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2004-309
TOWN OF QUEENSBURY F4T*1 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040309 Application Number: A20040309 Tax Map No: 523400-289-017-0001-015-000-0000 Permission is hereby granted to: OLGA SAITO For property located at: 76 ASH 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: OLGA SAITO 76 ASH Dr Septic Alteration Residential Total Value QUEENSBURY, NY 12804-0000 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-309 SEPTIC ALTERATION $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, May 14, 2005 (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 eensb T S. ,y, May 13, 2004 SIGNED BY f / s for the Town of Queensbury. Director of Building& rode E •rcement Application for Permit-Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: Office Use Location of installation: 0C� — T Map No. / / File Permit No. L Lelr .4./ . 5z3 ,f ,0v ZAcx> , t7-- ' - S O c Fee Paid owners Name: C)/ c � 4)C\\*CD Address: 7(p if,--.7,- r ..V . !r" ' . 7 /Ye 4C , 2. INSTALLER'S NAME : -k,y / '- PHONE NO. i 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 Computation = Total Daily Flow r"\\I'ep 1980 or older x 150 gal/bdrm = 1980- 1991 x 130 gal/bdrm = 1991 —present x 110 gal/bdrm = 3 3 c-3 Garbage Grinder Installed yes_ / no?‘.. a�u ' c,G* • Spa or Hot Tub Installed yes_ / no 1\�Op\NC'0 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) To ography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply MO qjtEP at what depth at what depth m icipal Rolling oam a A/4) feet feet Steep slope clay if well; water supply __%slope other ry from any septic-system depth: absorption is to a ft. other /o v Percolation Test: (To be completed by licensed professional engineer or architect) Rate: 1,52 minute per inch 30 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: /0001 gallon (min. size 1,000 gal.) .--- Tile Field: each trench -_ft. Total System Length: ft. Seepage Pit(s): number of size of each: — ft. byft. Size ctf Stone to be used: # / depth or thickness feet i Bed System Size: x Alternative System: �/J Y , . ,_,,2,`�R, length and/or size 2 y�, A j 2 6. HOLDING TANK SYSTEM: (if required) \r Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons d Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. y 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. V ,._ (7, ..,-17 ..--- --� � / Zri na ure of responsib erson p • • • r' , • '' '1 o vtt of (2ut;ott alntry $rwca1c atttl SeW;. l C I)iltjx,sal elmittrr . Apprtttli x t . AnSOR,1'''1'IO i FIELD) • SI:I'AltATION Itl;QUIItEMI':N'I` i , . -\\___::::•kliNt4 ----k%iiii /'.k POND ID `,....z........ .<7 ,.. j Hlt:.u_ IN t/NF R• .: rt 14'0.4 t. 1 , 4 // ''.... i / ,•,\ 1buaE 1. jP \ �� .. _ L. 7 ,....,. ( '. ..11 . � �r ' ScrtM, 11/ u4,4 N g ...MOW 1.1.1..• g k • t l ht DC- I __._ I 1.� ri t if)ir,litimi Jilt,T I i • \‘ :'"?..".' rip....;...3 \.0,,,yi. . ...-----J ....... . . /,. • 7. SINA►TURE &INFORMATION?OAR xuri uuiz rzx.a%., < \Ingo.."..., I i NOTE. _ a~ of 1,►'" - FINISH GRADE 1.1 SEPTIC TANK TO BE FORT MILLER OR EQUAL �f° � ' - � 4" TOPSOIL n TANK TO BE HEAVY DUTY IF WITHIN TRAFFICED F4 �Kr - AREA. TANK TO PREFERABLY BE SEAMLESS IF vF, Vf NOT.PROVIDE SECURE WATERPROOF JOINTS. . . ♦ ♦ . . , ♦ ♦ . , . , . , . . , , , , . : ♦ff+♦ 2: PROVIDE fi -12 OF COVER OVER TANK. PROVIDE yoxiv:,t a t;tirr'I!, Li ♦ f , ♦ ♦ ♦ ♦ ♦ 4 ♦ , f f f , . . , . i ♦ ♦ ♦ ♦ ♦ ♦ ♦ , • f EXTENSION COLLAR F COVER OVER TANK EXCEEDS € , , f i ♦ , f s. OUTLET (TYP. OF 8) 12"♦ !! 17 t SUITABLE BACKFILL _. GROUT UNUSED OPENINGS p r + 3. PROVIDE MIN. 3 PEA STONE, COARSE SAND OR GRAVEL 4 PERF. PIPE (ROCK, COBBLES TO BE REMOVED) ii ___..:..� 12 COVER MtN. -�-11 ' I BASE UNDER SEPTIC TANK, LAID LEVEL 4'_O" r` 4.! WHERE SEASONAL HIGH. GROUNDWATER (SHGW) CAN �` 1 RISE ABOVE THE TANK BASE, ANCHOR AGAINST . . GEOTEXTILE COVER EACH OUTLET FITTED FLOTATION AND DO NOT PUMP DURING SHGW PERIOD. : WITH SPEED LEVELERS BAFFLE ; TYP. HOLES AT A INLET :� A 5. IT IS REQUIRED THAT MODEL A1801-4x18-VT-B35 _ > 3 ,. t•, . 5 & `7 O'CLOCK . i t.i. 4" INLET PIPE ZABEL EFFLUENT FILTER BE PROVIDED ON THE SEPTIC BANDING STRAPS © �� TYP, MIN. SLOPE 1/8 */* T. 4" OUTLET PIPE TANK OUTLET. PROVIDE A ZUES RISER AND LID TO0 0 f - MIN. SLOPE 1/8 "/FT. ACCESS ZABEL FILTER . ♦ . .. .. t�,►.•.,,;.• 12 MIN. COURSE • e ,..:�•::1i�j' SANG OR PEA STONE IN-DRAIN UNIT i r NOTE: 2 -1 LAID LEVEL 24` INSPECTION SECTION A-A - DISTRIBUTION 80X TO BE N0. 2 DB PL4N VIEW ( I i COVER (TYP.) TYP. I SEWAGE DISPOSAL SYSTEM NOTES: ' CONCRETE SAND ... ip - COLLAR IF COVER BY FORT MILLER OREQUAL. PROVIDE EXTENSION I o S. .O.T. -07 ,.. .... .. ... .. OVER BOX EXCEEDS 12 . �NLET III III -� OUTLET N.Y. D #703 THIS DESIGN IS FOR A NEW 3 BEDROOM RESIDENCE TO BE SITE. LOCATION MAP TYP. DISTRIBUTION BOX I ( CONSTRUCTED AFTER THE EXISTING CAMP IS REMOVED. 