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TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150296 Application Number: A20150296
Tax Map No: 523400-239-016-0001-018-000-0000
Permission is hereby granted to: WILLIAM & MARY ANN GREEN
For property located at: 24 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: WILLIAM& MARY ANN GREEN
38 FORT AMHERST Rd Septic Alteration Residential
QUEENSBURY NY 12804-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
BP 2015-296
Residential Septic Alteration Year 1920 camp - 4 bedrooms
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 09,2016
(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�Jdate.
Dated at the To of Q nsb ;/( L,��ay,July 09,2015
SIGNED BY Q for the Town of Queensbury.
Director of Building& Code Enforcement
SEPTIC DISPOSAL APPLICATION Office Use Only
Received
DATE: LEM ac, .O15 Tax Map ID
Permit No. IS-�
TAX MAP ID: 39. i�o — I - l g
Permit Fee 40 .
ZONE:
APPLICANT � (l Lm (_(Cee() PHONECAtee=hcbcd-0
/E-MAIL Ce(Q: a�,p-0 35/ it
ADDRESS � 8Ll.rvit lrtcl� •ROcc41- /A)(7) I a0O'j
INSTALLER/ PHONE/E-MAIL V
BUILDER
OWNER 0;I Il col-, L. 6rieen
ADDRESS 3 eel\S , /v. ! ,go4
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: /„,-\_)l't(1(r rr� �reev-
PHONE/E-MAIL
RESIDENCE INFORMATION
Year Built lc( #of bedrooms X gallons per bedroom =total Daily flow
1980 or older X i-I- Garbage grinder installed _Yes No
1981-1991 Spa or Hot Tub installed _Yes No
1992-Present
PARCEL INFORMATION
Topography Flat rolling Steep slope %Slope
Soil Nature Sand Loam Clay Other
Groundwater At what depth:
Bedrock/Impervious material At what depth:
Domestic Water Supply Municipal II • ,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 /457 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: ze • /
Alternative System Bed or other type: /J (/) )
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 QueensburyrSanitary Sewage Disposal Ordinance.
PRINT NAME: WILLIAM L G 1 E L IJ DATE: `Ifs'/S
SIGNATURE: • j tr74-, .G DATE: 7/ /�S
Town of Queensbury Building&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: t2F C Inspected on:
Location: 7—LA RR C>E-E RS�! Arrive: U m.1 .mom}.
Permit No.: Inspector's Initials:
Com n andlor diagram
Soil Type: Sand 1 Loam 1 Clay
Type of Water: Municipal I Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50'+! _Y N_NIA
1150'to well required if No]
Absorption Field: Total length ft. - U LT
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 I 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 �4-
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits I ft.
Conforms as per Plot Plan _N
Engineer Report and As-Built I VY_N
ETU Maintenance Contract provided j —Y N
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Stat :
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report
C) ENGINEERING PLLC
July 1, 2016 inr
Town of Queensbury
Attn: Mr. John O'Brien, Codes
742 Bay Road
Queensbury, New York 12804
www.jkobrien93@yahoo.com
Re: Onsite Wastewater Treatment System Installation
Green Cottage �.
24 Burnt Ridge Road i LT
Queensbury, New York 12804
Town of Queensbury
Dear Mr. O'Brien:
The undersigned completed final observation of the above-referenced onsite wastewater
treatment system on July 1, 2016. Construction observation was completed during the
construction phase. The installation was completed in substantial conformance with the
intent of the design drawings dated July 1, 2015.
Do not hesitate to contact me at(315)254-6891 if you have any questions.
Since' ;
Eric E. Murdock, P.E.
cc: Mr. Bill Green, Owner
P.O. Box 1265, Syracuse, New York 13217 • Phone (315) 254-6891
www.onsite-engineering.us
SALES & SERVICE, LLC
FUSION INSPECTION&. MAINTENANCE AGREEMENT
Property Location: 24 Burnt Ridge Road, Queensbury,New York, 12804
Owners Name: Bill Green
Address:
Phone Number: (518)260-0354
Term: 2 Years; 7/13/16—7/13/18
FUSION SERVICE PROGRAM—AGREEMENT TERM
Clarus Environmental, Inc. (Glarus) the manufacture of the Fusion treatment unit recommends the Fusion be
maintained every 6 months by a Clarus trained service provider. This Fusion Inspection & Maintenance Agreement
(AGREEMENT) is between the owner and Onsite Sales& Service, LLC. (OSS). Two years of scheduled maintenance
is included in the purchase of the Fusion. After this two year term expires, the Fusion owner must subscribe to the
inspection and maintenance program.
