2008-275 TOVN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20080275 Date Issued: Wednesday, July 09, 2008
This is to certify that work requested to be done as shown by Permit Number P20080275
has been completed.
Tax Map Number. 523400-297-010-0001-035-000-0000
Location: 3 LYNDON Rd
Owner. CONNIE & BRIAN FISK
Applicant: CONNIE & BRIAN FISK
This structure may be occupied as a:
Septic Alteration Residential
By Oder 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: P20080275 Application Number. A20080275
Tax Map No: 523400-297-010-0001-035-000-0000
Permission is hereby granted to: CONNIE & BRIAN FISK
For property located at: 3 LYNDON 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: CONNIE & BRIAN FISK
Septic Alteration Residential
3 LYNDON Rd
QUEENSBURY, NY 12804-0000 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2008-275
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 T Queens ry; Monday,June 09, 2008
7
SIGNED BY for the Town of Queensbury.
Director of Building&Cod nforcement
----- __ - ____�
/-3-5-OFFICE USE ONLY , '
-Z7 TAX MAP NO. PERMIT NO. PERMIT FEE 00
APPROVALS: ZONING TOWN CLERK 41� ,vy
-------------------------------------------------_--"-_______ '.
:.
)WN
APPLICATION FOR SEPTIC DISPOSAL SYSTEM
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJE T TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT. �� /
OWNER:a q`i (at N S Ic INSTALLER: 4
ADDRESS: :3 �y 47 U Y` c� ADDRESS:
loe
PHONE NOS. J6 PHONE NOS. �L
LOCATION OF INSTALLATION:
:................................................................................................:............:...................................................................... ..... .................................................................... RESIDENCE INFORMATION.
NO.OF
YEAR BUILT X COMPUTATION- = i TOTAL DAILY FLOW
BEDROOMS G
................................................;. -...;............._............ .......................,................ .................. ...................................... GARBAGE
.1980 or older X 150 gallon per bedroom - �..�__............ INSTALLED?
RIN F r... —
.................. .........................;........... ...... ...... ..
................ ...
I 1981 -1991 ' X 130 gallon per bedroomSPA OR
................................................e...................,..........................i...........y.........................................................................y...........i........................................................................... B
T U 1992 present X 110 gallon per bedroom = INSTAL
LED
.............................................
...........a..........................................................................i...........
...........................................................................i
PARCEL INFORMATION: t7
nr
✓ TOPOGRAPHY: FLAT ROLLING � STEEP SLOPE %SLOPE �J �G fAi j"F
✓ SOIL NATURE: SAND LOAM CLAY OTHER
p
✓ �r 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 (2 N A,'a .5 2 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:loco 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: ZU` X
✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
✓ HOLDING TANK SYSTEM:(If required) NO. OF TANKS: /SIZE OF EACH
✓ GALLONS./TOTAL CAPACITY. GAL.
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 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 @pueensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.gueensbury.net
S' nature of Perso esponslble ate
9 Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury,NY 12804
s
169 Haviland Road, Queensbury, NY 12804
Phone-518-7454400 Fax -518-792-851
June 27, 2008
Project#49270
Dave Hatin
Code Enforcement Officer
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Re: Fisk Residence—3 Lyndon Road—Replacement Septic System
Dear Dave:
This letter is to inform you that we inspected the completed septic system for the Fisk Residence on
3 Lyndon Road in the Town of Queensbury on June 10, 2008.
The septic system as installed was for a 3 bedroom house and consisted of a new 1,000 gallon septic
tank, a new pump station, a new distribution box and a new 20 foot wide by 30 foot long shallow
absorption bed. The absorption bed was constructed with stone and 4—25 feet long perforated pipe
laterals. The system conforms to the requirements of the approved design letter.
Please call me if you have any questions.
Sincerely,
homas R. Center Jr, P.E.
Cc w/encl.: Brian Fisk w/encl.
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/DM Depart. am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: t
NAME: ^-�
PERMIT N
LOCATION: _ INSPECT ON:
RECHECK:
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 Len th 50' + / - Y N N/A
Absorption Field: Total length ft.
Length of each trench ft.
De th 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 Pi s&Baffles —Y_ N
Location Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan N
Engineer Report and As-Built Y N
Location of System o Property:
Front ear Left Side Right Side Middle Front Middle Rear
s m 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 Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am,/p i Depart: am/pm
742 Bay Rd.,Queen ury,NY 12804 Inspector's Initials.
NAME: PERMIT NO.: ^�
LOCATION: INSPECT ON:
RECHECK:
Comments and/or diagram
Soil Type: Sand/Loam/Clay
Type of Water: Municipal/Well Water
Waterlines aration distance ft.
Well separation distance ft` `J�`�•�-`�'V�" !
Other wells: ft.
Absorption Field: Total length ft.
