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2012-096 TOWN OF QUEENSBURY 742 Ba•Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20120096 Date Issued: Monday, October 21, 2013 This is to certify that work requested to be done as shown by Permit Number P20120096 has been completed. Tax Map Number: 523400-309-015-0001-046-000-0000 Location: 50 CAROLINE St Owner: WALTER BOHLMAN Applicant: WALTER BOI-ILMAN 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 property owner of the responsibility for compliance with Site Plan, �' f(( 7. - Variance, or other issues and conditions as a result of approvals by the Director of Building&Co e Enforcement Planning Board or Zoning Board of Appeals. 0110k TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 431 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20120096 Application Number: A20120096 Tax Map No: 523400-309-015-0001-046-000-0000 Permission is hereby granted to: WALTER BOHLMAN For property located at: 50 CAROLINE St 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: WALTER BOHLMAN Septic Alteration Residential 50 CAROLINE St Total Value QUEENSBURY,NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications septic alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, March 16, 2013 (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 of nsbury; Frid y arch 16,2012 SIGNED BY f` for the Town of Queensbury. Director of Building&Cod Enfoo-ment "ii E .0 E _0, W E n 2 0 Community Development Office Town of Queensbury • 742 Bay Road • Queensbury, New York •128] Office Use Only 5 ---1--'g TOWN OF QUEENSB- Y TAX MAP NO. ©Pit 4P i PERMIT NO. ( r -( /G�CQ PERMIT FFF BUILDING & CODES APPROVALS: ONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS, APPLICATION IS SUBJECT TO REVIEW : FORE ISSUANC OF A VALI% PERMIT. OWNER k C'Z-4Z �V� (t }i INSTALLER: IPi_1%4_.i.r . 0 , . - J J . ,! '' f__ADDRESS: C? Q C �eSSL 2Zt/ _ ADDRESS: J(� ) , (, PHONE NOS. 2-2-2- 7 5S-7 Q PHONE NOS. 7 9( -- 0 P LOCATION OF INSTALLATION: S o OA—pc)C 1 0 RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT X = TOTAL DAILY FLOW BEDROOMS (gallons per bedroom) GARBAGE GRINDER, 1980 or older — X 150 = 145,7 INSTALLED? rJ J 1981 -1991 X 130 = SPA OR HOT TUB t 1992-present X 110 = INSTALLED? 1�'`v PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND / LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHATEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL ✓/_ WELL (If well:water supply from any septic system absorption is: ft) ✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpi] (Test to be completed by a licensed professional engineer or architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a annnning Board approved subdivision). ,4C t4 > L (-)TANK SIZE: CO G LON(MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder, spa or whirlpool tub. SYSTEM TYPE: ❑ ABSORPTION FIELD(WITH NO.2 STONE) Total length ft. Each trench X_ ❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? ,TERNATIVE SYSTEM e,or other type?__ 0 •X 2-S o HOLDING TANK SYSTEM Total required capacity? __Tank size? _Number of tanks? __ NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant,shall be void. I have read the. -•ulations with resect to this application and agree to these'a . : requireme'.:. of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL Sanita Sewa•= l �'osal Or .nce. 1 codes(a�queensburv.net ,)' -- -r%a r ----- — 2 —4 1 i, a_— VISIT OUR WEBSITE FOR MORE INFORMATION •' nat re of P- so 'esponsible D to wvrw.queensburY.net - � I MIM � I I l � I f ■ ■■ I H I I I I I 1 I ■v _l i ■.. I 1 1 1_ I _I _I_ _ ' _I- 1H ■ I l 1 1 ■■■ ■■• p ! 1 1 i 1 1 1 ' .l 1,_) • I-.S 1- • 1 1 ■■W1 I._ _ H I -I ipimml..1 ii I .■■ . 11 I I i 1 1 1 I I I UNII 1 rI I I I I I I I1 1 1 1 ■■■ . 1 1 1 t_, I I I I I I U. 1111■■■■ I I I ■ I I I ■ ■■1 1 1 1 „ mpg■p I 1 1111■ 1111■ 1 1111■■■■■ ■■i I 1111■■1■ ■1111■■■■.■ .1.1 W■■..111111•11 ■■ I 111 •••■■■■■■■■ ' MIR ■■I ■ .1111: C�1 Ocn da. 1 - 3 Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: 3 —/62•-it Queensbury Building &Code Enforcement Arrive: am/pm Depart: 96`l am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: /'6l.( (� NAME: Ct_kI\}-rn1 J•c\QA PERMIT NO.: / c _O �7 6:7 LOCATION: .56 a(, rp I i n Q &t INSPECT ON: -- 19 RECHECK: Comments and/or diagram Soil Type., Sa / Loam / Clay Type of Water: Municipal / Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - Y N N/A Absorption Field: Total length h ft. Length of each trench j- ."71- ft. r Depth of trenches '?. ft. 7 ci 7c� . 1 Size of Stone Seepage Pits: Number Size: . Stone Size: Piping Size Type Building to tank ig.' tkl Tank to Distribution Box 4q- Distribution Box to Field / Pit 2/ Opening Sealed: k/ ' N 4-12*; End Ca v N Inlet/Outlet Pipes&Baffles YN Location/ Separations �� • Foundation to tank cY ft. 1-.1 Foundation to absorption ft. Separation of Pits AI ft. Conforms as per Plot Plan ✓ Y Engineer Report and As-Built Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear S st-i Us- : - pproved_) Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc CENTER PROJECT SERVICES 73 Sheridan Street, Glens Falls,NY 12801 Phone-518-796-2515 March 12, 2012 Project# 151 Dan Drellos Sanitary Sewer Services Luzerne Road Queensbury,NY 12804 Re: Proposed Replacement Septic Bohlman Residence—50 Caroline Street, Queensbury,NY Dear Dan: At your request we have reviewed your proposed replacement septic system design at the site of the existing 3 bedroom house of at 50 Caroline Street 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 450 GPD and a percolation rate of 1 to 5 minutes, you will need 474 square feet of absorptive area. We recommend using a 20 ft wide by 25 ft long absorption bed with 4 — 20 foot long laterals, which will provide 500 sf of absorptive area. The absorption bed can be constructed with the existing 1,000 gallon septic tank, new distribution box, and 4 inch diameter perforated pipe and stone. Please feel free to contact me at 796-2515 if you have any questions and that you for your assistance with this request. Sincerely, air Thomas R. Center Jr, P.E.