2007-434 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
(E)w Community Development- Building &Codes (518) 761-8256
CERTIFICATE (3101 COMPLIANCE
Permit Number. P20070434 Date Issued: Thursday, February 10, 2011
This is to certify that work requested to be done as shown by Permit Number P20070434
has been completed.
Tax Map Number. 523400-297-006-000 1-00 1-000-0000
Location: 13 STONEWALL Dr
Owner. BRIAN & ANDREA BLACKBURN
Applicant: BRIAN & ANDREA BLACKBURN
This structure may be occupied as a:
Septic Alteration Residential
By Omer 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: P20070434 Application Number. A20070434
Tax Map No: 523400-297-006-0001-001-000-0000
Permission is hereby granted to: BRIAN&ANDREA BLACKBURN
For property located at: 13 STONEWALL Dr
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. Tune of Construction Value
Owner Address: BRIAN &ANDREA BLACKBURN
Septic Alteration Residential
13 STONEWALL Dr
QUEENSBURY,NY 12804 Total value
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2007-434
SEPTIC ALTERATION RESIDENTIAL FEE WILL BE MAILED
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday,July 13, 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 To o .Q`iiBensbu Frdday,,.July 13, 2007
SIGNED BY for the Town of Queensbury.
SJ f Director of Building&Code E i.orcement
-----------
OFFICE USE ONLY ;
TAX MAP NO. PERMIT NO. PERMIT FEE ;
APPROVALS: ZONING TOWN CLERK
--------------------------------------------------------
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.
OWNER: Brian Blackburn INSTALLER:
ADDRESS: 13 Stonewall Drive ADDRESS:
PHONE NOS.798' 5499 W18—G,4'9'/ PHONE NOS.
LOCATION OF INSTALLATION: 13 Stonewall Drive
RESIDENCE
NO.OF
YEAR BUILT INFORMATION:X COMPUTATION= = TOTAL DAILY FLOW
BEDROOMS
198� 0 or older X 150 gallon per bedroom = GARBAGE GRINDER
INSTALLED?
1981 -1991 X 130 gallon per bedroom =
1992-present X 110 gallon per bedroom = 440 N A OR HOT'TUB
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY OTHER See plans
✓ GROUNDWI'.TER: AT WHAT DEPTH?,.ffiNS BED ROCKAM PERVIOUS MATERIAL: AT WHAT DEPTH? SEE PLANS
✓ DOMESTIC WATER SUPLY:
MUNICIPAL_ WELL (IF W WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT. )
✓ PERCOLATION TEST: RATE IS SEE PLANS 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.
- SEE PLANS
✓ SEP fIC TANK: .1250 _GALLON(MIN.SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH_SEE PIFffiNS
✓ TOTAL SYSTEM LENGTH: FT. SEEPAGE PIT(S):HOW MANY? SIZE OF EACH FT.X FT.
✓ S!ZE 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 GAL.lrOTAL 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.
1 have read the regulations with respect to this application and agree
CALL 761-8256 OR EMAILto abide by these and all requirements of the Town of Queensbury dgueensbury.netSanitary Sewage Disposal Ordinance. (:QUESTIONS
T OU FOR MORE INFORMATIONueensbury.net
7
Signature of Person Responsible Date
Town of Queensbui•y - Community Development Office - 742 Bay Road, Queensbury, NY 12804
Septic Inspection Report
Office No. (518) 761-8256 Date Ins request received:
Queensbury Building&Code Enforcement Arrive; am/ am/pm
742 Bay Rd., Queensbury, NY 12804 Inspec toes initials:
NAME: PERMIT NO.:
LOCATION: c INSPECT ON: l L t k
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
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 Ca 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 ft.
Separation of Pits ft.
Conforms as per Plot Plan —Y—N
Engineer Report and As-Built _Y_N
ETU Maintenance Contract Y N
provided
Location of System on Property:
Front R Left Side Right Side Middle Front Middle Rear
m t
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiling\2010\Building Codes FormsUnspecuon Fom►s\Wm Inspection ReporL03 2910.doc
6
Septic Inspection Repprt
Office No. (518) 761-8256 Date Ins request received:
Queensbury Building&Code Enforcement Arrive: EFEM am/��rt: am/pm
742 Bay Rd., Queensbury, NY 12804 Ins ibais:
NAME: Ain) PERMIT NO.: �7✓ ��
LOCATION: INSPECT ON: G O
RECHECK:
Commend and/or diagram
Soil Type; Sand Ct
Type of Water: Municipal/PVell Wate
Waterline separation distan ft.
