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SEP-0474-2018 TOWN OF QUEENSBURY iT 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building 8z Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: SEP-0474-2018 Date Issued: Wednesday, August 8, 2018 This is to certify that work requested to be done as shown by Permit Number SEP-0474-2018 has been completed. Tax Map Number: 301,6-1-35 Location: 13 PINION PINE LN Owner: Mike Gersten 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 4 property owner of the responsibility for compliance with Site Plan, � c \ 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 r4,� � 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 I Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: SEP-0474-2018 Tax Map No: 301.6-1-35 Permission is hereby granted to: Sanitary Sewer Service For property located at: 13 PINION PINE 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 Uniform Building Codes and the Queensbury Zoning Ordinance Type of Construction Owner Name: Mike Gersten Septic Disposal-Residential" $0.00 Owner Address: 13 Pinion Pine LN 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 $ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,July 19,2019 (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 -xpiration dat-.) Dated at the Town o is Queens$ ; t hur.". . �, : ,2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement I .k� l �' , Y�Tza ' 1 SEPTIC DISPOSAL PERMIT (--tA'-T-lO .�-----:-'-er:�ice l►se Only - :_ 742 BayRoad Queensbury,NY 1280r, ,i pi I j p 1 �/ nwnoffQiicenshur Q JUL IS 2e18Per ,U • (e —0 'I —to [ L� P:518--769-`S256 �vww.clueerasb=.�'s`a ,c I- 1 Tax Map ID#: 3°l - b JS/ ncliAV6i=='; z.F ,44eeii (t Fee:$-7..; invoice#: aco 7-d a &CODES f 2 � �@ €��E.illaDui�� Project Location:_/�Jii/V/dat/__ / "�`BUc _._.s Deptic variance? Yes No Primary Owner(s) M//tlo r in V Gees-ten/ Mailing Address /3?. ,, p-i O N v/i, y,,c- Phone & Email / Installer/Builder S4/11, 'c ewec f'ct i c e ' Mailing Address Pd , ig©X ,-2- z -/ ,w ct l`-4�r%, NV /2c / Phone &Email Sl f_ 7X-376o Engineer f,.L (lie_ r Mailing Address Phone & Email Contact Person for Building&Code Compliance: Phone: RESIDENCE INFORMATION: • Year Built ' #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes No 1980 or older Ill /iC2 !`Ve, Installed? (circle one) k 1981-1991 Spa or Hot Tub Yes No Installed? (circle one) 1992-Present PARCEL INFORMATION: Topography V Flat Rolling Steep Slope %Slope Soil Nature 6e. Sand Loam Clay Other Groundwater At what depth? ,"--iei Bedrock/Impervious material lott.what depth? /v/-r Domestic Water Supply Vlunicipal _Well(if well,water supply from any septic system absorption is ft.) Percolation Test Rate: /-S' per minute per inch(test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size / 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: VAlternative System Bed or other type: Z.-c9 'X 30 ' 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. `� PRINT NAME: Ce-C r e _. 'v`" DATE: i '77— / e' SIGNATURE: ,1'r` Z '. z:n--------'' '' DATE: 7.--- [7— i r Town of Queensbury Building&Code Enforcement Revised February 2017 301.6-1-35 Gersten, Mike S&AmyEP-0474-2018 �� 13 Pinion Pine Ln TOWN QUEENSBURY Residential Septic Alteration BUILDING & CODES DEPT. Review By: Date: -- S, OWN OF QUEENSBURY UILDING DEPARTMENT �('' Based ur ndhanotnce ilhorc mmetss be ca rued as indicating he plans and specifications are in full comp! nce with the building Codes of New York tate. c � C `5 ,Tit ,rs. ) lt/AYt.P ._.1 Z Co ch a x P SEPTIC PLOT PLAN 1. a-- --•.--- I HAVE SEEN OR OBSERVED ALL OBJECTS Q VDU L SUCH AS HOUSES, WELLS, TREES, FENCES, ETC Fri) SHOW> HIS DOCUMENT.I HAVE PERSONALLY ME BOR HE DENS SET FORTH 0 ie DIAGRAM._/ [[1: ,JUL 1 8 2018 [0 SIGNATUR DATE TOWN OF OUI'~INSBURY BUILDING&CODE'S 1 3 -------------- --- ------------------------------- CENTER PROJECT SERVICES 73 Sheridan Street, Glens Falls,NY 12801 Phone-518-796-2515 July 16, 2018 Project#273 George Drellos Sanitary Sewer Service Queensbury,NY 12804 Re: Proposed Replacement Septic 13 Pinion Pine Lane, Queensbury,NY Dear George: At your request, we have reviewed your proposed replacement septic system design of the existing 4-bedroom house at 13 Pinion Pine Lane 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 1 to 5 minutes, you will need a minimum of 464 sf of absorption area. We recommend using 20 ft wide by 30 ft long absorption bed with 4 - 25 ft long laterals. The absorption system 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. J u JUE2 ] 018 TOWN OF QUEENSBIJRY BUILDING&CODES •