2012-235 0111111016, TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120235 Date Issued: Tuesday, November 13, 2012
This is to certify that work requested to be done as shown by Permit Number P20120235
has been completed.
Tax Map Number: 523400-227-009-0001-014-000-0000
Location: 94 ROCKHURST Rd
Owner: JOAN BETOR WEAVER
Applicant: JOAN BETOR WEAVER
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 •l
property owner of the responsibility for compliance with Site Plan, 7v
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.
1
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120235 Application Number: A20120235
Tax Map No: 523400-227-009-0001-014-000-0000
Permission is hereby granted to: JOAN BETOR WEAVER
For property located at: 94 ROCKHURST 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: JOAN BETOR WEAVER Septic Alteration Residential
38 TERRACE Ct Total Value
BALLSTON LAKE,NY 12019-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans& Specifications
2012-235
Res. Septic alteration
1000 gal tank, PuraFlo BioFiltration System
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, May 14, 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 ury; on. : , i ay 14,2012
4
SIGNED BY C � for the Town of Queensbury.
Director of Building& Code Enforcement
[F1 ' 1 (i 1 1
Community Development Office 2012 , (L)
1!= -
Town of Queensbury • 742 Bay Road • Queensbury, ew York -12804
i ` ;
I Office Use Only y
TAX MAP NO. f�a ). /(� --/—/,/ PERMIT NO. i ca-d 35PERMIT FEE Vo t
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS. yVAPPLICATION`' IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.
OWNER: NK 4 Fi Imo , �Yaz INSSTALLLLEER:.�Q-rep
ADDRESS: 494 etC.114H1.R T 4FA. 7.OADDRESS: 'o CA. ENC�.T�'ALE � WI' ,�9TrCJ
PHONE NOS. CaSCo-- AV5 ZCI PHONE NOS.
LOCATION OF INSTALLATION: CIA' CI'}614T VD
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINDER
1980 or older X 150 = INSTALLED?
1981-1991 X 130 = SPA OR HOT TUB
1992-present 'b X 110 = 350 INSTALLED?
PARCEL INFORMATION: /
✓ TOPOGRAPHY: FLAT ROLLING •/ STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM / CLAY OTHER
•
✓ GROUNDWATER: AT WHAT DEPTH? "i ea
•
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ., (.G
✓ DOMESTIC WATER SUPLY:MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft) % .�
✓ PERCOLATION TEST: RATEIS 1%•• ii. PER MIINUTE PER INCH[mpi] (Test to be completed by a licensed professional GOMM RAE,
engineer or architect) M D e.,,0,,,,+ TE4'T.E
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: to 00 GALLON(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:
0 ABSORPTION FIELD(WITH NO.2 STONE) Total length ft. Each trench X
0 SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size?
ALTERNATIVE SYSTEM Bed or other type? ?V.I .AFL 0 '510'F%r%i—GTILPT. Cly '"{'TS.M
0 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 regulations with respect to this application and agree to
abide by these and all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
nitary Sewage Disposal Ordin e. codes(@queensburv.net
$, 4-`Z VISIT OUR WEBSITE FOR MORE INFORMATION
ature of Person Responsible Date www.queensbury.net
f±)PI )35
RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL
VARIANCE APPLICATION OF FIRM AND JOAN WEAVER
RESOLUTION NO.: BOH 3, 2012
INTRODUCED BY: Mr. Tim Brewer
WHO MOVED ITS ADOPTION
SECONDED BY: Mr.John Strough
WHEREAS, the Queensbury Town Board serves as the Town's Local Board of Health and
is authorized by Town Code Chapter 136 to issue variances from the Town's On-Site Sewage
Disposal Ordinance, and
WHEREAS, Firm and Joan Weaver have applied to the Local Board of Health for variances
from Chapter 136 to install a replacement wastewater system as follows:
1. Absorption field to be 50' from Lake George instead of the required 100' setback;
2. Septic tank and pump tank/force main to be 4' from the dwelling instead of the
required 10' setback;
3. Absorption field/peat modules to be 4' from the property line instead of the required
10' setback; and
4. Absorption field to be 11' from the dwelling instead of the required 20'setback;
on property located at 94 Rockhurst Road, Queensbury,
NOW,THEREFORE,BE IT
RESOLVED, that the Town of Queensbury's Local Board of Health will hold a public
hearing on Monday, March 19th, 2012 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay
Road, Queensbury, to consider Firm and Joan Weaver's sewage disposal variance application
concerning property located at 94 Rockhurst Road, Queensbury (Tax Map No.: 227.9-1-14) and at
that time all interested persons will be heard, and
BE IT FURTHER,
RESOLVED, that the Local Board of Health authorizes and directs the Queensbury Town
Clerk to publish the Notice of Public Hearing presented at this meeting and send a copy of the
Notice to neighbors located within 500' of Mr. and Mrs. Weaver's property as required by law.