Well separation distance ft.
Other wells: ft.
Absorption Field: Total lengnft.
Length of each trench ft•
DepLh of trenches
Size of Stone
Seepage Pits: Number'
Size: x
Stone Size:
Piping Size -Type
Building to tank
Tank to Distribution Box 11
Distribution Box to Field f Pit 0
opening Sealed: Y N Partial
End Ca
Inlet/Outiet Pi &Baffles Y N
Location Se rations
Foundation to tank ft.
Foundation to a ii Z ft.
Separation of Pits ft•
Conforms as per Plot Plan Y N
En ineer Report and As-Built Y N
Location of System on Property:
Front Rear Left Side Right
;;Partial
Fro Middle Rear
m
Approved
Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Last revised 021006
Last revised 1/6/05
VISION ENGINEERING, LLC
4 Glens Falls Technical Park,Box#3
Glens Falls,NY 12801
Phone:(518)792-9264
Fax:(518)792-9282
April 19, 2007
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
Attention: David Hatin, Building & Codes Department
RE: Deep Test Hole Verification
Blackburn Property
13 Stonewall Drive, Queensbury NY 12804
As requested, I have completed onsite verification for the above referenced location in regards to
sub-surface conditions related to the replacement septic system design. Attached are deep test
hole logs pertaining to this project for inclusion in your review. Presumably test holes were
conducted at or near the proposed septic system location. Soil present at the site consists of well
drained sand for the upper two to three feet. Below the sandy horizon lies firm gray fine sandy loam
which is well mottled and will be the controlling factor for the depth of the new system. The
prevalent gray color is indicative of prolonged saturation which prevents oxygen from entering the
soil horizon. Please also keep in mind there is a DEC wetland boundary along the rear property line
which needs to be considered in the placement of the proposed system.
Please do not hesitate to call if you have any questions or require additional information.
Sincerely,
Daniel W. an, P.E.
VISION Engineering, LLC
Quality ■ Experience ■ Service ■ Teamwork
SOIL BORING AND DEEP TEST HOLE FIELD LOG
Project: Blackburn Residence Location: Same
Address: 13 Stonewall Drive Test Hole#: Test Hole#1
...................................................................................................
Queensbury, NY 12804 Soil Survey Map Ms A
County: Warren Designation: 1 2
Date: 4/19/07 1 Soil Series: Massena Fine Sandy Loam
..................................................................
Weather: Sunny 2 Slope Class: 0-3 Percent Slopes
..................................................................
Temperature: 500 F
Remarks: (Site description, usage, anticipated daily wastewater flow, etc_) Replacement system for single family home:
............................... ...
Note:DEC wetland boundar�f along rear property line: Must comply with percolation and setback requirements.
Depth (in) Boundary Color Soil Texture Soil Structure Consistency Stickiness Moisture
Condition State
Matrix Mottling
0-6 topsoil
clear
6-9 silt/topsoil mix
clear
9-28 brown med sand single grained loose none dry
clear
28-63 It gray rd brn fne sandy loam blocky firm slight dry
clear
63-84 dk gray na fne sandy loam ND ND ND wet
1. Describe and record the average thickness of each horizon.
2. Record each horizon boundary in terms of distinctness.Designate as Very Abrupt(<0.5 cm),Abrupt(0.5-2 cm), Clear(2-5 cm), Gradual(5-15 cm),
Diffuse(>15 cm).
3. Record the topography of the horizon boundary.Designate as Smooth, Wavy,Irregular(undulating boundary), Broken(discontinuous or
intermingled horizons or irregular pockets).
4. Indicate the color of each horizon.The matrix color is the majority color within peds,and the mottle color is the minority color within the peds.
Record ped surface color where colors exist that are associated with an organic coat/clay film/carbonate mass/etc. Record the percent of mottles
as Few(<2%), Common(2-20%),Many(>20%). Record the mottle contrast as Faint,Distinct, Prominent.
