2015-144 iATOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150144 Date Issued: Monday, July 20, 2015
This is to certify that work requested to be done as shown by Permit Number P20150144
has been completed.
Tax Map Number: 523400-239-016-0001-021-000-0000
Location: 8 BURNT RIDGE Rd
Owner: LENTON & BARBARA SIMMS
Applicant: LENTON & BARBARA SIMMS
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 4
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: P20150144 Application Number: A20150144
Tax Map No: 523400-239-016-0001-021-000-0000
Permission is hereby granted to: LENTON & BARBARA SIMMS
For property located at: 8 BURNT RIDGE Rd
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: LENTON & BARBARA SIMMS
Septic Alteration Residential
8 BURNT RIDGE Rd
LAKE GEORGE,NY 12845 Tota Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-144
Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,May 11,2016
(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 o eens r V '. ay 11, 2015
i
SIGNED BY f \ for the Town of Queensbury.
Director of Building&Code Enforcement
rmrdifrqr-,7771
SEPTIC DISPOSAL APPLIC • -Office Use Only
dei`ed
DATE: `7 i< MAY 0 7 2015 ap ID
TAX MAP ID: 2 .16- ermi, No. 201`x-
TOWN OF QUEENSBURP`ermit Fee V-10 , 06
ZONE: -;'ILDING&CODES
APPLICANT GtJ/ ' D` NS 7/74/vLS, PHONE/E-MAIL S -1e -y0
ADDRESS AioV ,Iii-KEGaie6E/aIscim s@ Rookt/l .
INSTALLER/ Kao Gk / /
1 PHONE/E-MAIL GO/11
BUILDER �-r /' �/ j, //2,04S C A
OWNER Le/J OtJ S eV ii3/7 I"t Sim/4s 511444e t.3 "` e
ADDRESS a S Gar `)
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: LE/UTD S//3// S
PHONE/E-MAIL 5 S6, - 1).-1Z-
RESIDENCE
D7ZRESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older 2- 4°`/?f� Garbage grinder installed Yes No
1981-1991 Spa or Hot Tub installed Yes A/No
1992-Present
PARCEL INFORMATION
t24Q
t
Topography Flat rolling K Steep slope %Slope
Soil Nature Sand Loam Clay Other focj y W/A it pvt
Groundwater At what depth: /VA
Bedrock/Impervious material At what depth: N/(fi
Domestic Water Supply LAXEMunicipal Well(if well,water supply from any septic system absorption is ft.)
�
Percolation Test & " Rate: per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size gallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total length ft.;Each Trench
Seepage Pit with#3 stone How many: ;Size
Alternative System Bed or other type:
Holding Tank System Total required capacity? Tank size #of tanks
Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will
no longer allow systems to be covered until such time as an As-Built plan is received&approved. The installed system must match the
septic system layout on file—no exceptions.
Declaration: Any permit or approval granted which is based upon or is granted in reliance upon any material representation 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 and agree to
abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
PRINT NAME: L i J( a/v J I 41-S DATE: 377)/f
SIGNATURE: C5 142 DATE: S/l//J
Town of Queensbury Build ng&Codes Principal Structure Application Revised September 2014
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received:
Name: :( frt�� Inspected on: lkC®(Cir
Location: RAtAirr Arrive: r =Lim a.m./p.m.
Permit No.: l � (44- Inspector's Initials:
Comments and/or diagram
Soil Type: Sand/Loam/Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft.
Well separation distance
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 1/41.)\/
Seepage Pits: Number
Size: x ey\) 0U-4C411.
StoneSize:
Piping e 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 Pi sm .
Con ..:<:'.s p- *lo lan?-
Engine-
Engine- :-.e- .ndAs-Built Y N
ETU Maintenance Contract provided Y N
Location of S stem on Pro seri :
Front '-a Left Side Right Side Middle Front Middle Rear
S stem Use Sta •
/Appr. -d
''al Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved (.4
Septic Inspection Report
4/i."1"4" L_ J
ENGINEERING PLLC
June 22, 2015
Town of Queensbury
Attn: Mr. David Hatin, Director of Building& Code Enforcement
742 Bay Road
Queensbury, New York 12804
RE: Septic System Installation
Simms Cottage
8 Burnt Ridge Road
Queensbury,New York 12845
Dear Mr. Hatin:
The undersigned completed final observation of the above-referenced onsite wastewater
treatment system on June 12, 2015. Construction observation was completed during the
construction phase. The installation was completed in substantial conformance with the
intent of the design drawings dated April 29, 2015. I have also attached a completed
electrical inspection approval form.
Do not hesitate to contact me at (315)254-6891 if you have any questions.
