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2002-425 TOWN OF QUEENSBURY 7 2 B R n NY 12 4-5902 518 761-8201 ow 4 ay oad,Quee sbury, 80 ( ) Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20020425 Date Issued: Monday, August 18, 2003 This is to certify that work requested to be done as shown by Permit Number P20020425 has been completed. Tax Map Number: 523400-289-007-0002-006-000-0000 Location: 674 MOON HILL Rd Owner: KRIS ERCEG Applicant: KRIS ERCEG This structure may be occupied as a: By Order of Town Board Septic Alteration Residential TOWN OF QUEENSBURY ("Da4IP 4 kil."1 Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 FON Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020425 Application Number: A20020425 Tax Map No: 523400-289-007-0002-006-000-0000 Permission is hereby granted to: KRIS ERCEG For property located at: 674 MOON HILL 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: KRIS ERCEG 674 MOON HILL Rd Septic Alteration Residential Total Value LAKE GEORGE,NY 12845 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2002-425 SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,May 28,2003 (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 f Quee b4r; •sd. ,May 28,2002 dr'. SIGNED BY 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: _ _ �-- Location of installation: �� 0 0 /� ��( it r) Office Use File Permit No.Q= f -L/ 5 Tax Map No. / / Fee Paid Owner's Name: Kr- Eacci Address: Y 7N„ 2. INSTALLER'S NAME : ( /3. S. 5c,r/ PHONE NO. trt4Y 2a 3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s) and mul •st _ 2 bedrooms with applicable gallons per bedroom to equal totals,y`lt .. '� ;v' G• Year of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older 3 x 150 gal/bdrm = ys 1980-1991 x 130 gal/bdrm = 1991 -present xg� 110 gal/bdrm = Garbage Grinder Installed yes_ / no tl Spa or Whirlpool Installed yes_ / no K 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) Tip graphy re Ground Water Bedrock or Impervious Material Domestic Water Supply Flat s•,..#, at whet depth at what depth i'cipal oiling •• 3 feet feet Steep slope c ay 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: l & t 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: # / depth or thickness feet Bed System Size: x i A./dl rc-f/ '' 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 th own of Queensb Sanitary Sewage Disposal Ordinance. C.- 1—)4' )0d 61 Signature of responsible person Date Septic Inspection Report Office No. (518) 761-8256 Date Inspection reque,t re ived: Queensbury Building&Code Enforcement Arrive: am/I epart: �I am/pm 742 BayRd.,Queensbury,NY 12804 Inspector's Q ury, Inspector s Initials: •.• PERMIT NO.: 6 LOCATION: ? MOO KILL— 4). INSPECT ON: 7/L/11 .• 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. 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/Partial Location/Separations Foundation to tank ft. Foundation to absorption ft. g/f QSeparation of Pits ft. /7'{/4-U Conforms as per Plot Plan Y N C6q5 Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear S stem Use Status. 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 COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Permit No. Cert. O 81407 Cut-in Card No. !.