2008-268 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
4z Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
PennitNumber. P20080268 Date Issued: Wednesday, September 15, 2010
This is to certify that work requested to be done as shown by Permit Number P20080268
has been completed.
Tax Map Number. 523400-301-006-0001-053-000-0000
Location: 19 SUGAR PINE Rd
Owner. THOMAS & CONSTANCE KEEN
Applicant: THOMAS & CONSTANCE KEEN
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,
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: P20080268 Application Number. A20080268
Tax Map No: 523400-301-006-0001-053-000-0000
Permission is hereby granted to: THOMAS & CONSTANCE KEEN
For property located at: 19 SUGAR PINE 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: THOMAS & CONSTANCE KEEN
Septic Alteration Residential
19 SUGAR PINE Rd
QUEENSBURY,NY 12804 Total value
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2008-268
SEPTIC ALTERATION
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday,June 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 own o ee ®� A4rry—,
June 09, 2008
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
........ .....��......r.r...r....................... ...... . r.
3 OFFICE USE ONLY �N
TAX MAP NO. / PERMIT N0. yPERMIT FEE—t?
yI
APPROVALS: ZONING TOWN CLERK rl g '.� It
APPLICATION FOR SEPTIC DISPOSAL SYSTEM
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT. ``�
OWNER: drips 1 CU/�S7gitC • �C INSTALLER:
ADDRESS: Star+✓ / � °� �'' ADDRESS: �),Rr
PHONE NOS. 7�d ' :�i y f'IS�I' `115���1 6 3�
PHONE NOS.
LOCATION OF INSTALLATION:
ffd.1•dF » RESIDENCE INFORMATION:
».».•.................•........ .. .._............
YEAR BUILT X COMPUTATION: a TOTAL DAILY FLOW
• ___ BEDROOMS GARBAGE GRINDER
1980 or older» »X »»160 gallon per bedroom» »_ »»»»»»»•»..»»» »»»»»»»»»»»» INSTALLED?-O1
»» 1981 •1991» » .X» »»130 gallon per bedroom. _ _ »1..... »»» SPA OR HOT TUB
�»1992•present. ..............» »N.....-... X. 110 gallon per bedroom... !.•_.. .........»•..r...•,.••�.••.....•.».».».......r.•...,.i`` INSTALLED?
...N_..N».N...N.N...»».. .».»..»....................NN.N»»...•....».H.».......................»..•............. �».....».... ... l
PARCEL INFORMATION: f �:nr �,j y�_�J»_ ' f f b.»»»t Ir?,spa Pe In
✓ .TOPOGRAPHY: FLAT ROLLING ✓ STEEP SLOPE %SLOPE
✓ SOIL NATURE:SAND ✓ LOAM CLAY OTHER
✓ GRQUNDWATER: AT WHAT DEPTH? BEDROCMMPERVIOUS MATERIAL: AT
WHAT DEPTH?
✓ QOMgSTIC WATER SUPLY: MUNICIPAL 4 WELL
(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
IV gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub.
✓ SEPTIC TANK: 1 00'C GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH FT.
N
.� ✓ TOTAL SYSTEM LENGTH: i 41 FT. SEEPAGE PIT(S): HOW MANY?
��— I ✓ SIZE OF EACH FT.X FT.
�r-
� ✓ 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./TOTAL CAPACITY: GAL.
NVI.IrNNI•NIN.I4N4.NI•IrN1.N..NNNN144.1444.......NNI.1.1.1.14.1.1.1.1.1.1.1.1.IN.1•..1.......4•NI.1.1•N......I.N.N.WI......I.1.1•MNIN4.NN........NNIN4..•.•..1.1.1..•1...1•N...1•.•NIN...N .....4•NIN44•NN•N•1.1.1•...W...4.1•.•1.1.1.NI•N14r14NN•.•IMVwNW....•...•1.1•I4•.r..
i NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
+ APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. i
N V.4•NI.1•V1.144.14•NNI.NI•NI4...NNI...NINNNN•IN.NI.I•I44...N!•1.W NNN•...NNN.N1•I.NNI.....NIN4.1.1.1.INN4..4 ....NNNNI4.1.144.1N4N•INNN.NNNI.1.1•NN1.14.NNNN.NN•1.......14•1.144N.......4•.•NN.4•NI.NNNNI•NNI4.......1•NNI.1.1•I.1•NI4.1•N1444.NNNIN•1.....
