2014-322 TOWN OF QUEENSBURY
fors 742 Bay Road,Quccnsbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140322 Date Issued: Monday, July 28, 2014
This is to certify that work requested to be done as shown by Permit Number P20140322
has been completed.
Tax Map Number: 523400-308-016-0001-047-000-0000
Location: 26 PINEWOOD Rd
Owner: DANIEL & HEIDI PRICE
Applicant: DANIEL & HEIDI PRICE
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 Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
`ON 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
=/� Community Development- Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20140322 Application Number: a20140322
Tax Map No: 523400-308-016-0001-047-000-0000
Permission is hereby granted to: DANIEL& HEIDI PRICE
For property located at: 26 PINEWOOD 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: DANIEL& HEIDI PRICE Septic Alteration Residential
26 PINEWOOD Rd Total Value
QUEENSBURY NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
SANITARY SEWER
GEORGE DRELLOS 792-7257
PO BOX 224
GLENS FALLS NY
Plans&Specifications
2014-322
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,July 22,2015
(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 o .go. ;ensbury• Tue ay July 22,2014
SIGNED BY / - 1 � ' for the Town of Queensbury.
Director of Building&C.r:e En . cement
f n , C '! Office,Use only
Town of Queensbury Building &Codes '—'eiv! /edI II I
Rec :
SEPTIC DISPOSAL PERMIT I JUL 21 2014TaxWAD: (3o . no -1
1 -y 7
I P�itNo.: 111 -34,A.
A permit must be obtained before beginning construction 7 o pc,1 OVVN OF QUEENFERemiit Fee: $
nn D BUILDING&CO )W, provallss:: /
Applicant 714,, / `lee „ Installer/Builder c/�/r�i- ��'e <Jeetove '
Address . rP Pt, ✓Char-,(/ Address PO,- :17-2_ 2-7
Phone: , Phone ift-7?- -7/f /� n
Owner. Location of Installation �-Fi P,arositya-/2
Address:
Phone
Contact Person for Building&Code Compliance: Clef" a brei/S Day Phone: 77�i
1 �i'o
Residence Information: ((//
Year Buift #of Bedrooms x Gallons per bedroom =Total Daily Flow
1980 or older x 150 = Garbage Grinder installed? /VD
• 1981-1991 x 130 = Spa or Hot Tub Installed? /✓U
1992-Present r x 110 = yYo
Parcel Information:
Topography De-Flat Rolling _Steep Slope _%Slope
Soil Nature QSand Loam _Gay _Other
Groundwater At what depth? N✓1
Bedrock/Impervious Material At what depth? N/f
Domestic Water Supply Municipal _Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate- 1- 3- per minute per inch(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 /OPP gallon(minimum size 1,000 gallons),add 250 gallons to size of septic tank for each garbage grinder,spa or whirlpool tub
System Type: Absorption Field(with#2 stone) Total length ft. Each trench Y X ZJ�
Seepage Pit(S)(with#3 stone) How many? Size?
Alternative System_) Bed or other type? Lo.X Joy
Holding Tank System Total required capacity? Tank sae? #of tanks?
NOTE: 1)Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agency-see Certified Electrical form
on Town website; 2) Effective as of March 23, 2006 Septic System-As Built Plot Plan: The Building Department will no longer allow systems to be
covered until such time as an As-Built Plot Plan is received and approved by the Building Inspector. The installed system must match the septic system
layout on file. There will be no exceptions.
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 to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary
Sewage Disposal Ordinance. �/ t�
Print Name: /j�e¢"r -erp, o� Date: /7 -7/
, z/- �/
Signature: 9 �ti°l Zt' Date: / —7/ —1Y
Town of Queensbury Building&Codes Septic Disposal Permit 518-761-8256
Town of Queensbury Building & Code Enforcement `jho W,30
Offide No. (518)761-8256
Septic Inspection Report
Inspection request received:ec
Name: ` .11.t.& Inspected on: — -Agit
Location: a(t7 �hg kT n aa Arrive: I �� ' ' _
Permit No.: / 1 - 3 c k A_ Inspector's Initials:
'omments and/or diagram
Soil Type:. Clay
Type of Wa > I Water
Waterline .. . ion distance ft.
Well separation distance ft.
Other wells' ft.
Well Casing Length 501+/- Y N N/A
[150'to well required if NO]
Absorption Field. Total length ft.
Length of each trench '3. ft. ez --, u32-Wa�
Depth of trenches z.' -3j ft.
Size of Stone 3 —7....._
Seepage Pits Number
Size x
Stone Size.
Piping Size Type
Building to tank y x‘ Q '3 C_.- c .-'s-\51\.t
Tank to Distribution Box ti
1 l3
Distribution Box to Field I Pit VY y 1` ' .5\).5\)��
/flh -35.- TD +�P = S
7 �FQ
Opening Sealed.
End Cap Yom" N Cco?� 2
Inlet/Outlet Pipes&Baffles awl ‘X� ,�T
Manholes 12"or less below grade Y N �� .0%- ����
[provide extension collar if Yes] _ N
Location/Separations
Foundation to tank $45Ti%lit.
Foundation to absorption Z ft.
Separation of Pits ft.
Conforms as per Plot Plan /_N
Engineer Report and As-Built _Y N
ETU Maintenance Contract provided _Y N
Location of S stem on Pr•se :
Front Re. Left Side Right Side Middle Fron Middle Rear
S stem Use Status:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report
CENTER PROJECT 3� -
SERVICES
73 Sheridan Street, Glens Falls, NY 12801 1
Phone-518-796-2515
July 18, 2014
Project# 195
George Drellos
Sanitary Sewer Services
Luzerne Road
Queensbury,NY 12804
Re: Proposed Replacement Septic
Dan Price—26 Pinewood Road, Queensbury, NY
Dear George:
At your request we have reviewed your proposed replacement septic system design of the
existing 4 bedroom house at 26 Pinewood Road 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 440 GPD and a percolation rate of
I to 5 minutes, you will need 488 square feet of absorptive area. We recommend using a 20 ft
wide by 30 ft long absorption bed with 4 — 25 foot long laterals, which will provide 600 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.
TOWN OF QUF2NC3! ,�\ _
BUILDING & GOD" 'E ' 10
Reviewed By,1/ . .
Date: —i p
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DAN. Prr ce
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SEPTIC PLOT PLAN �,{
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I HAVE SEEN OR OBSERVED ALL OBJECTS r 0vit
SUCH AS HOUSES, WELLS, TREES, FENCES, ETC rd
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ON THIS DOCUMENT.I HAVE PERSONALLY vv
toE�EDTHE OISSTANC TFO THIS DIAGRAM. �--"--- —_
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