2007-711 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERT I F I CAT E OF COM P L I AN CE
Permit Number. P20070711 Date Issued: Tuesday, November 16, 2010
This is to certify that work requested to be done as shown by Permit Number P20070711
has been completed.
Tax Map Number. 523400-296-012-0001-004-000-0000
Location: 11 BAYBERRY Dr
Owner. MARK & MICHELLE ROGERS
Applicant: MARK & MICHELLE ROGERS
This structure may be occupied as a:
Septic Alteration Residential
By Older of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the r- /�
property owner of the responsibility for compliance with Site Plan, � /
Variance, or other issues and conditions as a result of approvals by the A40 --
Director of Building&Code Enfon ement
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: P20070711 Application Number. A20070711
Tax Map No: 523400-296-012-0001-004-000-0000
Permission is hereby granted to: MARK&MICHELLE ROGERS
For property located at: 11 BAYBERRY 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. Type of Construction Value
Owner Address: MARK&MICHELLE ROGERS
11 BAYBERRY Dr Septic Alteration Residential
QUEENSBURY,NY 12804-0000 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2007-711
septic alteration residential
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,November 20, 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 T 4,Queetf�u /'Tue iday,November 20,2007
SIGNED BY - / for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY1,7
/} '
TAX MAP NO. PERMIT NO. V PERMIT '11�ij ► ;
I APPROVALS: ZONING ,TOWN CLERK ;
, ,
-------------r-i i-iii--ir I-»r----I-r--r----ir--r--. ,s--r-sr-r-i--------J
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJEC REVIEW BEFORE ISSU CE OF A VALID
PERMIT. �{�
OWNER: RA1,12— ('� INSTALLE %�/7�
ADDRESS: ADDRESS: le X -2-22�-Y .
PHONE NOS. ✓ / PHONE NOS. 796
O ��
LOCATION OF INSTALLATION:
............................................................................................................ ................................................................... .................................................................... RESIDENCE INFORMATION.
NO.OF
YEAR BUILT X I COMPUTATION= _ TOTAL DAILY FLOW
BEDROOMS GARBAGE GRINDER
.. .. ..........................I...........;. ...................................................................................
,.................................................................................... G
77
1980 or older X 150 gallon per bedroom _ INSTALLED?_��
_............................._..........................................._............................,...........y........._....................................._................_ .;
€ 1981 -1991 ..X_r......130 gallon per bedroom
.......a....-....r.........................................................................I
i............................................._;....„............._............_.-... INSTALLED?.
PA R O T
1992-present X 110 gallon per bedroom
.................................................................................................:............................................_.........................................;....................................................................................
;
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE l
✓ SOIL NATURE: SAND LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? j+ 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 EMI& SJ�'PER MIINUTE PER INCH (TEST TO BE
COMPLETED BY A LICENSED PROFES ZONAL 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 fi Id for each garbage grinder, spa or whirlpool tub.
'rxg7i w
✓ SEPTIC TANK: 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:^2-0 X 3 D '
✓ 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
sbury Sanitary a ge Disposal Ordinance. codes§gueensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
7 www.gueensburv.net
S na ure of Person Fillesponsible Dite
�= Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
/
TOWN 4F QU
BUILDING & O T.
c Reviewed B
t a o Date:
Isepric-
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury, NY 12804
Phone-518-745-4400 Fax -518-792-8511
April 27, 2007
Project 949243
Mr. Dave Hatin
Town of Queensbury
742 Bay Road
Queensbury, NY 12801
Re: Replacement Septic System - Rogers Residence—
11 Bayberry Drive, Queensbury, NY
Dear Dave:
On April 23, 2007, we performed a percolation test and deep soil test pit at the Mark Rogers
residence located at 11 Bayberry Drive in Queensbury. The test was performed to the east of the
existing residence in the location where construction of a replacement 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:
Test Pit Percolation Test
0 —6" Topsoil Stabilization percolation rate - I" in 4 min., 52 sec.
6—24" Medium Coarse Sand
24—55 " Fine Silty Sand
Mottling observed at 30"
Water observed @ 57"
The hole was presoaked and the test was run 4 times until it stabilized with three consecutive
runs of 4:31, 4:46 and 4:52 respectively.
The design flow for this 4 bedroom residence at 110 gpd per bedroom requires 440 sf of
absorptive area. The replacement septic system should be a shallow absorption bed system no
greater than 6" below the existing grade. Prior to installation of the absorption bed, the
contractor must completely remove the buried topsoil layer.
The replacement shallow absorption bed system for the proposed residence should consist of the
existing 1,000 gallon septic tank located on the east side of the residence, a new 4 foot diameter
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 east of the residence.
