BOTH-000115-2016 W Arn 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-000115-2016 Date Issued: Wednesday, March 15, 2017
This is to certify that work requested to be done as shown by Permit Number BOTH-000115-2016
has been completed.
Tax Map Number: 308.6-1-61
Location: 0 Petrie LN
Owner: SAMUEL WAHNON
Applicant: Queensbury Village
This structure may be occupied as a: Residential Septic Alteration
Shared system for 36&38 Petrie Lane By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the 4t
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.
f TOWN OF QUENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
= Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000115-2016
Tax Map No: 308.6-1-61
Permission is hereby granted to: Queensbury Village
For property located at: 0 Petrie 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
Tyne of Construction
Owner Name: SAMUEL WAHNON Septic Disposal $0.00
Owner Address: 1304 Route 9 Total Value $0.00
Gansevoort,NY 12831
Contractor or Builder's Name/Address Electrical Inspection Agency
Dig A Hole
1304 State Route 9
Gansevoort,NY 12831
Plans&Specifications
Residential Septic Alteration
Shared system for 36&38 Petrie Lane
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,March 4,2017
(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 Town ofeensed say ,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL APPLICATION Office Use Oniy
Received
DA'Z'E: 34 `" tr � .Tax Map ID
ll
TAX MAP ID: r` td 7' errnit No.
ZONE: IV E rmit Fee A
RL
APPLICANTQ ,„P.PGA rQ PHONE/E-MAIL 6 gZd 4
ADDRESS 30 U )r`9 (L)(3��
INSTALLER Ifl�f PHONEE-M¢IL�
BUILDER
OWNER
ADDRESS
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: dUd/V
PHONE/E-MAIL _r{If
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =totaI Daily flow
1980 or older Garbage grinder installed Yes Na
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 1 Impervious material At what depth:
Domestic Water Supply 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 engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION Lj
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 requiremlen�t�s,of the Town o'f"Que.ensbury Sanitary Sewage Disposal Ordinance.
PRINT NAME: DA'Z'E:
SIGNATURE: DATE:
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
GRADE SURFACE
DESIGN DATA, TOWARDS THE SWALE
DESIGN FLOW= 700 GPD FOR TWO UNITS W/THREE BEDROOMS EACH (6 BR TOTAL)
NEW STANDARD FIXTURES, (1.6 GPF&3 GPM MAX.)
AN ELGIN SYSTEM IS PROPOSED AS A SUBSTITUTION TO PREVIOUSLY APPROVED
SEEPAGE PITS
1-5 MINUTE PERCOLATION RATE W/APP RATE OF 1.7 G/SF o
(28) 843 ELGIN MATS REQ'D, (4) ROWS OF 7
8 OUTLET DBOX W/ SPEED LEVELERS
1750 GALL DC TANK
—28 x i7yb e35 EA —
17
m
co
0
I
0
I a ILE COPY
c
10' �
MIN
I I
LOTS ORIGINALLY APPI
CALCULATE ADDITIONAL
AND SIZE SHALLOW SV
2 BRDOUBLE zo CONSTRUCT SWALE RAIN INTENSITY, i=2"f
WIDE MOBILE BETWEEN DOUBLE ADDITIONAL AREA FOR
HOME in WIDE HOMES,GRADE 1960 SF
SURFACE TO SWALE TIME — 1 HR
RUNOFF: 2"X 1960SF
STORAGE CAPACITY OF
70' 70° TIME FOR FULL SWALE
��
L-DT FOR A 12" DEEP SWAL
J( 12' !/
,� APPENDIX 75A SETBACK
n 28' 28' TREATMENT AREA TO PR(
TREATMENT AREA TO RE°
I F SEPTIC TANK TO WATER s
PARKING 24'X20' I� I PARKING 24'X20' I 1�
1 I I �� I { I I
SHUT OFF ��/ SHUTi*�FF
ACCESS ROAD B TOWN OF QBUILDING &Revievved-Bye
PLAN - DOUBLE WIDE LOT Date:
SCALE 1"= 20'
GENERAL NOTES:
1. DESIGN AND ALL WORK FOR TREATMENT SYSTEM
PER NYSHD APPENDIX 75—A
2.ALL ROOF OR HOUSE DISCHARGES SHALL BE
12'-0" DIRECTED AWAY FROM THE TREATMENT AREA.
