2007-234TOV~~N OF QUEENSBURY
BUILDING PERMIT
Permit Number: P20070234
Application Number. A20070234
Tax Map No: 523400-308-015-0001-004-000-0000
Permission is hereby granted to:
For property located at:
CORINTH 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: BRIAN & VICKIE WARNER
3 VAN DUSEN Rd
QUEENSBURY, NY 12804-0000
Contractor or Builder s Name /Address
Plans & Specifications
Septic Alteration Residential
Totai Value
Electrical Inspection Agency
-234
LOT IS BETWEEN CORINTH RD & PITCHER RD (DRIVEWAY FACES PITCHER RD
$25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Sunday, May 11, 2008
(If a longer period is required, an application for an extension must be made to the code Enfo~+cement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To ensb Frid~y, May 11, 2007
SIGNED BY for the Town of Queensbury.
Director of Building & e E rcement
742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201
Community Development -Building & Codes (518) 761-8256
BRIAN & VICKIE WARNER
~~~ y ~ ~-~ ~ o ~ ~ ~ ~
o .°~ ~ ~ ~ ~ Z o ~ ~
~ ~ ~ ~ ~ ~ "C C~.
o A o n ~ ~ ~ ~
y
i'. ~ V1 [9
ao• ~ -d ~ ~ ~ ° b ~
o a' ~ ••, ~ -o ~ p C N O
~, a `2' -o `~~' ~ t~7 ~ w y W ` ) ~ o
~ ~ W o
~ ~ O
y~~C ~ ~ ~ ° ~ ~ ~° ~ ~
~.
y ~ ~ n Ro ~ ~ o ~ ~r
~ ~ x ~ ~ ~
ofDp G~G ~ a. ~ ~ ~
~~ y G ~ O ~' O ~ o
A~ ~' fD ~ H o ~~D ~ N ~i
y ~ ~ ~ y p ~c ~ ^ ~ !~
i y ` J b, r
~ ~ A ~ O ~ ~ t1. ~ V J
a o ~. a Q y~~
~ ~ ..
z
c ,~
c p;
d ~ ~ r N
p~ ~ ~
o ~~ ~ ~
.~ ~ ~
o~
~ ~~ N ~ ^
~ `°~ z ~ ° '~ l J
~ ~~
~ a ~,
~ ~ Q
For an EPA homeowner's guide: htip•//www epc~ qov/npdes/pubs/homeowner guide iong customize r~df
I I j OFFICE USE ONLY ~ ' ++ y F - ~W -~
;R ,
(~~°~` ~ "
TAX MAP NO. PERMIT NO. PERMIT FEE
"~ ,
APPROVALS: ZONING TOWN CLERK
;TO~vr~fi ,_ .~.,~
.., _ } ~.
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. f~ ^ / '` ~,1 n
OWNER: DAd I V ~ , E-•~a Iti/At~ p INSTALLER: ^17.~~/ 1,.Q/ /'1 ~l~J~~ W/`t F.
ADDRESS: P~ TC~ LC'~ 1`O/dJ~, Ql~ t~_ ADDRESS: ___ ~i-7D W~Jr j /~'l ~ ~Di4-j7, ~~j
PHONE NOS. ~~pp II ,,// P/HONE,NIOS. D ~+
LOCATION OF INSTALLATION:?/74/l~.~ /-~/~I7 t T~"i~ ~ ~ ~ 3oG '~J ~ "" ~'
RESIDENCE
INFORMATION:
YEAR BUILT NO. OF
BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW
1980 or older X 150 gallon per bedroom =
1981 -1991 X 130 gallon per bedroom =
1992 -present X 110 gallon per bedroom = ~ 3 ~
PARCEL INFORMATION:
/ TOPOGRAPHY:
FLAT ROLLING v STEEP SLOPE
GARBAGE GRIN ER
INSTALLED? ~_
SPA OR HOT TUB~ 1~,,
INSTALLED?
SLOPE
/ SOIL NATURE: SAND LOAM CLAY OTHER
J
/ GROUNDWATER: AT WHAT DEPTH? ~ ~! BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? 7 2~
/ DOMESTIC WAT SUPLY:
MUNICIPAL WELL (If well: water supply from any septic system absorption is: ft)
/ PERCOLATION TEST: RATE IS l M ~ S PER MIINUTE PER INCH (TEST TO BE 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).
TANK SIZE: ~DD 0 GALLON (MIN. SIZE IS 1,000 GAL.) Add 250 gallons to the size of the septic tank for
each garb ge grinder, ,spa or ~y~hirlpQol tub. ~L~ EN s. ~,~~
SYSTEM TYPE: sE~ E~t!(~l~~~i~/~C.~ ~G/~f/Y'.s '" /
^ ABSORPTION FIELD (WITH NO. 2 STONE) Total length ft. Each trench X
^ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size?
^ ALTERNATIVE SYSTEM Bed or other type?
^ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks?
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL
INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
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 factor
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 Sewa a Disposal Ordinance.
