BOTH-000178-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000178-2015 Date Issued: Friday, February 5, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000178-2015
has been completed.
Tax Map Number: 308.14-1-52
Location: 183 PITCHER RD
Owner: FOREST PARK MHC,LLC
Applicant: FOREST PARK MHC,LLC
This structure may be occupied as a: Septic alterations for 9& 11 Gregwood Circle
By Order of Town Board
TOWN OF QUEENSBURY
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 12804-5904 (518)761-8201
:--.- Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000178-2015 Be Zo 1S 11 all
Tax Map No: 308.14-1-52
Permission is hereby granted to: FOREST PARK MHC,LLC
For propertylocated at: 183 PITCHER RD R
EVIS E D
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
Owner Address: 183 Pitcher RD Septic Disposal $0.00
Queensbury,NY 12804 Total Value $0.00
Contractor or Builder's Name/Address Electrical Inspection Agency
FOREST PARK MHC,LLC
183 Pitcher RD
Queensbury,NY 12804
Plans&Specifications
Septic alterations for 9&11 Gregwood Circle
PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,October 14,2016
(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 piration da-. /
Dated at the To f Quee ury; I-. •:ay,October 14,2015
If \
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT
Office Use Only
DALE 10/13/15 Received
2 r} Tax Map ID
TAx MAP Io 3O c . I�-I ` 1 - C). Permit No. �A5--Lt cil EO
t iY f j} Permit Fee 1 t V E '
LOCATION OF INSTALLATION �L1 r f S �U/� 1 uyy(� IL,
L c 1�^1 �.? LG U v
Approvals:
L0-t L 9i t1P 1 ! /� +q� y�
APPLICANT 51)1AC �✓t51[1Ut14 110,4 j +^�li PHONE/E MAIL f D- * f �3" T 2015
ADDRESS c L co I , St/1.95 ( 1'( Iz+6 CTOWN OF QUEENSBURY
ii f 1 l BUILDING &CODES
INSTALLEEIMILDER: S i1"1 C S L(1fl l 1 f er✓t 5, LL.C PHONE/E-MAIL Or-c; dr-- : ,,
ADDRESS: q305- kvvAC 5U f 5 cc 6\ 5,kehl55 L t[ /24/6 69
OWNER IZy LI I c t P 5 PHONE/E-MAIL 5( 0(- Tic- 7776 C
Address 1 g'3 f ‘icAle/ RS 1 Qvr-e00)w--j-/ ► l y 1 Zcol
0 (CONTACT P iSON FOR BUILDING&CODES COMPLIANCE; 0f'fn-'1 of C 1C PHONE - 23;?-1,7617
RESIDENCE INFO_R�TIO_N
Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow
1980 or older '"' Garbage grinder installed _Y _N
1981-1991 Spa or Hot Tub installed _Y _N
1992 Present 6 I LQ______ 6 G C)
PARCEL INFORMATION Y
Topography 7( Flat rolling Steep slope %slope
I
Soil Nature Sand Loam Clay Other
Groundwater At what depth? fkra,r
Bedrock/Impervious Material At what depth?_, AOC..
Domestic Water Supply X Municipal 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 engineering 1 architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank Size AOIX) 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 Total length ft.;Each trench, x___51- ______
Seepage
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.
DECL_A ATION: 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 by ese -nd all require. ents oft Town of Queensbury Sanitary Sewage Di pos I Ordinance.
Print Name: _.•a i v N Date: _ /0//,//r
Signature: Date:
Town of Queensbury Building&Codes Septic Disposal Permit July 2014
‹,,NEW YORK Department
TE TFof HalthORTUNIN. �,.
HOWARD A.ZUCKER, M.D.,
ANDREW M. CUOMO
J.D. SALLY DRESLIN, M.S., R.N.
Governor Commissioner Executive Deputy Commissioner
September 18, 2015
Ryan Riper, P.E. FILE COPY
RK Engineering, PLLC
225 Ruggles Road
Saratoga Springs, NY 12866
Re: Forest Park Mobile Home Park, Facility#56-6822,
Town of Queensbury, Warren County
Lots 1, 3, 5, 7, 15, 17, 9, 11, Replacement of
Onsite Wastewater Treatment Systems (OWTS)
Mr. Riper:
The New York State Department of Health Glens Falls District Office has received plans to
install OWTSs for eight (8) lots at the Forest Park Mobile Home Park, located in the Town of
Queensbury, Warren County. NY.