3. OWNER/CONTRACTOR RESPONSIBLE FOR
ASBUILT SKETCH OF ACTUAL LOCATION OF
SEED TO COMPONENTS.
GRASS 4. PRIOR TO EXCAVATING CONTACT NYS DIGSAFE AT
1-800-962-7962.
5. PERCOLATION RATES TAKEN FROM APPROVED
SEEPAGE PIT DESIGN BY VDS,3--16-93.
7.TREES AND ROOTS SHALL BE REMOVED IN
�IN—SITU SAND TREATMENT AREAS.
8.SEAL UNUSED INLETS OF SEPTIC TANK.
10.ALL COMPONENTS TO BE SET ON A LEVEL 12"
SWALE CROSS SECTION STONE BASE.
2"= 3' 11. D—BOX TO BE B OUTLET W/SPEED LEVELERS,
SCALE: 1/2" CAULK OULTET SEALS.
12.SEPTIC TANK TO BE FM OR EQUAL W/4000 PSI
CONCRETE AND 5-9%ENT.AIR
13.WATER SUPPLY IS MUNICIPAL.
MOUND TOPSOIL TO
ALLOW FOR SETTLEMENT
6-12"TOPSOIL
WHITE
ANTI—SILTATION
FABRIC
843 ELGIN MAT n
IT IS A VIOLATION OF THE LAW FOR ANY PERSON,
o UNLESS ACTING UNDER THE DIRECTION OF THE
I LICENSED ENGINEER,TO ALTER ANY ITEM OR
1N—STN SAND PORTION OF THIS DOCUMENT IN ANY WAY.
THE ENGINEER HAS NOT BEEN RETAINED TO
PERFORM OR PROVIDE INSPECTIONS OR
4"PERFORATED PIPE-1CERTIFICATIONS ASSOCIATED WITH THIS PROJECT.
IF IN THE COURSE OF THIS PROJECT A CONDITION
N—SITU SAND
EXISTS WHICH DISAGREES WITH THAT AS
REPRESENTED ON THESE PLANS.THE CONTRACTOR
SHALL STOP WORK AND NOTIFY THE ENGINEER OR
GROUNDWATER OR IMPERVIOUS LAYER ASSUME ALL RESPONSIBILITY ARISING THEREFROM.
IT IS THE RESPONSIBILITY OF THE
OWNER/CONTRACTOR TO ENSURE THAT ALL
ELGIN DETAIL MATERIAL ORDERED COMPLIES WITH PROJECT
SCALE: 1/2"= 1' REQUIREMENTS.
FOR SINGLE WIDE HOMES,
DOFF FOR DOUBLE WIDE HOMES
IOUR FOR 100 YEAR STORM
WIDE; 980 SF/UNIT X 2 = 5: � CPN e/j, 0
53 CF(100 YR STORM) r #
_E IS 7 SF/FT X 55' 385 CF.
RAIN AT 5 MIN /IN IS 1 HOUR
Arf Eur Q
84062 ��C?
NCES:
en arnera $SIO��'�
Y LINE: 10'
:E: o'
M M low—
a a + RYAN M. BURNS,NYS P.E. LICENSE No.084062
DESTROY PREVIOUSLY DATED DRAWINGS
X �
1 12/14 RB ENG. COMMENTS
• TT+d 1�Ivar i
�! 1;,G 1/ti4 X14 z I {4E NO. DATE BY REVISIONS
AD
�;rp ... "`"'- °''Ty,,1�t"` •-•'°'"` .du algra✓ UPSTATE DESIGN ASSOCIATES
RESIDENTIAL DESIGN AND CML ENGINEERING
RYAN M. BURNS, P.E. IRA S.ADLER, P.E.
t " 180 PLEASANT STREET 10 MADELINE DRIVE
KEE5EVILLE, NY 12944 SARATOGA SPRINGS NY
h�rtmgn #}� P; 518-572-0255 518-573-2549 12866
l7anlelataWn (� Fe waod4 F: 518--536-9058
QUEENSBURY VILLAGE MHP
1fi$ . .w_ ,-_ s neynoli
PROJECT: ELGIN SEPTIC RUNOFF DESIGN +
LOCATION: PETRIE LANE,QUENSBURY NY
LOCATION MAP, SCALE: 1 °' = .3 MILES DATE:
DRN. BY; RMB SHEET NO.
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