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2012-439 TOWN OF QUEENSBURY 742 Bay Road,Qucensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20120439 Date Issued: Friday, September 14, 2012 This is to certify that work requested to be done as shown by Permit Number P20120439 has been completed. Tax Map Number: 523400-309-013-0001-048-000-0000 Location: 8 CONNECTICUT Ave Owner: JANE CAMPBELL Applicant: JANE CAMPBELL 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, Variance, or other issues and conditions as a result of approvals by the Director of Building&Code nforcement 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: P20120439 Application Number: A20120439 Tax Map No: 523400-309-013-0001-048-000-0000 Permission is hereby granted to: JANE CAMPBELL For property located at: 8 CONNECTICUT Ave 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. Tyke of Construction Value Owner Address: JANE CAMPBELL Septic Alteration Residential 8 CONNECTICUT Ave Total value QUEENSBURY,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency SANITARY SEWER GEORGE DRELLOS 792-7257 PO BOX 224 GLENS FALLS NY Plans&Specifications 2012-439 Residential Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,September 10,2013 (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 Queensbury; Monday,September 10,2012 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement _r-;:-.__--. Community Development Office — Town of Queensbury • 742 Bay Road • Quet pur(y1\liaork •12804 Office Use Only a C I TAX MAP NO.__3 O -(,[3-1._k/ PERMIT NO. / '7 PERMIT FEE#?-16) •v APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEMERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS PPLICATION IS SUBJECT TO REVIEW : • FORE ISSUANCE OF A ),LID PERMIT. OWNER: j. 1`1 O !Z v__ INSTALLER7 1 LI � � _ ADDRESS: U Q C�T/ G V J ADDRESS: (IP0 9 �',Y` _y 6_F PHONE NOS. )i— 7 9!„/ PHONE NOS._ 7 (Oa-Pc-5-'0 LOCATION OF INSTALLATION: P- C 0 N/LJ . 1/4I RESIDENCE INFORMATION: NO.OF COMPUTATION YEAR BUILT X = TOTAL DAILY FLOW T BED ODMS (Gallons per bedroom) GARBAGE GRIND 1980 or older X 150 = INSTALLED? 1981-1991 X 130 = SPA OR HOT TUB I ,i 1992-present X 110 = INSTALLED? NJ LJ PARCEL INFORMATION: , / i TOPOGRAPHY: FLAT ROLL STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND LOAM____ CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ 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 Planning Board approved subdivision). TANK SIZE: I 0 0 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 ed 'other type? 1 0 'X30 ❑ HOLDING TANK SYSTE otal 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. av read the -•. .tions with respect to this application and agree to i by thes ..al requi •ents of the Town o Qu ensbury QUESTIONS? CALL 761-8256 OR EMAIL itary Se I, D .-.0 �, &lance. codes(a�queensbury.net ig ature of son Responsible Date VISIT OUR WEBSITE FOR MORE INFORMATION www.queensbury.net C (0 S-C-- ) 2 ,2 / TEL Septic Inspection Repo / 2_ OfficeNo. (518) 761-8256 Date Ins ion r-' ' e�!iv y•: , Queensbury Building &Code Enforcement Arrive: L,, \V - ' ' •rt: a •m 742 Bay Rd., Queensbury, NY 12804 Inspector's Initia 7.0110 NAME: C44r"‘ l �/ Pre MIT NO.: LOCATION: 55 (-cam AC.C_1-- c-iii i I of , ,',SPECT ON: MEN RECHECK: Comments and/or diagram Soil Type. a'_ •*. ' ay Type of Water: ' • cipal 'ell Water Wate - - •aration distance \r----) _ 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 i ,k Size: x V Stone Size: Piping Size Type Building to tank L.1, i/L,k *t Tank to Distribution Box /W,' /.,L3`' ` I ^ Distribution Box to Field / Pit c2-rj, v��( Opening Sealed: N End Cap _ N Inlet/Outlet Pipes&Baffles N Manholes 12"or less below grade _ N [provide extension collar if Yes] _Y_ N Location/ Separations Foundation to tank Oa . AS BUILT Foundation to absorption Separation of Pits ft. Conforms as per Plot Plan _ N Engineer Report and As-Built Y_ N ETU Maintenance Contract _Y_ N provided Location of System on Property: Front Rear Left Side Right Side Middle Fro Middle Rear S stem Use S tus: 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 --7,77-97 6---- :at€ ° kr.— :As p`meina '1,, -10; . 0 'a °ma-me Afl8srND2no do N1' OI iima sv Community Development Office v Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 SIDE PROPERTY LINE ,7--z-- --z--L -71 , . ,I �P.1 21 �141ltr. i;-c• L� • a J.`� �, ,;rr uc siud 7'' lues?. OS - �{ �?�:f� rll31 n �r 11 S r �.'ll^ in `S:-.2.1 ( �, � '� :3 J '17 U t .1 �Ir.! ZS I ( '_v IS.'t:l J`r} 5 �� S In (UG( lil1_l �8 (pisC,,, I(.iC I';: 1li @v i9 J!M-? 'AP i • i Af3li I C;;,� FJ A -3S1l: 1( '"' I I 1 I . i (Z I - J) . r} ,-_c"' CC 0 sa 1• 30 I I r 1 1 1 tl 1 . 1 .14, , IS . I I _ _ 3 4 I . 9'j . , _ _.1 1 CENTER PROJECT SERVICES 73 Sheridan Street, Glens Falls, NY 12801 Phone-518-796-2515 August 22, 2012 Project# 163 Dan Drellos Sanitary Sewer Services Luzerne Road Queensbury,NY 12804 Re: Proposed Replacement Septic Campbell Residence—8 Connecticut Ave, Queensbury, NY Dear Dan: At your request we have reviewed your proposed replacement septic system design at the site of the existing 2 bedroom house of at 8 Connecticut Avenue in Queensbury. As per our conversation the residence has an existing failing 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 220 GPD and a percolation rate of 1 to 5 minutes, you will need 232 square feet of absorptive area. We recommend using a 10 ft wide by 30 ft long absorption bed with 3 — 25 foot long laterals, which will provide 300 sf of absorptive area. The absorption bed will be constructed with a new 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. Community Development Office Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 SIDE PROPERTY LINE 3/iPti r idp, 7y9sPida( OsE sr�cLIT LiC L; . [n Co •AIN �t. aa �a r;a} s `s i�� `vCi :i1� ,I r i.s �s41.:u '' t/ • :rteI'aNl�1 � w cO• j------- —e w a IC1.2 a 3*� w - r '