2012-224 4 ` TOWN OF QUEENSBURY
742 Bay Road uccnsbu NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120224 Date Issued: Tuesday, May 15, 2012
This is to certify that work requested to be done as shown by Permit Number P20120224
has been completed.
Tax Map Number: 523400-309-009-0002-001-000-0000
Location: 200 LUZERNE Rd
Owner: HOMESTEAD VILLAGE L P
Applicant: HOMESTEAD VILLAGE L P
This structure may be occupied as a:
Septic Alteration Commercial
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the (7/)41A0 ;43k9-'
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: P20120224 Application Number: A20120224
Tax Map No: 523400-309-009-0002-001-000-0000
Permission is hereby granted to: HOMESTEAD VILLAGE L P
For property located at: 200 LUZERNE 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: HOMESTEAD VILLAGE L P
4294 ROUTE 5 Septic Alteration Commercial
CALEDONIA, NY 14423 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2012-224
24 Windsong Drive
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, May 07, 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 a ensbury• M04'.y May 07,2012
f
SIGNED BY 4 for the Town of Queensbury.
Director of Building&Coe Enfo ement
10 Tu ( 2 IC ij. .,fir
Community Development Office lig
= 1AY 0 4 2012
Town of Queensbury • 742 Bay Road • Queensbury, New York •12 04
TOWN 0;= (aULtic&EbI=t
Office Use Only BUILDING & CODES Y
TAX MAP NO._3 bq,q= a_-I PERMIT NO. ia— .A1 PERMIT FEE 1>5
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM P RMIT: A PERMIT MUST BE OBTAINED
BEFORE ORK BEGINS. APPLICATIONtIS SUBJECT TO REVIEW B ORE ISSUANCE OF VALID PE IT.
OWNER: MIS') Q c(i (D ��1 �1 INSTALLER: /(l //Arty GGI
- I�Q,e 1-'(--'
/�C/•
ADDRESS: (1 2 Q L- N RD t/ ADDRESS:_ 0 M.-)X 2---Z—Y/
.- 7', G T
PHONE NOS. 7 9 2 2 (-/‘33 PHONE NOS. 7 96 - O Q( X6-0
LOCATION OF INSTALLATION:40 7--2 Y G-/-,--x-0J-L ,4-dc-,- Z3-2..t C>e
/ RESIDENCE INFORMATION:
NO.OF COMPUTATION
YEAR BUILT X = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINID
1980 or older X 150 = INSTALLED? !V CJ
1981-1991 X 130 = SPA OR HOT TUI {J
1992-present X 110 = INSTALLED? �'
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLINSi STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY _ OTHER_
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WH EPTH?
I DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft)
I 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 Planning Board approved subdivision).
TANK SIZE: 304) GALLON (MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,
spa or whirlpoo tub.
SYSTEM PE: /
ABSORPTION FIELD (WITH NO.2 STONE) Total length/53 ft. Each trench X_ 11
❑SEEPAGE PIT(S) (WITH NO.3 STONE) How many? Size?_
❑ALTERNATIVE SYSTEM Bed or other type?
❑ 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 re. .ations with respect to this application and agree to
a 'de y these an" -quiremen of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
nit Sewag �'� .•: al Or•' ice. / codeso(�.queensburv.net
I. --- �i �' VISIT OUR WEBSITE FOR MORE INFORMATION
fgnature of Pers• Responsible Date www.queensbury.net
Septic Inspection Repo
Office No. (518) 761-8256 Date Ins.- ion r-. .
Queensbury Building &Code Enforcement Arrive: L"AV! f �`�.part: ] X) /pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:/.�
1
NAME: 1-AO ETE)��,1 kcc Pka Z--ZZ�
LOCATION: 2 1 11 I .SPECT ON: 5-I4-1 Z_
RECHECK:
Comments and/or diagram
Soil Type: Sand/ 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 1 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
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] TY N
Location / Separations
Foundation to tank ft.