Sincere ;
Eric E. Murdock, P.E.
cc: Mr. and Mrs. Simms, Owner
P.O. Box 6265, Syracuse, New York 13217 • Phone (315) 254-6891 • eric@onsite-engineering.us
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No. /5 I 44—� " Cert. N2 42932 Cut-in Card No
Owner �-r .ct��.,44..., ',i..5"
X
Location (,1 tQ rk-e 09 6e a
Installation Consisting of..if e foP"f -moi lLJL� (/T0.c,s.
Installed By 0, /91-1-4-"1'e- 4- Lie.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privile e of makin pections at any time, and if its
rules are violated,the
Company shall have the right to ke this tate.
Date SLY ( J INSPECTOR.....
Member N.F.P.A.,I.A.E.I.
Town of Queensbury Building & Code Enforcement --i—rt
Office No. (518) 761-8256 2--4
ii Septic Inspection Report
Inspection request received: (1ti i`7
Name: 5\vv\w\S Inspected on: `a
Location: b pj„w„-,-1' (i--...ccs, Arrive: a.m./p.m.
Permit No.: I7 - \4 Inspector's Initials: AFr��
Comments and/or diagram
Soil Type: Sand/Loam/Clay
Type of Water: Municipal/Well Water AL. 51 r 2 - 1,0, 01 1
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50'+/- Y N N/A SRE1;21"4
[150'to well required if NO]
Absorption Field: Total length _ ft.
Length of each trench ft.
Depth of trenches ft.
1 Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type \/w•.,,c��--\- 4rb
Buildingk o tank 'F'-‘-''F'-‘-' ��1\
Tank to Distribution Box
Distribution Box to Field/Pit t 1 ��
Opening Sealed: Y N (�
End Cap Y N `s ick - 1
Inlet/Outlet Pipes&Baffles _Nc_ `
ciZI (/41)g Manholes 12"or less below grade Y N
[provide extension collar if Yes] Y_N
Location/Separations
Foundation to tank ft. --c(
Foundation to absorption ft. 5a2— g
Separation of Pits ft. I/���
Conforms as per Plot Plan Y N
_-------
Engineer
Engineer Report and As-Built Y N
ETU Maintenance Contract provided Y NLprkeziSA)\— C,e..=
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
S stem Use Status:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report
L
a.flENGINEERU\ GPLLC
r,` $ "t
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To���p N U&CODES
May 1, 2015
Town of Queensbury
Attn: Mr. David Hatin, Director of Building & Code Enforcement
742 Bay Road
Queensbury,New York 12804
RE: Onsite Wastewater Treatment System Design
Simms Cottage
8 Burnt Ridge Road
Queensbury, New York 12845
Dear Mr. Hatin:
Attached please find two copies of the Onsite Wastewater Treatment System (OWTS)
design drawings for 8 Burnt Ridge Road, Queensbury, New York. These drawings
specify the installation of a Clams ZF450 Fusion to replace an existing septic tank. This
treatment unit is an NSF Standard 40 approved Class I system with a daily design flow of
450 gpd.
Please call if you have any questions.
Sincere •
Eric E. Murdock, P.E.
cc: Mr. and Mrs. Simms, Owner
P.O. Box 6265, Syracuse, New York 13217 • Phone (315) 254-6891 • eric@onsite-engineering.us
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EX57ING
2 BEDROOM
CAMP
ONSITE WASTEWATER TREATMENT SYSTEM PLAN
W 0 30 60 100
SCALE: 1" = 30'
BASIS OF DESIGN
THIS PLAN INCLUDES INFORMATION PERTAINING TO
REPLACING AN EXISTING METAL SEPTIC TANK WITH AN
ENHANCED TREATMENT UNIT AT AN EXISTING 2 BEDROOM
COTTAGE. THE COTTAGE IS SEASONAL USE ONLY AND
IS ON THE SAME PARCEL AS THE OWNERS PRIMARY
RESIDENCE. THIS SYSTEM WILL HANDLE ALL THE
WASTEWATER GENERATED AT THE COTTAGE. NO
ADDITIONAL BEDROOMS ARE BEING PROPOSED.
THIS DESIGN SPECIFIES THE INSTALLATION OF A CLARUS
FUSION ZF450 ENHANCED TREATMENT UNIT. THE FUSION
ZF 450 IS AN NSF STANDARD 40 APPROVED CLASS I
SYSTEM WITH A 450 GPD TREATMENT CAPACITY.
GRAVITY FLOW THROUGH THE FUSION CONTINUES TO AN
EXISTING DRY WELL.
DESIGN FLOW 110 GALLONS PER BEDROOM X 2
BEDROOMS = 220 GALLONS PER DAY, NO GARBAGE
GRINDER. NO ADDITIONAL BEDROOMS SHALL BE ADDED.
