BOTH-000353-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
r
- _ Community Development-Building& Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000353-2015 Date Issued: Friday,November 20, 2015
This is to certify that work requested to be done as shown by Permit Number BOTH-000353-2015
has been completed.
Tax Map Number: 289.19-1-8
Location: 1 BLACKBERRY LN
Owner: Lucille Delsignore
Applicant: IBS Septic
This structure may be occupied as a: Residential Septic Alteration
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
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000353-2015
Tax Map No: 289.19-1-8
Permission is hereby granted to: IBS Septic
For property located at: I BLACKBERRY LN
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 Unifomr
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: Lucille Delsignore Septic Disposal $0.00
Owner Address: 1 Blackberry LN Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
IBS Septic
2 WARREN ST
Glens Falls,NY 12801
Plans&Specifications
Residential Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,November 13,2016
(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 ern / / �hu d r 19,2015
SIGNED BY: , for the Town of Queensbury.
Director of Building&Code Enforcement
Community D vc-iopment Office
Town of Queensbury e 742 foRba &`&snsbury, New York •12804
Office nly
TAX MAP NOPERMIT NO. (' 14 , 00()3 PERM TEF E LLy dv
APPROVALS: ZONING TOWN CLERK
APPLICA77ON FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT.
C i
OWNER p�I S I 1- INSTALLER- M
ADDRESS: I I ( ADDRESS: y pew f1 ! n f
PHONE NOS- 16 II 11 PHONE NOS
LOCATION OF INSTALLATION: I 'Ol(,l< '4,1 v�t 1-
RESIDENCE INFORMATION:
NO.OF COMPUTATION = TOTAL DAILY FLOW
YEAR BUILT B ROOMS x Gallons r bednwrtl GARBAGE G
1980 or older x 150 = INSTALLED?
.1981-1991 x — 13D SPA OR HOT
1992-present x 110 = INSTALLED?
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT RO NG_ STEEP SLOPE U %SLOPEI 1 V 1
✓ SOIL NATURE SAND LOA}A-M IV tT CLAY OTHER
-1GROUNDWATER: AT WHAT DEPTH?, N
✓ BEDROCK(IMPERVIOUS MATERIAL' AT WHAT DEPTH? 1
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption i1 I�1 ftl
✓ PERCOLATION TEST: RATE —PER MIINITfE PER INCH[mp7 (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: W GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,
spa or whirl I tub.
SYSTEM PE: \ \ L) W
ABSORPTION FIELD(WITH N0.2 STONE) Total lengthl_d�ft Each trench X
❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? _
❑ALTERNATIVE SYSTEM Bed or other type? „' I1
❑HOLDING TANK SYSTEM Total required capacity? -ALTank size? v r 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 7615256 OR EMAIL
Sanitary Sewage Disposal Ordinance. codes6oueensbulv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
Signature of Person Responsible Date www.gueensburv.net
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AIIVNOS2i d 3AVH 1�.LN3W(10o0 , NNIOHS - CROSS SLOPE INFORMATION SHOWN ON THIS DRAWING IS. TAKEN- FROM -
