP NO. -7 /-/7 - e PERMIT NO. *((-5-C96 PERMIT FEE `-'G APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM RMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW EFORE ISSUANCE A VALI RMIT. OWNER: fl‘ C .g L f"k I cite) Cr INSTALLER: /-0 i A 1/90 ADDRESS: 12 ( c1 ✓4,w? fi 7 e 1 J tO itr ADDRESS: P O X -2-1-1-e, 6 PHONE NOS. Q(� PHONE NOS. 7 6- oP SO LOCATION OF INSTALLATION: 1 l 9 <J U��W y-p--2 XiL i 4{— RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT BEDROOMS X (Gallons per bedroom) = TOTAL DAILY FLOW r GARBAGE GRINDM-O 1980 or older 3 X 150 = S U INSTALLED? r�' 1981-1991 X 130 = SPA OR HOT TUB ru 1992-present X 110 = INSTALLED? PARCEL INFORMATION: V F ✓ TOPOGRAPHY: FLAT ROLUN STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: I ft) ✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpij (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:1 daD 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 SYSTEMr other type? /Cj x 3a 1 ❑ 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 h.ye read the -. - ions with resp-ct to this application and agree to abid- by these an, • emen F o le Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL n' Sewage r* •, • •in . f r� codes{c�,queensburv.net ✓L2 e. t' l t/ t� VISIT OUR WEBSITE FOR MORE INFORMATION •i• ature of Person Responsible Dat www.queensbury.net �,-s Septic Inspection Report Office No. (518) 761-8256 Date Inspection requ Queensbury Building &Code Enforcement Arrive: • : !Z;Ltb am friBlo 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial4rr NAME: 1 CAA©� NO.: I I -A-62.(4, LOCATION: ►Z\ Oc NSPECT ON: -z_— 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 ear Left Side Right Side Middle Front Middle Rear stem U 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 Report03 29 10.doc Page 1 of 1 * 1 ;,01 I...SZPri. V\i, NIL lit \o ril ilk 4 1111 IN stNY1: 4 St b4,kD,i' ..�{�0A ..tpt, 1; --,„4446.4, e tat ; a vtt 111111;\ + 111111 ll. Scaisbar length always=30011oet a ■ a IMINE11111111111111111111111111111111111300ft The Town of Queensbury does not warrant the correctness or accuracy of this data or assume any responsibility for any explicit or implied uses. # Town of Queensbury ,.s 4 ' ,5 742 Bay Road — Queensbury,NY. 12804-5902 IA" 1 �I C X110 -s -c LL, http://gby2svr/GIS/printdis.asp 11/14/2011 1111 NACE ENGINEERING, P.C. 169 Haviland Road, Queensbury, NY 12804 Phone-518-745-4400 Fax -518-792-851 December 5, 2011 Project# 49331 Dave Hatin Code Enforcement Officer Town of Queensbury 742 Bay Road Queensbury, NY 12804 Re: Nicoles— 119 Sunnyside Road North—Replacement Septic System Dear Dave: This letter is to inform you that we inspected the completed replacement septic system for 119 Sunnyside Road North in the Town of Queensbury on November 17, 2011. The replacement septic system as installed was for a 3 bedroom home and consisted of a new 1000 gallon septic tank, a new pump station, new distribution box and a 15 ft wide by 30 ft long absorption bed with 3 — 25 ft long laterals constructed of perforated pipe and stone. The system conforms to the requirements of the approved replacement septic system