2013-400 OINK QUEENSBURY
OF
742 Bay Road,Queensbury,NY 12804-5 27
�� j Q n, �o (518) 61-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130400 Date Issued: Thursday, September 05, 2013
This is to certify that work requested to be done as shown by Permit Number P20130400
has been completed.
Tax Map Number: 523400-302-017-0003-029-000-0000
Location: 55 I-IIDDEN HILLS Dr
Owner: DELORES LYNN LAM
Applicant: DELORES LYNN LAM
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QUEENSBURY
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Issuance of this Certificate of Compliance DOES NOT relieve the f
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
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130400 Application Number: A20130400
Tax Map No: 523400-302-017-0003-029-000-0000
Permission is hereby granted to: DELORES LYNN LAM
For property located at: 55 HIDDEN HILLS 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: DELORES LYNN LAM Septic Alteration Residential
55 HIDDEN HILLS Dr Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency ,
SANITARY SEWER SERVICE
Plans&Specifications
BP 2013-400
Septic Alteration-replacement for 5-bedroom home
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, August 23,2014
(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 ueen my; //rid • ust 23,2013
i
SIGNED BY r for the Town of Queensbury.
Director of Building&Code Enforcement
Community Development Office Alin 2 2 2013
Town of Queensbury • 742 Bay Road - Queensbury, New York .12804
Office Use Only p /
TAX MAP NO. PERMIT NO. PERMIT FE
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.
OWNER: PA-'I-f" ; C L/�!►'1 I / n INSTALLER: L�/'j-•"; '(�{'y U e tJ-C�2 e:1/!ce
ADDRESS: $ J^ His c/d ' /-/.//s ,d✓ ADDRESS: /VY An e,'e /L- 627 -
PHONE NOS. /V- PHONE NOS. Z -7 -�
LOCATION OF INSTALLATION: fia-KuC G-CfiZ"24-- 441
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINDER
1980 or older X 150 = INSTALLED? /kms
1981 -1991 X 130 = SPA OR HOT TUB
1992-present X 110 `c) INSTALLED? .442
PARCEL INFORMATION: 1J
✓ TOPOGRAPHY: FLAT ROLLING !Jr- STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND X LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? /
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? /1/7+
✓ DOMESTIC WATER SUPLY: MUNICIPAL Yt WELL (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS S 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:/e),Z2 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 Bed or other type? 4:20 'X_
❑ 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 these and�all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
5a Sew a� Or nce. codesCa?queensbury.net
zz -i3
Signatu a of Person Responsible Date VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.net
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Septic Inspection Report
Office No. (518) 761-8256 Date Inspectio j - ••c=' -,:
Queensbury Building &Code Enforcement Arrive: " • .it : i• •.rt: SILWAIM,
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia s: L.----
NAME:
NAME: I-__ A {`-)\ P'RNO.: q-k-Aeo
LOCATION: .5.5- !--11 tAQC--t1 \\L _f) Dep I► PECT ON: —,c—1.3
RECHECK:
Comments and/or diagram
Soil Typ-. .. ". L••m / Clay
Type of Water: unici..- Well Water -q ) .)-c %gyp,
Waterlin- -•aration distance cX-- 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 `"11 ft.
Length of each trench ik6P1 ft. r ) \--)DcD Q
Depth of trenches .7. - _ ft.
Size of Stone 4d
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tankVViTI r\-..)(---,Tank to Distribution Box '-« k.,\-1 3i-;
Distribution Box to ield 4e_.-77it ' 17e_.-77 i5
Opening Sealed: _N
End Cap • _ N ( 'c
Inlet/Outlet Pipes&Baffles Y
Manholes 12"or less below grade ,-/N
[provide extension collar if Yes] ‘./(1'_ N
Location/ Separations
Foundation to tank k) ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan _Y— N
Engineer Report and As-Built _Y_ N
ETU Maintenance Contract _Y_ N
provided
Location of System on Property:
Front •e. eft Side fight Side Middle Front Middle Rear
S stem Use Stat :
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
CENTER PROJECT A.0 2 2 2013
SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
August 16,2013
Project# 174
Dan Drellos
Sanitary Sewer Services
Luzerne Road
Queensbury, NY 12804
Re: Proposed Replacement Septic
Lamb Residence—55 Hidden Hills Drive, Queensbury, NY
Dear Dan:
At your request we have reviewed your proposed replacement septic system design at the site of
the existing 5 bedroom house of at 55 Hidden Hills 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 550 GPD and a percolation rate of
1 to 5 minutes, you will need 611 square feet of absorptive area. We recommend using a 20 ft
wide by 35 ft long absorption bed with 4 — 30 foot long laterals, which will provide 700 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,
'/&),)/an TOWN OF w O .j 'E} s; ;•
BUILDING & C A-,. ,.