\... Owner C -ee • Location 674 00 0 4) AI( , 0. .62I-€_ ( r Installation Consisting of. ze-b49 CQA-)T/ Installed By se S / - e 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 ma spections at any time, and if its rules are violated,the Company shall have the right t r v e ific f. Date /z_U� INSPECTOR Member N.F.P.A.,I.A.E.1. Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: /S Queensbury Building&Code Enforcement Arrive: a Depart: C b,, am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials NAME: _ r cj PERMIT NO.: 0 —9- ' --S LOCATION: `\C,. g. INSPECT ON: 03 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. Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ' ft. Size of Stone Seepage Pits: Number Size: i x Stone Size: t Piping Size ype Building to tank ,�/��� FI EC CC. Tank to Distribution Box /V Distribution Box to Field/Pit 1/V,�P -� C (- Q 5 Opening Sealed: Y/N/Partial `� [ �' 0VT l,C--g %1 Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: roved artial 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 TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Names ER?Ce Loc 1i� n ToJA/ lb/ cJ- Date P rmit # ®`Z` SOIL TYP : Sand-Loam- lay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: '` r ABSORPTION FIELD: Total Length U5/ Length of each trench 2..4 Depth of trenches / Size of stone CJ/Ci-4J SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: ize Type Bldg. to Tank Tank to Dist. Box ` Dist. Box to Field/Pi ^5C2 Openings Sealed? Yes No Partin LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption feet Separation of Pits - eet Conforms as per Plot Plan s No LOCATION OF SYSTEM ON PROPERT (circle one) Front - Rear - Left Sided Right Sid Middle S: /Ei4 /4— a COMM�MENNTS 7d 4 LA SAP. —47(L • A% &Awl) ,4l" /rl/1 ///e( SYSTEM USE APPROVED: YES NO, Arrived: Departed: Building Inspector 4'- 6' TOPSOIL 4"- 6' TOPSOIL FIN GRADE FIN GRADE FIN GRADE ELEV 99.00 (TOP) —7 INSTALL CONTROL PANEL INDOORS. MAKE ALL i ��- i i i �/ ELECTRICAL CONNECTIONS OUTSIDE PUMP CHAMBER. s— 77 LOAMY BACKFILL —s 4' PERFORATED CLEAN. MED-COARSE 4' PERFORATED PANEL BOX SHALL HAVE A WARNING LIGHT AND PVC PIPE CONCRETE SAND <-- LOAMY BACKFILL ON PVC PIPE so LOAMY BACKFILL No AUDIBLE ALARM. SEAL CONDUIT AND AIR PASSAGES BANDING STRAPS GEOTEXTILE ,1 BANDING STRAPS PROVIDE 4" PVC PUMP CHAMBER VENT. 'IN-DRAIN' UNIT o GEOTEXTILE 'IN-DRAIN' UNIT' CONCRETE SAND MED-COARSE LOCATE SCREENED OPENING AS FAR AS FROM PUMP CHAMBER WITH SEAL- TIGHT FITTINGS AND/OR PRACTICABLE FROM RESIDENCES. NON-SHRINK GROUT TO PREVENT OUTFLOW OF GASES. rz CLEAN. MED-COARSE L T-DUTY MH CONCRETE SAND z z D •;' cp FRAME & COVER FINISHED GRADE PROVIDE A DISCHARGE BALL s" 36' OIL 00 s" 'L 36• L 24- �I 3 L�6' � 24' ?•I� 36" WL 12" / / / / / / / / / / / / / / / / / / VALVE FOR THROTTLING 4'- 0' ,• • • • • CONDUIT TO PANEL BOX SECTION GRAB BAR PART - SECTIONl I/2" "BA KER" OR "MARTINSON" PITLESS l 1/2" SWING CHECK SINGLE "IN-DRAIN' MODULE "IN-DRAIN" ABSORPTION SYSTEM ADAPTER GRADE 4" SCH 40 PVC INLET l 1/2" PVC FORCE MAIN ;/1110 FROM SEPTIC TANK: POWER • DARK SEAL WALL PENE TRA T LEAD PENETRATIONS l 1/2 " GAL V. STEEL PIPE 5ANDY-11XAM 500-GALLON ALARM 1.5 PRECAST H YDR OMA 'TIC EFFL UEN T SEPTIC TANK •• PUMP - MODEL OSP33 PUMP START S TA B/L IZED PER COLA TION FINE TAN SAND PUMP STOP TEST RATE, AFTER PRESOAK. TERMITE BL K • SE T CA S TING ON 12" IS 20 MIN / INCH !