Four systems will serve the following lots:
• Lots#15 and #17 Gregwood Circle
• Lots# 9 and #11 Gregwood Circle
• Lots#1 and # 3 Gregwood Circle
• Lots#5 and # 7 Gregwood Circle
Each home will be provided with a 1000-gallon concrete tank except for#17 which will receive a
1250-gallon tank to allow for a one bedroom expansion. Each pair of adjacent homes will share
an absorption field consisting of 4-55' ADS HANCOR ARC 24 Chambers. This configuration will
be replacing a single 1000-gallon septic tank and dry wells.
The plans are approved with the following conditions:
1. THAT the Engineer obtains required Permits from the Town of Queensbury and
Warren County. and.
2. THAT the Engineer certifies in writing that the systems are installed in conformance
with the plans approved this day, Or,
F:\Forest Park Mobile Home Court\Forest Park MHC OWTS Lots 1-17 Replacement Plans Approval.docx
Empire State Plaza,Corning Tower,Albany,NY 12237 I heatth.ny.gov
3. THAT, upon completion, the Engineer submits certification that all systems are
installed in conformance with provided as-built drawings showing approved changes
to the design.
Two sets of stamped plans are being returned to you, and one set is being retained for our
records.
The purpose of the Department of Health review is to verify compliance with the Design
Handbook (2012) and the State Sanitary Code Part 75-A and in no way guarantees proper
system design, installation or operation. If you have any questions or concerns please contact
me at (518) 793-3893.
in
S cerel
Y,
Michael E. Hallock, P.E.
Public Health Engineer 2
NYS DOH
Glens Falls District Office
77 Mohican St.
Glens Falls, NY 12801
Cc: Anita Gabalski, NYSDOH GFDO
Town of Queensbury Code Enforcement
Maggie Gannon,
Park Place MHC, LLC
31200 Northwestern Pkwy.
Farmington Hills, MI 48334
F:\Forest Park Mobile Home Court\Forest Park MHC OWTS Lots 1-17 Replacement Plans Approval.docx
Empire State Plaza,Corning Tower.Albany.NY 12237+health.ny.gov
PLOT DATE: 2015
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GENERAL NOTES:
DESIGN INFORMATION SOILS INFORMATION: SITE INFORMATION: 1. SEE NOTE SHEET. CALL ENGINEER TO
1k BEDRMS DESIGN FLOW DESIGN PERC, REO'D LENGTH OF PT = PERCOLATION TEST TOPOGRAPHY AT TREATMENT FIELD IS RELATIVELY LEVEL CLARIFY ANY DESIGN DETAILS.
HA11< LATERALS DTP DEEP TEST PIT
TEPERFORMED ON 8-18-15 WITH STONE INDUSTRIES AND NYSDOH DWELLING SUPPLIED WITH MUNICIPAL WATER. 2.USE DIMENSIONS GIVEN: DO NOT
6 660 GAL/DAY 1-5 MPI 275'-257.-=206'
[RESPTR=ESENTATIVE ON SITE.
SCALE DRAWINGS.
0"-12" DARK SANDY TOPSOIL NO ACTIVE NEIGHBORING WELLS NOTED/VISIBLE WITHIN 100' 3,ALL PERMITTING/VARIANCES TO BE
12"-66" TAN/BROWN SAND. SOME ROOTS OF TREATMENT AREA. Ex I F
PROPOSED INSTALLATION: OBTAINED BY CONTRACTOR AND/OR
NO GROUNDWATER OR MOTTLING NOTED
PROPERTY OWNER.
TRENCH SYSTEM WITH ADS HANCOR ARC 24 CHAMBERS DTP #2
TOTAL NUMBER OF LATERALS = 4 0"-8" DARK SANDY TOPSOIL
8"-32" BROWN SAND. ' c! t
LENGTH OF EACH LATERAL = 55-0" 32"-72" LIGHT TAN/BROWN SAND 1 � LOCAIMIN
TOTAL LENGTH OF LATERALS = 220' NO GROUNDWATER OR MOTTLING NOTED L�
PT X11 STABILIZED PERCOLATION RATE: 1:10 MPI N 0 R TI I
PT #2 STABILIZED PERCOLATION RATE: 1:09 MPI •`' t_ r
PER NYSDOH APP. 75—A(FEB 3, 2010); A 25% REDUCTION IN • t g—
TRENCH LENGTH IS ALLOWED WITH USE U OF 7. GALESS CHAMBERS 31STING 5,7,9,11A15,&17LED EPTIC FLOWING TO A ANGLE SEPTICCONSISTS OF CMBINED LOTS
TANK THEN TO DRYWELL(S), PROJECT LOCATION PLAN
WITH 1.6SF/FT OF BOTTOM AREA & VOLUME OF 7.5GAL/FT & OPEN
SIDEWALLS. TABLE 6C OF NYSDOH "GREEN" HANDBOOK. AS PURPORTED. PROPOSED PLAN IS TO PROVIDE EACH 3 BEDROOM LOT WITH
INDIVIDUAL 1000 GALLON SEPTIC TANKS AND A TREATMENT AREA DESIGNED NOT TO SCALE
FOR TWO LOTS WHICH EQUALS 6 BEDROOMS TOTAL LOT 17 IS LARGE AND
DESIGNED FOR A 4 BEDROOM UNIT. THIS DRAWING TO BE REFERENCED WITH
OTHER LOTS NOTED ABOVE.
