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2008-206 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number. P20080206 Date Issued: Thursday, April 16, 2009 This is to certify that work requested to be done as shown by Permit Number P20080206 has been completed. Tax Map Number. 523400-301-008-0002-085-000-0000 Location: 36 HILLCREST Ave Owner. JESSAMYN A LAMBERT Applicant: TODD & CHERYL SMITH This structure maybe 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, 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. I TOWN OF QUEENSBURY 742 Bay Road,Qwensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20080206 Application Number. A20080206 Tax Map No: 523400-301-008-0002-085-000-0000 Permission is hereby granted to: TODD & CHERYL SMITH For property located at: 36 HILLCREST Ave 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 Queens bury Zoning Ordinance. Type of Construction Value Owner Address: TODD & CHERYL SMITH 36 HILLCREST Ave Septic Alteration Residential QUEENSBURY,NY 12804 Total value Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2008-206 septic alteration residential $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, May 09,2009 (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 T a ee ry; 4FI May 09,2008 SIGNED BY 'IVfor the Town of Queensbury. Director of Building&Code Enforcement � Xt , OFFICE USE ONLY , TAX MAP NO.AM -L- 07 PERMIT NO.�7 b ERMIT FEE Z&QQ APPROVALS: ZONING TOWN CLERK _ _ _ ; AP�PLICATIQN FOR E�P�IC DISPOSAL SYSTEM PERMIT: TP. IT MUST BE OBTAiNED�EFORORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID A ERM PERMIT. OWNER: A k-'l`� 11� l_FMt�F� INSTALLER: ADDRESS:-(a k wa:S EEi�)r A )E— ADDRESS: PHONE NOS. a-'5s" PHONE NOS. LOCATION OF INSTALLATION: t a H(-_r'1 EhT Ry I!. RESIDENCE INFORMATION: YEAR BUILT NO.OF 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 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 ell (If well: Water supply from any septic system absorption is ft.) ✓ PERCOLATION TEST: Rate is ti — minutes per inch [MPI] (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. i SYSTEM TYPE: Y ABSORPTION FIELD (WITH NO. 2 STONE) Total length ft. EatS-F�- h X Z > M4EEPG� (S) NO. E) ma :::���� e? ❑ 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 Cade of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation 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 with respect to this application and agree to abide by these and all requirements of the Town of QUESTIONS? CALL 761-8256 OR EMAIL Queensbury Sanitary Sewage Disposal Ordinance. codes(ftueensburv.net VISIT OUR WEBSITE FOR MORE INFORMATION www.aueensbury net Signature of Person Responsible Date Ilia Tou"n of QtreensburY- Cormnunity Development Once • 742 Bay Road, Queensbury, NY 12804 B 5-LGL 6/06 .I�...I. ..........IIIIII................r..i.r...r....2 I r.I.....I...r - ..tea... / ICE USE ONLY W-7 EE % TAX MAP O.-�� PERMIT NO. `UPERMIT FEE S� / APPROVALS: ZONING TOWN CLERK MAY 0 8 2008 1 % r.r..r......r.......r.......... .............. . ..r......r : I ... QUEENSF3URY' APPLICATION FOR SEPTIC DISPOSAL SYSTEM P DING & CODES A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. F� /^J �f yy� ' OWNER: �QG`-�//llL�//�4I INSTALLER: ADDRESS:—sJ l(1 [/�C,LiG-�I/ � ADDRESS: PHONE NOS.�T�'6�©4_ PHONE NOS. ' LOCATION OF INSTALLATION: .No...OF.. .......... ...-. ..r.....,...,... -..,...- ._.w.......