SEP-000275-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
.a_
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: SEP-000275-2017 Date Issued: Monday, July 3, 2017
This is to certify that work requested to be done as shown by Permit Number SEP-000275-2017
has been completed.
Tax Map Number: 289.7-1-38
Location: 25 REARDON RD
Owner: James Davis,Dorothy Smith
Applicant: Sanitary Sewer Service
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: SEP-000275-2017
Tax Map No: 289.7-1-38
Permission is hereby granted to: Sanitary Sewer Service
For property located at: 25 REARDON 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
Tvce of Construction
Owner Name: James Davis Septic Disposal-Residential $0.00
Owner Address: 25 Reardon RD,Ext Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Sanitary Sewer Service
PO Box 224
Glens Falls,NY 12801
Plans&Specifications
Residential Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 1,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of ns / 1 ursd Ju 1,2 7
SIGNED BY: I for the Town of Queensbury.
Director of Building&Code Enforcement
4742 SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only
Twp
Bay Road,Queensbury,NY 12804
P:518-761-8256 www.aueensbury.net Permit#: 2-01 :7
Tax Map ID#: I— Permit Fee:$� �O
Invoice#:
Project location: `z S Qe�Roe�.L Qb l�oCt fu septic variance? SO
Primary Owner(s) p
Mailing Address
Phone & Email ,�-� )Uir
Installer/Builder R� �' \!f CL TOWN OF QUEEN
MailingAddress Lv TY DEVELOPMB T
Phone & Email _ 7 IT
t
Mailing Address V69
Phone & Email I 45 -03 } v c I n (Aw eh Prr f
Contact Person for Building&Code Complianc Phone:
"��fS�oSo"7
RESIDENCE INFORMATION:
Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes o
1980 or older 41 41g0 Installed? (circle one)
1981-1991 Spa or Hot Tub Yes
Installed? (circle one)
1992-Present
PARCEL INFORMATION:
Topography Flat Rolling _Steep Slope _%Slope
Soil Nature Sand _Loam _Clay _Other
Groundwater At what depth?
Bedrock/Impervious material At what depth?
Domestic Water Supply —Municipal Well(if well,water supply from any septic system absorption is_ft.)
Percolation Test Rate: 'q6 p"minute}ier inch (test to be completed by licensed engineer/archRect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION:
Tank size V_ne gallons(min.size 1,000 gallons,add 250 gallons for each garbage cylinder or spa/hot tub
System Absorption field with#2 stone Total length ft.; Each Trench ft.
Seepage Pit with#3 stone How many: ;Size:
Alternative System Bed or other type: '
Holding Tank System Total required capacity? ;tank size ;#of tanks
NOTES: 1.Alarm system &associated electrical work must be inspected by a Town approved electrical inspection
agency;2.We will no longer allow systems to be covered until such time as an as-built plan is received and approved.
The installed system must match the septic layout on file—no exceptions.
Declaration:Any permit or approval granted which is based upon or is granted in reliance upon any material
representation 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 and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage
Disposal Ordinance. /rye 6
PRINT NAME: M GS P.• J "I S DATE: eZ�
SIGNATURE: 1&4h• «" DATE:
Town of Queensbury Building&Code Enforcement Revised February 2017
'4 SVCTEM MATERIAL SPECIFICATIONS lSITE SOILS DATA ABSORPTION BED AGGREGATE TEST PIT TO 1 WASHED CRUSHED STONE,L E G END STONE IS TO BE 314 -112 TP-1 5116117 BY TOM HUTCHINS, P.E. EFFLUENT FILTER 0-7 TOPSOIL I-INCH FILTRATION, POLYLOK PL-122 OR EQUIVALENT.-22" REDDISH BROWN LOAMY FINE SAND I . I - , ,,I '.d , , A I EFFL LIEN T FIL TER TO HA VE 1/1 6 0 Iff IRON HOD FOUND P