SCOPE OF SERVICES
OSS will perform the maintenance and inspection steps outlined in the Clarus document entitled "Owners Manual"
(document number CL0056). Inspection and maintenance of the Fusion will be conducted every 6 months at the
above-referenced address during the term of this Fusion Maintenance and Inspection Agreement. This Agreement
includes 4 visits to the site. Field data will be collected and the system will be adjusted. A Maintenance Service
Report(Document Number FM2418)will be competed as needed. Completed inspection checklist will be provided to
the owner and the applicable regulatory agency as requested. Applicable regulatory entity may be notified if the
agreement is terminated at any time, regardless of the reason.
ADDITIONAL SERVICES
The owner will be notified of outstanding conditions that need to be addressed that are not included in the scope of this
Agreement. These items may include replacement of parts, laboratory testing, pumping out accumulated foam/sludge
or site grading. The cost associated with additional items is not included in this Agreement.
Property owner agrees to operate the unit in accordance with the manufactures recommendations as presented in the
Owner's Manual. The undersigned agrees to the terms of this Inspection & Maintenance Agreement.
xtp
O er
P.O. Box 6265, Syracuse, New York 1321 7 Phone (315) 254-6891 . eric@onsite-engineering.us
"7 4
24 Bunt Ridge Rd
SITE LOCATION MAP
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TOVWOF' OUEENSBURY
BUILDING & CODES
SITE MAP
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Date:
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INDEX OF DRAWINGS
FIGURE 1 — SITE LOCATION MAP & DRAWINGS INDEX
FIGURE 2 — REPLACEMENT ONSITE WASTEWATER TREATMENT SYSTEM
FIGURE 3 — SELECTED DETAILS
FIGURE 4 — SYSTEM SPECIFICATIONS & GENERAL NOTES
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FILE
IDATE '
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TALL FUSION ZF450 UNIT
SPECS & DETAILS
IGHT
FECTION UNIT
SPECS & DETAILS
PROPERTY LINE
AS PER SURVEY TYP.
ONSITE WASTEWATER TREATMENT SYSTEM PLAN
1" = 30'-0"
BASIS OF DESIGN
THIS PLAN INCLUDES INFORMATION PERTAINING TO REPLACING AN
EXISTING METAL SEPTIC TANK WITH AN ENHANCED TREATMENT UNIT
AT AN EXISTING 4 BEDROOM COTTAGE. 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. EFFLUENT FROM THE FUSION WILL FLOW BY
GRAVITY THROUGH AN ULTRAVIOLET LIGHT AND CONTINUE TO
EXISTING DRY WELL.
BASIS OF DESIGN: DESIGN FLOW 110 GALLONS PER BEDROOM X 4
BEDROOMS = 440 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.
SCALE: V= 30'
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EEM2015-034
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iNOTES
1) DIMENSIONS Y AND 'E' ARE TO THE BOTTOM OF THE INLET/OUTLET PIPE.
2) THE OVERALL HEIGHT DIMENSION 'H' IS TO THE TOP OF THE NARROW
ADAPTER RING, NOT THE RISER UD.
3) A RISER COVER COMES STANDARD. ADDITIONAL RISERS ARE
PURCHASED SFPERATELY.
EXCAVATING DIMENSIONS
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FUSION 450
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FUSION 450 - DIMENSIONS & EXCAVATION DETAILS
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FUSION 450 - TYPICAL PROFILE
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FUSION TREATMENT UNIT
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FUSION 450 - AIR PUMP DETAILS
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FILE NUMBER
EEM2015-034
DATE
07-01-2015
ou
GRADE
ELECTRICAL IUNCTION BOX
ia II I 1 406 SCHD 40 RISER
iffifil IIS
4"0 SCHD 40 TYP.
M IIII \—
CHAMBER
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UV LIGHT DISINFECTION UNIT DETAIL
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SYSTEM SPECIFICATIONS
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 INTERRUPTER (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 A
CLARUS MODEL 5250-0004 ULTRA VIOLET LIGHT DISINFECTION UNIT. INSTALL THE ULTRA
VIOLETJICtiZ_DISINFECTION UNIT IN ACCORDANCE WITH THE MANUFACTURES WRITTEN
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GENERAL CONSTRUCTION NOTES
ALL ELECTRICAL WORK SHALL BE COMPLETED BY A QUALIFIED ELECTRICIAN IN COMPLIANCE WITH
THE NATIONAL ELECTRIC CODE, STATE CODE, AND LOCAL CODES.