Length of each trench ft. j
Depth of trenches ft.
S
ize 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/Partial
End Ca s
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 Sta s•
Approved
Partial Approved and needs to be re-inspected,please call the Building& Codes Office
Disapproved
Last revised 1/6/05
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Rd., Queen�sbury, NY 12804 Inspector's Initials:
NAME: ! / PERMIT NO.:
LOCATION: INSPECT ON:
RECHECK:
Comments and/or diagram
Soil lypfr San oa
Type of Water: Icl a
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N_N/A A',"
Absorption Field: Total length ft.
Length of each trench 17 ic ft. .__.o-�c�� �'"�,A
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size:
Stone Size:
Piping Si e Type
Building to tank SASAO
Tank to Distribution Box
Distribution Box to Field Pit
Opening Sealed; VY1 N
End Ca N
Inlet/Outlet Pipes&Baffles Y N
Location Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits
Conforms as per Plot Plan N
Engineer Report and As-Built Y N
Location of Syste roperty:
VarFront Left Side Right Side Middle Front Middle Rear
System !7,Partial
pproved Approved a needs to be re-inspected, ascall the Building &Codes Office
Disapproved
Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc
169 Haviland Road, Queensbury, NY 12804
Phone-518-745-4400 Fax -518-792-851
June 4, 2008
Project#49272
Dave Hatin
Code Enforcement Officer
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Re: Brian Fisk—3 Lyndon Road—Replacement Septic System
Dear Dave:
On May 9, 2008, we performed a deep soil test pit and percolation test at the Brian Fisk residence
located at 9 Lyndon Road in Queensbury. The tests were performed to the west of the existing
residence in the location where construction of a replacement leach field is proposed. The current
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:
Test Pit Percolation Test
0 —4" Topsoil Stabilization percolation rate - 1" in 13 min., 57 sec.
4—59" Medium Fine Sand w/gravel & some boulders
Mottling observed at 24"
Groundwater observed at 59"
The 18 inch deep hole was presoaked and the test was run 5 times; at a depth of 12 inches, until it
stabilized with three consecutive runs of 13:29, 13:42 and 13:57 respectively.
The design flow for this 3 bedroom residence at 110 gpd per bedroom (330 gpd design flow),
requires 550 sf of absorptive area. The replacement septic system should be a shallow absorption
bed system installed at the existing grade. The topsoil should be removed and replaced with a
minimum of 4 inches of loamy medium fine sand fill.
The replacement shallow absorption bed system should consist of a new 1,000 gallon septic tank, a
4 foot diameter concrete pump station, and a 20 foot wide by 30 foot long absorption bed with a
distribution box & 4—25 foot long laterals located to the west side of the building.
Please call me if you have any questions.
Sincerely,
Thomas R. Center Jr, P.E.
Cc w/encl.: Dan Drellos
Community Development Office
' Town of Queensbury • 742 Bay Rd.
Queensbury, New York •12804 PLOT PLAN
Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property lines.
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SM PROPERTY LINE
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@M PROPERTY LINE
1 SQUARE = FT.
� ACCESS HATCH MOVE INSTALLATION OF DISPOSAL EIEI nS
INLET BAFFLE ,r L s>r•e°� I. CONSTRUCTION SHALL BE AS SHowN ON THIS DRAWING,
IAL AND SHALL BE IN ACCORDANCE WITH THE N.Y.S.
DEPARTMENT OF HEALTH INDIVIDUAL HOUSEHOLD SYSTEMS, AND
►,�:�,:. .t.� ASTM F481-78 INSTALLATION OF THERMOPLASTIC PIPE AND
` f BUILDING; O O CORRUGATED NK"TUBING IN SEPTIC TA LEACH FIELDS
�
2. NO HEAVY EQUIPMENT SHALL BE ALLOWED WITHIN THE LIMITS
OF THE DISPOSAL FIELDS AFTER PIPE INSTALLATION HAS BEGUN.
SWW PEAGRA TAW I AFTER EXCAVATION OF BED TO THE DEPTHS REQUIRED,
MDR
aC FROM
FROM HOUSEfl AT
10�W.LRE �.�FRA eA: T WALL BACK 70 FULP STATION ILTA THE WALLS AND FLOOR OF EACH SIDE WALL SHOULD BE CLEANED TIOIT roar ro PVC FpE yM �; AND RAKED TO ACHIEVE AN EVEN SURFACE AND 70 LOOSEN
' :��
a oPE t� a L ,. SMEARED SECTIONS OF TRENCH.
'. a F1�F1�
DIs7R ovow BOL of BE t/UE' • : : • 4. PLACEMENT OF THE PERFORATED PIPE SHALL BE AS SHOWN.
