2005-929 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. P20050929 Date Issued: Friday, May 12, 2006
This is to certify that work requested to be done as shown by Permit Number P20050929
has been completed.
Tax Map Number. 523400-297-007-0001-023-000-0000
Location: 39 HICKS Rd
Owner. BRYAN BRAMER
Applicant: BRYAN BRAMER
This structure maybe 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 Enfo n
Planning Board or Zoning Board of Appeals.
ter- TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050929 Application Number: A20050929
Tax Map No: 523400-297-007-0001-023-000-0000
Permission is hereby granted to: BRYAN BRAWR
For property located at: 39 HICKS 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: BRYAN BRAMER
LISA TOKAR7, Septic Alteration Residential
Total Value
39 HICKS Rd
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
01TEENSBITRY SEWER
NY 12804-0000
Plans&Specifications
2005-929 SEPTIC ALTERATION
$25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, December 06, 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 Queen ury; u day, December 06, 2005
SIGNED BY for the Town of Queensbury.
Director of Building Code nforcement
/..._ ...... ... OFFICE USE ONLY...._...._._.__...._-- .'ll ' .C� i
TAX MAP NO. PERMIT NO.C)J-?,�, PERMIT FE ; DEC Q ,
Z005
APPROVALS: ZONING TOWN CLERK ;
TOWN OF QUIE-ENSB1JRY%
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS.SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.
OWNER: !// [/< 1W m e. e INSTALLER: 0,4 e L• J �-LJ
ADDRESS: cf �C/G� ' ADDRESS: wec `
PHONE NOS. PHONE NOS. --� !
LOCATION OF INSTALLATION: < Y— ��-f l (�' e. e r
..............................................................................BEDROOMS......... RESIDENCE IN:.........,..,,........,.............., RESIDE ORMATION.
YEAR BUILT i NO.OF I X COMPUTATION= i = TOTAL DAILY FLOW I
::
�.
. ..................................� ...............,................................................
...............:.....i..........................................................................? GARBAGE GRIND.E�
1980 or older ' X 150 gallon per bedroom i = { i INSTALLED? [/
a................. ................. i......................................................................................
;
1981 -1991 X 130 gallon per bedroom R
SP O OT
[ 1992-present j X 1 110 gallon per bedroom I = INSTALL ED? TU�� ,l
i.............................................................. �r.•...... ..... ...,..............................................................�� .....'?"""'""""""""..:
PARCEL INFORMATION: b R t:!s6 V—%
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPED � --
✓ SOIL NATURE: SAND. _ LOAM 'CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? BEDROCK/IMPERVIOUS MATERIAL: AT
WHAT DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL
(IF WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS /d o FT. )
✓ 'PERCOLATION TEST: RATE IS 1 1�4;dPER MIINUTE PER INCH (TEST TO.CBE
COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT)
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 TANK40 /-)-�GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH FT.
✓ TOTAL SYSTEM LENGTH:/V 0 FT. SEEPAGE PIT(S): HOW MANY?
✓. SIZE OF EACH FT; X FT.
✓ SIZE OF STONE TO BE USED: # _/DEPTH OR THICKNESS__Z _FT.
✓ BED SYSTEM SIZE: �cy X 6L
✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
✓ HOLDING TANK SYSTEM:(If required) NO. OF TANKS: /SIZE OF EACH
✓ GALLONS./TOTAL CAPACITY. GAL.
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN �!
i APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
...:...:...................:.................................:.:.:...................................,.:.:.:.: .:.:.:.:.:..,,..,..,,.........,..........,...,..,.............:,,.,,,,:: ,:....,,...,....::.:::,,,::..:.................................................f
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 QUESTIONS? CALL 761-8256 OR EMAIL
Queensbury Sanitary Sewage Disposal Ordinance. codes@aueenabury.net
VISIT OUR WEBSITE FOR MORE INFORMATIgN
www.aueensbury.net
Signa ure of P6'rson Responsible -Date
Fl Town of Queensbury • Community Development Office m 742 Bay Road, Queensbury; NY 12804
S
Septic Inspection Report
Office No. (518)761-8256 Date Ins ction re ue recei
Queensbury Building&Code Enforcement Arrive: In pa ani/pm
742 Bay Rd.,Queensbuiy,NY 12804 Inspector's Initi .
NAME: S��RBEVI P RMIT NO.: 7_Cj�F=92t
LOCATION: ,"Act 1-1 1 CVO a SPECT ON:
RECHECK: `F� }�T E o F6DNA_� — CZ—n
Comments and/or diaeram
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. �1
Length of each trench ft.
-Depth of trenches ft.
Size of Stone
Seepage Pits: Number `
Size: x l�
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.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Location of System on Property:
Front Rear Left Side Right Side
Midd/FroMiddle Rear
S stem Use Sproved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
LASueHemingway\Building.Codes.Inspection.FORMS1.Septic Inspection Report.doc January 28,2003
Septic Inspection Repe
Office No. (518)761-8256 Date Inspection
Queensbury Building&.Code Enforcement Arrive: " : am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's InitiNAME: zLOCATION:
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 (� E
Building to tank
Tank to Distribution Box
Distribution Box to Field/Pit
Opening Sealed: Y/N/Partial
End Caps
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built u Y N
Location of System on Property:
Front Rear Left Side Right Side
Middle Front Middle Rear
System Use Status:
Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved ~-�-� �V-_:R\�
C)F
Last revised,1/6/05
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. OV
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No........................................Cert. 90Cut-in Card No................................