*/-). • • COMPA C TED CRUSHED ROCK DESIGN IS BASED ON 20 MINUTE 3.0' GROUNDWATER _ " " , , - , • - • . . RATE APPLIED FOR IN-DRAIN ABS. • • . • , s , S YS TEM A S PER MANUFA C TURER. - . • ' - . ' - . 4.0' DETAIL 501L, BOG EFFL UENT LIFT STA T/ON NTy 51' EGIFIGAT10N5 36" x 48" x7" 4" PERFORA TED IN-DRAIN UNI T- VEN T PVC LATERAL 2/ UNITS REQUIRED BED FORCE MAIN AT A DEPTH OF 5 FEET BELOW GRADE. MOON HILL ROAD 34' 15' 11/2" DIAM. FORCE MAIN SHALL BE PRESSURE RA TED A T /00 PSI MIN. EDGE OF PAVEMENT INCREASE l I/2" FORCE MAIN DIAMETER TO 4" DIAMETER l0 FEET AHEAD CONC OF DISTRIBUTION BOX. PROTECTIVE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SAND _. R-O-W LINE_ . . __ __•' -1 _F_ENCX_EEFFLUENT ' _ . EFFL UEN T PUMP SHALL BE SOE 'H YDROMA TlC OSP 33" CAP ABLE A BLE OF X X DELIVERING 20 GPM AGAINST A TOTAL HEAD OF 22 FEET. p2 �— —MAC. D/S T PROVIDE A THROTTLING BALL VALVE ON THE PUMP DISCHARGE LINE. \ X ' PORCH BOX t� P SET CONCRETE CASTINGS DEAD LEVEL ON I2" COMPA C TED CRUSHED ROCK. Irk - - X `• — ��� oA THE EL GEN TYPE-B 'IN-DRAIN' MODULAR SYSTEM IS DESIGNED AND MANU- I FACTORED BY ELJEN CORP.. 15 WESTWOOD ROAD. STORRS. CT 06268. ��� EFFL UEN T /2" B NUT X _j 3-,qEDROom HOUSE 4" PVC--a► U lO" B'SPRUCE �_ 28 PREPARE IN-DRAIN ABSORPTION SYSTEM BY PLACING MEDIUM CONCRETE SAND ABS. SYSTEM �' SO THAT IN-DRAIN UNITS WILL LIE STRAIGHT AND DEAD LEVEL. WELL TOP FIN. GR. ...................... ...... ... .. .... ��, .- 30' ELEV 9 9.0 0 4• SCHED INSTALL IN-DRAIN UNITS EXACTLY A S RECOMMENDED B Y THE MANUFACTURER. TBM TOP CAP 40 PVC PLAN GEOTEXTILE SHALL BE SOE l8ON NONWOVEN NEEDLE-PUNCHED M/RAFI • FORCE FILTER FABRIC" MANUFACTURED BY M/RAFI GEOSYNTHET/C PRODUCTS. ELEV /OO.oO "IN-DRAIN' ABSORPT/ON SYSTEM MAIN 3500 PARKWAY LANE. NORCROSS. GEORGIA 30092. .... ..... ... ... BECK NEW. SAP TIC VENT L IF r STATION AND ABSORPTION SYSTEM TO ATMOSPHERE AS SHOWN. gg ........ LIFT TANK s TA rioly DISTRIBUTION BOX SHALL BE 18" WIDE BY 30" LONG MINIMUM. PROVIDE GARAGE OUTLET FLOW LEVELERS FOR EQUAL DISTRIBUTION. g� FO.R.CE in MAIN NO TICE TO CON TRA C TOR � yo THE IN-DRAIN ABSORPTION SYSTEM SHALL BE RAISED CODE GOMFIIANGE . �IW D ' ...... ABOVE EXISTING GRADE A MINIMUM OF LO FT. TOP OFM4y 2 4 2702 . - ABSORPTION SYSTEM FINISHED GRADE ELEVATION SHALL CONTRACTOR SHALL COMPLY WITH ALL REQUIREMENTS OF THE TOWN F r�w��� P1+'r r„ rC` Div e1[JRII BE 99.00 RELA T/VE TO ELEV 100.00 ON THE WELL CAP. QUEENSBURY AND THE NA TONAL ELECTRIC CODE. -- - o-,, g6 THE ABSORPTION SYSTEM MUST BE PRO TEC TED FROM TRAFFIC. A PRO TEC TI VE FENCE IS REQUIRED AS SHOWN. �r�+ +i^ u�Eu �Rr aL it►�JG�'EF/1R'ME"JT Bo:aed on our limited examination, Seen or Qh compliance vvith our comments shall , p^ serJe�, or believe I saw evidence of g� not be construed as indicating the ' ' ' ' �s t'?t!ses, wells trees, , fences ete plans and specifications are in full , Um?�n t. l also re,,)resent that l h compliance with the cod �� 'V s+ : � t? e �`e _ ,., � istances set forth on the diagram.,, g� . KRIS ER 674 MOON HIL L R OA D g� QUEENSBURY. NEW YORK 12804 g� �� •h WTI S TE WA TER S YS TE SI TE PL A N z a �P � AUGUST 200/ / 20 ��� t SCUDDER ASSOC/A TES TOWN OF QUEE.tv�BU " 20ale CONSUL TING ENGINEERS y f � . TAX ID 12 8 9. 07-2- 61 CHARDS Vt SCUDDER P.o. BOX 79z BUILDING & GLENS FALLS. NY 'I280/ REVIEWED t DATE Z T. o L—