2015-360 TOWN OF QUEENSBURY
(a 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150360 Date Issued: Monday, November 28, 2016
This is to certify that work requested to be done as shown by Permit Number P20150360
has been completed.
Tax Map Number: 523400-308-014-0001-052-000-0000
Location: 183 PITCHER Rd
Owner: FOREST PARK -- 65 GREGWOOD CIRCLE
Applicant: FOREST PARK 29 & 31 BRIWOOD CIRCLE
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
property owner of the responsibility for compliance with Site Plan, �Y
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
4411111ki
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150360 Application Number: A20150360
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: FOREST PARK 29 & 31 BRIWOOD CIRCLE
For property located at: 183 PITCHER 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. Type of Construction Value
Owner Address: FOREST PARK-- 65 GREGWOOD C Septic Alteration Residential
31200 NORTHWESTERN Hwy Total Value
FARMINGTON HILLS MI 48834-00
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-360
Residential Septic Alteration
29 & 31 Briwood Circle
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 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 To n o eens u day, August 13,2015
SIGNED BY for the Town of Queensbury.
Director of Building&Code nforcement
SEPTIC DISPOSAL AP ' • "" Office Use Only
v1
Received
DATE: ) I I ,15- l Tax Map ID 21
TAX MAP ID: 31(,) -G. IL/ - 1-50 RI X01' Permit No. 2();5
a
■`l,, Permit Fee 44 I-pi op
ZONE: • ..W
Y1 M f
APPLICANT ke,,,- ?as---� n', C LLC PHONE/E-MAIL (5)0-)(4 5.
-)--7 7
ADDRESS }�' 9►aC11CA-l0f- It-{\. (l).Q Q,r\. l I)011.) 1\1 Y OSCLI La+ 9q J\
1
INSTALLER/ J PHOVE/E-MAIL
BUILDER 5-one Z(-\ 11\CL IbnS (5) 3 19107
OWNER citl�1
ADDRESS Le,
I3t5 2-+5� .X�+ *iSC ao
N 1 I {� S2
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: �Q X-1 CS p CC1qL
PHONE/E-MAIL (51'0 - (970'1
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older Garbage grinder installed Yes No
1981-1991 Spa or Hot Tub installed Yes No
1992-Present 11 c' L C
PARCEL INFORMATION az.j2 1/ \`C� ho d P 'cn�
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: per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size IODbgallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total length 09C)C ft.;Each Trench 9 x55
VAIP Lte35 Seepage Pit with#3 stone How many: y ;Size
av9A,M\C005 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&approved. The installed system must match the
septic system 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: I vA 10 ( DATE: III( I I
SIGNATURE: '-/Yl DATE: 81111 Id
1A
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
Town of Queensbury Building &Code Enforcement 4- — ti
Office No. (518)761-8256
Septic Inspection Report
Inspection request received: c6 )1 14 ii
Name: c' " e ST W? )`� r `'4�nspected on: (�
Location: 9-`1 3 1 e)r i L)601 ( t,( - Arrive: "A.1L� 04e
Permit No.: )S 1 Inspector's Initials: _f
C•Onts and/or dia.ram
Soil Typ S Lgacn-I-Clay
Type of Water unicipal)Well W r — Z 1Eu \ZOO 6 Au-Dt•.3
Waterline separaflo ce 04' ft. L � `C ��,1/ 3
Well separation distance ft. V �
Other wells: ft.
Well Casing Length 50'+/- Y N N/A ���� � `�
[150'to well required if NO] 'k)-5-\-N-LE-A--
Absorption Field: Total length 2-2-O ft.
Length of each trench AjeW
Depth of trenches 2_--z.tkit.