5. Record the moisture state of each horizon.Designate as Dry or Moist.
6. Soil Texture: Designate as Sand, Loamy Sand, Sandy Loam,Loam, Silt Loam, Silt, Sandy Clay Loam, Clay Loam, Silty Clay Loam, Sandy Clay,
Silty Clay, Clay.Sand,loamy sand,and sandy loam may be further classified into coarse, medium fine,fine,and very fine.
7. Soil Structure: Designate peds as Granular,Blocky,Prismatic, Columnar, Platy, Single Grained,or Massive.Structure grade shall be described for
peds as Weak, Moderate,or Strong.
8. Soil Consistence: Designate as Loose,Friable,Firm,or Extremely Firm. Indicate ND for not determinable if too wet for test.
9. Record stickiness as Non-Sticky(little or no soil adheres to fingers after release of pressure), Slightly Sticky(soil adheres to both fingers with little
stretching upon separation), Moderately Sticky(soil adheres to both fingers and stretches some on separation), Very Sticky(soil adheres and
stretches greatly)
10. Roots: Record the quantity,size and locations of roots.Designate as Few, Common,Many. Record size as Very Fine(<1 mm),Fine(1-2 mm),
Medium(2-5 mm), Coarse(5-10 mm), Very Coarse(>10 mm). Location shall be noted to be between peds, in cracks,throughout, in mat at top of
horizon,or matted around rock fragments.
Boundary Condition Observed and Depth: Bedrock None ft Groundwater 65 inches Impervious Strata 30± inches
Slope of Site : 0-5 % Mottling Depth 30± inches Ground Cover: Grass Wooded
Barren Crops
Landscape Position: Depression Hill Top Side Slope Foot Slope Shrubs
Describe Roots: (Quantity, Size, and Location): Few fine roots to 6 inch depth
This form was created by VISION Engineering,LLC-Copyright 0 2006 by VISION Engineering,LLC,All rights reserved
1-
SOIL BORING AND DEEP TEST HOLE FIELD LOG
Project: Blackburn Residence Location: Same
Address: 13 Stonewall Drive Test Hole#: Test Hole#2
-----------•-----•.............................•------------•------------.............••-••-.......
Queensbury, NY 12804 Soil Survey Map Ms A
County: Warren Designation: 1 2
Date: 4/19/07 1 Soil Series: Massena Fine Sandy Loam
..................................•--------.......................
Weather: Sunny 2 Slope Class: 0-3 Percent Slopes
--•-•...............•-•-••-•--•-----------........................
Temperature: 500 F
Remarks: (Site description, usage, anticipated dailx wastewater flow:etc.) Replacement system for single family home:
Note: DEC wetland boundar�r along rear property line. Must complX with percolation and setback requirements.
Depth (in) Boundary Color Soil Texture Soil Structure Consistency Stickiness Moisture
Condition State
Matrix Mottling
0-2 topsoil
clear
2-26 brown med sand single grained loose none dry
clear
26-60 It gray rd bm fne sandy loam blocky firm slight dry
dear
60-72 dk gray na fie sandy loam ND ND ND wet
1. Describe and record the average thickness of each horizon.
2. Record each horizon boundary in terms of distinctness.Designate as Very Abrupt(<0.5 cm),Abrupt(0.5-2 cm),Clear(2-5 cm),Gradual(5-15 cm),
Diffuse(>15 an).
3. Record the topography of the horizon boundary.Designate as Smooth, Wary,Irregular(undulating boundary),Broken(discontinuous or
intermingled horizons or irregular pockets).
4. Indicate the color of each horizon.The matrix color is the majority color within peds,and the mottle color is the minority color within the peds.
Record ped surface color where colors exist that are associated with an organic coat/clay film/carbonate mass/etc.Record the percent of mottles
as Few(<2%),Common(2-20%),Many(>20%).Record the mottle contrast as Faint,Distinct,Prominent.
5. Record the moisture state of each horizon.Designate as Dry or Moist.
6. Soil Texture:Designate as Sand,Loamy Sand,Sandy Loam,Loam,Silt Loam, Silt,Sandy Clay Loam,Clay Loam, Silty Clay Loam,Sandy Clay,
Silty Clay, Clay.Sand,loamy sand,and sandy loam may be further classified into coarse,medium fine,fine,and very fine.
7. Soil Structure:Designate peds as Granular,Blocky,Prismatic,Columnar,Platy,Single Grained,or Massive.Structure grade shall be described for
peds as Weak,Moderate,or Strong.