•....:......... .................. RESIDENCE INFORMATION: YEAR BOIL? BEQROOMS X COMPUTATIONs :- TOTAL DAILY FLOW w1980 or older. ........ .N-.»..N N X 15..... .........n .,....»......-..._... _ _.-_....,..._.......w.-.........»-.... QARBAQE QRINDER�� _ O gallon per bedn�om - -. - - -.. --- - -- INSTALLED? - 1981 -1991 . X 130 gallon per bedroom : SPA OR HOT TUB »..1992--present N ._,.,.............N.--.... ..X- ...�1,10,gallon per bedroom... -.'.. .... M. .............. �. �.... ...� INSTALLED? /Vl� PARCEL INFORMATION: ✓ .TOPOGRAPHY: FLAT ROL LING-Z STEEP SLOE /.SLOE ✓ SOIL NATURE: SANDZ LOAM CLAY OTHER ✓ GR,OUNDWATER, AAT WHAT DEPTH? BEDROCK/iMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPALZWELL (IF WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT. ) ✓ PERCOLATION TEST: RATE IS PER MIINUTE 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).Add 250 gallons to the size of the septic tank and leach field for each garbage grinder,spa or whirlpool tub,: ✓ SEPTIC TANK: GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH FT. ✓ TOTAL SYSTEM LENGTH: FT. SEEPAGE PIT(S): HOW MANY? ✓ SIZE OF EACH FT. X FT. ✓ SIZE OF STONE TO BE USED: #_ /DEPTH OR THICKNESS FT. ✓ BED SYSTEM SIZE: X ✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE ✓ HOLDING TANK SYSTEM:(If required) NO. OF TANKS: /SIZE OF EACH ✓ GALLONS.ITOTAL CAPACITY: GAL. IN•NI,WI.W4,NWN.IN.IN4.N.V.Y......INN•1.l•.•1.1.1•N.•.•I.NI•I.IN.......14.....1.....1•..1.1..N•IN•...•Ni...1..•I.W....N...•l•.•.•...4•.•1N•..NN.N•1N.1N•1•..1•..INN..•...•.N•.•.•I..•.N..........•1.1......•....NN.NN•INN....NN•.•.....•.4N....•.....•l•.•l•.•INN,IN•W........-..•1•N.....N4..... � NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. INN4.1.1•VMN.N•1•INV•WN.IVN.V144N•N.•.NNN•.•I•.N..N.VINN.wNN..N......•1•✓.•.•.•.NN..•........•l•INN•IN4.....1.l•....... NN.I.1•I......NN•...............•.•.•.W...•.........•..NNW.•...•1..•I..4..N•iN•1..NN.I,NINN•I..rNNNI•NI44.NNI.NI.IN.N14•I..............N•..1NN.IN....•.•.N.II 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 misrepresentation or failure to make a material fact or circumstance known by.or on behalf of an applicant, shall be void16 I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town ofCIQIUE:STIONS? CALL 76148288 OR EMAILQueensbury Sanitary Sew a sposaI Ordinance. eodeaftueensburv:net WEBSITE FOR MORE INFORMATION www.aueensburv.net Signature of Person Responsible 540 Town of Queensbury • Community Development Office• 742 Bay Road, Queensbury,NY 12804 Community Development Office 'ce Town of Queensbury • 742 Bay Rd. Queensbury, New York •12804 PLOT PLAN Show all existing and proposed structures. Indicate th setbacks of all structures and buildings from all property lines. SIDE PROPERTY LINE r— ' , , I l I Z _ _ } , rt o LU - S- a i r. { i i m cc CL w - - m � ';_ i ___i..-_.........r._.r._.. _... _. oll Ilk , 4 - ._ ...... i..._ , SIDE PROPERTY LINE 1 SQUARE = FT. A N1 wh Septic Inspection Report Office No. (518) 761-8256 Date Inspection r est ec d: Queensbury Building &Code Enforcement Arrive: a /p epart: a 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials NAME: c� � AAP)EF� P MIT NO.: LOCATION: c'�1'c> {�1 L C' 'T 4A\lE_ PECT ON: ' I — RECHECK: Comments and/or diagram Soil Ty L a la Type of Water i ell Water _ Wa!kine2gffation distance ft. -- Well separation distance ft. Other wells: ft. Well Casing Length 50' + - Y N_N/A Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Af See a Pits: Number Size: x Stone Size: Piping Size Tpe