7 EFFLUENT SEWER PIPE 0 iff IRON PIPE FOUND 22-78" YELLOW-LIGHT BROWN FINE & VER Y 0 IR5 IRON ROD SET WTH 118- PER FOOT MINIMUM SLOPE. I-35 OR SCH-40 PVC. INSTALL PIPING TO BE 4 SDR a5phalt UTILITY POLE FINE SAND, LITTLE SILT FILTER FABRIC TE E R EQUIVAL ciriV6WaY ICDCDCDC) STONE WALL :.�;::�,- 111� 4'�" ^- �--j�61 ENT WIRE FENCE FILTER FABRIC TO BE 4.8 OZISY NON-WOVEN SEPARA77ON FABRIC, NCA 7 MIRAFI 14ON 0 X ROOTS TO 20"oh HOUSE SEWER PIPE, PE D carport NO GROUNDWATER EVIDENCE Kq PIPING TO BE 4 SDR-35 OR SCHEDULE 40 PVC. INSTALL TH 114" PER FOOT MINIMUM SLO '[Pi 0 I�01 N T "l<I 11 catch V2:5 TOPSOIL Lands IFENC��,OST If—chw— OVERHEAD WIRES PERCOLATION TEST BLISH TURF. I)WERLY Nicholas C, Taylor PLACE 4 MINIMUM TOPSOIL OVER ENTIRE BACKFILL AREA. SEED, MULCH, AND ESTA NOW OR FO Linda T. PT-1 5116117 BY TOM HUTCHINS, P.E.Nancy M. Defayette 0 STABILIZED PERCOLATION RATE: 3 MINUTES 45 SECONDS WASTEWATER SYSTEM DESIGN......................... -BEDROOM RESIDENCE (DESIGN TO 4-BEDROOM)Trustees L. 4661 P 31 ......... DESIGN FLOW - 110 GPDIBEDROOM C;). .... ..................... ....... ................................... ......rivevvay.,*"...-""-*-..""""""*...... 440 GPD 0 SYSTEM DESIGN FLOW -SITE LOCATIO......... ... ............. SEP 77C TANK --:PROP. 1,250 CALLON POLYE774YLENE N...............I.-........................ ................... ...... LOCATION MAP
.................................
APPLICA77ON RATE TO,EXISTING SOIL: .95. GPDISF, BASED ON........... .................. e�EXIST. 1-5 MINIIN PERCOLA71ON RA TE NEIGHBORING ............ IIWELL POINT± li5i... ......... ............ ABSORPTION BED AREA REQD (440 GPD)I(.95 GPDISF)I464 SF 7P 1 concrete ....................... ... ISORP719-N--ffD AREA ERQMM 1 x3 AB, 5' 1' 465 SF.......... PT-1 E WATER SUPPLY IS ON-S17E WELL POTABL M TH'PROP. 4- PVC V�NT CARBON Fif7ER Iporch 5 Cp IMAINTAIN 50' MINIMUM SEPARATION BETWEEN SEPTIC TANK & WELL PROP. 15'x3l' .100' MINIMUM SEPARATION BETWEEN ABSORPTION FIELD & WELL% ABSORP71ON MAINTAIN BED OVER cc IVEP 5n............: PROP. DISTRIBt pool EXIS71NG NEIGHBORING WASTEWATER SYSTEM ITION�8OX IRF 5hed Cn PROP. EFFLUENT SEWER. MAIN�TIN MINIMUM SLOPE (118- PER FO T)03 4" PVC VENT WITH CARBON FILTER Lands n/f N64'30'00"E tIcover orch Gordon C. Stockman Stockman M & Carol B. ILIMIT OF EXIST. 15'x3l' 4" PERFORATED PVC LATERALS 131+ L. 1142 P. 115 WELL± INSTALLED NEAR LEVEL IN STONE BED BED CONFIGURA TION SITE LOCATIO Faver5 N PROP. 1,250 GALLON POLYETHYLENE SEP77C TAW B EIGH ORH ""OD MAP
2 5 NEW HOUSE SEWER TO BE BROUGHT ................ SY15CTEM INSTALLATION NOTES PROPOSED
E TO HIGHEST FEASIBLE ELEVA77ON GLEN LAK ITHIS DRA MNG AND IN ACCORDANCE MTH THE N.Y..S. DEPARTMENT OF
DISTRIBUTION BOX CONSTRUCTION SHALL BE AS SHOWN ON.......... INDIVIDUAL HOUSEHOLD SYSTEMS AND ASTM F481 INSTALLATION OF THERMOPLASTIC PIPE AND 1-�-5 \G\A-) HEALTH IIporch ED TUBING IN SEP77C TANK LEACH FIELDS.4 PVC EFFLUENT CORRUGA7 7 SEWER
Iock ON BED TO THE DEPTHS REQUIRED, THE WALLS AND FLOOR ISHALL BE CLEANED AND RAKED IN ORDER TO LOOSEN SMEARED AREAS OF SOIL.15' IAFTER EXCAVATION OF 15' MDE X 31' LONG ABSORP77
I -U, PLACEMENT OF CRUSHED STONE, PERFORATED PIPE AND FILTER FABRIC SHALL BE AS SHOWN, AND CARE SHALL
'5 2 5""cc BE EXERCISED TO AVOID INCLUSION OF FINE GRAINED SOILS AND WASTE MATERIAL IN THE STONE AND PIPE.
