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2005-528 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20050528 Date Issued: Tuesday, July 26, 2005 This is to certify that work requested to be done as shown by Permit Number P20050528 has been completed. Tax Map Number: 523400-297-017-0001-076-000-0000 Location: 43 MEADOW VIEW Rd Owner: ERIC & LISA LOWDER Applicant: ERIC & LISA LOWDER 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&CoAlEnforNment 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: P20050528 Application Number: A20050528 Tax Map No: 523400-297-017-0001-076-000-0000 Permission is hereby granted to: ERIC &LISA LOWDER For property located at: 43 MEADOW VIEW 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 Zonuig Ordinance. Type of Construction Value Owner Address: ERIC & LISA LOWDER 43 MEADOW VIEW Rd Septic Alteration Residential Total Value QUEENSBURY, NY 12804 Contractor or Builder's Name / Address Electrical Inspection Agency SANITARY SEWER DAN DRELLOS PO BOX 224 GLENS FALLS NY Plans&Specifications 2005-528 SEPTIC ALTERATION $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, July 13, 2006 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the 7Quee ury• nesday, July 13, 2005 i i SIGNED BY for the Town of Queensbury. Director of Building&Co Enforcement Application for Permit— Septic Disposal System Town of Queensbury 742 Bay Road Queensbury, JVY 12804 (518) 1761-8256 1. OWNER INFORMATION: ............................... .................. Office Use Location of installation: Y2 MF-Af3,jW ec.,; coss�w File Permit No Tax Map No. Fee Paid Owner's Name: C. ............................................................................. ........... Address: '7 3 AF/T Ag 2. INSTALLER'S NAME :,fALj i L&"A2Ljie-t PHONE N079d ',a$-,-P f 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 Dailv Flow 1980 or older x 150 gal/bdrm = 1980- 1991 x 130 gal/bdrm = 1991 -present x 110 gal/bdrm = Garbage Grinder Installed yes no .,-*" 'ED Spa or Hot Tub Installed yes not;?,:" RECEI% JUL 11 2005 4. PARCEL INFORMATION: (circle applicable information& indicate measuremf6WN OF QUEUNSBURY BUILDING AN_____CO Tc6�ravhv S-oiJ-Nature Ground Water Bedrock or Impervious Mat 4iaoDE estic Water Suppl efla t) ( sand at what depth at what depth municipal ng feet —feet well Steep slope c ay if well; water supply %slope other from any septic-system depth: absorption is other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: 1—6" 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: 1000 gallon (min. size 1,000 gal.) Tile Field: each trench (5eO ft. Total System Length: OJ 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 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. k I have read the regulations with respect to this application and agree to abide by these and all requirements of the To;wT eensbury Sanit wage Disposal Ordinance. it Si tur f r sponldb(16 person t DAe Si ature of re�_p r� 1 i s Town of Queensbury Sewers and Sewage Disposal Chapter Appendix C ABSORPTION FIELD SEPARATION REQUIREMENTS i Sr"At4 `-` . ° ti �t Appendix C ABSORPTION FIELD SEPARATION REQUIREMENTS f WA r W aA.L- Nei. W.A�tW$L R1fy1iT +ram Septic Inspection Report I Office No.(518)761-8256 Date Inspection request received: 7 �Mart: p Queensbury Building&Code Enforcement Arrive: am 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: AME: Ile PERMIT NO.: fir OCATION: _ INSPECT ON: -� (n1'' RECHECK: 0 Comments and/or diagram Soil Type: S Clay Type of Wat r: Municip 1/Well Water Waterline sepa'1%4on_di4ance ft. Well separation distance ft. Other wells. ft• Absorption Field: Total length ft. Len h of each trench ft. Depth of trenches ft. Size of Stone .,j i-'r Lorg AV 1� Seepage Pits: Number Size: x Stone Size: Piping Siz Type Building to tank Tank to Distribution Box Distribution Box to Field/Pit_ • Opening Sealed: Y/N/Partial 4 End Cape Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Vy N Engineer Report and As-Built Y N Location of Sys on Property: Front Oea Left Side Right Side Middle Front Middle Rear System Use Stat An, Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved Last revised 1/6/05 169 Haviland Road, Queensbury,NY 12804 Phone-518-745-4400 Fax -518-792-8511 June 30, 2005 Project# 49170 Mr. Jay Sweet Queensbury Septic It PO Box 4283 RE Bay Road 79 Lake George,NY 12845 JUL �00 ISBURY Re: Percolation Test ``=`°D BODE Eric Lowder Residence - 43 Meadow View Road, Queensbury,NY Dear Ju J• At your request I have performed soil testing (deep test and percolation test) at the site of the 4 bedroom house of Eric Lowder on Meadow View Road in Queensbury. The tests were performed in the location of the proposed replacement septic system, to the northwest of the existing residence. The results of the testing are as follows: Deep test 0-7" Topsoil 7-21" Loamy medium to fine sand 21-68" Medium to fine sand (compact) Mottling at 48"'; no water Percolation test Stabilized percolation rate— 1" in 4 minutes, 22 seconds Based upon a 4 bedroom house at 110 gpd/bedroom and a percolation rate of 1 to 5 minutes, you will need a 184 linear feet of absorption trench. Based upon these tests and the owner replacing all fixtures with new code compliant water saving fixtures, I agree that constructing the proposed replacement septic system with 4—50 ft standard absorption trenches is acceptable. Please call me if you have any questions. Sincerely, Thomas R. Center, PE cc: Dave Hatin, Town of Queensbury TOWN OF O EEPv'S URY BUILDING O D � REVIEWED DATE JUL 12005 �7