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 voidIl
I have read the regulations with respect to this application and
agree to abide by these and all requirements of the Town of OUESTIONS? CALL 761. :14 OR EMAIL
Queensbury Sanitary Sewage Disposal Ordinance. coduCaueensburvnet
�J VISIT OUR WESSITE FOR MORE INFORMATION
Vwyw
Signature of Person Responsible Date
Town of Queensbury- Community Development Office- 742 Bay Road, Queensbury,Ny 12804
Septic Inspection Report
Office No. (518)761-8256 Date I11niffio
Queensbury Building&Code Enforcement Arrive: a m rt arriden742 Bay Rd., Queensbury, NY 12804 InspecNAME: NO.:LOCATION: c ,YiSPECT ON:
RECHECK: 23S:z cff
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' +/ - Y N N/A
150'to well required if NO
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft. �� �'►� a�Z17
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 t�
Opening Sealed: Y N
End Cap Y N
In Outlet Pipes&Baffles Y N
Manholes 12"or less below grade Y N
extension collar if Yes 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
ETU Maintenance Contract iY_.__N
provided
Location of System on Property:
Front R Left Side Right Side Middle Front Middle Rear
stem Use
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
L:\Pam Whiting\2010\80ding Codes Formsunspecbon Forms\Septic Inspecbon Report •0:3 2910.doc
14
3" CD --3'
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart:,O-I?,en am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: Jv
NAME: E E PERMIT NO.: Q
LOCATION: 1k) INSPECT ON:
RECHECK:
Comments and/or diagram
Soil T m/ Cla
Type of Water: u a eil Water
—Waterline—a—ration distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length
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
AL—
Distribution Box to Field/ Pit -Opening Sealed: Y N T�
End Ca Y N
Inlet/Outlet Pipes &Baffles ' Y N
Location Separations
Foundation to tank
Foundation to absorption ft. --�
Separation of Pits ft.
Conforms as per Plot Plan
Engineer Report and As-Built N
Location of Systenear
operty:
Front Left Side Right Side Middle Front Middle Rear
5ystem UseVApproved
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
�'L
t I IY
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection req iv
Queensbury Building&Code Enforcement Arrive: .a part: _
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: P IT NO.:
LOCATION: !9 G'ao t L� I PECT ON:
RECHECK: _ZD
Comments and/or diagram
Soil T Sand Loam Clay
TyjLe of Water: Municipal Well Water
Waterline separation distance ft. 1 �JF►LT -i�� b��"ti�a-!;
Well separation distance ft.
Other wells ft.
Absorption Field: Total length ft. 3 a� LAB
Length of each trench ft.
Depth of trenches ft. !LA XA UV-
Size of Stone
Seepage Pits: Number Mcw)�M�?M � N��1S1 14
Size: x
Stone Size:
Piping Size Type
Building to tank PLO M(3! IJG FI X-Tl)� WIt
Tank to Distribution Box
Distribution Box to Field Pit
Opening Sealed: Y I N Partial '6R\1(t'--�6 V V—�
End Ca
Inlet/Outlet Pipes&Baffles Y N
Location Se rations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Repqrt and As-Built Y N
Location of System on Property:
Front Rear Left Side Right Side
Middle Front Middle Rear
System Use Stattuss
fApproved
Partial Approved and needs to be re-inspected, please call the Building &Codes Ofte
Disapproved
Last revised 021006
Last revised 1/6/05
STREAM PROPERTY LINE
PROPERTY LINE
WELL IN
0§1
WATER POND
TIG yy\IN ING W G� ' 154
` CASING./
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HOUSE 2 �� \N�MJ GARAGE (L
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CV TANK W 2
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ABSORPTION FIELD
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PROPERTY LINE
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SEWAGE SYSTEMS: SEPARATION REQUIREMENTS - ABSORPTION FIELD
Please refer to Queensbury Town Code, Sewers and Sewage Disposal, Appendix A, 136:A1 and
Appendix B, 136:A3, for more detailed information on SEPARATION REQUIREMENTS.
vzr-pj cmm I IUN KtQUIREMENTS - SEEPAGE PIT
POND
PROP,�Ft'!'l U1N� r \
WEII IN
Please refer to Queensbury Town ( WATER �-15'MIN
TlCiliT
Code, Sewers and Sewage Disposal, C"'Ni
Appendix A, 136:A1 and Appendix B,
136:A3, for more detailed information o
on SEPARATION REQUIREMENTS. 2
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x 8
v SEPTI TANK GARAGE
ISTRIBUTION BOX0
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Community Development Office
Town of Queensbury • 742 Bay Rd. l r s211
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Queensbury, New York •12804 PLOT PLAN '
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Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property s
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SYSTEM SIZING '
SYSTEMS INC
Quick4 Equalizer 36 Chamber System Sizing in New York
Table 1 provides chamber adsorption system sizing guidance based on the NYSDOH Interoffice Memorandum,Onsite Wastewater Treatment Systems;Specific
Waiver Criteria-Gravelless Systems and Secondary Treatment Units(STUB),dated November 24,2004. This NYSDOH memorandum provides trench length data
based on a 25%length reduction and design flow reduction from 130 to 110 gpd/bedroom. Table 2 provides similar chamber sizing guidance to Table 1 with
respect to the length reduction,but assumes a design flow of 130 gpd/bedroom.