— It is a violation of NYS education law article 145 for
any person, unless he/she is acting under the
PARKING direction of a licensed professional engineer, to alter
an item in any way. Refer to education law §7209.
LOT #11 EXISTING 3 SOLID 4"0 SCH40 AT "
BEDROOM PER FOOT, AS READ., TYP. LOT INFORMATION:
DWELLING
REMOVE TREE, TAX MAPZE
: 308.14-1 -52
BY OTHERS. SHE TOWN OF QUEENSBURY
I
I LOT SIZE: 48.9 ACRES
4 LATERALS AT 55' EACH. L1 A
•i.: .•• '- .`�-�' `<. >- ��-` •• -.:��- ,: NEW 1000 GALLON CONCRETE
ADS RANCOR ARC 24 CHAMBERS.
SEE DETAILS. �! �� 5' TANK WITH FILTER.SEE DETAILS. APPROVAL STAMP / NOTES
1 :.: f.: ,.: �: .. ., ..::..:...:.....::. .... .:..:.:. INSTALLER TO LOCATE ALL UNDERGROUND
'
6WYE
I UTILITIES PRIOR TO CONSTRUCTION.
LOCATE WATER LINE AND Imo,- -1O'MIN. L4 >: - D-BOX O
MAINTAIN 10' HORIZONTAL N
SEPARATION TO SEPTIC, TYP. NEW 1000 GALLON CONCRETE Ij {, ! F` 03 2016
PARKING TANK WITH FILTER.SEE DETAILS.
�]'� _ z.✓
1
/�+ k sly
� I I iL?
t EXISTING SEPTIC TANK, PUMP ;, ��.
OUT AND FILL IN. DO NOT
G) DISTURB MOBILE HOME
LOT g EXISTING 3 FOUNDATION.
�.
# BEDROOM
® j I DWELLING
® PROJECT: SEPTIC REPLACEMENT DESIGN GRAVELLESS CHAMBER
® FOREST PARK - GREGWOOD CIRCLE
SHED LOT #9 & #11
® I ACTUAL SEPTIC COMPONENT LAYOUT 183 PITCHER ROAD, QUEENSBURY, NY (TOWN OF QUEENSBURY)
MAY VARY.
DRAWING TITLE.
AS—BUILT TIE—IN DIMENSIONS FT OFW
A B C D K . ��� ZE�GI25 ENEERINGPRIPLLC SITE PLAN
SEPTIC SITE PLAN t- �� NGS,NY
r- 518.581.3893 FILE NAME SITE
LO w SCALE 1" = 20'-0"
0 D—BOX 6.2 6.1 � . � W N0. SUBMITTAL / REVISION APP'D. DATE
04 t� DATE SEPTEMBER 2015
L1 BEGIN 6.8 12.5
PLOT PLAN INFORMATION OBTAINED FROM WARREN COUNTY GIS I.,
AND AS PURPORTED BY PROPERTY MANAGER. � � CS A ISSUED FOR REVIEW/APPROVAL RKR s/1/15 REVISION 1
o w L1 END 62,2 63.7 THIS DRAWING DOES NOT REPRESENT A LAND SURVEY AND MUST d 07 50h q$ 1 RECORD DRAWING RKR 10/22/15 SHEET
L4 BEGIN 15.6 8.7 NOT BE CONSTRUED AS SUCH. A ti
�O BSSI � C-001 2
a. a_ L4 END 61.5 61 F o 1 of
PROJECT NOTES:
MOUND TOPSOIL FOR SETTLING. 1. SYSTEM DESIGNED IN ACCORDANCE WITH 2010 NYSDOH APPENDIX 75-A.