~~ ~ D~~
Signat of Person Responsible Date
QUESTIONS ? CALL 761-8256 OR EMAIL
codes(~gueens bury. net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.gueensbur~,r.net
'Ibu~rt of Queenshury ~ c~tf~nrt~>r~ry L)ez~elvprrteait. Office • 742 f3rry Road, Queensbury, N~' 12804
SCUDDER ASSOCIATES
CONSULTING ENGINEERS ~` ;°~ ~~~
P.O. Box 792 T~~r ~ ~ F ; ,~
Glens Falls, NY 12801 ~~; ;-; ,
518-793-1475 ~ ~ ~ `~
goscud(a)_adelphia.net
April 5, 2007
David Hatin
Director of Building and Code Enforcement
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
RE: David A. Howard
Pitcher Road, Queensbury, NY 12804
TAX ID: 308.15-1-4
Dear Mr. Hatin:
Our office has been retained by Mr. Howard to design a wastewater system to
serve a proposed new 3-bedroom house on his Pitcher Road parcel as depicted
on the attached plan.
We therefore request that the engineer appointed by the Town of Queensbury
coordinate with our office to witness a deep test pit and percolation tests in
accord with the latest Queensbury procedural requirement.
Sincerely,
C
Charles H. Scudder, P.E.
Principal
Cc: David A. Howard
VISION ENGINEERING, u.c
4 Glens Falls Technical Park, Box #3
Glens Falls, NY 12801
Phone: (518) 792-9264
Fax: (518) 792-9282
April 20, 2007
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
Attention: Qa~rK~i Hatia, Building & Codes Department
RE: Deep Test Hole Verification
David Howard
Pitcher Road, Queensbury NY 12804
RECEIi/E'~
l~~~^' .a
TOVVIV yr ~uLCi CODEY
B~l~p-NG AND
As requested, I have completed onsite verification for the above referenced location in regards to
sub-surface conditions related to the septic system design. Attached is the deep test hole log
pertaining to this project for inclusion in your review. The test hole was conducted at or near the
praposed septic system location in ftont of the proposed three bedroom house. Soil present at the
site is predominantly well drained sand. There was no evidence of elevated groundwater and/or
mottling in the test hole. 1 also witnessed the percolation testing conducted at two locations onsite
near the deep test hole. The field percolation rate was determined to be 52 seconds which is less
than one minute per inch therefore requiring onsite soil mod cation.
Please do not hesitate to call if you have any questions or require additional information.
Sincerely,
Daniel W. yan, P.E.
VISION Engineering, LLC
Quality ^ Experience ^ Service ^ Teamwork
SOIL BORING AND DEEP TEST HOLE FIELD LOG
Project: Dave Howard Location: Tax ID 308.15-1-4
Address: Pitcher Road
Queensbury, NY 12804 Test Hole #: Test Hole #1
Soil Survey Map Oa A
County:
Warren Designation: 1 2
Date: 4/20/07 1 Soil Series: Oakville Loamy Fine Sand
Weather: Sunny 2 Slope Class: 0-3 percent slopes
Temperature: 45° F
Remarks:_(Site description, usa~er.antici~ated.dailx wastewater flow, etc.1 Three bedroom sinr~le.family home :.................
Depth (in) Boundary Color Soil Texture Soil Structure Consistency Stickiness Moisture
Condition
Matrix
Mottling State
Q-$
l topsoil
ear
c
8_2$ brown none loamy fne sand single grained loose none dry
Gear
28-36
d
l pale brn none crs sand single grained loose none dry
gra
ua
36-82 pale brn none fine sand single grained loose none dry
1. Describe and record the average thickness of each horizon.
2. Record each horizon boundary in terms of distinctness. Designate as Very Abrupt (<0.5 cm), Abn-pt (0.5-2 cm), Clear (2-5 cm), Gradual (5-15 cm),
Diffuse (>15 kxn).
3. Record the topography of the horizon boundary. Designate as Smooth, Wavy, Irregular (undulating boundary), Broken (discontinuous or
intermingled horizons or irregular pockets).
4. Indicate the color of each horizon. The matruk color is the majority color within pads, and the mottle celor is the minority color within the pads.
Record pad surface color where colors exist that are associated with an organic coaVCay film/carbonate mass/etc. Record the percent of mottles
as Few (<2%), Common (2-20°k), Many (>20%). Record the mottle contrast as Faint, Distinct, Prominent.
5. Record the moisture state of each horizon. Designate as Dry or Moist.
6. Soil Texture: Designate as Sand, Loamy Sand, Sandy Loam, Loam, Silt Loam, Silt, Sandy Clay Loam, Clay Loam, Silty Clay Loam, Sandy Clay,
Silty Clay, Clay. Sand, loamy sand, and sandy loam may be further classified into coarse, medium fine, fine, and very fine.
7. Soil Structure: Designate pads as Granular, Blocky, Prismatic, Columnar, Platy, Single Grained, or Massive. Structure grade shall be described for
pads as Weak, Moderate, or Strong.