Building to tank �' c-�5► e � Tank to Distribution Box kA V h Distribution Box to Field / Pit ZH I( Opening Sealed: Y Z N End Ca N ,gyp L,oC7� Inlet/Outlet Pipes&Baffles Y N Location Separations i Foundation to tank 112 ft. Foundation to absorption 7-1� fJ ILA Separation of Pits ft. Conforms as per Plot PlanA N v� I Engineer Report an As-Built Y N 1 Location of System o Property: Front ear Left Side Right Side Middle Front Middle S m us• 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 NACE ENGINEERING., P.C. 169 Haviland Road, Queensbury, NY 12804 Phone-518-745-4400 Fax -518-792-8511 April 2, 2009 Project#49285 Mr. Jay Sweet Queensbury Septic Queensbury,NY 12804 Re: Percolation Test Lambert Residence—36 Hillcrest Avenue, Queensbury,NY Dear Jay: At your request we have reviewed your proposed replacement septic system design at the site of the existing 3 bedroom house of Jessamyn Lambert at 36 Hillcrest Avenue in Queensbury. As per our conversation the residence has an existing failed septic systems. 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 330 GPD and a percolation rate of 1 to 5 minutes, you will need 348 square feet of absorptive area. We recommend using a 15 ft wide by 25 ft long absorption bed with 3 — 20 foot long laterals, which will provide 375 sf of absorptive area. The absorption bed should be constructed with a new distribution box, 4 inch diameter perforated pipe and stone. Please call me if you have any questions. Sincerely, � C Thomas R. Center Jr.,�PE " Cc: Dave Hatin, Town of Queensbury MEET C 00Nvk Septic Inspection Repo Office No. (518) 761-8256 Date Ins ionA r eived: �Queensbury Building &Code Enforcement Arrive: 1Depart: `, pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initi NAME: a�$edt E I PER NO.: Z� LOCATION: C© Bit.- C T� X1F INSP ON: — RECHECK: Comments and/or diagram Soil T oam Clay Type of Water: ftnicipal ell Water Waterli ara io distance ft. -zit '-C. Z-b i -tr -6 f)V Well separation distance ft. Other wells: oco Well CasingLength 50' + - Y N _N/A C1 Absorption Field: Total length ft. Length of each trench ft. C F Depth of trenches ft. tot Size of Stone Seepage Pits: Number Size: x I Stone Size: Pi in Size T " Buildingto tank Tank to Distribution Box Distribution Box to Field / Pit } Opening Sealed: Y N l End Ca 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 Rear Left Side Right Side Middle Front Middle Rear System Use Status: epproved partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-01-1)\Building&Codes\Inspection Forms\Septic Inspection Report.doc d 00 wedl.,--es Septic Inspection Report Office No. (518) 761-8256 Date Ins uest received: Queensbury Building&Code Enforcement Arrive: - am/ �epft- am/pm 742 Bay Rd., Queensbury, NY 12804 Inspecto Initials: �V NAME: 5 PERMIT NO.: LOCATION: -e INSPECT ON: — RECHECK: Comments and/or diagram Soil Type: Sand Loam Clay Type of Water: Municipal Well Water Waterline separation distance Well separation distance ft. Other wells: ft• -Absorption Field: Total lengthft. -Length of each trench ft• v!. -Depth of trenches ft• Size of Stone -Seepage Pits: Number Size: x P� Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: Y N Partial End Ca In Outlet Pipes&Baffles Y N Location Se rations Foundation to tank ft. Foundation to absorption ft• Separation of Pits ft• Conforms as Der Plot Plan Y N Engineer Report and As-Built Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 021006 ast revised 1/6/05