Duly adopted this 5th day of March, 2012,by the following vote:
AYES: Mr. Strough,Mr. Brewer,Mr. Stec,Mr. Metivier
NOES: None
ABSENT: Mr. Montesi
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No. Cert. N2 20403
Cut-in Card No
Owner
f r 1.(J
Location L / &oc1 /4-Lt r ee&--t pyo ESC c
Installation Con isting of - - l�r.(.�� P&4u PS ` - 670
1-p f v C)
Installed By 6-, L° 2 Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making ins. tions at any time, and if its
rules are violated,the Company shall have the right to rev this cete.,//�
Date // /�� INSPECTOR
Member N.F.P.A.,I.A.E.I.
o Iplllllllllll
mor,,,,IIIIIIIIIIIII
ENVIRONMENTAL DESIGN
PARTNERSHIP, LLP
November 7, 2012
Town of Queensbury Building Dept.
742 Bay Road
Queensbury,NY 12804
Attn: Dave Hatin
Re: Weaver-94 Rockhurst Road
Septic Disposal System
Dear Dave:
In compliance with application approvals granted by the Town of Queensbury I offer the following
regarding the referenced project.
The design plan reviewed and approved by the Town as associated with the wastewater system
application is as follows:
• Proposed Wastewater System Improvements For Firm&Joan Weaver
94 Rockhurst Road May 10, 2012
o Sheet 1 of 2 Site Plan with Wastewater System Improvements
o Sheet 2 of 2 Design Details and Notes
During the course of construction I was on the job site to observe key components of the system
installation by Crandall Excavating. It should be noted that the system has been installed at the location
as indicated on the design plan although the piping connections from the Puraflo modules to the
absorption bed have been direct connected to the lateral piping, eliminating the D-box. This revision is
now reflected in the attached `as-built' drawing. All other aspects of the work were constructed as
designed and using the materials as specified. Based on my inspection of the system installation it is my
opinion that the wastewater system is in compliance with the intent of the approved design plan and is
ready for operation.
Please contact me should you require any further information.
Sincerely,
Dennis MacEiroy,PE
Environmental Design Partnership
Attachment
Cc: Firm &Joan Weaver
900 Route 146, Clifton Park, New York 12065 phone (518) 371-7621 -fax (518) 371-9540
SITE LOCATION MAP
SCALE: 1" = 2000'
RECORD NORTH A5 P®
® MAP
REFERENCE No.
APPROXIMATE RELOCATED
RETAINING WALL WITH
STEPS
STONE BED AREA
28'X15' (420 SF)
LANDS N/F OF b
MARY EISENBERG
(LAKE WATER SUPPLY)
^.
U,
— - (3) PURAFLO BIOFILTRATION PEAT MODULES
DINSTRIBUIION P)WITH INDrADUAL IPINC TO THE ABSORPTION ®NJ
BED AREA
COVERED
RDAT
OGC'K
J
-S0647 5-0 "-w (TIE LINE) - -83.37 -
It goo"
L
ri 1 1 i 11
o 1 I i O1j FR OEd
1 1 j I I AMP
^ I
1 j `J 1 I
I L
/ G RAGE if' ASFH�LT
DRIVE/PARKING
r
V0-8---0-1-730 "E 83.0
ROCKHURSTJ ROAD
AS—BUILT SEPTIC ,SYSTEM
SCALE: 1" = 20'
WOOD
CRIB
POCK
mm
0-1 l
1000 GALLON
PUMP TANK WITH DUPLEX
PUMP ASSEMBLY
o�
w�
zw
Ampmm
H �
O
0
Uz
z 9r Q
PL�
� a W
n
E..