6' SEED AND COVER WITH STRAW. DUE TO GRADE CHANGE SEE NYSDOH'S "APPENDIX 75-A, WASTEWATER TREATMENT STANDARDS -
6" BURIAL DEPTH WILL VARY AND SPACING OF INDIVIDUAL HOUSEHOLD SYSTEMS"& "NYSDOH - (GREEN) DESIGN
TYP. ABSORPTION HANDBOOK" FOR ADDITIONAL DESIGN AND INSTALLATION GUIDELINES. NO
MIN. EXCEED 24". INSTALL LATERAL TRENCHES = 6' O.C. GUARANTEE ON SYSTEM PERFORMANCE OR LONGEVITY.
GRAVELLESS NATIVE END VENT >3' DEEP.
EARTH 2. INFORMATION ON THESE DRAWINGS IS FOR SEPTIC SYSTEM DESIGN
CHAMBER I_ PURPOSES ONLY.
BACKFILL III-
1_ I-III- I-1 11-
II_ d I1=11 III-I 1=111- 3. CONSTRUCTION SHALL BE AS SHOWN ON THESE DRAWINGS AND
=1 I7=1 I- - - I=III- ,� - - 1=III II1=I IN ACCORDANCE WITH ALL NYSDOH AND SYSTEM MANUFACTURER'S
I--1 I 1=1 I I-1 I' �11 I I I�11=111=11 I I I I.12 CHAMBER ''1 I I_11'- -_- 1=1I
i I�1 I� 1-
HEIGHT X11-1j1 ONE CHAMBER REQUIREMENTS.
? PROPOSED GRADE, SLOPE TO LONGITUDINAL SECTION 4. ALL WORK MUST COMPLY WITH LOCAL, STATE & FEDERAL SAFETY
2' DRAIN. SEED AND MULCH. REGULATIONS, (NYSDOH, OSHA, NYSDOT). PERMITTING REQUIREMENTS ARE
DO NOT SMEAR SOILS DURING INSTALL LEVEL. REMOVE THE RESPONSIBILITY OF THE OWNER.
EXCAVATION. DEBRIS, RAKE FLOOR & WALLS. 5. HEAVY EQUIPMENT SHALL BE KEPT AWAY FROM THE TREATMENT FIELD.
GROUND WTER, NO VEHICLES ALLOWED ON TREATMENT FIELD.
ABEDROCK OR
IMPERMEABLE STRATA 6. SMEARED TREATMENT AREA FLOORS AND WALLS ARE TO BE RAKED.
It is a violation of NYS education law article 145 for
PER NYSDOH I APP. CHL75-AFEB 3, AL ; A 2N any person, unless he/she is acting under the 7. TREATMENT FIELD SHALL BE GRADED TO SHED RAINFALL AND TO
REDUCTION IN TRENCH LENGTH IS ALLOWED WITH USE OF R n MODEL
GRAVELLESS CHAMBERS WITH 1.6SF/FT OF BOTTOM AREA ADS HANCOR ARC 24 CHAMBER MODEL direction of a licensed professional engineer, to alter DIVERT SURFACE RUNOFF FROM ADJACENT AREAS.
& VOLUME OF 7.5GAL/FT & OPEN SIDEWALLS. an item in any way. Refer to education law §7209.
GRAVELLESS CHAMBER TRENCH TREATMENT SECTION B. RECOMMENDATION: DOWNSLOPE OR SHALLOW WELLS SHOULD HAVE
UV TREATMENT OR CHLORINATION AND FILTRATION SYSTEM INSTALLED.
SCALE: NTS
WELL WATER QUALITY SHOULD BE TESTED PERIODICALLY.
4PRECAST
NK r-T-1---------- 24" DIA 9. INSTALL EFFLUENT FILTER IN SEPTIC TANK, (POLY-LOK PL-122) WITH
C I I I i t A RISER OR EQUAL.
INLET II OUTLET 10. GARBAGE GRINDERS AND WATER TREATMENT SYSTEM SHALL NOT ATTACH
TO SEPTIC. NO SUMP PUMP DISCHARGE ALLOWED. LEAKING FIXTURES WILL
CAUSE FAILURE OF SEPTIC SYSTEM.
