2011-510 TOWN OFQ UEENSBURY
742 Bay y Roa d,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110510 Date Issued: Wednesday, October 26, 2011
This is to certify that work requested to be done as shown by Permit Number P20110510
has been completed.
Tax Map Number: 523400-227-014-0001-003-000-0000
Location: 29 HICKOK Ln
Owner: CHALMERS B DEWEY IRREVOCABLE TRUST
Applicant: CHALMERS B DEWEY IRREVOCABLE 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
(DL 4 ;I
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
.411%
ON742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110510 Application Number: A20110510
Tax Map No: 523400-227-014-0001-003-000-0000
Permission is hereby granted to: CHALMERS B DEWEY IRREVOCABLE TRUST
For property located at: 29 HICKOK Ln
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: CHALMERS B DEWEY IRREVOCA
JULIA L. DEWEY IRREVOCABLE] Septic Alteration Residential
MELISSA THAYER PAGNOTTA A: Total Value
PO BOX 8
KATTSKILL BAY,NY 12844-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
COOKS SEPTIC
NY 12804-0000
Plans&Specifications
2011-510
septic alteration residential
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday, October 14,2012
(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 eensbu t� Fr•cay October 14,2011
J.
SIGNED BY c / �, � �i for the Town of Queensbury.
Director of Building& ode' En.rcement
0 Community Development Office ' r
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 ,
Office Use Only A
TAX MAP NO. Z2 7-a/" I -I -3ll—_570 PERMIT NO. PERMIT FEE4/ "s l
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.
OWNER: JULIA L. DEWEY IRREVOCABLE TRUST INSTALLER: ilL' j Jl11,0,__.. 1ki
ADDRESS: PO BOX 8, KATTSKILL BAY, NY 12844 ADDRESS: 194 alk(,L b ILI {V.i, LAieb5 1A,261.140:7-
PHONE
A, 261.NiPHONE NOS. (518) 761-0991 (H) / 656-9370 (L) PHONE NOS.C% L!jZ ,ab^ 30S
LOCATION OF INSTALLATION: 29 HICKOK LANE
RESIDENCE INFORMATION:
NO.OF COMPUTATION
YEAR BUILT X = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINDER
1980 or older X 150 = INSTALLED?
1981 -1991 X 130 = SPA OR HOT TUB
1992-present 2 X 110 = 220 INSTALLED?
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND ✓ LOAM CLAY OTHER ✓ ROCK
✓ GROUNDWATER: AT WHAT DEPTH? N/A
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? 0-6'
LAKE GEORGE WATER SUPPLY
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: 52 ft)
✓ PERCOLATION TEST: RATE IS N/A 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: 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 Bed or other type?
!1 HOLDING TANK SYSTEM Total required capacity? 3,000 Tank size? 1,500 Number of tanks? 2
(in gallons)
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 have read the regulations with r- sect to this application and agree to
abide by th;se andquireme Af the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sanita -'`age Di s sgil :1 0 •' .n codes(BYcueensburv.net
Signure e'er oj._ ......,
n Responsible Date VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.net
affriiihrifer) /0 - /Z 7X-tiro7
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: /Z m/pm
742 Bay Rd., Qu-:•sbury, NY 12804 Inspector's Initials: ---�
Il S7O
NAME: _ �./ PERMIT NO.: Ar
,i)
INSPECT ON: _1C: =
RECHECK:
Comments and/or diagram
Soil Type: Sand/ Loam/Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft.
Well se,. . '•n distance ft.
• • -r wells: ft.
Well Cas' • Length s'+/ Y N N/A
[150'to ell required NOi
Absorptio Field: Total le • • ft.
Le •th of each tre h ft.
Depth of trenc , ft.
Size of St• e
See•••- Pits: Nu •-r
ze: x
Stone ize:
` Pipingtan Size 4\s°Building ��� - 1• .
Tank to Distributio' :•
Distribution Box to Field Pit <vO , �". �C
Opening Sealed: c
Y N ! 1
End Cap
Iniet/Outiet Pipes&Baffles NManholes 12"or less below grade _N
[provide extension collar if Yes] N
Location/ Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft. < � 124MJ
_.�
Conforms as per Plot Plan Y N
Engineer Report and As-Built —Y_N
ETU Maintena - •ntract Y N
provided
Location of • : rty:
Front Rear -ft Side Right Side Middle Front Middle Rear
System Use Sta :
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Fo.ms\Inspecdon Forms\Septic Inspection Repori`03 29 10.doc
FINISHED LAWN AREA
4" PVC
SDR— 35
MIN. SLOPE
114" PER FOOT
SEAL WITH SINGLE BUYTL
01100= 017'A
LANT AT TONGUE
AND GROOVE JOINT TYP.