6" 36" 6" NOT TO SCALE NOTE: - - - - - - - - _ - - LL J 1.) SEWAGE FLOWS:3 BEDROOM HOME AT 130 GAL/DAY/BEDROOM 4' MIN. TO IMPERVIOUS STRATA, BEDROCK 8'-8 1/2" TOTAL EXPECTED FLOW = 390 GAL/DAY/BEDROOM OR SEASONAL HIGH GROUNDWATER r I 2.) SEPTIC TANK DESIGN SIZING: 3 BEDROOMS - 1000 GAL. PLAN VIEW 4* INLET 3.) CONVENTIONAL ABSORPTION ELJEN IN-DRAIN SYSTEM DESIGN: ELJEN IN--DRAIN CROSS SECTION MIN. SLOPE P 1/4 ice• IN. SLOPEp1P/8 "/FT. PERCOLATION RATE = 1-5 MINUTES/INCH - LOADING RATE 1.2 GAL/SF NOT TO SCALE 8�_O„ 6" 4'-0" ucwlD LEVEL 4, 390 GPD FLOW = 325 SF TRENCH AREA N 1.2 GPD SF - I 18" o 3 TYP. �, - ELJEN SIZING CREDIT 7 SF/LINEAR FT. 8N -- BAFFLE (�•) �' - USE 2 LINE AT '24 FT. LENGTH - PROVIDE 12 IN-DRAIN UNITS. T T ( )LL -- LEACH SYSTEM SIZE = 12'x24' I 4" TYP. -MAX. SLOPE IN EXISTING SOILS IS LESS THAN 2�b. • r 4.) CONTRACTOR SHALL AT ALL TIMES COMPLY WITH THE REQUIREMENTS OF � - :�:�W:.:��'� '..y �'.•y _ ' THE N.Y.S.D.O.H. DESIGN DOCUMENT APPENDIX 75-A-WASTEWATER 8'-8 1 2" 3" MIN. COARSE SAND GRAVEL TREATMENT STANDARDS FOR INDIVIDUAL HOUSEHOLD SYSTEMS AND THE IN-DRAIN UNIT ' OR PEA GRAVEL " N.Y.S.D.O.H. PUBLICATION INDIVIDUAL RESIDENTIAL WASTEWATER v (LAID LEVEL) 4 SECTION VIEW TREATMENT SYSTEMS DESIGN HANDBOOK". I N I ' SEPTIC TANK DETAILS - lOOO GAL. 5.) THE LOT INFORMATION HAS BEEN TAKEN FROM A MAP BY"RICHARD W. BENNET f DATED 9/18/81, PREPARED FOR EDWARD WHALEN. NOT To SCALE 6. PROVIDE A SURFACE DRAINAGE SWALE AR 4""DIA. PERF. PVC ) AROUND THE ABSORPTION SYSTEM TO DIVERT SURFACE RUNOFF AWAY FROM THE SYSTEM. INSTALL NO CLOSER (LAID LEVEL) THAN 10 FROM THE FILL EDGE. CONCRETE SAND ' I 7.) CONTRACTOR SHALL FOLLOW THE N.Y.S.D.O.H. CONSTRUCTION GUIDELINES FROM THE INDIVIDUAL RESIDENTIAL WASTEWATER TREATMENT SYSTEMS DESIGN HANDBOOK. 4" DIA. PVC 8.) HOUSE, DRIVE, WELL AND SEPTIC SYSTEM LOCATIONS INDICATE ONE SCENARIO THAT MEETS REGULATORY REQUIREMENTS. OTHER LAYOUTS MAY BE ACCEPTABLE. 9.) CONTRACTOR TO SECURE ALL REQUIRED PERMITS FOR PROJECT. 4" DIA. PVC - FROM SEPTIC TANK 10.) CONTRACTOR RESPONSIBLE FOR COMPLIANCE WITH ALL OSHA REGULATIONS AND r REQUIREMENTS. ELJEN IN-DRAIN SYSTEM PLAN 11.) ALL-WORK MUST CONFORM TO ALL FEDERAL, STATE AND LOCAL CODES, NOT To SCALE I r.• • SPECIFICATIONS, ORDINANCES, RULES AND REGULATIONS. , OF QUEENSM-URY � 12.) ALL UTILITY LOCATIONS, IF SHOWN, ARE APPROXIMATE. CONTRACTOR TO [ ,G �t �" FIELD VERIFY AND CONTACT UFPO AS REQUIRED. BUILD 13.) CONTRACTOR TO PROVIDE RECORD DRAWINGS FOR THE ON-SITE SEWAGE R {EWED BY DISPOSAL SYSTEM TO THE N.Y.S. DEPT. OF HEALTH. - ©ATE ....- ".. , r , 14.) THERE ARE NO KNOWN WATER SUPPLY WELLS WITHIN 100 FEET OF THE PROPOSED LEACH FIELD OR SEPTIC TANK. fw' ASH _ 9♦ EXISTING DRIVE "a 15.) ALL REFUSE, DEBRIS AND MISC. ITEMS TO BE REMOVED SHALL BE _ G �! ` DEPAE DISPOSED OF OFF SITE BY THE GENERAL CONTRACTOR. y r.. �UII.OING RY , \ \ ( TOYVNOF� tamed exa�r� � 16.) ALL POINTS OF CONSTRUCTION INGRESS :OR EGRESS SHALL BE MAINTAINED:JT N WM our COMM COPYBaste the PREVENT TRACKING OR FLOWING OF SEDIMENT OR DEBRIS ONTO A;PUBLIC ROAD r \ \ EWIN IN-DRAIN LEACHING as and EXISTING WELL M �`'� SYSTEM Ai ansor►s areas OR ON THE PAVED AREAS OF THE SITE. 12 UNITS O 4' domPwan�W arid itt(the BuiMm9 Miy \ 12'x24' of New Yot�state. 