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2009-542 �-, TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 C ERTIFICATE %F COMPLIMN C..E Permit Number; P20090542 Date Issued: Wednesday, December 02, 2009 This is to certify that work requested to be done as shown by Permit Number P20090542 has been completed. Tax Map Number. S23400.308-014-0001-052-000-0000 Location: 183 PITCHER Rd Owner. ARC COMMUNITIES 14, LLC Applicant: ARC COMMUNITIES 14, LLC 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 (4 , 4 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 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20090542 Application Number. A20090542 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: ARC COMMUNITIES 14, LLC 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: ARC COMMUNITIES 14, LLC Septic Alteration Residential 900 Total Value PO BOX 790830 SAN ANTONIO, TX 78279-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2009-542 16 BRIWOOD CIRCLE $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,November 03, 2010 (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 theT nofQ � nuy uu 11 esday,November 03, 2009 SIGNED B ,' a'��� for the Town of Queensbury. Director of Build'ng&&e Enforcement OFFICE USE ONLY TAX MAP NO. PERMIT NO. di�/JZPERMIT F ; 9 2009 APPROVALS: ZONING TOWN CLERK ' ;. N OF QUEENS___...____ SU �_ E�fltl fKly &UO ES APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: -rCr64 91.E ����� INSTALLER: ADDRESS: KO ADDRESS:'PbMOLQ PHONE NOS. `�- � � ` PHONE NOS. el 9 LOCATION OF INSTALLATION: YEAR BUILT NO.OF RESIDENCE INFORMATION: X COMPUTATION= TOTAL DAILY FLOW BEDROOMS GARBAGE GRINDER 1980 or older X 150 gallon per bedroom = INSTALLED? 1981 -1991 X 130 gallon per bedroom - SPA OR HOT TUB 1992-present X 1 110 gallon per bedroom = INSTALLED? 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 SUPLY: Municipal Well (If well: Water supply from any septic system absorption is ft.) ✓ PERCOLATION TEST: Rate is per minute per inch. (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: GALLON (MIN. SIZE IS 1,000 GAL.) Add 250 gallons to the size of the septic tank for each garbage grinder,spa or whirlpool tub. SYSTEM TYPE: ❑ ABSORPTION FIELD (WITH NO. 2 STONE) Total length _ft. Each trench 6 X ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? ❑ ALTERNATIVE SYSTEM Bed or other type? ❑ HOLDING TANK SYSTEM Total required capacity? Tank size? 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 misranraQam+n+;-- ._ failure to make a material fact nr cirniirv+�+.,.,,.-- ------ Septic Inspection Rep Office No. (518) 761-8256 Date Inspection es Queensbury Building &Code Enforcement Arrive: =I- Dart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initi s: NAME: F_-F~-�[ PAV PER' NO.: C59 :�E L.`Z LOCATION: 1U, oze_ wrcv RECHECK: CAQL IN ECT ON: Comments and/or diagram Soil Type: Sand Loam/ Clay Type of Water: Municipal Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - 1 Y N N/A Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: Y N End Cap Y N Inlet/Outlet Pipes &Baffles Y N Location Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N Engineer Report and As-Built Y N Location of System on.Property: Front ar Left Side Right Side Middle Front Middle Rear s Us s Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc Septic InspectiofEON: Office No. (518) 761-8256 Date Inspection r Queensbury Building &Code Enforcement Arrive: \: 2K` %part: a� 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial NAME: Q P .: 1 "Y LOCATION: a I RECHECK: Comments and/or diagram Soil T oam/ gLay Type of Water, unicip ater Wa ration distance L -V--- Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - 1 Y N N/A Absorption Field: Total length Z Z, ft. Len th of each trench Z + ft. Depth of trenches Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank i_ 1` c-jA I Tank to Distribution Box L 'i (- } Distribution Box to Field/ Pit Lit � Opening Sealed: Y End Ca _ _N Inlet/Outlet Pipes&Baffles N Location Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. n Y N En ineer Report and As-Built Y Location of System on Property: Front Rear �f��eht Side Middle Front Middle Rear System Use Status: F L �►���� pproved �' i Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved l..uw�`z � Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc STATE OF NEW YORKNnv DOE DEPARTMENT OF HEALTH wl� C7 uEENSEtUR' Gins Paps D1401 !OMb BUILDIIVY _ODES 77 Mahican Street Glens Falls,New fork 12801 (518)793-3M Fax Alchard F.Dairies,M.D. Wendy E.Saunders Commisskww Chief of cuff To: joyr� From: KRts v� l - Fax: �,� Pages ind cover: Phone: -i-(p 1_199 as'6 Date: Re: Comments: 'jLA iGH iS n cb �►p• CryaDt otiJ�Ir WPP�ovr41.