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2007-398 (2) 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. P20070398 Date Issued: Thursday, August 26, 2010 This is to certify that work requested to be done as shown by Permit Number P20070398 has been completed. Tax Map Number. 523400-303-016-0001-011-000-0000 Location: 69 QUEENSBURY Ave Owner. FRANCES M DUELL Applicant: WILLIAM & FRANCES DUELL This structure maybe occupied as a: Septic Alteration Residential By Odder 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: P20070398 Application Number. A20070398 Tax Map No: 523400-303-016-0001-011-000-0000 Permission is hereby granted to: WILLIAM &FRANCES DUELL For properly located at: 69 QUEENSBURY 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 Queensbury Zoning Ordinance. TWe of Construction Value Owner Address: WILLIAM &FRANCES DUELL 69 QUEENSBURY Ave Septic Alteration Residential QUEENSBURY,NY 12804 Total value Contractor or Builders Name/Address Electrical Inspection Agency SANITARY SEWER DAN DRELLOS PO BOX 224 GLENS FALLS NY Plans &Specifications 2007-398 SEPTIC ALTERATION RESIDENTIAL $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday,June 29, 2008 (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 Tfo'�Queen j� 'r V ` ri ne 29, 2007 SIGNED BY b< V; for the Town of Queensbury. Director of Building&Code Enforcement ..........r...r..r OFFICE USE ONLY � r � ' i TAX MAP NO. / J PERMIT NO. ERM1T FE '/ ' / 0 APPROVALS: ZONING TOWN CLERK ; APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJEC TO REVIEW BEFORE SSUANCE O A VALID PERMIT. / OWNER: (� �I INSTALLER: A-/V ITW �IG�J "�`'{ C� ADDRESS: r V Q ADDRESS: 1 y S? b PHONE NOS. 7 - PHONE NOS. LOCATION OF INSTALLATION: .......................•.........._..............................•................... ................................_.._.................................... RESIDENCE INFORMATION YEAR BUILT X COMPUTATION- I TOTAL DAILY FLOW BEDROOMS 1 GARBAGE GRINDER _...... ._... .. ... . .... ............................„.-.....•_.........•......•............. p .... .... ..._....... 1980 or older X 150 gallon per bedroom i 1 i INSTALLED? ...1981--1991-....: ..........•...........•............• .•X.. .....130 gallon per bedroom....1,..�...................................................•................... SPA OR HOT TUB ... #.•.•......... ......•...........•..•..........,............,.....,...........•.............................................•... INSTALLED -••..1992-•present...........•... xI..........10.gatlon per bedroom.......;..._...!,..........,�`�.�......................................., ? PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND ZLOAM , CLAY OTHER ✓ GR;OUNDWATER: 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 /^'`'11A-C- 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: 003 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. :.:.,.,•....:...........................................;.:...........................................................,.................................:...:.,.:,:.:.................:.:.:.:...,.,.,.,.:.,.,.:.:.,...,.,.,.,.,.:.................:..............•..,.....:.,.,...............:•..,..,..:.,.;.,........................... �:.,.,.,•,.,•:.,.:.,.,.;; NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. 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 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 sbury Sanitary S W e Disposal Ordinance. codes@aueensburv.net VISIT OUR WEBSITE FOR MORE INFORMATION 624- n ©� www.aueensburv.net gn'ture of Person ponslble D to fi Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804 -5yr l ail=� Septic Inspection Report Office No. (518) 761-8256 Date Inspection eart: Queensbury Building &Code Enforcement Arrive: =J-/(� am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's InitiaNAME:LOCATION: RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/ Clay Type of Water: Municipal/Well Water Waterlineseparation 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. 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 Manholes 12"or less below grade _Y_N [provide extension collar if Yes Y N Location Separations Foundation to tank ft. Foundation to absorption Separation of Pits ft. r Plot Plan N (Engineer Re d As-Built Y N Contract Y_ N provided Location of System on Property: Front zus: r Left Side Right Side Middle Front Middle Rear st m Use S Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspecdon Forms\Septic Inspection Report 03 2910.da +08J25/2010 15:51 5187928511 VAN DUSEN AND STEIlES PAGE 02r`02 r PROJECT SERVICES 73 Sheridan Street, Glens Palls, NY 12801 Phone-518-796-2515 August 23, 2010 Project# 116 Mr. Dave Hatin Town of Queensbury 842 Bay Road Queensbury,NY 12804 Re: Replacement Septic System-Duell Residence•-69 Queensbury Ave., Queensbury,NY Dear Dave: This letter is to inform you that we inspected the completed replacement septic system .for the Duell Residence located at 69 Queensbury Ave in the Town of Queensbury on or about June 27, 2007. The replacement septic system as installed was for a three bedroom home and consisted of the existing septic tank,new distribution box and 20 ffi wide by 20 ffi long absorption bed constructed with pipe & stone and 4 -- 15 it long laterals. The system conforms to the requirements of the approved replacement septic system design. Please call me if you.have any questions or concerns. Sincerely, i;: Thomas R. Center Jr.,PE 7oe:s4o4,-1- Septic Inspection Report Office No. (518) 761-8256 Date Ins wn Queensbury Building &Code Enforcement Arrive: 10rPECTON: : am 742 Bay Rd., Queensbury, NY 1/2804 Inspector's Initda NAME: 1 P LOCATION: I RECHECK: Commen and/or diaoram Soil Ty San m Cia Type of . Munici I ell Water Waterline sebam#eWdRance ft. Well separation distance ft. Other wells: ft. Absorption Field: Total length ft. Length of each trench ft. q 1...0oQvap Depth of trenches ft. Size of StoneZ Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank �'- Tank to Distribution Box Hit Distribution Box field Pit ► l f" PEPS Opening Sealed: Partial End Ca In Outlet Pipes&Baffles Y N Location Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. �..- Conforms as r Plot Plan Y N '� Engineer Report and As-Built Y N Location of System on Property: Front Rear Left Side Right Side fiddle Front Middle Rear m Approved Partial Approved and'needs ca Build Disapproved Last revised 021006 Last revised 1/6/05 CENTER PROJECT SERVICES 73 Sheridan Street, Glens Falls, NY 12801 Phone-518-796-2515 June 25, 2007 Project# 116 Mr. Dave Hatin Town of Queensbury 842 Bay Road Queensbury,NY 12804 Re: Replacement Septic System-Duell Residence—69 Queensbury Ave., Queensbury,NY Dear Dave: On June 22, 2007, I performed a percolation test and deep hole test at the Bill Duell residence located at 69 Queensbury Ave. in Queensbury. The test was performed to the east of the residence in the location where construction of a new leach field is proposed. The 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: Deep Test 0—5" Topsoil 5 —32" Medium Fine Sand 32—39"Loamy Medium Fine Sand 39—68" Medium Fine Sand No groundwater observed, Mottling observed at 62" Percolation Test Stabilization percolation rate - 1" in 1 minute, 01 seconds The hole was presoaked and the test was run four times until it stabilized with three consecutive runs of 2:12, 2:27 and 2:41 respectively. The design flow for this 3 bedroom residence at 110 gpd per bedroom requires 347 sf of absorption area. The new replacement absorption system for the proposed residence should consist of the new septic tank located on the east side of the residence and a new distribution box with a 20' wide by 20' long absorption bed (400 sf) with 4 15 foot long absorption laterals located to the east of the residence. Please call me if you have any questions. Sincerely, Thomas R. Center, PE Cc: Bill Duell cal a • -D,sa. QQx C