8. Soil Consistence:Designate as Loose,Friable,Firm,or Extremely Firm.Indicate ND for not determinable if too wet for test.
9. Record stickiness as Non-Sticky(little or no soil adheres to fingers after release of pressure),Slightly Sticky(soil adheres to both fingers with little
stretching upon separation),Moderately Sticky(soil adheres to both fingers and stretches some on separation), Very Sticky(soil adheres and
stretches greatly)
10. Roots:Record the quantity,size and locations of roots.Designate as Few, Common,Many.Record size as Very Fine(<1 mm),Fine(1-2 mm),
Medium(2-5 mm), Coarse(5-10 mm), Very Coarse(>10 mm).Location shall be noted to be between peds,in cracks,throughout,in mat at top of
horizon,or matted around rock fragments.
Boundary Condition Observed and Depth: Bedrock None ft Groundwater 66 inches Impervious Strata 26t inches
Slope of Site : 0-5 % Mottling Depth 26t inches Ground Cover: Grass Wooded
Barren Crops
Landscape Position: Depression Hill Top Side Slope Foot Slope Shrubs
Describe Roots: (Quantity, Size, and Location): Few fine roots to 6 inch depth
This form was created by VISION Engineering,LLC-Copyright 0 2006 by VISION Engineering,LLC,All rights reserved
H.Thomas Jarrett, P.E.
Professional Engineering Kenneth Martin, P.E.
�C7yVN OF C.IUEENSBURY.
;',C>�%o ,1i 1NfrY DEVELOPMENT
RECEIVED
April 17, 2007 107
F,CU
Dave Hatin,Building Inspector B&C PLANNING
Town of Queensbury FM �rxleC.DIR.
742 Bay Road
Queensbury,NY 12804
Re: Brian Blackburn
13_Stonewall Drive_ _- -- -- -
Tax Map#: 297.6-1-1
Dear Dave,
We would like to perform subsurface investigations for planning purposes. We have
tentatively scheduled this with Dan Ryan of Vision Engineering for Thursday,April 19`h,
2007 at 10 am. The scope of that work would involve test pits to determine seasonal high
ground water, and percolation tests. Attached is a copy of the Warren County GIS
depicting the location of the property.
If you have any questions do not hesitate to contact me or Pete Beecher at 792-2907.
Sincerely,
Jarrett-Martin Engineers, PLLC
Icy„
H. Thomas Jarrett, P.E.
Principal -
Enc.
F:\DataFile\2007 Projects\2007 Resid\07-021 Blackburn WW\A Design\Conesp\Sent\07021 070417 Perk Test Ltr to Tn.doc
12 East Washington St. • Glens Falls, NY 12801
518-792-2907 / 518-798-1864 Fax ®Pd ted of Recycled Pape,
Page 1 of 1
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http://gis.co.warren.ny.us/output/SDV_QUEENSBURY_plande112052352015470 jpg 4/17/2007
SEWAGE SYSTEMS: SEPARATION REQUIREMENTS - SEEPAGE PIT
POND
PROPEFt�LANE � �
WELL IN
Please refer to Queensbury Town WIG
�-�s MIN.
Code, Sewers and Sewage Disposal, °`S'"i
Appendix A, 136:A1 and Appendix B,
136:A3, for more detailed information o
on SEPARATION REQUIREMENTS.
— m
SEEPAGE PIT \" HOUSE
Z ' � 2° p�
0 m 1
DuD
m `'�
O MX �
0. • Z SEPTIC TANK GARAGE
ISTRIBUTION BOX P-k
o Doo
PROPERTY LINE
ROAD
STREAM PROPERTY LINE
PROPERTY LINE
WELL IN
4 1 WATER POND
TIGHT
CASING WELL IN
"D WATER 15'
0 � 1 TIGHT MIN.
CASING/
O
W
Z
J
W
W
LJ
a
Z �J a
HOUSE C1 NO = GARAGE
MAN HOUSE
O O GARAGE
0
J LLI
Zuj
O Z
�, ° SEPTIC Q
0 ° o SEPTIC Q a TANK
a CV TANK W O
> a DISTRIBUTION BOX
Ilf
0 �
ABSORPTION FIELD
80 0 0
o ?
PROPERTY LINE
_-------- ROAD
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.