=3' 013 'S3%3� 'S33J1 'S11 V1`S35flON S3�HV0n i RECOMMEND ALL ACCESS CONCRETE OR STONE ON SLOPED SITES WARREN COUNTY TAX MAP INFORMATION AND ORIGINAL SUBDIVISION = = L(D
Y1 , x0. S103Poo JIV 03Aa3SO0 X10 N335 & CLEANOUT OPENINGS MARKER ABOVE ALL OVERFILL TO ALLOW -
N�1`icl yp ld UIyd3S APPROXIMATE gE RAISED TO 6 BELOW MAP PREPARED BY COULTER & McCORMACK AUG. 1972 _
FINISH GRADE FINISH GRADE. „ BURIED COVERS FOR SETTLEMENT
GRA�E D RECOMMENDED. �E�ENDUl
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' , t R \- , // / / �� - - - - PROPERTY LINE z
INLET BAFFLE 12" MIN. OVER OVER � PROPERTY LINE SETBACKS
r' I I ALL STRUCTURES o FILLTH�.• UNTREATED BUILDING PAPER, _
P"� I #1 DISTRIBUTION BOX _ , ��- OR -TEXTILE. — E E E — ELECTRIC SERVICE
1 . „ T1 BY FORT MILLER OR 2 MIN• cfl No.j DESCRIPTION I DATE ri
I7 I I-3 ( � I EQUAL -- 4 PERFORATED E/F' EDGE OF PAVEMENT _ o
11 - LIQUID LEVEL TO REVISIONS
x MIN. SLOPE — FR)M SEPTIC ----- 4 PVC M LATERAL =
,__ D-BOX �a ,� _
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1/4'� PER FOOT r MIN. SLOPE TAVK I „„a
1/s” PER FOOT PERCOLATION TEST RESULTS
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iV °$°"°o«T�3 ALL OUTLET INVERTS �, (ooh �D��c w �..• - �' - �,
SEPTIC TANK TO BE SET AT bro�on o (�O�c�o�o, ` - ��- 3 4 TO 1 1/2 = N
INLET & OUTLET �� �_ a .� a. PERCOLATION TEST PERFORMED 7 OCT 2015 BY a
BY FORT MILLER OR PEA / ETHAPI P. HALL - RUCINSKI HALL ARCHITECTURE _ a
EXACTLY THE SAME z' CRUSHED STONE , O �,
EQUAL BAFFLES GRAVEL DEPTH STABILIZED RESULT OWN 0 ���9� I . iD �r� ' `l 0 Z
ELEVATION. = W Z
4 r, \I— ;z a \.. (USE OF SPEED LEVELERS in inches per one inch drop Yui ' _I [ 7.p �' _ = Z - �,
<*a' o E COURAGED 6-0 N 0 ¢ _ , i
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aII��: _ 20 10 00 1 _ U.l 0 a Z -_ u_
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J p I �/ MAXIMUM SEASONAL HIGH— - TE J T PIT DATA W o cs
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' D I S TR I B D TI O N B 0/� GROUND WATER ELEVATION Z _ _rn
f, MINIMUM 2x WIDTH N.T.S. -ST PIT PERFORMED 7 OCT 2015 BY IBS SEPTIC of Q x
t MAXIMUM 4x WIDTH - VIINESS BY ETHAN P. HALL - RUCINSKI HALL ARCHITECTURE W o 0 0
L STANDARD ADSORPTION TRENCH SECTION TP# 1 J ¢ Fo
}t, _ a: o0 0000 N.T.S. 0- 12 Inches, topsoil & organics J o W o F
'', , PROVIDE 3 SAND OR (60(�p 12-30 Inches, dark brown\black loarny gravel ,� � , it a-
h; '' '' `•,:,PEA GRAVEL UNDER TANK
with medium size rocks - sus acted burn la layer T Ei a
BARRIER MATERIAL p y = > `n`� ``' o
"�'Ir , ' r h _ 30-60 Inches, light brown\red medium sands w/trace gravel : O:f - �,? rn a o oco
t t , SEPTIC TANK �. '=1111 ,„1111= I, , , III►= ---�_ _ ” � -a = C ig Q� >, < o = .~
12 MAX. _,;11— — ---� Roots to 60 below grade o > L co co 6 o Z ,- _
�h „, N.T.S. I=I I(I—IIII—� _____-•-.-'_ No water seeping - No mottling encountered - a, `� a `��'0 Q ; a
,' zi ”. __-.`c i -_ MIN. ) �v In In N Env-r� 16- SEPTIC SYSTEM DESIGN _ () 0 o . � a Q