W =^H
z
WV�
C)
GL, F p W
aN�
L
EWi Z } H
� W�aw Cfj
L L
® `" 400
�, F L6 z
Z
E-{ p" . Q
U) E� CCJ J
W c G
Z
Q z p1 z
U �
a ®- o� �Hz
> -
zoz
a � H E sw 0:
LANDS N F OF
LARRY CLEVELAND 1 I
(43) PURAFLO BIOFlLTfiATJON PEAT MODULI i 1 1
(LAKE WA TER SUPPLY) N )NON -WEEPING) WITH INDIVIDUAL COLLECTION/ ! ( � � I �� , � �1250 GALLON
1250 GALLON
SEPTIC TANK
/
ICO ✓EREO�
/✓OGD
DOAK I
CRIB
I
0
_ (TIE LINE) , 8.3.3; '
APPROXIMATE LOCATION OF
EXISTING TANK ACCESS
APPROXIMATE LOCATION OF
COVERS
EXISTING WASTEWATER SYSTEM
— �—
—
1(0
RETAINING
'vV ILL co
a°tiE
LANDS N/F OF
CAMP
LARRY CLEVELAND
(L4 KE WA TER SUPPL Y)
L ---J
I
i
I
LANDS; N/F OF
o
I
13
MARY EI SENBERG
ASPHALT
o
(LAKE WAITER SUPPLY)
M GARAGE
DRIVE/PARKING
N
Z
N08°01'30"E—
ROOKHURST ROA®
LANDS N/F OF
:EPA TRICK CONNERS
t ;
•'Jl n IA/4 TFP CI /PP/ Y)
o�
w�
zw
Ampmm
H �
O
0
Uz
z 9r Q
PL�
� a W
n
E..
W =^H
z
WV�
C)
GL, F p W
aN�
L
EWi Z } H
� W�aw Cfj
L L
® `" 400
�, F L6 z
Z
E-{ p" . Q
U) E� CCJ J
W c G
Z
Q z p1 z
U �
a ®- o� �Hz
> -
zoz
a � H E sw 0:
LANDS N F OF
LARRY CLEVELAND 1 I
(43) PURAFLO BIOFlLTfiATJON PEAT MODULI i 1 1
(LAKE WA TER SUPPLY) N )NON -WEEPING) WITH INDIVIDUAL COLLECTION/ ! ( � � I �� , � �1250 GALLON
1250 GALLON
SEPTIC TANK
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm part: 4 I�cr–a-m/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: _
NAME: WllPERMIT NO.: `a 3 5
LOCATION: ? ./ INP(`g± Poi INSPECT ON: I.1
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 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:
i
Piping Size Type Building to tank ( 7g )s.J
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: _Y T N
End Cap Y_ N
Inlet/Outlet Pipes&Baffles _Y N �� f 5
Manholes 12"or less below grade _Y N - .�/ 1-3 �^f
[provide extension collar if Yes] Y_ N
regi2(ir
Location/ Separations
Foundation to tank ft.
Foundation to absorption _ft.
Separation of Pits / ft.
Conforms as per Plot Plan u N
Engineer Report and As-Built Y_ N
ETU Maintenance Contract N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
S stem Use Sta .
Appr• -•
-•rtial 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 Report 03 29 10.doc
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/p Depart:9j y zc am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: ' L
NAME: ' t'7 PERMIT NO.:
LOCATION: (-1 A, R rt," INSPECT ON: C
RECHECK:
Comments and/or diagram
Soil Type: Sand/ Loam/ Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft. dA �
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' +/ - Y N N/A
[150'to well required if NO] y
Absorption Field: Total length ft. i�- L -`157(-- -4\/k
_--
Length of each trench ft.
Depth of trenches ft.
Size of Stone C�1' --
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: _Y T N
End Cap N
Inlet/Outlet Pipes&Baffles VY N _
Manholes 12"or less below grade _Y N �h'� `���
[provide extension collar if Yes] Y N
Location/ Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft
Conforms as per Plot Plan 7Y .
Engineer Report and As-Built —Y V N
ETU Maintenance Contract _Y_ N
providedw�JL"�YY� ���3y�,.� �' 1�-►" R-�,
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
stem Us- S . , s:
A
artial A rov nd please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\1nspection Forms\Septic Inspection Report_03 29 10.doc
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm epart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: C.;4 1 `
NAME: \f`IGctNitc` rZ_ PERMIT NO.: 2- Z—2.
LOCATION: .c:14- �:c 5. INSPECT ON: G lan
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 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 "311,--6f?
Size:Size:
Stone Size: A`:.3
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: _Y�._N
End Cap ' N �\� Z
Inlet/Outlet Pipes&Baffles N
Manholes 12"or less below grade VY_ N
[provide extension collar if Yes] _Y_ N
Location / Separations
Foundation to tank ft.
Foundation to absorption ,ft.
Separation of Pits ft.
Conforms as per Plot Plan _Y�. N
Engineer Report and As-Built Y_ N
ETU Maintenance Contract Y_ N
provided
Location of System on Property:
Front Rear Left Sid- Right Side Middle Front Middle Rear
S stem Use Sta s:
A.: . .-:
•artial Approved .nd needs to be re-inspected, please call the Building &Codes Office
11 +... •,-,
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report_03 29 10.doc