SEP-0694-2018 TOWN OF QUEENSBURY
+, 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development - Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: SEP-0694-2018 Date Issued: Friday, November 16, 2018
This is to certify that work requested to be done as shown by Permit Number SEP-0694-2018
has been completed.
Tax Map Number: 302.18-2-68
Location: 5 BENTLEY PL
Owner: Larry Levine
Applicant: Center Project Services
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
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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.
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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-0694-2018
Tax Map No: 302.18-2-68
Permission is hereby granted to: Larry Levine
For property located at: 5 BENTLEY PL
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: Larry Levine Septic Disposal-Residential $0.00
Owner Address: 7 Raceway RD Total Value $0.00
Jericho,VT 05465
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: Tuesday,November 5,2019
(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 expiration date.)
Dated at the Town of Queensbury; Monday,November 5, 2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only
742 Bay Road,Queensbury,NY 12804
Town of(titan P:518-761-8256 www.queensbury.net Permit#: ��"` � - ZQA�
Tax Map ID#: 302.18-2-68 Permit Fee:$1-5 ; Invoice#: 14
Project Location: 5 BENTLEY PLACE Septic Variance? Yes No
Primary Owner(s) LARRY LEVINE
Mailing Address 5 BENTLEY PLACE I
Phone & Email 802-238-7866 lEGEOWEE
Installer/Builder SANITARY SEWER SERVICES
Mailing Address LUZERNE ROAD,QUEENSBURY NY NOV 0 5 ZO1
Phone & Email 5187963760
Engineer TOWN DING&CODES
QUEENSBURYOF
g TOM CENTER-CENTER PROJECT SERVICES ......—.•
Mailing Address 73 SHERIDAN STREET,GLENS FALLS,NY 12801
Phone & Email TCENTER36@YAHOO.COM
Contact Person for Building&Code Compliance: GEORGE DRELLOS Phone: 5187963760
RESIDENCE INFORMATION:
Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes No
1980 or older Installed? (circle one)
1981-1991 Spa or Hot Tub Yes OD
Installed? (circle one)
1992-Present 3 110 330
PARCEL INFORMATION:
Topography ✓ Flat Rolling Steep Slope %Slope
Soil Nature Sand Loam Clay Other
Groundwater At what depth? DEEPER THAN 6'
Bedrock/Impervious material At what depth? NONE
Domestic Water Supply j Municipal _Well (if well,water supply from any septic system absorption is ft.)
Percolation Test Rate: 1'-5' per minute per inch (test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION:
Tank size 1000 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: 20 X 25 FT BED
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: TOM CENTER DATE: 11/2/18
SIGNATURE:
Town of Queensbury Building&Code Enforcement Revised February 2017
CENTER PROJECT SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
November 2, 2018
Project#279
John O'Brien
Code Enforcement Officer FILE COPY
Town of Queensbury
742 Bay Road r j C CE '
Queensbury,NY 12804
Re: Levine—Replacement Septic System NOV 0 5 2018
TOWN OF QUBBNSBURY
Dear Dave: BUILDING&CODES
On October 29, 2018, I performed a deep soil test pit and percolation test at the Levine residence
located at 5 Bentley Place in Queensbury. The test was performed to the south of the existing
residence in the location where construction of a new leach field is proposed. The residence has
an existing failed septic system which will be decommissioned upon completion and certification
of the replacement system.
The results of the testing are as follows:
Deep Soil Test Pit
0—9" Topsoil
9—24" Loamy Medium Fine Sand
24—63" Medium Fine Sand
Mottling observed at 40", Moist @ 45"
Percolation Test
Stabilization percolation rate - 1" in 1 minute, 01 seconds
The hole was presoaked and the test was run 3 times until it stabilized with three consecutive
runs of 1:00, 1:00 and 1:01 respectively.
The design flow for this 3 bedroom residence at 110 gpd per bedroom requires 348 sf of
absorptive area. The new replacement absorption system should consist of a new 1,000 gallon
septic tank located south of the residence, a new distribution box, a 20 foot wide by 25 feet long
absorption bed(500 sf) with 4—20 foot long laterals located to the northeast of the residence.
See the typical detail sheet attached for installation details.
Please call me if you have any questions.
Sincerely,
Thomas R. Center, PE
• � 4r�
CENTER PROJECT SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
November 16, 2018
Project# 277
Charlie Dyer
Code Enforcement Officer
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
Re: Levine Residence—Replacement Septic System
Dear John: Z..zbc--t _ j B
This letter is to inform you that we inspected the completed replacement septic system for the
Stetson residence located at 5 Bentley Place in the Town of Queensbury on November 14, 2018.
The replacement septic system as installed was for a 3 bedroom home and consisted of a new
1,000 gallon septic tank, new distribution box and a 20 ft wide by 25 ft long absorption bed with
4—20 ft long pipe and stone laterals.
The system conforms to the requirements of the approved replacement septic system design.
Please call me if you have any questions.
Sincerely, NOV 16 2016
TOWN OF QUEENSBURY
Thomas R. Center, PE BUILDING&CODES