DRINKING WATER IS SUPPLIED TO THE COTTAGE FROM
LAKE GEORGE. NO ONSITE DRINKING WATER SUPPLY
WELLS ARE KNOWN TO BE LOCATED WITHIN 100' FROM
THE EXISTING SEPTIC SYSTEM.
CONSTRUCTION SHALL BE UNDER THE SUPERVISION OF
THE PROFESSIONAL ENGINEER CERTIFYING THAT THE
SYSTEM WAS INSTALLED IN SUBSTANTIAL ACCORDANCE
WITH THE APPROVED DOCUMENTS. THESE PLANS HAVE
BEEN PREPARED FOR THE USE BY THE CURRENT
PROPERTY OWNER. UNAUTHORIZED ALTERATION OR
ADDITION OF THESE PLANS IS A VIOLATION OF THE NEW
YORK STATE EDUCATION LAW ARTICLE 145, SECTION
7209,
FILE NUMBER
EEM2015-014
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NOTES
1) MOISIONS Y AND V ARE TO THE BOTTOM OF THE HNIET/UURET PPE
2) THE OVERALL HEIGHT DIMENSION -H- IS TO THE TOP OF TIE NAPoNIW
ADAPTER RING, NOT THE RISER UD.
3) A RISER COVER COTES STANDARD. ADDITIONAL RISERS ARE
PURCHASED SEPENAMY.
IXCAVAIFNG D ENSION5
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FUSION 450 - DIMENSIONS & EXCAVATION DETAILS
NTS
FUSION CONTROL PANEL
CLEANOUT
BLOWER
AIR LINES
FUSION 450 - TYPICAL PROFILE
NTS
RISER AND UD
— TO DRAIN FIELD
FUSION TREATMENT UNIT
FUSION 450 - AIR PUMP DETAILS
NTS
TIPM RISER CONRGUPA"
OFDOWL DECORAIAE I= COFIGAWpN
TYPICA NEROR CONFIGURATION
AIR PUMP DETAILS
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FIGURE NO.
3
GENERAL NOTES
INSTALL FUSION ZF 450 AT THE LOCATION SHOWN ON FIGURE
2 IN ACCORDANCE WITH MANUFACTURES WRITTEN
INSTALLATION INSTRUCTIONS FOUND IN CLARUS DOCUMENT
CL0056, DATED 2012. TREATMENT TANK SHALL BE PLACED
ON 6" LAYER OF WASHED BROKEN STONE (1/4 - 1/2 INCH
DIAMETER) LEVELED TO WITHIN 1/8 -INCH SIDE TO SIDE AND
END TO END. TANK EXCAVATION SHALL EXTEND 12-18"
LONGER AND WIDER THAN TANK. FUSION 450 TANK
MEASURES 85'L X 44"W X 62'H. SUITABLE GRANULAR
MATERIAL SHALL BE PLACED ON THE SIDES OF THE FUSION
UNIT TO BRING THE SURROUNDING GROUND TO GRADE.
INSTALL THE FUSION WITH ONE 6 -INCH RISER TO BRING THE
LIDS TO GRADE.
INSTALL ONE DEDICATED 115 VOLT, 20 AMP ISOLATED
ELECTRIC CIRCUIT FROM THE MAIN ELECTRICAL SERVICE TO
FUSION PANEL. INSTALL A GROUND FAULT INTERRUPTOR (GFI)
EXTERIOR OUTLET INSIDE THE RISER WHERE THE COMPRESSOR
IS LOCATED.
FUSION EFFLUENT SHALL BE PIPED THROUGH A 4" DIAMETER
SCHEDULE 40 PVC WITH SOLVENT -WELDED JOINTS, LAID AT
MINIMUM GRADE OF 1/8 INCH PER FOOT INTO AN EXISTING
DRY WELL.
SYSTEM SPECIFICATIONScn
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ALL ELECTRICAL WORK SHALL BE COMPLETED BY A QUALIFIED ELECTRICIAN IN COMPLIANCE WITH THE
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NATIONAL ELECTRIC CODE, STATE CODE, AND LOCAL CODES.
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NO ROOF DRAINS, FOOTING DRAINS, OR WATER SOFTENING BACKWASH SHALL BE CONNECTED TO THE
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SYSTEM.
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ANY CURTAIN DRAINS MUST BE 15 FEET FROM THE DISPERSAL FIELD.