LAKE
IPF,
0
EORli! E
I
16
7 -IM
4'-4"
PRECAST CONCRETE EXTENSION
TO GRADE WITH TRAFFIC RATED
CAST IRON MANHOLE COVER
WITH WATERTIGHT INSERT
12"f COVER
MAINTAIN 2" MINIMUM DROP IN INVERTS
BETWEEN INLET & OUTLET PIPES
90-00,
FINISHED LAWN AREA
PRECAST CONCRETE EXTENSION
TO GRADE WITH TRAFFIC RATED
CAST IRON MANHOLE COVER
WITH WATERTIGHT INSERT
EXTERIOR WEATHERPROOF JUNCTION
BOX (IF NECESSARY). SEAL CONDUIT
GAS TIGHT. INSTALL ALARM PANEL IN
HOUSE
12"± COVER
7.1
4" PVC SDR -35 Li
VENT PIPE MAXIMUM LIQUID LEVEL
INSTALL FLOAT SWITCHES TO 0—
OPERATE ALARM PANEL AT
&—
INDICATED LEVELS
6'-0"90% CAPACITY
0— (2700
40-4
80% CAPACITY
WARNINGISHUTGAL) DOWN
50% CAPACITY (2400 GAL)
ALARM ON
Y HIGH LEVEL
VER
(1500 GAL) ALARM ON
HIGH LEVEL
4" P v1 S 0 5� -LA-11
ALARM ON
SEAifB=ZXT9R9XPT
1500 GAL PRECAST CONCRETE
HEAVY DUTY HOLDING TANK
98-0.
(2) - 1500 f%_3%F4L HOLDING TANKS IN SERIES DETAIL
LANDS OF 7-C,
AYERS
j
------ HOLDING TANK SIZING
LAKE ELEVATION TOWN OF QUEENSBURY REQUIRED MINIMUM HOLDING TANK CAPACITY.•
5/18/1 1 3 19.98 2 BEDROOM RESIDENCE — 3000 GAL
—INSTALL (2) 1500 GAL PRECAST CONCRETE HOLDING
-------- --
TANKS IN SERIES
TRAFFIC RATED EXTENSION
TO GRADE ON INLET SIDE OF —POTABLE WATER SUPPLY TO BE EXISTING LAKE GEORGE LAKE
.... .... ....
TANK (TYPICAL ON EACH TANK)
WATER SUPPLY
•
PROPOSED 3000 GAL (2 AT •Z 49 7 —RELAY TO BE INSTALLED ON WATER PUMP CIRCUIT TO SHUT DOWN
1500 GAL) PRECAST CONCRETE 0
HEAVY DUTY HOLDING TANKS 4 9
0 WATER SUPPLY TO HOUSE WHEN ACTIVATED BY WARNING/SHUT DOWN
—35 ALARM ON PANEL
4" PVC SDR
CONNECTOR PIPE
v
0) BETWEEN TANKS
.... ......
•
Cb
.. .... ... ....
0
p
.......... .
---- - ------
A,
i II
.............
. .... .. .. .........
... ....... . ......... ----------
..............
--- --------
CRUSHED
a
IPFT
TONE
ONE STORY WOOD -'7-- Area
P ING I
FRAME MOUSE .21095 9t sq. ft.
--------- .48 Acres
R
_01PF'
. ...... NIZZ
60
T REPUTED LOCATION OF
EXISTING SEPTIC SYSTEM
RESOLUTION APPROVING SANITARY SEWAGE DISPOSAL f 4" PVC SDR -35 VENT
-,E ARECON515T5 OF EXPOSED ROCK LEDGE
i ......... ENTIRE A
VARIANCE FOR THE JULIA L. DEWEY IRREVOCABLE TRUST 0 on.PIPE BETWEEN TANKS
RESOLU`fION NO.: BOH23,2011 \9 AND SOILS 1-2'DEEP OVER ROCK LEDGE. NO AREA
INTRODUCED BY: Mr. Roruda[M.ntesi —35 HOUSE SEWER,
4 PVC SDR
A WITH USABLE SOILS FOR CONVENTIONAL
. ..........
WHO MOVED ITS ADOPTION 114" PER FT. MIN. SLOPE
SECONDED BY: Mr. Anthony Metivier ............. -73 p I ABSORPTION FIELD INSTALLATION 15 AVAILABLE.
WHEREAS, The Julia L. Dewey Irrevocable Trust applied to the Local Board of Health for RETAINWG.: %
a variance from Chapter 136, §136-11, which requires applicants to obtain a variance for holding WALL
Lan" and the applicant wishes to install two (2) 1,500 gallon holding leaks to replace the cun-cm x
septa system on property located at 29 Hickok Lane in the Town ofQueensbury, and
WHEREAS, the Town Clerk's Office published the Notice ofPublicHearing in the Town's
I Q)
Lk
official newspaper and the Local Board of Health conducted a public hearing concerning the
Q)
variance request on Monday, July 25, 2011, and
WHEREAS, the Town Clerk's Office has advised that it duly notified all property owners in
M
within 500 feet of the subject property, cr)
254.