design. We have also provided a copy of the suggested easement for access to the replacement system on an adjacent parcel owned by the Nicoles. Please advise in writing that this easement is acceptable and we will file the easement with Warren County. Please call me if you have any questions or concerns. Sincer ly, Th mas R. Center Jr, P.E. i F r 04-189 November 21, 2011 Suggested description of easement area as is granted and reserved by Malcolm Nichols. All that certain piece or parcel of land situate, lying and being in the Town of Queensbury, County of Warren and the State of New York, being east of Lot 50 of Sunnyside North Subdivision, more particularly bounded and described as follows: BEGINNING at an iron rod set in the ground for a corner at the most northerly corner of said Lot 50 and the northeasterly or easterly corner of Lot 51 of said subdivision, being also in the southerly bounds of lands now or formerly of Kirk and Donna Barton; thence running along said lands of Barton the following two courses and distances: (1) South 58 degrees, 12 minutes and 31 seconds East, a distance of 97.06 feet; (2) South 77 degrees, 07 minutes and 18 seconds East, a distance of 20.00 feet;thence running through the lands of the grantor herein, South 47 degrees, 26 minutes and 25 seconds West, a distance of 72.48 feet to an iron rod set in the ground for a corner at the most easterly corner of Lot 49 and the most northerly corner of Lot 48 of said subdivision;thence running along the northeasterly bounds of Lot 49 and 50, North 24 degrees, 55 minutes and 08 seconds West, a distance of 164.65 feet to the point and place of beginning, containing 3,669.50 square feet of land to be the same more or less. Bearings given in the above description refer to magnetic North. SUBJECT to easements of record. Van Dusen &Steves Land Surveyors NYS Lic. #50135 CtOS� ` v 1O — IZ J , -;u a r 1/: (1S;3,, Septic Inspection Rep Office No. (518) 761-8256 Date Ins 11 lb pection r-• - ived: Queensbury Building&Code Enforcement Arrive: = ► -• p;,./,a._ ft: = D .m/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initi: �% NAME: Ni C',Ul S , w RMITNO.: 1/ - J '0 LOCATION: j CO S,,v c J ,tri R-D, NAT 1-� INSPECT ON: //til RECHECK: Comments and/or diagram Soil Type• . •.:- Clay Type of Water: Municipal/ ( ell Wat- Waterline separa ,• -• e _ft. Well separation distance 100 ft. r— Other wells: , t C) ft. '1— vir Well Casing Length 50' + / - Y N N/A Absorption Field: Total length � ip Length of each trench ,:� -- e Depth of trenches MIME Size of Stone 9 Ap v.K__N `LAS\-- Seepage Pits: Number Size: x ��\-ZIO 4\1-7 -7 ?--r-- --- Stone Size: Piping Size Type Building to tank 9.1' (-tk Tank to Distribution Box L-(' ` S Distribution Box to Field/ Pit �`r h`*- it-775. -�gVg Opening Sealed: v( N End Cap c.YT -- 1...b 7 Inlet/Outlet Pipes&Baffles N / Location/ Separations • Foundation to tank (tom ft. Foundation to absorption ft. Separation of Pits k - 5 .'3 .A�\ E tSi. 1L Conforms as per Plot Plan _ �i1V Y ` Engineer Report and As-Built —Y� \`� Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear cla)i -AV System Use Status: pproved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc ACCESS HATCH /JUNCTIONAL BOX !