Thomas R. Center Jr,P.E.
Reviewed / ...
Date -
THIS PLAN TO BE ON PROJECT
SITE AT ALL TIMES FOR THE
DURATION OF CONSTRUCTION
Patrick Lam BP 2013-400
Sanitary Sewer Service
55 Hidden Hills Drive
Septic Alteration - residential 5 bedrooms
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I HAVE SEEN OR OBSERVED ALL OBJECTS �-' �
SUCH AS HOUSESWELLS, TREES, FENCES, ETC TOWN'� � -' ---"- '
SHO1A8N.DN2THIS DOCUMENT.I HAVE PERSONALLY BUILDING `
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Septic Inspection Report
Office No. (518) 761-8256 Date Inspection req ` '-i ..
Queensbury Building &Code Enforcement Arrive: j'DD a p ••rt: '7 am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's InitialsL1116
NAME: • R• 1T NO.: t COO
LOCATION: \5,5- C�D�� 1�k1 V_Im \-)E.E. :.ECT ON: (-I -� '1�
RECHECK: M
Comments and/or diagram
Soil Type: yc�' oa Clay
Type of Water: unlci.. r ell Water T S 7
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 ft.
Length of each trench I-I ft. E
Depth of trenches -- ft.
Size of Stone 7_-
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank +.i
Tank to Distribution Box
Distribution Box to Field/ Pit p 3±7
Opening Sealed: Y_ N
End Cap �Y i N M.- �
Inlet/Outlet Pipes&Baffles •✓( N
Manholes 12"or less below grade _Y N
[provide extension collar if Yes] _ _ N
Location / Separations
Foundation to tank 11' ft. ‘-; �`
Foundation to absorption 7Z ft. 41
Separation of Pits
Conforms as per Plot Plan _ N
Engineer Report and As-Built _Y_ N
ETU Maintenance Contract _Y_ N 10
provided
Location of System on Property:
Front Rear -; ' :e Right Side Middle Front Middle Rear
S stem Use Stat .
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 Report 03 29 10.doc
Septic Inspection Repo
Office No. (518) 761-8256 Date In pection r-,.. 41-i •: —
Queensbury Building &Code Enforcement Arrive: a'-',111! it-part: - a -
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia s: � `3—1-‘00
NAME: 1-- MA P ' NO.:
LOCATION: 5 1 i)Dei l-\ t \R . I.. • CT ON: 1 -,,ti - k?-3
RECHECK: \-. cl`1 1).-T-
Comments and/or diagram
Soil Type: Sand/ Loam / Clay
Type of Water: Municipal/ Well Water _
Waterline separation distance ft. L k`"� ���
Well separation distance ft.
-,--V\-- _. C3 4e E
Other wells: ft. � 1N
Well Casing Length 50' + / - Y N N/A r , a N � �\be u .11-6___
_
[150'to well required if NO] -Tt_`
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone it�Sev_ \ L L,
Seepage Pits: Number
Size: x N C__C_ ? .
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: _Y_N
End Cap _Y NLkq
Inlet/Outlet Pipes&Baffles _Y N 7 r� 1 \
Manholes 12"or less below grade _Y N
[provide extension collar if Yes] Y_ N
Location/ Separations
Foundation to tank ft.
Foundation to absorption _ft.
Separation of Pits ft.
Conforms as per Plot Plan Y_ 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 Front Middle Rear
System Use Status:
pproved
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 Report 03 29 10.doc