(SEE NOTE 4) 4-0�'ID PRS9CAST OO ONE
MANROLE WI1H M7E10RAL FL(A EFFwENT M WP THE PIPE SHOULD BE LAID AT THE GRADES AND TO THE
1a• ION AND Fur SLAB TOP. NE1f�) RELATIONSHIPS SHOWN ON THIS DRAWING, MAINTAINING STRAIGHT
SEE NOTE a 1�NNOOIE 5 Y AS YAMUFACRRED OR EGUV LAooER NRIOB) CONTINUOUS GRADES WITHOUT SAGS, HUMPS, SEPARATED JOINTS
OR OTHER UNSUITABLE CONDITIONS.
SEWAGE DISP AI LAYOUT IT PtIIIP ZA7M 5. ALL TO DIVERT SURFACE RUNOFF FROM TO SHED
Wt ENT AREAS AWAY
u 10�1. FROM THE DISPOSAL FIELD.
��• PLAP OR" AT A IfMM OF 30 GPM
1. TEE FIELD 10 BE 100'OR MOE FROM ANY AT BO FEET TOTAL OVNAIBC WWAD. F%W 70 BE 1/3 HP GOADS 6. REMOVE LEAVE
MODEL OR S. ROOM PLANTS AND ORGANIC DEBRIS. PLOW SURFACE PRIOR
OR M RE FR0 My OR ER LINE tINDE A10 10' z PUMP CONTROL PACKAGE 70 BE SUPPLED BY MAMWAC7UR8t TO SPREADING FILL MATERIAL
OR MORE fa1O1 ANY WI17ER LINE INWDER PRESSLltiE OR W-Www PoO.. NJME AND Y18BF MAN/TO BE ACTNMED BY ALARM FLOAT
f z FOR SENASE PPE BETA No=AND anymo U7IDN Boa 3. PULP CYCLE VOWME aZ GALLONS(BGX OF ASSOIW7=FIELD VoU0114
USE OICIl E OR CAST MON PPE,OR SOEMILE 40 7. DO NOT USE HEAVY EQUIPMENT WITHIN THE ABSORPTION FIELD AREA.
PVC MIN Cf]E71TED jam
3 DISC14ARGE FOONK ROOF M CELLARCELLAR DRAINAGE
AWAY FROM SEWI>�SVSTEy, 8. NO PART OF THE DISPOSAL FIELD SHALL. BE INSTALLED UNDER DRIVEWAYS
yy g�,pp� 7p p�
4. DISPOSAL Fal)SHALL BE CORSIRUCIED PARALIEL
WITH Awl1Y FRpA BED
CQN7OW LMES
L FOR RAISED ABSORPTION 1REKm SYSTEW WNBBtO1TAL SWARATM S�IU:AT Uf+!#1 SIDE 3�
DISTANCES WALL BE MEASAW FROM TINE EDGE W TINE FLL OF BID 1C DRAM NMOFF
E� Ir ,r SAGTa71 EARTH
j TER FABRWC
OR GE01E71M 2.
r MIN. lr 4WRA10
REC4BE10 AqLL+pA�D=
LA
CWAKCUT RAmmmr , OW 3 4/"Mil
E1R91APPROOa ATf FLASH GRADE 5' — 0' u.1IDL dtUSFED
E MSIMD GRADE 2 — ' TYP.
IYP.
Li
L1E�N. TEM
MM.AWE LIQUID LEVEL Lu 12" M
1/r PER FOOT " MIN sLaPE ' II
SEP7NS T INLETt OLIILET I/ PER FOOT 8' MIN.
BY FORT MI IM OR S
E70UAL '
8' MIN. jaOTTOMMeOWFBM - INTERCONNECT ENDS
�— PERFORATED PVC OF LATERALS
LATERAL. LAID LEVEL
NORM 2x YAM
MA1011LRI Mc WIDTH
WA�LI ER TAW SAW
SEPT}_C TANK
N.T.S.
SEPTIC TANKS
i.ALL UWIS SHALL COMPLY WITH 7WE REQ MEMERTS OF THE NEW YM
STATE DEPAITIENT OF NEAL7N AND SIWL BE PRECAST C0MCI EIE
AS MAMUPACRI RD BY FORT MUM OR EWVALENT.
Z.ALL STRIXILAES 70 BE PLACED ON Fift COMPACT SAID OR
GRAIL WI�rER EIESIMG F�►ED �� STANDARD SEPTIC SYSTEM
� � ���� FISK
NECESSARY 10 ACHIEVE ASTABLE FOMOATIOL. NACE ENGINEERING,P.C.
a O�ESIGNED FAUED M OR H-20 t M L 7RAFFIC AREAS OWL
0 QW Df1RA WAVY 169 HAVILAND ROAD 3 LYNDON ROAD DETAILS
QUEENSBURY, NY QUEENSBURY, NY
NWM WAM NIYr TO WAN DAM 06/04/00