17.) GRAVITY PIPING TO BE PVC SDR-35 OR SCH-40. ti ? , 18.) CONTRACTOR TO FOLLOW EROSION CONTROL GUIDELINES FOR ALL WORK AS PROVIDED f. FOR IN "NEW YORK GUIDELINES FOR URBAN EROSION AND SEDIMENT CONTROL" DATED Q�T2 GALLt�V�SEPITOICOTANK PERCOLATION TEST RESULTS. APRIL 1997 OR ITS MOST CURRENT UPDATE. z . f MINIMUM R�TYou�� PERC. RATE DEPTH No. (MIN:SECANCH) DATE (IN.) � - 19.) A PROFESSIONAL ENGINEER SHALL PERFORM INSPECTIONS OF THE SYSTEM AT THE PROPOSED DRIVE RECEIVE FOLLOWING TIMES: SEPTIC TANK OPEN, LEACH FIELD W/LATERALS EXPOSED. PT 1 2 min. 52 sec. 4/29/04 24 ® 48 HOUR NOTICE REQUIRED. ENGINEER TO CERTIFY THAT THE SYSTEM WAS PROPOSED PTtINSTALLED IN SUBSTANTIAL ACCORDANCE W/PLANS. A FEE IS REQUIRED z' PT 2 3 min. 01 sec. 4/29/04 23 DISTRIBUTION BOX ,yam MAY 3 2004 FOR THIS SERVICE. TEST PIT RESULTS rowrvoF . F 20.) ALL WELLS SHOWN ON PLAN ARE POINTS. LOCATION OF POINT ON BWN OFF; EE CODE Y ON LOT TO WEST OF PARCEL FROM MAP PREPARED BY ELYSIAN EXISTING WELL No. DESCRIPTION ACHITECTURE. LOCATION ON THIS PARCEL AND ON PARCEL TO THE " EAST TAKEN FROM PIPE DRIVEN IN GROUND MARKING LOCATION OF a� >� EXISTING HOUSE 1 0"- 6" TOPSOIL •� ! = To BE REMOVED 6 -60 DOMINANTLY FINE/MEDIUM SAND WELL AT TIME NEW POINTS WERE INSTALLED THIS YEAR. j f WITH GRAVEL, COBBLES AND SOME FINES EXISTING WELL NO GROUNDWATER , NO MOTTLING 21.) EXISTING SEWAGE DISPOSAL SYSTEM LOCATED BETWEEN HOME AND r LAKE SHOULD BE LOCATED AND FILLED IN OR REMOVED AT TIME THE { EXISTING CONC SLAB SOIL TEST BORING COMPLETED 4/29/04 BY BRIAN FEAR P.E.. PRESENT STRUCTURE IS REMOVED. EXISTING DOCK 21.) AT THE TIME OF THE SYSTEM INSTALLATION A LICENSED LAND SURVEYOR WILL DETERMINE PLACEMENT OF SYSTEM TO ENSURE 100' SEPARATION / TO ALL WELLS SHOWN ON SITE PLAN. GLEN LAKE SHORELINE Lands of Olga Saito " have seen or observed, or believe I saw evidence of, 76 Ash Drive ail objects such as houses, ,,ells, trees, fences, etc., TOWN OF OUEENSBURY WARREN COUNTY STATE OF NEW YORK 1 shown on this document.i also represent that l have SITE PLAN personally measure the di lances set forth on the diagram." of NEW a _ R•R°e y ON SITE SEWAGE DISPdSAL .SYSTEM /3 ¢ g SCALE: 1- = 50 --- r= • SITE P14A SIGNATURE D E m 11 DATE: 5 6 04 SCALE: AS NOTED DWG. NO.: Saito S tk.�! No. 1 �? / / ep wg A9°FESSI O CARRY ROBINSON P.E. 4. P.E. LtC. Na: s01ss REV. DATE NOTE CON�t7LTING lI'NGINh'ER - SHEET OF