INLETOUTLET L-L1-________ PROVIDE EFFLUENT
FILTER. SEE NOTES. APPROVAL STAMP / NOTES
1-1/2"
LOCKABLE INSTALL RISER & EFFLUENT FILTER (POLYLOK PL-122)
TYP
COVCRETE BAFFLE BACKFILL WITH CLEAN
OR EQUAL BAFFLE ON-SITE MATERIAL PLACED (FINISHED GRADE
IN 8 INCH LIFTS AND TAMPED EFFLUENT FILTER S/ TOP SOIL, SEED & MULCH
REMOVABLE COVER rr��.�tx� av nen ��« � WATERPROOF SEAL
COVER
x 12" MIN Z
POLY RISER
INLET INVERT
N U INLET ) OUTLET INVERT OUTLET
INLET — CAULKED 'r `^ CAULKED
-� OUTLET JOINT ?a JOINT
SANITARY QUI SANITARY TEE W/
2" MIN. TEE o 9 uLKHF1�D EFFLUENT FILTER
12" MIN. '0'0 3" MIN
ro ndpPoe
' °°° °�—
1_eCLEAN SAND PEA
4 ��� °�� GRAVEL OR AGGREGATE
o`a oma `�°�'�°a8 TF( =
IiT1rTiT ITL Jiiir i 11 Ill=� (3/4" - 1 1/2")
IF DESIGNED TO USE EXISTING SEPTIC TANK,PUMP OUT AND INSPECT
EXISTING TANK. PROVIDE WRITTEN REPORT TO ENGINEER. SYSTEM COMPONENTS SHALL BE
MAINTAINED. TANKS SHALL BE PUMPED PROJECT: SEPTIC REPLACEMENT DESIGN GRAVELLESS CHAMBER
1. MINIMUM TANK CAPACITY AS FOLLOWS: OUT AND INSPECTED EVERY 2 YEARS FOREST PARK GREGWOOD CIRCLE
1. PIPE JOINTS TO BE SEALED LIQUID TIGHT. - FOR 3 BEDROOMS OR LESS TANK SHALL BE 1,000 GALLONS, WITH OR LESS FOR OPTIMAL PERFORMANCE;
27 S.F. SURFACE AREA.
2. SPEED LEVELING DEVICES SHALL BE USED ON ALL - 4 BEDROOMS SHALL HAVE A 1,250 GALLON TANK WITH 34 S.F. EFFLUENT FILTER (IF INSTALLED) SHALL
OUTLET PIPES. SURFACE AREA BE CHECKED AND CLEANED LOT #9 & #11
- FOR EACH ADDITIONAL BEDROOM ADD 250 GALLONS & 7 S.F. REGULARLY. OTHERWISE PREMATURE
3. SEPTIC TANK TO D-BOX: 4" PVC OR SDR21, LIQUID SURFACE AREA. F A I L U R E C 0 U L D O C C U R . 183 PITCHER ROAD, QUEENSBURY, NY (TOWN OF QUEENSBURY)
TIGHT JOINTS, MIN. SLOPE 1/8" PER FOOT. - FOR HOT TUB/SPA AND/OR GARBAGE GRINDER ADD 250
4. 111E SLOPE OF OUTLET PIPES BETWEEN THE GALLONS TO TANK SIZE FOR EACH. DRAWING TITLE:
DISTRIBUTION BOX AND DISTRIBUTION LATERALS 2. BUILDING TO SEPTIC TANK: 4" PVC SCH. 40 PIPE, LIQUID TIGHT JOINTS, OF M cy
SHOULD BE SLOPED AT LEAST 1/32" PER FOOT MIN. SLOPE 1/4" PER FOOT. K 1'Q t EMG9M1E[ER0M(39 PLLCC DETAILS
AND CONSTRUCTED OF 4" PVC SCH. 40 OR SDR21 225 RUGGLES RD.,SARATOGA SPRINGS,NY
WITH LIQUID TIGHT JOINTS. 3. SEPTIC TANK TO D-BOX OR PUMP TANK: 4" PVC SCH. 40 PIPE OR Gj� �'� f� 518.581.3893 FILE NAME DETAILS
SDR21, LIQUID TIGHT JOINTS, MIN. SLOPE 1/8" PER FOOT.
n 5. USE DOUBLE SIDED STICKING RUBBER BUM FOR
DOSED SYSTEMS. 4. SEPTIC TANK TO CONSTRUCTED PER NYSDOH GUIDUNES. f� 'Jj W SCALE AS NOTED
N I NO. SUBMITTAL / REVISION APP'D. DATE
NEW CONCRETE FOR EACH MOBILE HOME UNIT PROVIDE �, f ° ' DATE SEPTEMBER 2015
w � �' A ISSUED FOR REVIEW/APPROVAL RKR s/1/1s
in W DISTRIBUTION BOX NEW 1000 GAL CONCRETE SEPTIC TANK �d � � w$ 1 RECORD DRAWING RKR 10/22/15 REVISION 1
A 7954
a a SCALE: NONE SCALE: NONE �OFEC-1001.
SSIO2EET
H OF
2