Owner................Q........`.......... ....................................................................................
Location.... ..:d.... �f. ......� .....................................�.j...,..,....�........ �t ...........
Installation Consisting of. ?7 ....> h t 1 ..... ? ..rh_e4�.�.................................
....................................................................................................................................................................................
............................../.�...................................................................................................................................................
Installed By.....7.Z..:..S .�(6 ...................................Li,.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 maki 'nspections at any time, and if its
rules are violated,the Company shall have the right tore ke thi certificate.
Izg-a. L Date................. ............... INSPECTOR... .. ............................................. .. ...........................
Septic Inspection Report
Office No.(518)761-8256 Date Inspection5s:
r ceiv d:
Queensbury Building&Code Enforcement Arrive: epart: L ' 3a� m
742 Bay Rd., Queensbury,NY 12804 Inspector's Initi
NAME: 1-3 fl titil P� IT NO.: Zu�LOCATION: �� �-�}L � (�non CT ON:
RECHECK:
Comments and/or diagram
Soil Type: an (?Loam' Cla
Type of Water: Municipal/Nell Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Absorption Field: Total length �ja, ft.
Length of each trench _ ;' — ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size:I - x L40
Stone Size:
Piping Size Type
Building to tank _
Tank to Distibnt-ion-Bex
�ud ,Distribution Box to Field/Pit " q ��
Opening Sealed: Y/N/Partial
End Caps
Location/Separations
Foundation to tank t5�ft. `�
Foundation to absorption ft. �v� i
Separation of Pits
Confo�s-pea-Plot Plan Y
ngineer Re ort d As-Built Y N
Location of System on Property:
Front Rear Left Side Right Side
Middle Fro Middle Rear
System Use States:
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Last revised 116105
Septic Inspection Report
Office No. (518)761-8256 Date Inspection r7�es ecei ed:
Queensbury Building&Code Enforcement Arrive: , am/p epart: = ,cA) a pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: /
NAME: (�Yrcq MQff IT NO.:
LOCATION: SPECT ON:
RECHECK:
Comments and/or diagrams
Soil Type: Sand Loam7jCla
Type of Water: Municipal426Le1.1xa_e-r
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 P �L., `V��1�1 1'\ lvb�
Stone Size: 1
Piping Size Type
Building to tank fi t0 _,
Tank to Distribratinn=$ox_ LA 1
Distr4-bufion=R-o-x to Field=L==-
Opening Sealed: Y/N/ artial
End Caps
Location/Separations ,���1 W\U CIG
Foundation to tank C `t. _
C'�M
Foundation to absorption t Z ft. _����� \�
Separation of Pits ft. Q- �C �— ��- �-` C-
Conforms as per Plat Plan _Y N _ _ 1 (A P'\AA Q A�
Engineer Report and As-Built Y N 3D ��� ��
Location of System on Property:
Front Rear Left Side Right Side
Middle F Middle Rea r
System Use Stat s:
Approved
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
October 31, 2005
Project.# 49175
NE
Mr. Jay Sweet J I
VED
Queensbury Septic .
PO Box 4283 DEC 0 5'200.5
Bay Road TOWN OF QUEENSSURY
Lake George,NY 12845.: BUILDING AN CODE
Re: Soil Tests & System Design .
Bramer Residence—.39 Hicks Road, Queensbury(T)
Dear Jay:
At the owners' request, on August '17, 2005, we-performed a percolation test and test pit_at the _ J
proposed location of a replacement septic system for the Bryan Bramer.afhis residence on Hicks.
Road in the Town of Queensbury. The test was performed to the east of the existing in-ground
swimming pool. The replacement absorption field will be located in the area above where the
swimming pool is currently located.
The results of the testing are as follows:
Soil Test Pit -
0—4 Topsoil
4—24 Silty Sand with gravel
24—71 Silty Sand with clay and gravel
No Groundwater observed, Mottling @ 24"
Percolation Test
Stabilization percolation rate- 1" in 15 minute, 55 seconds
The design flow for this residence with bedrooms;`with new water saving fixtures, at 110 gpd
per bedroom will be.330 gallons per day, and will require a minimum of 600 sf of absorption
area. Based on this design-flow rate, we recommend using a shallow absorption -bed with an
effluent pump station. The absorption bed; which will be located above the abandoned swimming
pool area,shall consist of an absorption area'of 20 feet wide by 40 feet long(800 sf) with 4—35
foot long laterals. Percolation rate of the fill material shall be between 5 and 15 minutes per inch.
'ECEIVED
DEC 0 5 2005
TOWN OF QUEENSSURY
BUILDING,AND CODE
�`•1'tr..jve seen or observed, or believe I saw evidence of,
,sects such-as houses, wells, trees, fences, etc.,
-;,,an on this docurinemt. I also represent that I have
snnaiiy measured the distance set forth on the diagram."
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