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INSTALLERLANDSCAPE - SHALL, EEXTENT PRACTICAL, LDISTURBANCEOTHE G
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VEGETATION INCLUDNGMATURETREESHSOME TREE REMOVAL MAY BE NECESSARY NOTREES
SHALL BE REMOVED WITHOUT THE OWNER'S EXPLICIT CONSENT, ALL AREAS DISTURBED BY THIS
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CONSTRUCTION SHALL BE COVERED WITH A MINIMUM OF 4 -INCHES OF TOPSOIL AND PROPERLY SEEDED TO
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GRASS AND MULCHED.
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SETTLING OF FINISHED LANDSCAPING IS LIKELY TO OCCUR AND MAY REQUIRE REGRADING IN A YEAR.
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SILT FENCE AND STRAW BALES SHALL BE INSTALLED AS NEEDED TO PREVENT SOIL FROM WASHING
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OFF-SITE.
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THE CONTRACTOR SHALL CALL DIG SAFELY NEW YORK (1-800-962-7962) AND HAVE THE PROPERTY
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OWNER LOCATE ANY ON-SITE UTILITIES PRIOR TO INITIATION OF ANY CONSTRUCTION ACTIVITIES. ANY
UNDERGROUND ELECTRICAL UTILITIES IN THE VICINITY OF THE OWTS DISPERSAL FIELD SHALL BE RELOCATED
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AS NEEDED AT THE DISCRETION OF THE OWTS INSTALLER.
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MAINTENANCE SHALL BE PERFORMED BY ONSITE SALES & SERVICE, LLC. IN ACCORDANCE WITH THE
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EQUIPMENT MANUFACTURES RECOMMENDATIONS OUTLINED IN THE HOMEOWNER'S MANUAL (CLARUS
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DOCUMENT CL0056, DATED 2012). ONSITE SALES & SERVICE, LLC. HAS BEEN TRAINED TO PERFORM
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INSTALLATION, OPERATION Sc MAINTENANCE BY THE EQUIPMENT MANUFACTURE AND IS AN AUTHORIZED
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SERVICE PROVIDER.
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ALL SYSTEM COMPONENTS SHALL BE INSTALLED, OPERATED, AND MAINTAINED IN ACCORDANCE WITH
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EQUIPMENT MANUFACTURES RECOMMENDATIONS, DESIGN DRAWINGS, AND ALL STATE AND LOCAL
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REGULATIONS.
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CONSTRUCTION SHALL BE UNDER THE SUPERVISION OF THE PROFESSIONAL ENGINEER CERTIFYING THAT THE
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SYSTEM WAS INSTALLED IN SUBSTANTIAL ACCORDANCE WITH THE APPROVED DOCUMENTS.
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NO GUARANTEE AS TO THE FUNCTIONALITY OR LIFE EXPECTANCY OF THE OWTS IS WARRANTED OR IMPLIED
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BY THE ENGINEER.
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THIS SEPTIC SYSTEM IS DESIGNED FOR USE WITH BIODEGRADABLE PRODUCTS ONLY, USE OF ANY OTHER
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PRODUCTS MAY CAUSE PREMATURE FAILURE.
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CORRECTING MATERIAL/PRODUCT DEFICIENCIES IS THE RESPONSIBILITY OF THE MANUFACTURE/SUPPLIER.
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WORKMANSHIP IS THE RESPONSIBILITY OF THE INSTALLER. THE UNDERSIGNED ENGINEER DOES NOT
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GUARANTEE
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OR WARRANTEE EITHER OF THE ABOVE.
THE ENTIRE WASTEWATER TREATMENT SYSTEM INCLUDING TANKS, PIPING, RISERS, COMPONENTS, AND LIDS
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SHALL BE INSTALLED WATER -TIGHT. THE SYSTEM MAY BE TESTED FOR WATER TIGHTNESS. CONTRACTOR
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WILL RE -INSTALL ANY EQUIPMENT/COMPONENT THAT IS NOT FOUND TO BE WATER TIGHT. TANKS SHALL
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BE INSTALLED AS NEEDED (TO BE DETERMINED BY THE INSTALLER) TO RESIST BUOYANCY.
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SPECIFIED EQUIPMENT AND MATERIALS MAY BE REPLACED WITH ENGINEER -APPROVED EQUIVALENT
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EQUIPMENT OR MATERIALS. PROPOSALS FOR PRODUCTS SEEKING APPROVED -EQUAL STATUS SHALL BE
FILE
NUMBER
SUBMITTED TO THE ENGINEER FOR REVIEW.
EEM2015-014
THESE PLANS HAVE BEEN PREPARED FOR THE USE BY THE CURRENT PROPERTY OWNER. UNAUTHORIZED
DATE
ALTERATION OR ADDITION OF THESE PLANS IS A VIOLATION OF THE NEW YORK STATE EDUCATION LAW
04-29-2015
FIGURE NO.
ARTICLE 145, SECTION 7209.
4
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