NO ROOF DRAINS, FOOTING DRAINS, OR WATER SOFTENING BACKWASH SHALL BE CONNECTED TO
THE SYSTEM.
ANY CURTAIN DRAINS MUST BE 15 FEET FROM THE DISPERSAL FIELD.
LANDSCAPE - INSTALLER SHALL, TO THE EXTENT PRACTICAL, LIMIT DISTURBANCE TO THE
EXISTING VEGETATION INCLUDING MATURE TREES. SOME TREE REMOVAL MAY BE NECESSARY
HOWEVER, NO TREES SHALL BE REMOVED WITHOUT THE OWNER'S EXPLICIT CONSENT. ALL
AREAS DISTURBED BY THIS CONSTRUCTION SHALL BE COVERED WITH A MINIMUM OF 4 -INCHES
OF TOPSOIL AND PROPERLY SEEDED TO GRASS AND MULCHED.
SETTLING OF FINISHED LANDSCAPING IS LIKELY TO OCCUR AND MAY REQUIRE REGRADING IN A
YEAR.
SILT FENCE AND STRAW BALES SHALL BE INSTALLED AS NEEDED TO PREVENT SOIL FROM
WASHING OFF-SITE.
THE CONTRACTOR SHALL CALL DIG SAFELY NEW YORK (1-800-962-7962) AND HAVE THE
PROPERTY 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 AS NEEDED AT THE DISCRETION OF THE OWTS INSTALLER.
MAINTENANCE SHALL BE PERFORMED BY ONSITE SALES & SERVICE, LLC. IN ACCORDANCE WITH
THE EQUIPMENT MANUFACTURES RECOMMENDATIONS OUTLINED IN THE HOMEOWNER'S MANUAL
(CLARUS DOCUMENT CL0056, DATED 2012). ONSITE SALES & SERVICE, LLC. HAS BEEN TRAINED
TO PERFORM INSTALLATION, OPERATION & MAINTENANCE BY THE EQUIPMENT MANUFACTURE
AND IS AN AUTHORIZED SERVICE PROVIDER.
ALL SYSTEM COMPONENTS SHALL BE INSTALLED, OPERATED, AND MAINTAINED IN ACCORDANCE
WITH EQUIPMENT MANUFACTURES RECOMMENDATIONS, DESIGN DRAWINGS, AND ALL STATE AND
LOCAL REGULATIONS.
CONSTRUCTION SHALL BE UNDER THE SUPERVISION OF THE PROFESSIONAL ENGINEER
CERTIFYING THAT THE SYSTEM WAS INSTALLED IN SUBSTANTIAL ACCORDANCE WITH THE
APPROVED DOCUMENTS.
NO GUARANTEE AS TO THE FUNCTIONALITY OR LIFE EXPECTANCY OF THE OWTS IS WARRANTED
OR IMPLIED BY THE ENGINEER.
THIS SEPTIC SYSTEM IS DESIGNED FOR USE WITH BIODEGRADABLE PRODUCTS ONLY. USE OF
ANY OTHER PRODUCTS MAY CAUSE PREMATURE FAILURE.
CORRECTING MATERIAL/PRODUCT DEFICIENCIES IS THE RESPONSIBILITY OF THE
MANUFACTURE/SUPPLIER. WORKMANSHIP IS THE RESPONSIBILITY OF THE INSTALLER. THE
UNDERSIGNED ENGINEER DOES NOT GUARANTEE OR WARRANTEE EITHER OF THE ABOVE.
THE ENTIRE WASTEWATER TREATMENT SYSTEM INCLUDING TANKS, PIPING, RISERS, COMPONENTS,
AND LIDS SHALL BE INSTALLED WATER -TIGHT. THE SYSTEM MAY BE TESTED FOR WATER
TIGHTNESS. CONTRACTOR WILL RE -INSTALL ANY EQUIPMENT/COMPONENT THAT IS NOT FOUND
TO BE WATER TIGHT. TANKS SHALL BE INSTALLED AS NEEDED (TO BE DETERMINED BY THE
INSTALLER) TO RESIST BUOYANCY.
SPECIFIED EQUIPMENT AND MATERIALS MAY BE REPLACED WITH ENGINEER -APPROVED
EQUIVALENT EQUIPMENT OR MATERIALS. PROPOSALS FOR PRODUCTS SEEKING
APPROVED -EQUAL STATUS SHALL BE SUBMITTED TO THE ENGINEER FOR REVIEW.
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.
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