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2008-304 TOWN OF QUE E NSB URY 742 Ba Road eensbu NY 12804-5902 518 761-8201 Y ,Qu rY, � ) Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20080304 Date Issued: Monday, June 23, 2008 This is to certify that work requested to be done as shown by Permit Number P20080304 has been completed. Tax Map Number. 523400-308-005-0001-022-000-0000 Location: 9 GLEN Ct Owner. MARK & PAMELA SISSONS Applicant: MARK & PAMELA SISSONS 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 therD 4 1I property owner of the responsibility for compliance with Site Plan, r- � 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. el \ TOWN OF QUEENSBURY Fivis 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20080304 Application Number. A20080304 Tax Map No: 523400-308-005-0001-022-000-0000 Permission is hereby granted to: MARK& PAMELA SISSONS For property located at: 9 GLEN Ct 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: MARK&PAMELA SISSONS 9 GLEN Ct Septic Alteration Residential QUEENSBURY, NY 12804-0000 Total Value Contractor or Builder's Name/ Address Electrical Inspection Agency SANITARY SEWER DAN DRELLOS PO BOX 224 GLENS FALLS NY Plans &Specifications 2008-304 SEPTIC ALTERATION RESIDENTIAL $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,June 17, 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 f Quee ury; Tu sday, June 17,2008 SIGNED BY for the Town of Queensbury. Director of Building&Co e Enforcement 35/ OFFICE USE ONLY " I TAX MAP NO. PERMIT NO.L- PERMIT FEE Z ���.J o "' � � ' S s- V—U APPROVALS: ZONING TOWN CLERK " ' APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJE 0 REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: F'(�L � LESi c) Al-f INSTALLER:; T/ l/ 7e'6,-)--k-- ADDRESS: 9 CL ei2 ©0 Z' ADDRESS: PP - 0Y 2-2% E� F PHONE NOS. 792' -; / 1-1J PHONE NOS. 7 9 d Q 1'Sb LOCATION OF INSTALLATION: NO.OF RESIDENCE INFORMATION: YEAR BUILT BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW GARBAGE GRINL R 1980 or older X 150 gallon per bedroom = INSTALLED? 1981 -1991 X 130 gallon per bedroom = SPA OR,HOT TUB 1992-present q X 110 gallon per bedroom = L,L 93 INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? 6- BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? `' ✓ DOMESTIC O ESTIC WATER SUPLY: MUNICIPAL 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 gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub. ✓ SEPTIC TANK: 12-5.7.a 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. /r ✓ SIZE OF STONE TO BE USED: # 2-- /DEPTH OR THICKNESS i Z FT. ✓ BED SYSTEM SIZE: 2d° ' X 3 L ✓ 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 ensbury Sa ' ary Sewage Disposal Ordinance. codes@queensburv.net VISIT OUR WEBSITE FOR MORE INFORMATION OP www.queensburv.net ignature of P son Responsible Date Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 r Septic Inspection Report Office No. (518) 761-8256 Date In i request received: Queensbury Building &Code Enforcement Arrive: am/p ep art: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspe is nitials: cj "`�`' NAME: 5/.S5 PERMIT NO.: .w C2 LOCATION: `J � 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 Length 50' + / - 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 o Property: Front •-ar Left Side Right Side Middle Front Middle Rear S -m - -tis: 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 -518-792-851 June 27, 2008 Project#49272 Dave Hatin Code Enforcement Officer Town of Queensbury 742 Bay Road Queensbury,NY 12804 Re: Sission Residence—9 Glen Court—Replacement Septic System Dear Dave: This letter is to inform you that we inspected the completed septic system for the Sission Residence on 9 Glen Court in the Town of Queensbury on June 18, 2008. The septic system as installed was for a 4 bedroom house and consisted of the existing 1,250 gallon septic tank, 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, 1:6 -i4 -2* -/Af• Thomas R. Center Jr, P.E. Cc w/encl.: Mark Sissions, w/encl. (ectc ,', •-5 �s-lO Septic Inspection Report Office No. (518) 761-8256 Date In coign request received: Queensbury Building &Code Enforcement Arrive: tN am/PT Depart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspecto s Initials: -�''C� NAME: 5SSojs PERMIT NO.: 111 LOCATION: / f� C • INSPECT ON: _ • ri . RECHECK: Comments and/or diagram Soil Type: oam / Clay Type of Water: __ Well Water Water - separation 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 " S ft. PL u5 Z 1v 6-1) 6f1)i Depth of trenches I ft. Size of Stone ?/ Seepage Pits: Number Size: x Stone Size: Piping �5 e Ty Building to tank (2 >l Tank to Distribution Box Distribution Box to Field/ Pit „ Opening Sealed: N End Cap N Inlet/Outlet Pipes &Baffles _• _ N Location/ Separations Foundation to tank 4/ 7-1. Foundation to absorption . Separation of Pits , . ft. Conforms as per Plot Plan ✓ Y_ N Engineer Report and As-Built _Y_ N Location of S - - -. Property: Fro R-- Left Side Right Side Middle Front Middle Rear m to 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 -518-792-851 June 10, 2008 Project # 49272 Dave Hatin Code Enforcement Officer Town of Queensbury 742 Bay Road Queensbury, NY 12804 Re: Mark Sissions—9 Glen Court—Replacement Septic System Dear Dave: On May 21, 2008, we performed a deep soil test pit and percolation test at the Mark Sissions residence located at 9 Glen Court 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 — 11" Topsoil Stabilization percolation rate - 1" in 2 min., 44 sec. 11 —27" Loamy Medium Fine Sand w/gravel 27— 50" Medium Coarse Sand w/ gravel Mottling observed at 27" Groundwater observed at 50" The 18 inch deep hole was presoaked and the test was run 3 times; at a depth of 12 inches, until it stabilized with three consecutive runs of 2:31, 2:41 and 2:44 respectively. The design flow for this 4 bedroom residence at 110 gpd per bedroom (440 gpd design flow), requires 463 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 8 inches of loamy medium fine sand fill. The replacement shallow absorption bed system should consist of the existing 1,250 gallon septic tank 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. SIDE PROPERTY LINE . . of r Z i` -- Wi .,T cci— 1,, _ i i F ...,...H.1,,,,,1, ,11 o n -� W _ o �' y Q w - - m cc : . . r,,,C) ;\.) �i. 9S` SIDE PROPERTY LINE 1 SQUARE = FT.