IL --.WASTEWATER SYS EM-PLAN THE PIPE SHOULD 'BE L -INDICA TED, MAINTAINING STRAIGHT c6NTINUOUS GRADES WITHOUT-AID �THE 'GRADES t ISCALE. 1"=20' SAGS, HUMPS, SEPARATED JOINTS, :OR 0774ER UNSUITABLE CONDITIONS. PIPE SHALL BE LAID �MTH HOLES DOWN IEG B IN ALL CASES.WE %WELL SrALE IGRAPHIC %-WTI 31'deck ALL DISPOSAL FIELDS SHALL BE GRADED TO SHED -RAINFALL AND DIVERT SURFACE-RUNOFF A WAY FROM THE 10 0 5 10 20 -40 ABSORPTION BED PLAN DISPOSAL FIELD.IN FEET N TS DO NOT USE HEAVY EQUIPMENT MTHIN 7HEABSORPTION AREA AFTER PIPING HAS BEEN'INSTALLED.THE WASTEWATER 7REATWENT SYSTEM IS DESIGNED AND APPROVED BASED UPON THE INSTALLA TION OF WA TER CONSERWNG FIXTURES AND A DESIGN FLOW OF 110 GPO PER BEDROOM. THE SYSTEM IS NOT DESIGNED TO M ACCOMMODATE EXTREME WATER USE FIXTURES, SUCH AS JACUZZI-TYPE SPA TUBS OR WATER TREA7 ENT:EQUIPMENT. THE INSTALLA77ON OF NON-CONSERONG, WATER FIXTURES OR EXTREME WATER USE FIXTURES IS$53015'00"W 4" MINIMUM 'TOPSOIL ON EN77RE 'HIS WASTEWATER TREA7MENT SYSTEM.101± APPROXIMATE 15' BED WID TH y BACKFILL'AREA; 'SEED AND CONTRARY TO THE APPROVAL OF 7--SLOPE ESTABLISH TURF EXISTING GRADE --7-7-- -7 17 777 OTING, GARAGE, CELLAR AND SURFACE WA TER DRAINAGE MUST BE EXCLUDED FROM THE WASTEWATER ROOF, FO ISYSTEM.4�-,INTO APPROXIMATE SUGGESTED: POLYETHYLENE 'i-A BED.;:j:,:�J 4 MAX,FINISH GRADE EXTENSION TO GRADE WITH �%MAFE SWALE UPGRADE OF SYSTEM IN ORDER T0bTV�qTGVRQCE ABSORP71ON'DE TAMPER RESISTANT ACCESS I S�UaT�fFI?E�L D CO VER BUI
0, &II2' MIN. USABLE SOIL :Reviewed By-,,----7�SUGGESrED: INSTALL POLYLOK 12pl± PL-122 FILTER SUCH THAT IT IS 12 MIN. Date: ,BACKFILL MATERIAL AS NEEDED SEPTIC PLOT F�LAN,-READILY REMOVABLE THROUGH COVER 15'x3l' CRUSHED STONE i ABSORP77ON BED TANK ACCESS COVER TO ESTABLISH GRADES I H � E SEEN OR LL OBJECTS RE
D A SU' H A' HOUSES, VVELLSjREES, FEN ET 4" SDR-35 PVC DISTRIBUTION BOX IHU CNI F, 11 'SEC71ON Sh W�ON T' S DOCUMENT.I HAVE PE NA'3j) 4 SDR-35 PVC ABSORPTION BED I
in
INLET FORTH ON THIS D N TS LIQUID LEVEL OUTLE T C:04 .0
MIN. SLOPE W CD
PER FOOT 41P MIN. SLOPE CU
114 118 PER FOO BAFFLE C1 16 BAFFLE��[ T L
Uj 4" MINIMUM TOPSOIL ON T1- USE SPEED LEVELERS 18"MIN. TO LS ENTIRE BACKFILL AREA; APPROXIMATE WA TER TI GH T ASSURE ALL OUTLETS ARE AT SLEEVE AND SEAL EXACTLY THE SAME ELEVATION SEED AND ESTABLISH TURF EXISTING GRADE 0-31' BED(TYP.) T1. LENGTH A Q U)