Size of Stone 1--tPtr3Crq.... INV.C- -zy µq20__4
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank Lc, 6 LA1/4
Tank to Distribution Box lA .L� 40
Distribution Box to Field/Pit / "f i� -CC �,�� Z\}
Opening Sealed: ,,,yr-
YN
End Cap i)f N
Inlet/Outlet Pipes&Baffles N
Manholes 12"or less below gradeN
[provide extension collar if Yes] N
Location/Separations
Foundation to tank ft. , \
Foundation to absorption ft. N 1j ,�� .vT`�
Separation of Pits ft. �ab _
Conforms as per Plot Plan _Y_N �(
Engineer Report and As-Built _Y
ETU Maintenance Contract provided Y N
Location of S stem on P o•e :
Front Re. Left Side Right Side Middle Front Middle Rear
S stem Use Statu
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report
pESIGN INFORMATION
FLOW
SEMMS
UES GN P C REQ,D LENGTH OF
RAM
ftDESIGN
660 GAL/DAY
1-5 MPI 276-25%0=206°
TRENCH SYSTEM WITH ADS RANCOR ARC 24 CHAMBERS
rnrAl NUMBER 0 LATERALS = 4
LENGTH OF EACH LATERAL = 55'-0"
TOTAL LENGTH OF LATERALS = 220'
e PER NYSDOH APP. 75-A(FEB 3, 2010); A 25% REDUCTION IN
TRENCH LENGTH IS ALLOWED WITH USE OF GRAVELLESS CHAMBERS
WITH 1.6SF/FT OF BOTTOM AREA & VOLUME OF 7.5GAL/FT & OPEN
SIDEWALLS. TABLE 6C OF NYSDOH "GREEN" HANDBOOK.
PT m PERCOLATION TEST (LOCATIONS, SEE PLAN)
DTP DEEP TEST PIT
TEST PERFORMED ON 6-05-15 WITH STONE INDUSTRIES AND NYSDOH
REPRESENTATIVE IN PROPOSED TREATMENT AREA.
DTP A(,SF gTE P AL N FOR LOCATION)
0"-10" DARK SANDY TOPSOIL
10"-27" LIGHT BROWN SAND
27"-67" TAN,GREY/BROWN SAND.
NO GROUNDWATER OR MOTTLING NOTED
PT X11 STABILIZED PERCOLATION RATE: 1:
PT #2 STABILIZED PERCOLATION RATE: 1:
SITE INFORMATION:
F
APHY AT TREATMENT FIELD IS RELATIVELY LEVEL
NG SUPPLIED WITH MUNICIPAL WATER.
GMERAI NOTES=
1. SEE NOTE SHEET. CALL ENGINEER TO
CLARIFY ANY DESIGN DETAILS.
2. USE DIMENSIONS GIVEN: DO NOT
SCALE DRAWINGS.
3. ALL PERMITTING/VARIANCES TO BE
OBTAINED BY CONTRACTOR AND/OR
PROPERTY OWNER.
FILE COPi(
0 / N O R TO -i
EXISTING FAILED SEPTIC SYSTEM CONSISTS OF COMBINED LOTS
21,23,25,27,29&31 FLOWING INTO A 1500 GALLON SEPTIC TANK THEN TOA ° SEPTIC PLOT PLAN.
DRYWELL PROPOSED PLAN IS TO PROVIDE EACH 3 BEDROOM LOT WITH I HAVE SEEN OR OBSERVED ALL OBJECTS
INDIVIDUAL 1000 GALLON SEPTIC TANKS ANDA TREATMENT AREA DESIGNED .
FOR TWO LOTS WHICH EQUALS 6 BEDROOMS TOTAL. ° SUCH AS HOUSES, WELLS, TREES, FENCES, ETC
° SHOWN ON THIS DOCUMENT. I HAVE PERSONALLY
MEASU E THE DISTANCE SET FORTH Off! THIS DIAGRAM.
EXISTING 3 s fGC,�='t'�.��'�. _ �� ► i f I
° SIG, I ATURE DATE
LOT #31 BEDROOM
PARKING DWELLING °
SOLID 4"0 SCH40 ;AT C
PER FOOT. TYPICAL. .
