2014-332 .� TOWN OF QUEENSBURY
wors 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140332 Date Issued: Monday, July 28, 2014
This is to certify that work requested to be done as shown by Permit Number P20140332
has been completed.
Tax Map Number: 523400-308-016-0001-072-000-0000
Location: 36 MINNESOTA Ave
Owner: EDWARD & CAROLYN HALL
Applicant: EDWARD & CAROLYN HALL
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 gewiP S�property owner of the responsibility for compliance with Site Plan, 1C
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.
SW
� TOWN OF QUEENSBURY
. 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20140332 Application Number: A20140332
Tax Map No: 523400-308-016-0001-072-000-0000
Permission is hereby granted to: EDWARD & CAROLYN HALL
For property located at: 36 MINNESOTA 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. Type of Construction Value
Owner Address: EDWARD & CAROLYN HALL
36 MINNESOTA Ave Septic Alteration Residential
QUEENSBURY,NY 12804 Total varve
Contractor or Builder's Name /Address Electrical Inspection Agency
SANITARY SEWER
GEORGE DRELLOS 792-7257
PO BOX 224
GLENS FALLS NY
Plans&Specifications
2014-332
Res. Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 25,2015
(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 To ofensb ; 9 d:/. , 25,2014
4# 4
SIGNED BY it for the Town of Queensbury.
Director of Building&Code Enforcement •
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ea
Community Development Office
Town of Queensbury • 742 Bay Road • Que'ensb'ury, 'w &k2• 04 u
iktil Y
Office Use Only \,(� T03 QU&CODES i _I
TAX MAP NO.3o 8 .110-1-"M PERMIT NO. i q=3c3o�PERMIT FEE 0 ��
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: �/olt<®/ykid J . / LL INSTALLER SmA �J"'�
ADDRESS: (3' 6 J !//an(->s C)a ADDRESS: l/ m 42r
PHONE NOS. '7?3-1790 PHONE NOS. 3&/ Q 95-a,
LOCATION OF INSTALLATION: 36 /721/Vive SAPS-
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BE ROOMS (Gallons per bedroom) GARBAGE GRiVp R
1980 or older X 150 = Li 60 INSTALLED?Ail
1981 -1991 X 130 = SPA OR HOT T
1992-present i X 110 = INSTALLED?
PARCEL INFORMATION: /
✓ TOPOGRAPHY: FLAT ROLI�NG k STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND V LOAM CLAY OTHER
I GROUNDWATER: AT WHAT DEPTH?
I BEDROCK/IMPERVIOUS MATERIAL: AT WHA DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL L WELL (If well:water supply from any septic system absorption is: ft)
I PERCOLATION TEST: RATE IS 1 "Si. 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).
_
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TANK SIZE:M 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:
o ABSORPTION FIELD (WITH NO. 2 STONE) Total length ft. Each trench X
o SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Size?
flALTERNATIVE SYSTEM Bed or other type? .8 6lti ,QYr2S
❑ 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 haveld 17 regulations with respect to this application and agree to
abi.-.'.y t 4;,..e an. all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
S.•,' ry . a.e aisposal Ordinance. codesaaueensburv.net
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VISIT OUR WEBSITE FOR MORE INFORMATION
gnat of Person Responsible ate www.queensburv.net
Town of Queensbury Building &Code Enforcement DnG�a� Jo —/ a
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received:
Name: [I Inspected on:
Location: Mh 3(-o t n A 33a Inspector's
Permit No.: 19 Inspector's Initials:
ar
r.
• ents and/or dia•ram
Soil Typ . Sand/ Clay F
Type of Wat r Municipal/ ell Water .1 r eaS
Waterline separation distance \0 ft. 3 t0,-095(.0
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 9 ccitibft
Length of each trench PZft.
Depth of trenches 3 ft.
Size of Stone
Seepage Pits: Number
Size' x
Stone Size
Piping Size Type
Building to tank 14 r 1 5L1-‘ LIM
Tank to Distribution Box LA"-
Distribution Box to Field I Pit 4'r ��1 � 1—D at( ?ac--
Opening
cc-Opening Sealed: �/Y fN
End Cap '' ✓ry L-D CW—V)
Inlet/Outlet Pipes&Baffles ✓Y
Manholes 17 or less below grade /1N
[provide extension collar if Yes] N
Location/Separations
Foundation to tank ft.
VpFto absorptionft.
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 Property:
Front Rear Left Side Right Side idd • : i Middle Rear
System Use Sta s:
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
d
CENTER PROJECT P 3 3a
SERVICES
73 Sheridan Street, Glens Falls, NY 12801
Phone-518-796-2515
July 11, 2014
Project# 193
Fred Smith
Smith's Excavating
Luzerne Road
Queensbury, NY 12804
Re: Proposed Replacement Septic
Carolyn Hall —36 Minnesota Avenue, Queensbury, NY
Dear George:
At your request we have reviewed your proposed replacement septic system design of the
existing 3 bedroom house at 36 Minnesota Avenue 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.
TOWN OF QUE .'
BUILDING & C' :�� a
Reviewed By. _ ._
Date: —
kr-
6,0 ro
SEPTIC PLOT PLAN � " "�
I HAVE SEEN OR OBSERVED ALL OBJECTS ���
SUCH AS HOUSES. WELLS, TREES, FENCES, ETC
SHOWN ON THIS DOCUMENT I HAVE PERSONALLY
MEA D THE DISi;a,CE S ORTH DIAGRAM.
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