*—SLOPE SLOPE----� TAX MAP # 289.7-11-38 00 0 M 4" PVC SCH-40 SOLID HEADER TO 24" E c:T( 0 E ESSIONAL PERFORATED TRENCH PIPING, 171 OF—U,,I ALTERATION 'OF THIS Dbcum:NT EkEPT BY A LICENSED PROF
'ISBURY-A-Y Dr
CON1 118" PER FOOT MIN SLOPE MUNI'T ENGINEER IS!A VIOLATION OF NYS EDUCATION LAW.TING-GRADE T-14± INTO'EXIS CU
PREFABRICA TED -4 1250 GALLON POLYETHYLENE II >
CO Lr)1. ;7 SEPTIC TANK '7.7 C14 (Y-
IIII6"± PEA GRA VEL . ........ISEPTIC TANK NOTES TS -A TE.__OF -FILTER-FABRIC, -TENd__THE - ------ ------ ------------ 4'L-SDR�35..PVC.PERFORA TED 0----------- ALL---UNITS--SHALL--COMPLY WITH--THE--REQUIREMEN __PIEW--YORK--STA TE--- LATERAL INSTALLED NEAR LEVEL, IN ABSORPTION-BED-PROFILE ------------ MIRAFI 14ON OR ISSUED FOR PERMIT 5124117
AND SHALL TED POLYETHYLENE.DEPARTMENT OF HEALTH EQUIVALENT BED CONFIGURA,TION N TS N o. el.ws.I o.n s- Date
7-------------------- L--STRUCTURES-SHALL-BE'-PLACED--ON -6"±--LEVEL--PEA--GRA VEL---BA SE. WHERE—AL EXISTING SOIL CONDITIONS ARE UNSUITABLE, CRUSHED STONE;SHALL BE PLACED 'DETAILS UNDER PEA GRAVEL AS NECESSARY TO ACHIEVE TAE WASTEWATEK 0Y%STEM PLAN ,&pre ared for p RUBBER GASKETS SHALL BE INSTALLED IN ALL INLETS AND OJTLETS. M A es Linda Davis TANK INSTALLATION, FILLING, AND BACKFILLING SHALL BE COMPLETED IN STRICT ig FSafely. CONFORMANCE WITH mANUFACTURER'S WRITTEN GUIDELINES.. 25 Reardon'Road Extension MAP REFERENCE.NeWPAYork Town-of Queensbur)� Warren Count)� NY BASE MAP INFORMA TION FROM "MAP OF A SURVEY 0 Call Before You Dig GTH Scale: NOTED Date: 511712017 EI Wait The Required Time POL YIETHYLEIVE SEPTIC T114-INKDETAIL MADE FOR JAMES P. DA:VIS & LINDA DA WS, Drawn: JRS Checked.,010/
0 Confirm Utility Response SITUATED IN THE TOWN OF, QUEENSBURY, COUNTY Ej Respect The Marks N TS OF WARREN, STATE OF NEW YORK. PREPARED BY . NY 2804 EM Dig With Care RUSSELL E. HOWARD LICENSED LAND SURVENG. -01 745-0307 Phone 800-962-7962 DATED APRIL 18, 201 7 www.digsafelyneviyorkcom Hutchins Engineering -(518) 745-0308 Fax
Hav
ee sbury,N Road
Queensbury,NY 12604
Hutchins Engineering Phone:(518)745-0307
Fax:(518)745-0308
TRANSMITTAL
Date: June 26, 2017
To: Town of Queensbury Building & Codes ---
Attn:
r - E9 �
Via: USPSD
From: Tom Hutchins JUN 7 9 2WTOWN OF QUEENSBURY
Re: James and Linda Davis, 25 Reardon Road Ext. _-_BUILDING& CODES II
Enclosed: (1)copy of Record Drawing 291146-01, last revised 6/19/17