Please call me if you have any questions.
Sincerely,
Thomas R. Center, PE
S*A5
Septic Inspection Report
Office No. (518) 761-8256 Date Ins ion
Queensbury Building &Code Enforcement Arrive: a rt: am/pm
742 Bay Rd., Queens ury, NY 12804 Inspector's Initi
NAME: RMIT NO.:
LOCATION: NSPECT ON:
RECHECK:
Comments and/or diagram
Soil Type: Sand/ Loam/Clay
Type of Water: Municipal Well Water
Waterline separation distance
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 ft.
Separation of Pits ft.
Conforms as per Plot Plan N
Engineer Report and As-Built :�?TE N
ETU Maintenance Contract Y_ N
provided
Location of System on Property:
Front R r Left Side Right Side Middle Front Middle Rear
stem Use S s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\80ding Codes Forms\Inspection Fours\Septic Inspection Repor—03 2910.doc
`. ( 4'/27/2EhO 14:10 5187928511 VAN DUSEN AND STEVES PAGE 03/04
i NACIE ENGINEERING, P.C.
169 Haviland Road, Queensbury, NY 12804
Phone-518-745-4400 Fax -5l 8-792-8511
September 23, 2010
Project#49243
FAXED—745-4437
Mr. Dave Hatin
Town.of Queensbury
742 Bay Road
Queensbury,NY 12801
Re: Replacement Septic System- Rogers Residence—
11 Bayberry Drive, Queensbury,NY
Dear Dave:
This letter is to inform you that we inspected the completed septic system for the Rogers
Residence at 1 I Bayberry Drive in the Town of Queensbury.
The septic system as installed was for a 4 bedroom house and consisted of, the existing 1,000
gallon septic tank, a new distribution box and 20 ft wide by 30 ft long absorption bed with.4 - 25
ft long laterals constructed with stone and perforated pipe. The system confomns to the
requirements of the approved design letter.
Please call me if you have any questions.
Sincerely,
Th/ma:tenter, PE
r
Septic Ins4rrs
rt
Office No. (518) 761-8256 Date Ince' ed:
Queensbury Building &Code Enforcement Arrive: epart: 1 Z�oc7 am m742 Bay Rd., Queensbury, NY 12804 Inspect
NAME: P NO.:
LOCATION: ECT ON: 1 7_— (c)—D7�
RECHECK:
Comments and/or diagram
Soil T nd oam Clay o s'�L C, '
Type of Wat urna I ell Water
Waterline separation distance ft. F4c,)T fQp
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + - Y N _N/A
� zz► '
Absorption Field: Total length luc ft. Tp QF1CFtLL �I E�
Length of each trench "— ft. ---�--F ` R t
Depth of trenches
Size of Stone Z
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to " t�P�TP►T ot,J
Z4'AP67 istribution Box to Field Pit 111221
Opening Sealed: Y N
End Ca N
Inlet/Outlet Pipes&Baffles Y N
Location Separations
Foundation to tank
Foundation to absorption ft.
Separation of Pits
Conforms as per Plot Plan Y
Engineer Report and As-Built Y N �►�6�1JE /J RE�c ;�
Location of System on Property:
Front ear �LeftSide Right Side Middle Front Liddl�.�Rear,
System
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 06/18/07 U\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No. ....... N2 3186Cut-in Card No.....................................
..... Cert.
?1 17
Owner................./.I/... ...... ..............
Location....
InstallationConsisting of ...................... ..................z..................................................................................
Aow"161-179
..................................................................................................................................................................................
....................................................................................................................................................................................
InstalledBy.....ef..syhaw.?z ............................................Lic.No...................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of mak' inspections at any time, and if its
i
rules are violated,the Company shall have the right to r v e th ce ficate.
Date...a.-&-.g.7................ INSPECTOR....a.O.rv.:-, . ........................................ .............................
O�Me Member r N.F.P.A.,I.A.E..
Septic Inspection Report
Office No. (518) 761-8256 Date Inspectio e i
Queensbury Building &Code Enforcement Arrive: m m art: �� a pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initi
NAME: _ P NO.: N-7-71
LOCATION: t>)� NSP ` ON:
RECHECK: P �
Comments and/or diagram
Soil T Sand Loam/ Clay
Type of Water: Munici al 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 Ca Y N
Inlet/Outlet Pipes&Baffles _Y N PO M�
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
7
Approved
Partial Approved and -i ase call in
Disapproved
Last revised 06/18/07 L:\Building&Codes Forms-01-1)\Building&Codes\Inspection Forms\Septic Inspection Report.doc