Foundation to absorption / ft. t,,,,
Separation of Pits / ft.Conforms as per Plot Plan /Y N BUIL1
Engineer Report and As-Built V Y_ N
ETU Maintenance Contract Y_ N
provided
Location of System on Property:
Front R r Left Side Right Side Middle Front Middle Rear
S stem Use Sta s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report03 29 10.doc
113
III��1
ENVIRONMENTAL DESIGN
PARTNERSHIP,LLP
May 14, 2012
Queensbury Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804
Via email john@queensbury.net
Attn: John O'Brien
Re: Homestead Village Mobile Home Park
Lot 24 Windsong
Dear John:
On May 9, 2012 our office representative visited above referenced Homestead Village Mobile
Home Park lot. The purpose of this visit was to observe the installation of the new septic system
designed by EDP dated May 3, 2012.
Based on my review of the plans and observation of the installation it is my opinion that the
installation of the system is in compliance with the intent of the design plans. I would like to
note that the configuration of the septic tank and "D-Box" connection was modified in the field.
I am mailing a revised plan.
Please contact me should you have any questions regarding this system.
Sincerely,
(274,7"01.426.
James E. Mitchell, P.E.
B 1,11
soo Route 146, Clifton Park New York 12065
phone(518)"I I)74.7621. 4,
31-9540
INSPECTION REQUIREMENTS: BORING AND PERCOLATION TEST: •L
ENGINEER OF RECORD TO INSPECT TRENCHES PRIOR TO BACKFILLING. ASSUMED CONDITION BASED ON SITE EVALUATION
0-5' MEDIUM FINE SAND
NO TET NO WATER OR MOTTLING p
I) BASEMAP INFORMATION OBTAINED FROM PUBLICLY AVAILABLE
RESOOU C i ANDu yE'OES NOT REPRESENT AN ACTUAL FIELD PERCOLATION RATE APPROXIMATELY ONE MINUTEINSTR _
NOTE SOIL CONDITIONS TO BE CONFIRMED BY P.E. PRIOR TO BACKFILLING SYSTEM.
NOR TTy SEPTIC DESIGN:
APPLICATION RATE = 1.2 GAL./SF/DAY
OT 24
3 BEDROOMS AT 100 GALLONS/BEDROOM
=300 GALLONS
AS-BUILT USE EXISTING 1000 GALLON SEPTIC TANK
p
DISTRIBUTION
noHrerLUSE 3 LINES AT 50 FT. EACH (SPACED 6 FT. ON—CENTER)
AS-BUILT WYE AND A•PVC SDR-35
(GASKETED BELL)AT IX MIN.
30'-g• AS-BUILT 1,000
GALLON SEPTIC TANK CONSTRUCTION NOTES:
•
I) CONSTRUCTION OF ABSORPTION FACILITIES SHALL NOT OCCUR WHEN THE GROUND IS FROZEN OR
AS-BUILT A•PVC THE SOL MOISTURE CONTENT IS HIGH. IFA FRAGMENT OF SOIL FROM APPROXIMATELY NINE INCHES
Alf SCH 40 AT 2S MIN. MOISTURE CONTENOW THE T ISE CAN TOOEHGH YOR CONSTRUCTION PURPOSES INSTEAD OBVIOUSLY. SOME STHE
ILT OR CLAY
1 t ill 1111.
MUST BE PRESENT FOR A RIBBON TO BE FORMED.