+' z
— oo ao
h s t'I 1. ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK f
2 MIN. Gb O�oo SLOPE aj -a 1 �,
�� STATE DEPARTMENT OF HEALTH AND SHALL BE PRECAST CONCRETE OQ�o�aa oo,, r 7�r,, n o a - o o
1. IAS MANUFACTURED BY FORT MILLER OR EQUIVALENT.
DESIGN FLOW - EXISTING 3 BEDROOM HOUSE WITH STANDARD TOILET '` `-' x ~
FIXTURES AT 130 Bpd PER BEDROOM - 390 Bpd rr w w
s" R?, . . -
e , Y z COMPACT SAND OR 6., Va, o C} o� i �,:,. " u ,. s
2. ALL STRUCTURES TO BE PLACED ON FIRM,
GRAVEL FOUNDATION. WHEREVER EXISTING FOUNDATION CONDITIONS ME ! 4 PERFORATED PVC LATERAL, SEP11C fANK - 1,000 gal TANK REQUIRED (IN RESIDENCES WHERE A ��yy, � Wl
-
y ` ; ° E SLOPE 1/16"-1/32" PER FT. GARBAGE DISPOSAL IS TO BE INSTALLED AN ADDITIONAL ,250 gal, OF WORK IS TO BE A5 5 a6
I v' ARE UNSUITABLE, CRUSHED STONE SHALL BE PLACED AS
11� NECESSARY TO ACHIEVE A STABLE FOUNDATION. SHOWN &
CAPACI fY WILL BE PROVIDED IN THE SEPTIC TANK)
1.
NOTES: f NOTED AND IN ACCORDANCE
#$ t ,, 7 1. END OF ALL DISTRIBUTOR PIPES MUST BE ABSC)RPfION FIELD - 8 to 10 MIN. PERC. RATE - APPLICATION RATE WITH MANUFACTURER'S
F, k:_ ; 3. SEPTIC TANKS INSTALLED IN TRAFFIC AREAS SHALL BE EXTRA HEAVY PLUGGED UNLESS INTERCONNECTED. 0.9 galfdayfsq. ft. - 390 Bpd DIVIDED BY 0.9 gal/day/sq. .ft. _ RECOMMENDATIONS, TRADE
CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING. 434 sq. ft. OF TRENCH REQ'D. AT 2' WIDTH PER LATERAL. USE 6 LATERALS = ASSOCIATION PUBLISHED =
N, ¢ 2. ALL LATERALS TO BE OF EQUAL LENGTH. AT 40' = 48U sq. ft. OF APPLICATION AREA.
= RECOMMENDATIONS AND
x44 I' ,_ :; 4 Y = GENERALLY ACCEPTED LOCAL
:-,'
a,f #,' STANDARD ABSORPTION TRENCH PROFILE
'SEWAGE DISPOSAL SYSTEM NOTES = CONSTRUCTION INDUSTRY
Ye, ;;; PRACTICES. -
' - . �jr N.T.S. THEME SHALL BE NO CHANGE ON THESE PLANS IN ADVANCE OF OR DURING -
„ ,,,:
_,,I:",: , ' CONSTRUCTION, WITHOUT PRIOR APPROVAL OF THE DESIGN PROFESSIONAL OR THE ,
I TOWN OF QUEENSBURY.
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DESIGN, CONSTRUCTION, MATERIAL STANDARDS AND INSPECTION REQUIREMENTS
�� lu Y., a,il,�u.u.ksa'kY S:kJ:uisd,:. l'..,Lde.:ae ou . TAU YY.Y W'W„W.,u,d:.-l,IR"d'
,. SHALL COMPLY WITH THE LATEST EDITIONS) OF THE NEW YORK STATE _
-`' DEP ;RTMEN T OF HEALTH WASTEWATER TREATMENT STANDARDS INDIVIDUAL
,, .,
hi. ` ` = HOUSEHOLD SYSTEMS APPENDIX 75-A. _ -
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SEPTIC 'TANK TO BE SET ON A LAYER OF COMPACTED PEA STONE OR WASHED
$h ,a GRA\SEL. = 4—d d'
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SEPTIC TANK 'TO HAVE SCH 40 PVC "T" AT INLET AND OUTLET. - CA 11
' _ 1 - - INLET 12” BELOW FLOW LINE, 6” ABOVE FLOW LINE t--� III
t 4" F 6"
- OUTLET 1 BELOW LOW LINE ABOVE FLOW LINE
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i NEW 1,000 GAL SEPTIC- TANK I NO FOOF, FOO IING, FLOOR, COOLING WATER, BACKWASH 'DRAINS, ETC.' SHALL BE = �+
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