8. Soil Consistence: Designate as Loose, Friable, Fimt, or Extremety F/m-. Indicate ND for not determinable ff too wet for test.
9. Record stickiness as Non-Stidry (little or no soil adheres to fingers after release of pressure), Slightty Sticky (soil adheres to both fingers with little
stretching upon separation), Moderately Sticky (soil adheres to both fingers and stretches some on separation), Very Sticky (soil adheres and
stretches greatly)
10. Roots: Record the quantity, size and locations of roots. Designate as Few, Common, Many. Record size as Very Fine (<7 mm), Fine (1-2 mm),
Medium (2-5 mm), Coarse (5-10 mm), Very Coarse (>10 mm). Location shall be noted to be between pads, in cradles, throughout, in mat at top of
horizon, or matted around rods fragments.
Boundary Condition Observed and Depth: Bedrock None ft Groundwater None ft Impervious Strata None ft
Slope of Site : 0-3 % Mottling Depth None ft Ground Cover: Grass Wooded
Barren Crops
Landscape Position: Depression Hill Top Side Slope Foot Slope Shrubs
Describe Roots: (Quantity, Size, and Location): Med and fine roots to 36 inch death
This form was created by VISION Engineering, LLC -Copyright ®2(W8 by VISION Engineering, LLC, All rights reserved
v vv L
Septic Inspection Report
Office No. (518) 761-8256 Date Ins ?~~Qn request received:
Queensbury Building & Code Enforcement Arrive: ~~ a" an~~~'~epart: amJpm
742 Bay Rd., Queensbury, NY 12804 Inspector's Inftiais.
NAME: ~~ °
LOCATION:
RECHECK:
n~~
Soli T Sa m Cia
T of Wa um ' Weii Water
Waterline se ra n d' nce ft•
Well separation distance
Other wells: ft•
ft•
Abso tion Field: Total len ft•
Len of each trench ft•
th of trenches ft•
Size of Stone L Jt
See a Pits: Number
Size: X
Stone Size:
Pi in Size . T
Buildi to tank ~'~
Tank to Distributi Box "' ~'
Distribution Box ieid Pit ~` ~
O nin Sealed: N Partial
End Ca
Inle Outlet Pi & Baffles Y N
Location / Se rations
Foundation to tank ft•
Foundation to abso tion R•
Se ration ofi Pits ft•
Conforms as per Plot Plan Y
En ineer Re rt and As-Built Y N
Location of System on Property:
Front ~ Rear Left Side Right Side
addle Front Middle Rear
PERMIT NO.:
INSPECT ON:
Comments and/or diagram
~G~-'I~,DiI ~ IM U T, ~ ~/ C.G.
~~,~ ~~c~-r'
.-~, ~~
v
~t P~ ~a-c.~. l,~ ~~ t~~° ~~K
~j/StPm Use Status• ~ ~ t..~ '~~~ ~~G~~~i/
pproved ~1
Partial Approved and needs to be re-inspected, please call the Building & Codes Office
Disapproved
Last revised 021006
Last revised 1/6/05
~7~vs i~s~c'D~i~.
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection
Queensbury Building & Code Enforcement Arrive: ~' am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's In Is:
NAME: '~ Gvhe~ ~ ERMIT NO.: _ ® ~ '~~~
LOCATION: INSPECT ON:~= ~~~
RECHECK:
Soil T :Sand loam Cla
T of Water: Munici I Weil Water
Waterline se ration distance ft.
Well separation distance
Other wells: ft.
ft.
Well Casing Length 50' + / -
150' to well r wired if NO Y N N/A
Absor tion Field: Total len th ft.
Len th of each trench ft.
De of trenches ft.
Size of Stone
See a Pits: Number
Size: x
Stone Size:
Pi in Size T
Buildin to tank
Tank to Distribution Box
Distribution Box to Field Pit
O ni Sealed: Y N
End Ca Y N
Inle Outlet Pi & Baffles Y N
Manholes 12" or less below grade
rovide extension collar if Yes _Y _. N
Y N
Location Se rations
Foundation to tank ft.
Foundation to absor ion ft.
Se ration of Pits ft.
Conforms as r Plot Plan Y N
En ineer Re rt and As-Built Y N
ETU Maintenance Contract
rovided Y _ N
Location of System on Property:
Front
Side Right Side
Partial Approved and needs to be re-inspected, please call the Building & Codes Office
Disapproved
Middle Front
Comments end/or diagram
~,Ojo s =~~ o~
~~
Middle Rear
L:\Pam Whidng\2010\Building Codes Fonns\Inspecdon Forms\SepHc Ir~spec~ion ReporX_03 2910.doc
LL'IULS %6~~ j ~
'S Hall C07LdOn
852 P. 290 1 ~°~ --
1
a
3
0
1
4~
\~
Hr
~~
0
AREA ~ ~
Q.88t ACRES o ~
33.1' ~~
plaatk: ~
fence v ~
nnA
M
i
o r
chain IMk
tents
9~~
walk
~1
Lands n~. f
Brian L. Warner
& Vicki L. Warner
L. 829 P. 023