I
LOCATE WATER LINE AND MAINTAIN :10'
HORIZONTAL SEPARATION TO SEPTIC.
I ACTUAL SEPTIC COMPONENT ,LAYOUT
MAY VARY DUE TO BURIED UTILITIES.
PARKING EXISTING 3
I %A LOT #29 BEDROOM
l DWELLING
N
+>,
PARKING
1
AS—BUILT TIE—IN DIMENSIONS FT
A B C D
D—BOX
L1 BEGIN
L1 END
L4 BEGIN
L4 END
LOT #27
°
NEV 1000 GALLON CONCRETE
TAN1� WITH FILTER.SEE DETAILS. `
P 1 1
PROJECT LOCAMN PLAN
Fes' . i,, I:czsaE
E?EALTH
LOI INFQNMIA llUN_;
TAX MAP: 308.14-1-52
TOWN OF QUEENSBURY
LOT SIZE: 48.9 ACRES
I 1 1
NEW 1000 GALLON CONCRETE
TANK 'NI FILTER.SEE DETAILS.
SHED e
SEPTIC REPLACEMENT' DESIGN / GRAVELLESS CHAMBER
FOREST PARK - LOT t29 & tt31
PLOT PLAN INFORMATION OBTAINED FROM WARREN COUNTY US
AND AS PURPORTED BY PROPERTY MANAGER.
THIS DRAWING DOES NOT REPRESENT A LAND SURVEY AND MUST
NOT BE CONSTRUED AS SUCH.
Mil
k�,Li
163 PITCHER ROAD, QUEENSBURY, NY (TOWN OF QUEENSBURY)
RKDRAWING TITLE:_
ENGINEERING, PLLC SITE PLAN
225RUGGLES RD., SARATOGA SPRINGS, NY
518.581.3893 ftIE NAME SITE
SCALE 1" = 20,-0"
V0: SUBMITTAL / REVISION PP'D. DATE ®ATE JUNE 2015
A ISSUED FOR REVIEW/APPROVAL RKR SA/15
REVISION A
SHEET
C-001 1 OF
2
-`
t
APPROVAL STAMP / NOTES
AUS
INSTALLER TO LOCATE ALL UNDERGROUND
-.
UTILITIES
PRIOR TO CONSTRUCTIO.
PUMP
WITH
AND FILL IN XIS AM x4
COMPACTED S ND�D LD;tI ';
' 4
TOW OF OU���, UR,
-
BUILDING & M T
Date:
I 1 1
NEW 1000 GALLON CONCRETE
TANK 'NI FILTER.SEE DETAILS.
SHED e
SEPTIC REPLACEMENT' DESIGN / GRAVELLESS CHAMBER
FOREST PARK - LOT t29 & tt31
PLOT PLAN INFORMATION OBTAINED FROM WARREN COUNTY US
AND AS PURPORTED BY PROPERTY MANAGER.
THIS DRAWING DOES NOT REPRESENT A LAND SURVEY AND MUST
NOT BE CONSTRUED AS SUCH.
Mil
k�,Li
163 PITCHER ROAD, QUEENSBURY, NY (TOWN OF QUEENSBURY)
RKDRAWING TITLE:_
ENGINEERING, PLLC SITE PLAN
225RUGGLES RD., SARATOGA SPRINGS, NY
518.581.3893 ftIE NAME SITE
SCALE 1" = 20,-0"
V0: SUBMITTAL / REVISION PP'D. DATE ®ATE JUNE 2015
A ISSUED FOR REVIEW/APPROVAL RKR SA/15
REVISION A
SHEET
C-001 1 OF
2
0 U
w
a0.
