2014-138 tr. 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: P20140138 Date Issued: Tuesday, April 29, 2014
This is to certify that work requested to be done as shown by Permit Number P20140138
has been completed.
Tax Map Number: 523400-302-005-0001-043-000-0000
Location: 11 CARLTON Dr
Owner: PIZZUTO FAMILY TRUST
Applicant: PIZZUTO FAMILY TRUST
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QUEENSBURY n
Issuance of this Certificate of Compliance DOES NOT relieve the (- 41.a %//�1.�—
property owner of the responsibility for compliance with Site Plan, ����••/// "�Q4
Variance, or other issues and conditions as a result of approvals by the Director of Building Sc Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
ea,� 742 Bay Road,Queensbury,NY 12804-5902 (5]8)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140138 Application Number: A20140138
Tax Map No: 523400-302-005-0001-043-000-0000
Permission is hereby granted to: PIZZUTO FAMILY TRUST
For property located at: 11 CARLTON 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: PIZZUTO FAMILY TRUST Septic Alteration Residential
11 CARLTON Dr
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
SANITARY'SEWER
GEORGE DRELLOS 792-7257
PO BOX 224
GLENS FALLS NY •
Plans&Specifications
2014-138
Res. Septic Alteration
$40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, April 28,2015
(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 bury• VIo 28,2014
SIGNED BY .' for the Town of Queensbury.
Director of Building& Code Enforcement
t, r
a' Community Development Office ��) _ I'
fP^ ? 4 21114 1, '
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804
Office Use Only II v 11''
TAX MAP NO.30 .c), 5—/— 13 PERMIT NO. /I- '3 B PERMIT FEED
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE W, RK BEGINS.��// APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.
OWNER: I"1 7?t4-A0 77urfr INSTAI I FR: S ril 1 JGo✓tiC j;en?e
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ADDRESS: 1/ 1��� �1i '✓ J)/'!r"C ADDRESS: /� • /70,'000 le-v C/%.✓1 Sal:
/
PHONE NOS. n PHONE NOS. -17 i— 771 - 7" 7
LOCATION OF INSTALLATION: k5 dtL ref
/
r7 RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINDER
1980 or older I X 150 = ys0 INSTALLED? en^,—
1981 -1991 X 130 = SPA OR HOT TU
1992-present X 110 = INSTALLED? 6d
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROWNGL STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? Nill—
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? /t'-11—
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS fr` PER MIINUTE PER INCH[mpg (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: AT" 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 TYV7IE ( I
ABSORPTION FIELD(WITH NO. 2 STONE) Total length lc ft. Each trench ZO X H £IJO Le( \)
CI SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size?
re AALTERNATIVE SYSTEM Bed or other type? a20 )c- LS
❑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
Sani ewag posal0 ' ce. codesnanueensburv.net
V--.2 %/4
VISIT OUR WEBSITE FOR MORE INFORMATION
Signatu of Person Responsible Date www.queensburv.net
Town of Queensbury Building &Code Enforcement ( S P M
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received:
Name: P I Z2/��(J� F� tn�ft —1-r0.24' Inspected on:
Location: cod 4-t,n be Arrive: L w a.m./p.m.
Permit No.: /<-/-/3 g Inspector's Initials:
Comments and/or diagram
Soil Type: id •.m/Clay
Type of Wateruma /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 <1.3e. ft. 2'c5X Zs tc3
Length of each trench ft _ J P — 27
Depth of trenches ft. �/`c5 a�"1
Size of Stone 2 .
Seepage Pits: Number
Size: VILVel
Stone Size:
Piping Size Type
Building to lankAy Iu i`--o
Tank to Distribution Box A"
Distribution
Distribution Box to Field/Pit 'kV
3 c
Opening Sealed:
End Cap /
Inlet/Outlet Pipes&Baffles v/S —N
Manholes 12"or less below grade Y N
[provide extension collar if Yes] Y N
Location/Separations
Foundation to tank r 0 ft. z e 1'-5
Foundation to absorption Z ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built Y N
ETU Maintenance Contract provided Y N
Location of System on Pr perty:
Front Re Left Side Right Side Middle Front Middle Rear
System Use St s:
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
. 1
1 o 5 IS PTIC PLOT PLAN
—
1 I HAVE SEEN OR OBSERVED ALL OBJECTS
SUCH AS HOUSES, WELLS, TREES, FENCES, ETC
i S s.. 2
s, • ,' • SHOWN 06 S DOCUMENT.I HAVE PERSONALLY
MEAS iDIS rSELEORTH 0 AGRAM.
. • SIGNATU-E DATE
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C TOWN OF QUEEN SP? ':r;`,
BUILDING & CUD -0E1
! �` Reviewed By;/ a/ . . t_
�f Elate:
I ,y.
1/ Cfrr'lioN h r 1 ye
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CENTER PROJECT
SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
April 23, 2014
Project# 181
George Drellos
Sanitary Sewer Services
Luzeme Road
Queensbury,NY 12804
Re: Proposed Replacement Septic
Pizzuto Trust— 11 Carleton Drive, Queensbury,NY
Dear George:
At your request we have reviewed your proposed replacement septic system design of the
existing 3 bedroom house at 11 Carleton 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 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 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.
Sinceerrely,
nc
Thomas R. Center Jr,P.E.