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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 1 v o xs 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.