J I 2) TRENCH LOCATIONS AND DEPTHS SHOULD BE MARKED BY STAKES BEFORE TRENCHES ARE
I I I D EXCAVATED. THE NATURAL SURFACE SHALL NOT BE SIGNIFICANTLY DISTURBED. Jr THE SITE IS
I 1 I REGRADED OR SIMILARLY DISTURBED. THE SOL SHALL BE ALLOWED TEl STABILIZE(I.E.,SETTLE
I I I NATURALLY FOR A PERIOD OF AT LEAST SIX MONTHS,INCLUDING AT LEAST ONE FREEZE-THAW
j 1 I CYCLE)AND NEW PERCOLATION AND DEEP HOLE TESTS CONDUCTED. HEAVY EQUIPMENT USE IN THE
I I 1 DESIGNATED ABSORPTION SYSTEM AREA SHOULD BE MINIMIZED TO PREVENT SOL PERMEABILITY
I
I H-
REDUCTIONRNUS TO COMPACTION PLUS POSSIBLE TRENCH CAVE-IN AND DISTRIBUTION PIPE
I 1
6
J J .1) SHALLOWAL A FINAL GRADE CHECK. TRENCH EXCAVATION MAT BEGIN. TRENCH DEPTHSHALL EBED AS
1 1 DESIGN
.45 POSSIBLE.BUT NOT LESS THAN TB INCHES TRENCHES SHALL BE EXCAVATED TO
AS-BUILT ABSORPTION FIELD I I 1W DESIGN DEPTH WITH BOTTOMS PRACTICALLY LEVEL
3 UNES AT 50 FT.EACH i I Teo 4) FOLLOWING EXCA VA ROI. THE TRENCH BOTTOMS SHOULD BE GRADED BY HAND THE BOTTOMS OF
J I
az THE TRENCHES SHOULD BE CHECKED BY A TRANSIT,ENGINEER'S LEVEL.OR CARPENTERS LEVEL TO
I m ASSURE THAT EACH 15 PRACTICALLY LEVEL. TRENCH BOTTOMS AND SIDE WALLS SHOULD BE
1 I IMMEDIATELY RAKED AFTER FINAL GRADING AND AT LEAST SIX INCHES OF AGGREGATE PLACED IN
�L 1 I yp�� THE TRENCHES
1 y B) GRAVITY DISTRIBUTOR PIPE SHALL BE CAREFULLY INSTALLED AT A SLOPE OF 11 TO y�INCH PER
000 FOOT PRESSURE OR DOSED DISTRIBUTOR PIPE SHALL BE INSTALLED LEVEL. GRAPES SHALL BE
DETERMINED BY AN ENGINEER'S LEVEL, TRANSIT OR CARPENTER'S LEVEL AN EASY METHOD OF
MEASURING THE T1 INCA PER FOOT SLOPE FOP DISTRIBUTOR PIPE IS TO TAPE A Y INCH BLOCK TO
ONE END OF A STRAIGHT FOUR FOOT BOARD. BY PLACING THE BLOCKED END LITH THE BLOCK
FACING DOWN ON THE DOWNSTREAM TOP OF THE DISTRIBUTOR PIPE.A CARPENTER'S LEVEL CAN BE
I USED TO DETERMINE THE B.INCH PER FOOT SLOPE. A IV INCH BLOCK SIMILARLY USED WOULD
RESULT IN A X. GI PLR FOOT SLOPE. ANOTHER METHOD USED TO ESTABLISH THE GRADE OF
DISTRIBUTOR PIPETS BY BATTER BOARDS. AGGREGATE SHALL BE INSTALLED IN THE TRENCHES TO
P.INTLL I A DEPTH OF AT LEAST 7N0 INCHES ABOVE THE TOP OF THE DISTRIBUTOR PIPES. ADDITIONAL
LOT I25 LOT 24 I'OT 23 AGGREGATE MAY BE REQUIRED TO BRING THE TOP OF THE AGGREGATE TO WITHIN SIX TO I?INCHES
OF FINAL GRADE.
I I 6) AFTER THE UPPER AGGREGATE IS PLACED IN THE TRENCHES THE GEOTEXTTLE,UNTREATED BUILDING
PAPER.HAY OR STRAW IS TO BE IMMEDIATELY INSTALLED ON THE AGGREGATE AND THE TRENCH
BACKFILLED 111TH EXCAVATED SOK. IF THE TRENCHES CANNOT BE IMMEDIATELY BACKFILLED, THE
TRENCHES SHOULD BE TEMPORARILY COVERED WITH AN IMPER NOUS MATERIAL,SUCH AS TREATED
d Ex BUILDING PAPER TO PREVENT SIDEWALL COLLAPSE AND SILTATION INTO THE AGGREGATE
7) THE EARTH BACKEILL IS TO BE MOUNDED SI KSNILY ABOVE TINE GfE/NAL GROUND LEVEL(I.E..NOT
WI�l DSONG DRI, GRADEC ED) TO ALLOW FOR HEAVY UIP ENT AND ETHE ENTIRE AREAS EQUIP BE
GRADED WITHOUT THE USE OF HEAVY EWIPMENT AND SEEDED N1iTl GRASS NEAW EQUIPMENT
SHALL NOT ENTER RIE ABSORPTION FACILITY AREA OR TIE PROPOSED EXPANSION AREA AFTER THE
412-4"I''' SUBSURFACE SEWAGE TREATMENT SYSTEM HAS BEEN CONSTRUCTED.