� :.: UBMERSI N c PUMP 4 PVC ALARM ON �t PUMP ON DIA. ISIPE (o PUMPS OF CHECK VAt, 1 CONCRETE TO BE TROWEL FINISHED 4'0 PUMP STATION MERCURY FLOAT EFFLUENT PUMP AS MANUFACTURED BY FORT MILLER SWITCH WITH OR EQUIVALENT WEIGHT (TYP.) CONCRETE OR STONE FINISHED MARKER ABOVE ALL GRADE RECOMMENDEDRS INLET BAFFLE 12" MIN. OVER OVER ALL STRUCTURES "—ALL OUTLET INVERTS EXACTLYTLTHE SAFE ELEVATION. PEA GRAVEL 1 FORCE MAIN DISTRIBUTION BOX SLOPE OOPE TO DRAIN BACK TO PUMP STATION N.T.S. PUMP STATION N.T.S. 1. PUMP TO BE EFFLUENT PUMP RATED AT A MINIMUM OF 30 GPM AT 20 FEET TOTAL DYNAMIC HEAD. PUMP TO BE 1/3 HP GOULDS MODEL 3885WE03L OR EQUAL. 2. PUMP CONTROL PACKAGE TO BE SUPPLIED BY MANUFACTURER. AUDIBLE AND VISIBLE ALARM TO BE ACTIVATED BY ALARM FLOAT 3. PUMP CYCLE VOLUME = 42 GALLONS ( 80% OF ABSORPTION FIELD VOLUME). 18" MIN. MI SN LOPE 1/4- PER FOOT NEW 1,000 SEPTIC TAN RECOMMEND ALL ACCESS & CLEANOUT OPENINGS APPROXIMATE BE RAISED TO 6" BELOW FINISH GRADE FINISH GRADE. LIQUID LEVEL INLET & OUTLET MIN. SLOPE 1/8" PER FOOT PEA GRAVVEL UNDERIDE 3" NDANKSEPTIC TANK N.T.S. NEW SEPTIC TANK 1. ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK STATE DEPARTMENT OF HEALTH AND SHALL BE PRECAST CONCRETE AS MANUFACTURED BY FORT MILLER OR EQUIVALENT. 2. ALL STRUCTURES TO BE PLACED ON FIRM, COMPACT SAND OR GRAVEL FOUNDATION. WHEREVER EXISTING FOUNDATION CONDITIONS ARE UNSUITABLE, CRUSHED STONE SHALL BE PLACED AS NECESSARY TO ACHIEVE A STABLE FOUNDATION. 3. SEPTIC TANKS INSTALLED IN TRAFFIC AREAS SHALL BE EXTRA HEAVY CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING. INSTALLATION OF DISPOSAL FIELDS BAFFLES 1. CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING, o zQ AND SHALL BE IN ACCORDANCE WITH THE N.Y.S. �m AND TO DIVERT SURFACE RUNOFF FROM ADJACENT AREAS AWAY DEPARTMENT OF HEALTH INDIVIDUAL HOUSEHOLD SYSTEMS, AND o Z) z 00 CY M to J MINIMUM 2x WIDTH 6. MAXIMUM 4x WIDTH MIN. SLOPE 1/8" PER FOOT PEA GRAVVEL UNDERIDE 3" NDANKSEPTIC TANK N.T.S. NEW SEPTIC TANK 1. ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK STATE DEPARTMENT OF HEALTH AND SHALL BE PRECAST CONCRETE AS MANUFACTURED BY FORT MILLER OR EQUIVALENT. 2. ALL STRUCTURES TO BE PLACED ON FIRM, COMPACT SAND OR GRAVEL FOUNDATION. WHEREVER EXISTING FOUNDATION CONDITIONS ARE UNSUITABLE, CRUSHED STONE SHALL BE PLACED AS NECESSARY TO ACHIEVE A STABLE FOUNDATION. 3. SEPTIC TANKS INSTALLED IN TRAFFIC AREAS SHALL BE EXTRA HEAVY CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING. INSTALLATION OF DISPOSAL FIELDS 1. CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING, 5. ALL DISPOSAL FIELDS SHALL BE GRADED TO SHED RAINFALL AND SHALL BE IN ACCORDANCE WITH THE N.Y.S. AND TO DIVERT SURFACE RUNOFF FROM ADJACENT AREAS AWAY DEPARTMENT OF HEALTH INDIVIDUAL HOUSEHOLD SYSTEMS, AND O FROM THE DISPOSAL FIELD. ASTM F481-76 INSTALLATION OF THERMOPLASTIC PIPE AND .... .... A CORRUGATED TUBING IN SEPTIC TANK LEACH FIELDS. 6. REMOVE LEAVES, ROOTS, PLANTS AND ORGANIC DEBRIS. PLOW SURFACE PRIOR 2. NO HEAVY EQUIPMENT SHALL BE ALLOWED WITHIN THE LIMITS TO SPREADING FILL MATERIAL. OF THE DISPOSAL FIELDS AFTER PIPE INSTALLATION HAS BEGUN. 