� CsyfZW► i -►�iJcf-�► RIZI—'Gt[ri ©i= AS — 6ULu— Z, De'V— L . NEW YQRK STATE DEPARTMENT OF HEALTH f� Inspection Continuation Bureau of Community Environmental Health and Food Protection / / Sheet Page 1.of� Facility F�_Ovm�t q Name ?Aev.- M"� Facility Code vjto- (DI aYY RT INISH Nameti�LO►#If p �j{�1tJ� © �pJ Facility Type p I peGtiort Time I k+ 15, PART I-eBff9C 171S.These items relate directly to factors that lead to injury and illness_The a mus co t edi ITEM DESCRIPTION OF VIOLATION 1 OI�S►Tf,_0 �►�.�-'1i�-6�4ir-�� L`.�- " - At t E'.tW�=✓O P�.it> QuU�-t +�-d ira ti�H-TttE, Fp W t I�t, Carte fl t i Iq� ' _ l A`� 1L1 t_IA+tJS r4uS% � SOP" +it%p �v 'P►, Gr 1�IPrIJ�H o•� "1"1 Hotrti><tA►� ��. ' Ids rr'a�.l� �'a 1�'a� bJ+�� i� t.3ls REVt,s+cam �-t �� {�+•�ot� , �1 us y �r� Q��'=c.�t�a►�� �� a �tic'- t�S rrr� AflD r�0+ 1tJDt. %i 4O 1 e V-1 1/aLL, {bs Alb ArJ LbtJM C OLD) N E ITEMS: EM DESCRIPTION OF VIOLATION (�2 J.c trx.14'►t�t� o i t,_ pint� �• oiJ t�s �f vi e-I� °+Su �"�►t,Ve� io R2o�tr� +,��oR.c-t��tatJ Qzrau�i�� P.j-1 i���yF� t-�oi€7D �utJ� ��-t P�stx�"�,,�����g,�- ,Au�o►� -� Flt�ns � ��7v JIJ°t1 LOt� IFA ltJ�r' �ORxS i A��- A utov L-(ou Q— 1i4 ;, 1'p�11tSi+t1i'f f.�A�M�i9 LECT110IN BY: REPORT RE IVED BY:(Signature) 1331f021081 ED AR �- Ito 9T • o,g�°' y INSTALLATION OF 14 SII NUCONSEPT INSTRUCTION DOUBLE WALL LIO-W/ PACKET 20' MANWAY OPENNING SEITI AL NUMB o e BAR CODE LABEL 4' INLET $ . 62.00 i 4' OUTLET TE' e INVERT J V 1 L 50.25 48.00 L I OU I D LEVEL !`! 25 NOMINAL WALL 64.00 99.33 ~� (o I I d i nens i ns i n j4jches=)-' 12' SEPTIC/CISTERN RISER WWJMHOP GREY [P/N 5160000W9=13 - OPTION& - NOT SHOWN PART # TANK:'---' "5 XMffl0W95 07 (M) HDLPE/WGRY 1050 SEPTIC SINGLE COMPARTMENT PLUMBED REF # 00000 04/03/07 believe t aw evideuCe of, , NOT ' ; n d Qr trees fences,at, t�!ave� a h as houses,wP,ls, nt that I have all ob,ec s s' l also rePTe�Y h a, the diagTam" WY.5.DEFT.OF HEALTH DE51GN 11AND800K 199G POP INDIVIDUAL RESIDENTIAL WA5TEWATER TREATMENT 5Y5TEM5b TO BE U5ED FOR DE51GN 5TANDARD5 1. "4'r mum separation d stance of septic tank from structure to be 1 O 2 M.mmum separation d stance of d stnbut,on box LOT (� and absorption f eId from structure to be 20' I LO I 16 3. 5pac ng of absorption field laterals shall be 6 OC and shall be of equal Iength I I I�i }1�-f •' LCIL` I 4. P.tch of absorption field laterals shall be f I a I I,G`-1/3 2"per foot of run ICVIi`,OI-� LI 131R yp 5. No driveways,large plantings or permanent ^t� ��Ip� C�^y�pep- Pw BtI:.-DING eS ODES �,,.,,,,_g structures shall be placed within G'of TOWN V N OF QUGC R B � ""` absor?ton field laterals,min,of 10' from property lines BUILDING&C D C I _ G. Percolation of sod s 2mm. 17se 1—h y RBViGWG'd© AS BUILT 7. Design flow is 2GO GPD 7 8. Total combined length of absorption laterals Date. DI to be 120 Im,ft. 9. septic Imes from structure to septic tank FROFOSED shall be Schedule 40 PVC and shall have 11,050 GALLON pitch of 1/4 inch per foot .SEPTIC TANK 10. Deep hole observations: o"-G°topsail PROPOSED I OO ( 'EXISTING G"-18"yellow sand G-HOLE l(I)50'LATERAL 18"-3G"gravel DIST. BOX xx ITO BE ABANDONED 30-72"yellow sand no water or mottlmg @ 72" U I I. Residence supplied by municipal water I Q 12. Field location to be adjueted as necessary 13. Old system backwashed several times, EXISTING tIEX 7N�washed and cleaned with 30 gallons of bleach PINE TREEjand back filled with clean 51114. 5ee attached for se tictank detailand manufacturere dataw C? E• L I EXISTING o p k °� wmurowow � 9 + RESIDENCE 300 GALLON F -� I TEST PIT N METAL S „ n� oxwu aao "I f�R Oro V EPTIC TANK x/� Pfl °I a ITO BE ABANDONED a G 1 � W1211 uJ - ' it -4 �E � - 1 '/ flSr32'PER FD]f Wpl w�4lEfl ttmo O __-____.-- TRENCH PROFILE TRENCH SECTION I w �< �tSD n q a y } f 42,00'I F0FN� BRIWOOD CIRCLE