2015-476 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
CL Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150476 Date Issued: Tuesday, October 13, 2015
This is to certify that work requested to be done as shown by Permit Number P20150476
has been completed.
Tax Map Number: 523400-301-012-0001-018-000-0000
Location: 16 HELEN Dr
Owner: MICHAEL D MANEY
Applicant: MICHAEL D MANEY
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QU NS UR
Issuance of this Certificate of Compliance DOES NOT relieve the �
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: P20150476 ApplicationNumber: A20150476
Tax Map No: 523400-301-012-0001-018-000-0000
Permission is hereby granted to: MICHAEL D MANEY
For property located at: 16 HELEN Dr
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: MICHAEL D MANEY
Septic Alteration Residential
16 HELEN Dr
QUEENSBURY,NY 12804-0000 Total value
Contractor or Builder's Name /Address Electrical Inspection Agency
SANITARY SEWER
GEORGE DRELLOS 792-7257
PO BOX 224
GLENS FALLS NY
Plans&Specifications
BP 2015-476
Residential Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,October 08,2016
(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 Toecnsbp3 y, October 08,2015
SIGNED BY C for the Town of Queensbury.
Director of Building& ode En orcement
SEPTIC DISPOSAL PERMIT
DATE r I 1
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TAX Mar
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LOCATION OFINSTALLAT/ON OF QUEE �"' Ovals:
BUILDING &C C .
APPLICANT Y///// �/�/'w 1 PHONE/E-MAIL
ADDRESS /h �!� !E'4' yQI
INSTALLER/BUILDER: �'NI TA • �✓tC/1 /C�L%�f' / PHONvyE/E-MAIL / lV -S'/�G
ADDRESS: , I9O Z Z j C,-/C-X,- h4/(� /Z-2 '12Z F01
OWNER ///!k P �u NAV P II PHONE/E-MAIL
Address
CONTACT PERSON FOR SUILDINO&CODES COMPLIANCE: �f SCI lC 'S PHONE / 3 /6G
RESIDENCE INFORMATION
Year Built #of bedrooms X Gallons per bedroom =Total Dally Flow
1980 or older Garbage grinder installed —Y X N
1981-1991 3 /1�2 �30 Spa or Hot Tub installed —Y -'N
1992-Present
PARCEL INFORMATION
Topography Fiat rolling _Steep slope _%slope
Soil Nature ,�,Sand _Loam _Clay _Other
Groundwater At what depth? A,0
Bedrock/Impervious Material At what depth? /✓/
Domestic Water Supply Municipal _Well(if well,water supply from any septic system absorption is_ft.)
Percolation Test Rate: / S per minute per inch(test to be completed by licensed engineering/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank Size 0�'� gallons(minimum size 1,000 gallons, add 250 gallons to size for each garbage grinder or spa or hot tub)
System Type Absorption field with#2 stone Total length ft.;Each trench x
Seepage Pit with#3 stone How many: ;size
Alternative System Bed or other type? cza x13 0
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-Buih plan Is received&approved. The Installed system must match the septic system
layout on file-no exceptions.
DEcLARanoN: 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 know by or on behalf of an applicant, shall be void. I have read the regulations
and agree to abide byJttese and all req remg�of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Print Name: C9 X14 e �7J Date: �� - 5 �f
Signature: / Date: /0
Town of Queensbury Building&Codes Septic Disposal Permit July 2014
Mike Manney BP 2015-476
-- ---- -- -- 16 Helen Drive
Residential Septic Alteration
FILE C��Y
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ILL z I HAVE SEEN OR OBSERVED ALL OBJECTS
( j L j'D o SUCH AS HOUSES, WELLS, TREES, FENCES, ETC
5 SHOWN ON THIS DOCUMENT,I HAVE PERSONALLY
p m ME' RED THE DISTA E SET F T ON THIS DIAGRAM.
SIGNATURE DATE
CENTER PROJECT
SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
October 5.2015
Project#219
George Drellos
Sanitary Sewer Service
Queensbury,NY 12804
Re: Proposed Replacement Septic
16 Helen Drive, Queensbury,NY
Dear George:
At your request we have reviewed your proposed replacement septic system design of the
existing 3 bedroom house at 16 Helen Drive, 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 330 GPD and a percolation rate of
1 to 5 minutes, you will need a minimum of 367 sf of absorption area. We recommend using 20
ft wide by 30 ft long absorption bed with 4 - 25 ft long laterals. The absorption system can be
constructed with the existing 1,000 gallon septic tank, new distribution box, and 4 inch diameter
perforated pipe and stone. The replacement absorption bed has been sized to accommodate a
future bedroom.
Please feel free to contact me at 796-2515 if you have any questions and that you for your
assistance with this request.
Sincerely,
7konfas Cvlt6l�
Thomas R. Center Jr, P.E.
Town of Queensbury Building &Code Enforcement
Office No:(518)761-8256
Septic Inspection Report
Inspection request received: J61q I.1
Name: Inspected on: 4j. Loa Y r1E/S
Location: I W 61 Arrive: /
Permit No.: D Inspector's Initial
C ents and/or dia ram
Soil T e: n oa lay i 1.
05
Typ ater: nicip ell Water J— (�
Waterline se stance 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 v
Size: _x AS V, .
Stone Size:
Piping Size Type
Building to tank L4 t I O
Tank to Distribution Box y %, ho V-1
Distribution Box to Field I Pit Lt. IN p L-11 I
Opening Sealed: _Y
End Cap
Inlet/Outlet Pipes&Baffles _
Manholes 12"or less below grade _ _N
[provide extension collar if Yes] _Y_N
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits
Conforms as per Plot Plan _Y)?- N
Engineer Report and As-Built Y_N
ETU Maintenance Contract provided _Y_N
Location of Syst
eme
Front Side ight Side iddle Front Middle Rear
S stem Use St
NJ Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
Septic Inspection Report
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