2005-127 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLI-ONCE
Permit Number: P20050127 Date Issued: Thursday, April 14, 2005
This is to certify that work requested to be done as shown by Permit Number P20050127
has been completed.
Tax Map Number: 523400-301-013-0002-038-000-0000
Location: 41 ALGONQUIN Dr
Owner: JAMES & VALERIE CARON
Applicant: JAMES & VALERIE CARON
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,
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: P20050127 Application Number: A20050127
Tax Map No: 523400-301-013-0002-038-000-0000
Permission is hereby granted to: JAWN & VALE,RIE CARON
For property located at: 41 ALGONQUIN 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: JAMES & VALERIE CARON
Septic Alteration Residential
41 ALGONQUIN Dr
QUEENSBURY, NY 12804-0000 Total Value
Contractor or Builders Name /Address Electrical Inspection Agency
OUEENSBI TRY SEWER
NY 12804-0000
Plans&Specifications
2005-127
SEPTIC ALTERATION
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, March 14, 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 To of Q ensb ff n arch 14, 2005
SIGNED BY �•V'f for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Permit-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION:
4
Office Use
Location of installation: — —
File Permit No.
Tax Map No.
` Fee Paid
Owner's Name: >V 1 t`1'L
Address: 4t
2. INSTALLER'S NAME - !`� - PHONE NO. 10
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply #of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: No. of Bedrooms x Commutation = Total Daily Flow
1980 or older x 150 gal/bdrm =
1980— 1991 x 130 gal/bdrm =
1,99� presen ,1 i x 110 gal/bdrm = ".
Garbage Grinder Installed yes_ �"
Spa or Hot Tub Installed yes / n)r
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
To-ooLyraDhv Soil Nature Ground Water Bedrock or Impervious Materi esti!& a Su 1
Flat san �) at what depth at what depth municipal
olling tz3am feet feet
Steep slope clay if well; water supply
�%slope other from any septic-system
depth: absorption is ft.
other
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: .5 gallon(min. size 1,000 gal.)
Tile Field: each trench ft. Total System Length: ft.
Seepage Pit(s): number of size of each: ft. by ft.
Size of Stone to be used: # --^' J depth or thickness V feet
Bed System Size: x
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.
Nor 7D
Sighatur d responsible person Date
cif (jueelIgI)IIry
Srwers :tiiti 5c;w;i>>,e Disposal t'11:1vto.
• Avpf tuiix C.
AIL►St)MITION F,II;I.,i)
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it POND
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7• SICxA1ATURE &INFORMATION Fm-mr6r .wi r.rr,4-o,2vi,w,.^ ••.•....:;:: ;;
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received: r
Queensbury Building&Code Enforcement Arrive: am/p epart:
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:,
NAME: `QL PERMIT NO.:
LOCATION: INSPECT ON: -- -
RECHECK:
Comments a d/o diagram
Soil Type: San Clay
T of Wat : Munici /Well Water
Waterlines istance ft.
Well separation distance ft.
Other wells: ft.
Absorption Field: Total length ft. -0,P �Y�/�t4A- ��W
Length of each trench ft.
Depth of trenches ft.
Size of Stone
See a e Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box k
Distribution Box to Field/Pit c� a
Opening Sealed: Y/N/Partial
End Caps ti
Location/Separations
Foundation to tank ft.
Foundation to absorption
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built Y N
Location of System on Property:
Front 0earLeft Side Right Side
Middle Front le Rear
S stem Use St
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Last revised 1/6/05
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury,NY 12804
Phone-518-745-4400 Fax -518-792-8511
March 8, 2005
Project#49158
Mr. Jay Sweet
Queensbury Septic
PO Box 4283
Bay Road
Lake George,NY 12845
Re: Septic System Design
Jim Caron Residence - 41 Algonquin Drive, Queensbury,NY
Dear Jay:
At your request I have reviewed your proposed replacement septic system design at the site of the
4 bedroom house of Jim Caron on Algonquin Drive in Queensbury.
I have reviewed the proposed replacement septic system design and application permit you
provided and I agree that a standard absorption bed is acceptable. Based upon a 4 bedroom house
and a percolation rate of 1 to 5 minutes, you will need a 463 square feet of absorptive area. I
recommend using 20 ft wide by 25 ft long absorption bed, which will provide 500 sf of
absorptive area.
Please call me if you have any questions.
Sincerely,
Thomas R. Center, PE
cc: Dave Hatin,Town of Queensbury
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