CI, giR
T B) A MINIMUM HORIZONTAL SEPARATION OF TO FEET SHOULD EXIST BETWEEN THE HOUSE SEWER AND
,9.�eM ANY WATERLINE. WHERE LINES MUST CROSS, THE WATER SERVICE LINE SHALL BE AT LEAST 12'180W�(P, INCHES B0W THE HOUSE SEWER IF A WATER LINE MUST PASS BELOW THE HOUSE SEWER, THE
m eb I Bli 6 VERTICAL SEPARATION MUST BE AT LEAST IB INCHES
1I > 9) ROOF,FOOTING.GARAGE. CELLAR AND SURFACE WATER DRAINAGE MUST BE EXCLUDED FROM THE
CO e
Yg SYSTEM. WATER SOFTENER. WATER RECHARGE AND BACKWASH WASTES NORMALLY ARE NOT TO GE
iiii i DISCHARGED TO THE SYSTEM UNLESS A SEPARATE SUBSURFACE DISCHARGE TO AN AREA?SC FEET
110
FROM WELLS OR WATER COURSES IS UNAVAILABLE.
I
opPleTRIII
AS-BUILT
SEPTIC DESIGN PREPARED FOR
EXISTING SANITARY STRUCTURES
CESEPTIC TANK SHE SEEPAGE
DEVICES ARE 7
0BECRUSHED IN PLACE
LOT 24 WINDSONG DRI VE
AND FILLED WITH NATIVE MATERIAL.
HOMESTEAD VILLAGE
TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK
NOTE: SCALE: 1" = 20' MAY 3, 2072
MOBILE HOME UNITS TO BE PLACED WITH A MINIMUM 10 FT. HORIZONTAL SEPARATION. ENVIRONMENTAL DESIGN PARTNERSHIP, LLP
THE LOCATION OF THE WATER SERVICE MUST BE VERIFIED BY CONTRACTOR PRIOR TO CONSTRUCTION 900 ROUTE 146 CLIFTON PARK, N.Y. 12065 (518)371-7621
TO CONFIRM PROPER SEPARATION DISTANCE FROM TILE FIELD (MINIMUM 10 FEET) ENGINEERING LANDSCAPE ARCHITECTURE LAND SURVEYING
JAMES E. MITCHELL P.E. 53,337
(A-) ed- re sc.a. I b-1 (100)
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection r-..-- - -..
Queensbury Building &Code Enforcement Arrive: - is • D-.art: 1?.= /pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initi. .
NAME: P.,r NO.: I a-a
LOCATION: c y i1.Jerldse,nq INSPECT ON: 5-9-/a
RECHECK: d
Comments and/or diagram
Soil TYi , � W / Clay
Type of Water: 'unicipal,/f ell Water
Water •e -•. ation distance Z
Well separation distance
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length I 15-C, ft.
Length of each trench = ft.
Depth of trenches "?ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tankL{ `` l�y L_ 17 5--
Tank
Tank to Distribution Box L1 I( rZ P----775—
Distribution
---zj Distribution Box to Field / Pit 4 " c$2-77c-f D 'e _
Opening Sealed: •f N
End Cap . !N
Inlet/Outlet Pipes &Baffles N
Location/ Separations
• Foundation to tank rn trka�t veJ L-rc
Foundation to absorption IC '
Cg-
Separation of Pits
Conforms as per Plot Plan ' Y
Engineer Report and As-Built Y ��� ck
Location of System on Property:
Front Reams . _'+e •is it Side Middle Front Middle Rear
S -u Us- . s:
Approved
Partial 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
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