SEE PLAN FOR NUMBER
OF LATERAL LINES
GRAVELLESS�
CHAMBER
0; lih(�60111114
II it Il,�ail1:al'
ONE A
LONGITUDINAL SECT
PER NYSDOH APP. 75-A FEB 3, 2016); A 259
REDUCTION IN TRENCH LENGTH IS ALLOWED WITH USE OF
GRAVELLESS CHAMBERS WITH 1.6SF/FT OF BOTTOM AREA
& VOLUME OF 7.5GAL/FT & OPEN SIDEWALLS
INLET
FROM SEPTIC TANK
4" DIA. SOLD PVC
M II
kBLE COVER
13
12" MIN.I
MOUND TOPSOIL FOR SETTLING.
SEEDD AND COVER WITH SAW.
TYP. (— MIN.
— & Min.
—CLEAN SAND, PEA
GRAVEL OR AGGREGATE
(3/4" - 1 1/2")
1. PIPE JOINTS TO BE SEALED LIQUID TIGHT
2. SPEED LEVELING DEVICES SHALL BE USED ON ALL
OUTLET PIPES.
3. SEPTIC TANK TO D -BOX: 4" PVC OR SDR21, LIQUID
TIGHT JOINTS, MIN. SLOPE 1/9- PER FOOT
4. THE SLOPE OF OUTLET PIPES BETWEEN THE
DISTRIBUTION BOX AND DISTRIBUTION LATE=RALS
SHOULD BE SLOPED AT LEAST 1/32" PER FOOT
AND CONSTRUCTED OF 4" PVC SCH. 40 OR SDR21
WITH LIQUID 71GHT JOINTS.
5. USE DOUBLE SIDED STICKING RUBBER BUTYL FOR
DOSED SYSTEMS. pp
NEW CONCRETE
DISTRIBU11ON BOX
SCALE: NONE
I
INS`
LOCKABLE COVER,
JOINT
-Ti-----------
11
tt't X ; 4 �I
Ell' O
II I
I
I� mn } • I'q.
,-
PROJ CT NOTES:
DUE TO GRADE CHANGE
BURIAL DEPTH WILL VARY. 1. SYSTEM DESIGNED IN ACCORDANCE WITH 2010 NYSDOH APPENDIX 75-A.
INSTALL LATERAL END VENTS SEE NYSDOH°S "APPENDIX 75-A, WASTEWATER TREATMENT STANDARDS -
INDIVIDUAL HOUSEHOLD SYSTEMS"& "NYSDOH - (GREEN) DESIGN
IF TOP OF CHAMBER >3' DEEP. HANDBOOK" FOR ADDITIONAL DESIGN AND INSTALLATION GUIDELINES. NO
GUARANTEE ON SYSTEM PERFORMANCE OR LONGEVITY.
f 2 INFORMATION ON THESE DRAWINGS IS FOR SEPTIC SYSTEM DESIGN
11/N
_E I PURPOSES ONLY.
3. CONSTRUCTION SHALL BE AS SHOWN ON THESE DRAWINGS AND
PROPOSED GRADE, SLOPE TO R ACCORDANCE WITH ALL NYSDOH AND SYSTEM MANUFACTURER'S
� REQUIREMENTS.
DRAIN. SEED AND MULCH.
N 4. ALL WORK MUST COMPLY WITH LOCAL, STATE & FEDERAL SAFETY
INSTALL LEVEL, REMOVE REGULATIONS, (NYSDOH, OSHA, NYSDOT). POMITT,NG REQUIREMENTS ARE
DEBRIS, RAKE FLOOR & WALLS. THE RESPONSIBILITY OF THE OWNER.
GROUND WATER, BEDROCK OR 5. HEAVY EQUIPMENT SHALL BE KEPT AWAY FROM THE TREATMENT FIELD.
IMPERMEABLE STRATA NO VEHICLES ALLOWED ON TREATMENT FIELD.
6. SMEARED TRF -A iMEN T AREA FLOORS AND WALLS ARE 10 BE RAKED.
7. TREATMENT FIELD SHALL 4E GRADED TO SHED RAINFALL A,VU TO
APPriaDIVERT SURFACE kUNOFF FROM ADJACENT APEAS.
