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2005-360
TOWN OF QUEENSBURY 4311 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20050360 Date Issued: Wednesday, June 01, 2005 This is to certify that work requested to be done as shown by Permit Number P20050360 has been completed. Tax Map Number: 523400-289-015-0001-037-000-0000 Location: 813 BAY Rd Owner: JANETTE BOMBARD Applicant: JANETTE BOMBARD 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 the property owner of the responsibility for compliance with Site Plan, ir 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 1. 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 low Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20050360 Application Number: A20050360 Tax Map No: 523400-289-015-0001-037-000-0000 Permission is hereby granted to: JANETTE BOMBARD For property located at: 813 BAY Rd 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: JANETTE BOMBARD 813 BAY Rd Septic Alteration Residential Total Value QUEENSBURY, NY 12804 Contractor or Builder's Name /Address Electrical Inspection Agency OIJEENSBITRY SEWER JAY SWEET Plans&Specifications 2005-360 SEPTIC ALTERATION $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, May 26, 2006 (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 of Quee b ; T� rsday, May 26, 2005 SIGNED BY ` for the Town of Queensbury. Director of Building&Cose Enforcement Application for Permit-Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: qr ' r `� T� Office Use Location of installation: J � /� File Permit No(400 A9 V Tax Map No., _ / / r Fee Paid o75 - 07) Owner's Name: a 6& �---\ c , 0 vyv b a v' k. Address: 1 3 \ $ a ` l 2. INSTALLER'S NAME : Ck,k,Q..e,j�,8 is sz-2 PHONE NO. ( 1 i 36�� PY # 3. RESIDENCE INFORMATION: (circle year of dw lling, indicate#bedroom(s) and multiply of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older. .',, x 150 gal/bdrrn = 198 — 1991 x 130 gal/bdrm = 1991 —present 3 `1` x 110 all/bddrm = 3 0 Garbage Grinder Installed yes_ / aQC , i C — / _3 rj Spa or Hot Tub Installed yes_ / -114 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) To a h Soil Nature Ground Water Bedrock or Impervious Material . Domestic Water Supply c t s nd at what depth at what depth unicip� Rolling loam feet feet Cal� Steep slope clay if well; water supply _%slope other from any septic-system depth: absorption is/ez) ft. other l/ Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch 5. 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: zr7Y gallon nun. size 1,000 gal.) RECEIVED Tile Field: each trench " ft. Total System Length: .7 C ft. MAY 7 44 ?(105 Seepage Pit(s): number of size of each: ft. by ItWN OF QUEENSBURY BUILDING AND CODE Size of Stone to be used: # / depth or thickness g r feet Bed System Size: ,- ) xt� Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) 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 Queensbury Sanitary Sewage Disposal Ordinance. Sig atu a ofi responsible person Date 1A`' ..'1 invtt of (Zuet»tsinlry }ntil' Scwcrs :Intl 4cwsij;e Disposal (.1t:tooter • /\Is11c�iuli x (: i ' A'13.S()It,�'•''t'1()N 1'1 E1,►I.) • . • si:I'AILA'I'1QN It1:(.11,3I11.1tN11,1N'1':4 ' '..\\,..c....,,,,_1., ...k. .o,}). ,/f 1 1111 Y'�H.Lt. IN I!(►T!.'it• �+�'� a ' l tt'►4.4 . ' 110(ttr WI,Inc , t x /,- o'''''. '.." I. 7 j . 1buac G At , t��* IlC>t s>: G . F . b k ✓ ,/. hoar i 1 tt 1. ,1 Sc t't Ic, t • ......:_ \\ ',.0''' . (I:5 :°°' •.....,....,.. i • . \......,,,,,,.,..I.- . / • • 7. SIGNATURE &INFORMATION FOR EgsrOmsx.tsidz,rr.a<N'•"i\Imes •,•`^"', • • ♦ . .. Septic Inspection Repo Office No. (518)761-8256 Date Inspection equ:.t - ed: -— Queensbury Building&Code Enforcement Arrive: .1111''ml.m 4r-part: \-).-%� n�%742 Bay Rd., Queensbury,NY 12804 Inspector's Initi. A t-- NAME:LOCATION: ��3 (� BFt�RD CZ() nv'.` CTOOT. Zbdh —�3C©() RECHECK: Comments and/or diagram Soil Type San)Loam/clay— Type of Water: unicipa /Well Water _ Waterline separation distance t c. _ft. Well separation distance \ 0 C' ft.-+' Other wells: 10 O ft.AC Absorption Field: Total length _rib ft. Length of each trench r ft. .i\p0 " Depth of trenches ft. V" Size of Stone Seepage Pits: Number Size: x Stone Size: • Piping Size Type Building to tank .--\ ` ` L.O Tank to Distribution Box LA `% (26- Distribution Box t Meld/Pit Le\ (� op. arm Ptp,v- Opening Sealed: ",N/Partial Location/Separations Foundation to tank \(l ft. Foundation to absorption 9 ft. Separation of Pits ft. Conforms as per Plot Plan Y N Location of System on Property: 'ront)Rear Left Sid Right Side Middle Front Middle Rear S stem Use S tus: Approved Partial Approved and needs to be re-inspected,please call the Building&Codes Office Disapproved L:\SueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003 NACE ENGINEERING, P.C. 169 Haviland Road, Queensbury,NY 12804 Phone-518-745-4400 Fax -518-792-8511 May 19, 2005 Project#49164 Mr. Jay Sweet Queensbury ury Septic PO Box 4283 Bay Road Lake George,NY 12845 Re: Percolation Test Robert Bombard Residence—813 Bay Road, Queensbury,NY Dear Jay: At your request, on May 12,2005, I performed a percolation test at the Robert Bombard residence located at 813 Bay Road 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 results of the testing are as follows: Percolation Test Stabilization percolation rate- 1"in 3 minute, 47 seconds The test was run in the native sand at a depth of 24 inches in a 30 inch deep hole. The hole was presoaked and the test was run 7 times until it stabilized with three consecutive runs of 3:40, 3:44 and 3:47 respectively. The design flow for this 3 bedroom residence at 110 gallons per bedroom requires an absorption area of 347 sf. The replacement system for the residence should consist of a 20 foot wide by 20 foot long absorption bed(400 sf of absorption area) with 4— 15 foot long laterals. Please call me if you have any questions. Sincerely, / f 1 Thomas R. Center Jr., PE RECEIVED C E I r /E D Cc: Dave Hatin,Town of Queensbury f�C V C MAY :, ; yr� TOWN OF QUEENSBURY BUILDING AND CODE . ,„ _DgoS-366 RECEIVED MAY Y. :i 20115 TOWN OF QUEENSBURY BUILDING AND CODE r ALl --A- Ur/4 Su/Ai- rx 4te5 4 allarpkr 4 ,......7-74 SpeC04;*".1 ./ .c. cr-, (\ ..4 r , . . ‘ 's --; _-_- r...4'";;; ; ,— : - ' . '. —' ' - . - ' LDING & c,'No <( I BUI REVIEWED BY ' E EPT, DATE 5 f_... I I have seen or observed, or believe I saw evidence ,ai! sbiects such as houses, wells, trees, fences, ) ic_jint,,,n on this document. I also represent that I have .;:rsonaily measured the distances s,t forth on the 1 CS'l NATURE I