NOW, THEREFORE, BE IT
o
o
RE -SOLVED, that 00 y7
1. due to the nature of variance, the Local Board of Health finds that the variance will J
not be materially detrimental to the purposes and objectives of this Ordinance or other
adjoining properties nor otherwise conflict with the purpose and objectives ofany'lown HOUSE
plan or policy; and
2. the Local Board of Health finds that the granting of The variance is necessary for the
reasonable use of the land and is the minimum varianee which would alleviate the
specific unnecessary hardship found by the Local Board of Health to all= the
LOCATION MAP Ao
applicant; and %—#Ir lil
NTS
BE IT FURTHER, 35,5
,I Board of Health hereby approves the application RESOLVED, that the Locer canon of The Julia LANDS NIF OF
L. Dewey Irrevocable Trust for a variance from the Sewage Disposal Ordinance to allow 0
installation of two (2) 1,500 gallon holding tanks to replace the current septic system on property TOWN OF QUEENSBURY
OEWEY I
situated at 29 Hickok Lane in the Town of'Queersbury bearing Tax Map No.: 22T14 -l-3. BUILDING DEPARTMENT
V Based on our limited examination, compliance
Duly adopted this 251" day of July, 2011, bythefollowinp vote: with our comments shall not be construed as"
indicating the plans and specifications are in TOWN OF QUEENSBURY
AYES: Mr. Strough, Mr. Brewer, Mr. Stec, Mr. Metivier, Mr. Menuesi full compliance with the Building Codes of'
NOES: None New York State, BUILDING A CO
9ES DH�
ABSENT:Nem: SHED Reviewed
Date: 0
SITE LOCATION SITE PLAN IPF
V,
SCALE: I"= I Or N o.
1500 GAL PRECAST CONCRETE
HEAVY DUTY HOLDING TANK
I,kUen, 0,Bliv6 De" Tarn Clerk 01 the Tn,,n of Ueensbury, Warren aunit,
Nen yoik,dohereby cen1[yNut lhave com.paiedtt5wegouig mW
the
0;q.,nal fesol,l*n 11 "111:.1111101111111�1,rlla wed day of
oraBaud I I In di rain I hel, dnl - �_4"l—
rimsame @ a correct — t and Owl Ike
20 �l ,h,ch a qooj�rn as Doesf Ne wbola aiginal %
to date,
IN WITNESS THEREOF. I have hereto set my hand and the SIA of said 0
w4
at Ifoeerstaury, IAay a:]� bt -1 20
SEA SIGNED.
Mr. A P8, A—
Deputy Ti*4 Clerk
10.6 of Oulle"11
HOLDING TANK NOTES
ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK
STATE DEPARTMENT OF HEALTH AND SHALL BE OF PRECAST CONCRETE
AS MANUFACTURED BY UTOPIA ENTERPRISES OR EQUIVALENT.
ALL STRUCTURES SHALL BE PLACED ON FIRM, COMPACT SAND OR
GRAVEL BASE. WHERE EXISTING SOIL CONDITIONS ARE UNSUITABLE,
CRUSHED STONE SHALL BE PLACED AS NECESSARY TO ACHIEVE A
STABLE BASE.
TANK INSTALLED IN TRAFFIC AREAS SHALL BE OF EXTRA HEAVY—DUTY
CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING.
ALL JOINTS MUST BE SEALED WITH WATERTIGHT SEALANT.
ALARM SEQUENCE
ALARM PANEL BY SJE—RHOMBUS® CONTROLS SHALL PROVIDE THE
FOLLOWING MONITORING AND CONTROL FUNCTIONS.
WHEN LEVEL OF TANK REACHES 50% LEVEL, AMBER LIGHT WILL INDICATE
"TANK HIGH LEVEL" ON ALARM PANEL.
WHEN LEVEL OF TANK REACHES 80% LEVEL, RED LIGHT WILL INDICATE
"VERY HIGH LEVEL" ON ALARM PANEL.
WHEN LEVEL OF TANK REACHES 90% LEVEL, BUZZER WILL SOUND AND
RED LIGHT WILL FLASH, INDICATING "TANK SHUTOFF LEVEL" AND RELAY
FOR THE MAIN WATER SUPPLY WILL DISABLE PUMP, DISCONTINUING
WATER SUPPLY TO HOUSE.
SYSTEM WILL RESET AFTER HOLDING TANKS ARE PUMPED DOWN TO
BELOW THE ACTUATION LEVEL OF "HIGH LEVEL" ALARM SWITCHES.
LANDS WF
A YEK5
G, alAa MeS ana1iaq j()'POA19sUr
, , l�G a_ r.e'
E.�n
06 2011 r Irl
,j . WN �7h7'(?U_E_EN_SE3U
BUILDING 9 ronr:Q
MAP REFERENCE:
BASE INFORMATION FROM "MAP OF A TOPOGRAPHIC
SURVEY MADE FOR JULIA L. DEWEY IRREVOCABLE
TRUST" BY VAN DUSEN & STEVES LAND
SURVEYORS OF 169 HAVILAND RD. QUEENSBURY,
NY 12804 AND DATED MAY 18, 2011.
TAX MAP # 22Z 14-1-3
ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED
PROFESSIONAL ENGINEER IS A VIOLATION OF NYS EDUCATION LAW.