TABLE 1:QUICK4 EQUALIZER 36 CHAMBER SIZING CHART FOR 110 GALLONS/DAY/BEDROOM AND 25 PERCENT LENGTH REDUCTION
Number of Bedrooms
2 3 4 5 Each Additional
Percolation Application 220 GPD 330 GPD 440 GPD 550 GPD 110 GPD
Rate Rate
(minlin) (9Pd/sf) Min.Trench Min.#of Min.Trench Min.#of Min.Trench Min.#of Min.Trench Min.#of Min.Trench Min.#of
Length(ft) Chambers Length(ft) Chambers Length(ft) Chambers Length(ft) Chambers Length(ft) Chambers
1-5 1 1.2 69 18 104 26 138 ' $5 172 43 35 9
6-7 1.0 83 21 124 31 165 42 207 52 42 11
8-10 0.9 92 1 23 138 35 184 46 230 58 46 12
11-15 0.8 104 26 155 39 207 52 258 65 52 13
16-20 0.7 118 30 177 45 236 59 295 74 59 15
21-30 0.6 138 35 207 52 275 69 344 86 69 18
31-45 0.5 165 42 248 62 330 83 413 104 83 21
46-60 0.45 184 46 275 69 367 92 459 115 92 23
FULL AND REDUCED LENGTH ABSORPTION AREA AND VOLUME COMPARISON
Equalizer 24 chamber sized @ 1:1 with a 2-ft-wide gravel trench and 130 GPD/bedroom
Design criteria:current Appendix 75-A trench length sizing ► Open bottom absorption area=0.98 sf/If x 217 If=212.7 sf
Percolation rate:8-10 minutes per inch ► Storage volume=4.5 gal/If x 217 If=976.5 gal
Home size:3 bedrooms
Required system length:217 If of trench(per Appendix 75-A Table 4A)
Equalizer 24 chamber open bottom area:0.98 sf/If
Chamber storage capacity:4.5 gal/If
Quick4 Equalizer 36 chamber sized @ 25%length reduction and 110 GPD/bedroom
Design criteria:trench length sizing per November 24,2004 ► Open bottom absorption area=1.61 sf/If x 138 If=222.2 sf(4%greater than
NYSDOH memorandum Equalizer 24) Ir
Percolation rate:8-10 minutes per inch ► Storage volume=8.0 gal/If x 138 If=1,104 gal(13%greater than Equalizer 24)
Home size:3 bedrooms ► Trench length difference=217 ft-138 ft=79 It(36%less than Equalizer 24)
Required system length:138 If Conclusion:Although the absorption system is"reduced"in length compared to the
(per November 24,2004 NYSDOH interoffice memo) length of the Equalizer 24,more absorption area and storage volume are provided using
Quick4 Equalizer 36 chamber open bottom area:1.61 sf/If the Quick4 Equalizer 36 chamber.
Quick4 Equalizer 36 chamber storage capacity:8.0 gal/If
TABLE 2:QUICK4 EQUALIZER 36 CHAMBER SIZING CHART FOR 130 GALLONS/DAY/BEDROOM AND 25 PERCENT LENGTH REDUCTION
Number of Bedrooms
2 3 4 5 Each Additional
Percolation Application
Rate Rate 260 GPD 390 GPD 520 GPD 650 GPD 130 GPD
'
(minlin) (gpd/sf) Trench Length #of Trench Length #of Trench Length #of Trench Length #of Trench Length #of
(ft) Chambers (It) Chambers (ft) Chambers (ft) Chambers (ft) Chambers
1-5 1.2 82 21 122 31 163 41 204 51 41 11
6-7 1.0 98 25 1 147 37 195 49 244 61 49 13
8-10 0.9 109 28 163 41 217 55 271 68 55 14
11-15 0.8 122 31 183 46 244 61 305 77 61 16
16-20 0.7 140 35 209 53 279 70 349 88 70 1 18
21-30 0.6 163 41 244 61 325 82 407 102 82 1 21
31-45 1 0.5 195 49 293 74 390 98 488 122 98 25
46-60 1 0.45 217 55 325 82 434 109 1 542 136 109 28
Table 1 and 2 Notes:
1.Sizing chart based on NYSDOH Interoffice Memorandum,Onsite Wastewater Treatment Systems;Specific Waiver Criteria-Gravelless Systems and Secondary
Treatment and Secondary Treatment Units(STUB),dated November 24,2004. Until changes to Appendix 75-A are promulgated,a specific waiver must be obtained for
reduced length systems,as described in the memo.
2.Apart from the sizing shown above,all Appendix 75-A design requirements for absorption trench systems are applicable.
3.Trench length data shown above does not include the length of the MultiPort End Caps.The laying lengths of the inlet and outlet end caps are 14.5 and
11.5 inches,respectively.
January 2005 www.infiltratorsystems.com For more Quick4 technical and product information,call 1-800-221-4436.
C09A