7. DO NOT USE HEAVY EQUIPMENT WITHIN THE ABSORPTION FIELD AREA. 3. AFTER EXCAVATION OF BED TO THE DEPTHS REQUIRED, U THE WALLS AND FLOOR OF EACH SIDE WALL SHOULD BE CLEANED 8. NO PART OF THE DISPOSAL FIELD SHALL BE INSTALLED UNDER DRIVEWAYS. AND RAKED TO ACHIEVE AN EVEN SURFACE AND TO LOOSEN r/2 -!; g SMEARED SECTIONS OF TRENCH. ^ j.�.�j 4. PLACEMENT OF THE PERFORATED PIPE SHALL BE AS SHOWN. as THE PIPE SHOULD BE LAID AT THE GRADES AND TO THE RELATIONSHIPS SHOWN ON THIS DRAWING, MAINTAINING STRAIGHT CONTINUOUS GRADES WITHOUT SAGS, HUMPS, SEPARATED JOINTS zm OR OTHER UNSUITABLE CONDITIONS. W SWALE AT UPHILL SIDE OF BED TO DRAIN RUNOFF AWAY FROM BED 2" MIN. 6" MIN. 12" MAX. 6" MIN. IRS= 6" TO 12" BACKFILL 5'-0" SLOPED TO DRAIN EARTH ALL 5'-0"- (r(p.) MAXIMUM GROUNDWATER ELEVATION iii : • • • : � . •. � . - ♦OR : :111111=101214 I" 24" MIN.2 —6 FILTER FABRIC OR GEOTEXTILE 4" PLAR%RA, TED 3/4" TO 1 1/2" CRUSHED STONE 6" MIN. INTERCONNECT ENDS OF LATERALS SEPTIC SYSTEM DESIGN DESIGN FLOW — EXISTING 3 BEDROOM HOUSE 3 BEDROOMS @ 110 GAL./DAY/BDRM = 330 GPD — OWNER WILL PROVIDE WRITTEN EASEMENT TO CROSS ADJOINING PARCEL FOR REPLACEMENT ABSORPTION BED. SEPTIC TANK — USE NEW 1,000 GAL. TANK ABSORPTION FIELD — EXISTING FAILED SEPTIC SYSTEM USE NEW PUMP STATION & REPLACEMENT ABSORPTION BED SYSTEM. AT NYSDOH APPLICATION RATE OF 0.95 GAL/DAY/SF, 347 S.F. OF ABSORPTION BED REQUIRED. USE 15' WIDE BY 30' LONG (450 S.F.) ABSORPTION BED WITH 3 — 25' LONG LATERAL. LANDS N/F OF KENT & VICTORIA BARTON 1263/195 f RPF S LANDS N/F OF KENT & VICTORIA BARTON Nob 767/306 A' 0 6o s F 3 LAKE SUNNYSIDE OIPF LANDS N/F OF KIRK & DONNA BARTON IPF 669/727 f i -� ss8o pp O& 'P,9 o'p 6o ALL IPF NEV i J- u GAL � >>, SEPTIC TAW rL MAP REFERENCES: MAP OF A SURVEY OF LANDS OF LEE & BETTY BARTON DATED: DECEMBER 18, 1970 LAST REVISED: OCTOBER 16, 1989 MAP OF A SURVEY MADE FOR BY: JOHN B. VAN DUSEN KAREN CULVER DATED: MAY 17, 2000 MAP OF A SURVEY MADE FOR BY: VAN DUSEN & STEVES, LEE & BETTY BARTON LAND SURVEYORS, LLC DATED: JUNE 26, 1979 REVISED: OCTOBER 17, 1979 BY: JOHN B. VAN DUSEN 50-1-23,42,42,43 & 86/279.17-1-46,33,34,35 & 10 '16 ti`0 1. IRS STATIW C> IW AREA DISTRIBUT � ss8oamc 16, 518 sq. ft. �2 0.38 acres 9' "��F o15/ 3 W A BORP�T N DE m LS . zs.a /\` 0 Jg���v �o IRS �� // '5;v A\ \ IRS . . . . . o \ a. 00 60 c 1 * /1 (�LDffTS 13F SEVER EASEMENT x x AREA 4, 659 sq. ft. x \ 0.11 acres - 5� \� d t�63 p0 29 dr 2 IRS rn -1 SITE PLAN WAM t" LEGEND: 876/228 OIPF = IRON PIPE FOUND OIRS = IRON ROD SET/TO BE SET ccL = UTILITY POLE x = FENCE LINE 23 = LOTS OF RIDER ESTATE SUBDIVISION �<l AREA 4, 687 sq. ft. 0.11 acres A00.82A1W S6601� Co %\ ' 0 � Z IRS 47 LANDS N/F OFA FRANK RICCIO — 885/223 46 IPFO 0?.y8„E 73 r 23 AREA 29,094 sq. ft. 0.67 acres LANDS N/F OF MATTHIAS GREENE f CD �l NV 0 OD READ. W Q � � � O CL � � V Co � o Q U fail Q- I O � .... .... A SLICE I O � W A U z 10-4 E..,, r/2 -!; g U 6 P li ^ j.�.�j U q as zm W � q U o► 0 OO 0 LACEMEN'n.1 m F O H P.4 U W O w 50.00 ' x N86009'58"W w C4 Date: JUL. 26, 2011 SCALE - AS NOTED 49331 SHEET 1 OF 1 DWG. N0. 49331