2012-338 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: P20120338 Date Issued: Monday, October 21, 2013
This is to certify that work requested to be done as shown by Permit Number P20120338
has been completed.
Tax Map Number: 523400-301-017-0001-029-000-0000
Location: 6 MORGAN Dr
Owner: WILLIAM SEELEY TRUSTEE OF
Applicant: WILLIAM SEELEY TRUSTEE OF
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
Variance, or other issues and conditions as a result of approvals by the Director of Building& ode Enforcement
Planning Board or Zoning Board of Appeals.
i
-rr-.: Community Development Office
..-.s-, 77t'77
— Town of Queensbury • 742 Bay Road • Queensbury, New YorK • izou4
Office Use Only I q
TAX MAP NO. 36 l , I ? I—� / PERMIT NO. 11133 pp'
PERMIT FEE 1 VO..0 0
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS.
NS. APPLICATION IS SUBJECT TO REVIEW B)RE ISSUANCE OF VALID P RMIT.
OWNER:/ LJ CA,(t.c...._ L . JEf L2,7 �2Us( INSTALLER: ri / ! Ai� �r 0z,7 deka e.e_
ADDRESS: 0 2 ,6 : t 2 _ ADDRESS:4 O 33 K �22-'1 6 !-
PHONE NOS. S( I — Q ' ( Z 0 PHONE NOS. 7 96 0 PC-3
/
LOCATION OF INSTALLATION: (O ' ' D-.4.. -F`'�
V RESIDENCE INFORMATION:
NO.OF COMPUTATION
YEAR BUILT X = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) _ GARBAGE GRI R,
1980 or older j X 150 = /(c v INSTALLED? 'J
1981 -1991 X 130 = SPA OR HOT TUB No
1992-present X 110 = INSTALLED?
PARCEL INFORMATION:
/ TOPOGRAPHY: FLAT ROLL G____ STEEP SLOPE %SLOPE
✓ SOIL NATURE: SANDLOAM CLAY OTHER_
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL 1 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 Planning Board app ved subdivision).
% ( fz,-I s r/A/ % I
TANK SIZE:k0Ou `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:
❑ABSORPTION FIELD(WITH NO.2 STONE) Total length_ __ft. Each trench X _
❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size?
ALTERNATIVE SYSTEM Or other type? 2-O' X 2 s
❑ 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•. . ' is with resp ct to this application and agree to
ab'de these .J . irem of the Town 7eQueensbury QUESTIONS? CALL 761-8256 OR EMAIL
S nita Sewa•i �� Or • e. codes(a�queensbury.net
• ---- 1 `• r VISIT OUR WEBSITE FOR MORE INFORMATION
a ure of Person Responsible D to www.queensbury.net
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120338 Application Number: A20120338
Tax Map No: 523400-301-017-0001-029-000-0000
Permission is hereby granted to: WILLIAM SEELEY TRUSTEE OF
For property located at 6 MORGAN Dr
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: WILLIAM SEELEY TRUSTEE OF Septic Alteration Residential
LUCILLE L SEELEY TRUST Total Value
6 MORGAN Dr
QUEENSBURY NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans&Specifications
2012-338
Septic Res. Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 13,2013
(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 Quee sbury Fri. , , / I 13,2012
41
SIGNED BY _ �� kikk for the Town of Queensbury.
Director of Building&Code Enforcement
t. e _sdc JCS ,r\_
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection reque 4 i
Queensbury Building &Code Enforcement Arrive: 1>1h, aeft 'eparE: \'.Z-5 an(�pm�
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: S e c-I e (,•MIT NO.: la-33 E
LOCATION: lQAVo rcr INSPECT ON:
RECHECK:
Comments and/or diagram
Soil Tye_• •• oam / Clay
Type of Wate . Kunicipal Well Water
Water r - separation distance Fc_ . 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 G-+<- a ft.
Depth of trenches z1 , 7_'t ft.
Size of Stone J I Z Fak)E—
SeePOI: Nirmt
C)E_C, Size: x Z5
Stone Size:
Piping Size Type
Building to tank Litt 5L-ti
Tank to Distribution Box (. <<
Distribution Box to Field / Pit ,t--( << PQ_3 5 Tp 1/" ' -F
Opening Sealed: VY N
End Cap --�✓�—N L—�
Inlet/Outlet Pipes &Baffles _ N
Location / Separations
• Foundation to tank _57 ft. r t\-4
Foundation to absorption 7_1> ft. 5' c
Separation of Pits
Conforms as per Plot Plan ✓Y N
Engineer Report and As-Built Y N
Location of System on Property:
Front Re•r Left Side Right Side Middle Front Middle Rear
S stet Us- - .• :
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 06/18/07 L:\Bullding&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
July 11, 2012
Project# 160
Dan Drellos
Sani ry ices
Luzerne Road
Queensbury,NY 12804
•
Re: Proposed Replacement Septic
Seeyle Trust Residence—6 Morgan Dr, 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 6 Morgan Drive 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 500 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,
Thomas R. Center Jr, P.E.
4�
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TOWN OF QUEENSBURY ,.l.
BUILDING & Co71
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