�M�aTION 3. RECOMMENDATION: Dl?tYNSLGfiE OR SHALLOW WELLS SHOULD HAVE
H;4TA'1 : UV TREATMENT OR CHLORINATION AND FILTRATION SYSTEM INSTALLED.
WELL WATER QUALITY SHOULD BE TESTED PERIODICALLY.
24' DIA . 9. INSTALL EFFLUENT FILTER IN SEPTIC TANK POLY—LOK PL -922 WITH
( _... A RISER OR EQUAL.
—' CUTLET 10. GARBAGE GRINDERS AND WATER TREATMENT SYSTEM SHALL NOT ATTACH
TO SEPTIC. AD SUMP PUMP DISCHARGE ALLOWED. LEAKING FIXTURES WILL
CAUSE FAILURE OF SEPTIC SYSTEM.
PROVIDE EFFLUENT
FILTER. SEE NOTES. APPROVAL STAMP / NOTES
FILTER (POLYLOK ISL -122)
GRADE
�TIONPISHOEIiL, SEED & MULCH
"WATERPROOF SEAL
POLY RISER
( OUTLET
SANITARY
°,
4J�11
JOINT
SANITARY TEE W/
TEE
EFFLUENT FILTER
3" MIN
�o
o a
o `:�Ci `dao'
IF DESIGNED T® USE DQ5TING SEPTIC TANK, PUMP OUT AND INSPECT
EXISTING TANK. PROVIDE WRITTEN REPORT TO ENGINEER.
SYSTEM COMPONENTS SHALL BE
1.
MINIMUM TANK CAPACITY AS FOLLOWS:
MAINTAINED. TANKS SHALL BE PUMPED
OUT AND INSPECTED EVERY 2 YEARS
- FOR 3 BEDROOMS OR LESS TANK SHALL BE 1000 GALLONS6Ii1i
27 S.F. SURFACE AREA. ,.
OR LESS FOR OPTIMAL PERFORMANCE;
- 4 BEDROOMS SHALL HAVE A 1,230 GALLON TANK WITH 34 S.F.
EFFLUENT FILTER (IF INSTALLED) SHALL
SURFACE AREA ;
BE CHECKED AND CLEANED
- FOR EACH ADDITIONAL BEDROOM ADD 250 GALLONS & 7 S.F.
REGULARLY. OTHERWISE PREMATURE
SURFACE AREA
FAILURE COULD OCCUR.
= FOR HOT TUB/SPA AND/OR GARBAGE GRINDER ADD 250
GALLONS TO TANK SIZE FOR EACH.
®'�--
2.
BUILDING TO SEPTIC TANK: 4" PVC SCH. 40 PIPE. LIQUID TIGHT JOINTS,
()�"
MIN. SLOPE 1/4" PER FOOT.�®
K.
3.
EP
SEPTIC TANK TO D -BOX OR PUMP TANK: 4" PNC SCH. 40 PIPE OR
SDR21. LIQUID TIGHT JOINTS, MIN. SLOPE 1/9a PER FOOT.
4.
SEPTIC TANK TC CONSTRUCTED PER NYSDOH GUIDUNES.
A
! i
E!0R
EACH MOBILE HOME UNIT PROVIDE
oil
NEW
1000 GAL CONCRETE SEPTIC TANK
�
7
��0
SCALE:
NONE
Tb l n
SEPTIC REPLACEMENT DESIGN / GRAVELLESS CHAMBER
FOREST PARK - LOT #29 & #31
163 PITCHER ROAD, QUEENSBURY, NY (TOWN OF QUEENSBURY)
D A
tKENGINEERING, PLLC DETAILS
225 RUGGLES RD., SARATOGA SPRINGS, NY
518.581.3893 FIE NAME DETAILS
SCALE AS NOTED
SUBMITTAL / REVISION PP'D. DATE
DATE JUNE 2015
ISSUED FOR REVIEW/APPROVAL RKR 6/5/15
REVISION I A
V SHEET
C-100 2 OF
2
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