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2003-507 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)'761-8256 TIFICATEO CERF . Permit Number: P20030507 Date-Issued:, Friday, July 04;2003 .This is to certify that workrequested.to.be,done as shown by-Perrnit Number T P20030 O7 has been completed Tax Map Number: 523400.301-008-0001-021-000-0000 Location: 8 MANOR Dr .Owner: BRYANT BUCKLEY JR Applicant: BRYAN J.BUCKLEY JR This structure may be occupied as a: By Order of Town Board Septic Alteration Residential . TOWN OF QVEENSBUEY Directot of Building&Code Enforcement TOWN OF QUEENSBUR 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development Building&Codes .(518) 761-8256 BVILDIN,G =PERMIT Permit Number: P20030501 Application Number:. A20030507 Tax Map No: 523400-3017008-00017027-000=0000 Permission is hereby granted to: _ BRYAN'J.BUCKLEY JR For property located at: g MANOR 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 her filed and approved and in compliance with the NYS Uniform Building Codes and1he Queensbury Zoning a Ordinance. Type of Construction' Value Owner.Address: BRYYAN J. BUCKLEY JR Septic Alteration Residential P.O. BOX 240 Total value BOLTON LANDING,NY 12814- Contractor or Builder's Name/.Address Electrical Inspection Agency Plans&Specifications 2003-507 SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS . $25.00 PERMIT FEE.PAII3--THIS PERMIT.EXPIRES- Sunday.,July 04,'2004 (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 tb Towu,,�f Qu4qlns ry; ;July 044,2003 , SIGNED BY £or the Towh of Queensbury. Director of Building&Code Enforcement J Application for Permit Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. O)V'IMR INFORMATION: ...........0ffi'e*e­Use* ........... Location of installation: A--1h17V012 Z>AO-21 IA-e — File Permit No. Tax Map No. Owner's Name: Fee Paid—';�Z /,7 C ....................... ...................... .............. ............. Address: 2. INSTALLER'S NAME PHONE NO. 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 1980 or older x 150 gal/bdrm = 1980- 1991 x 130 gal/bdrm = 1991 —present x 110 gal/bdrm = Garbage Grinder Installed yes no Spa or Hot Tub Installed yes no 4.' PARCEL INFORMATION: (circle applicable information&indicate measurements) Topography , Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply Flat sand at what depth at what depth municipal Rolling loam —feet —feet well Steep slope clay 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 S. 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: gallon(min. size 1,000 gal.) Tile Field: each trench_ft. Total SystemiLength: 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 Ap - Alternative System: length andlor size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: I 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 the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person Date Septic Inspection Report Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am `11 / am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: 4epart:adcr3 S-6-7 NAME: PERMIT NO.: LOCATION: INSPECT ON RECHECK: Comments and/or diagram Soil Type: Sand J Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance Well separation distance Other wells: 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 End Caps Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits --A Conforms as per Plot Plan N Engineer Report and As-Built Y N_ Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Z St us: US Approved Partial Approved and needs to be re-inspected,please call the Building&Codes Office Disapproved Last revised 1/6/05 Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queeiisbury Building&Code Enforcement Arrive: am�/ Depart: am/pm 742 Bay Rd.,Queensbu NY 12804 Inspector's Initials: NAME: rt,Clt— PERMIT NO.: 03 LOCATION: INSPECT ON: RECHECK: Comments and/or diagram Soil T e: Sand Loam C14Y Type of Water: Municipal/Well Water Waterline separation distance Well separation distance ft. Other wells: ft. Absorption Field: Total length ft. Length of each trench ft. Depth of trenches Size of Stone See e Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field Pit Opening Sealed: Y/NI Partial Location/Separations Foundation to tank Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y_N Location of System on Property: Front ear Left Side Right Side Middle Front Middle Rear System Use S-hkatus: Approved Partial Approved and needs to be re-inspected,please call the'Building&Codes Office Disapproved LASueHerningway\I3uiIding.Codes.rnspection.FORMS\Septic Inspection Report.doc January 28,2003 4"PVC 0 1%(MIN X..CUNIHAGIOR IU LXLAMit 10 11 EMN.) bLLIW­AOL 11 1IN1111 SOIL CONDITIONS/GROUNDWATER.(ENGINEER TO WITNESS) /-4"PVC 0 1%(MIN.) INFORMATON: D-BOX Cl w --- DESIGN BASIS 44I� NEW DRYWEL (TYP.) NEWNW YOOFRKQUEENS STATE BURY DEPARTMENT Or HEALTH TO -_-------- POTABLE NO KNOWN WATEER%IS`TUNpGp POTABLE WATER SUPPLY WELLS LOCATED WITHIN EXISTING SEPTIC4 --EXISTING DRYWELL TO 150 FT.OF PROPOSED WASTEWATER DISPOSAL SYSTEM. TANK COVER—I BE REMOVED 1-'0" DESIGN FLOW 4 BEDROOMS,110 GPD/BEDROOM-440 GEN (MIN (WATER'EAVER FIXTURES REQUIRED THROUGHOUT APARTMENT UNITS) T.P. #1 A 1000 GAL. SEPTIC TANK - Ci SEPTIC TANK BUILDING SEWER FOR 1]0" MIN (MIN.) 1 250 GALLON(MIN.)CAPACITY REQUIRED _\ 3-0 1 EX 1000 GAL SEPTIC TANK TO BE SUPPLEMENTED WITH WESTERLY 2 UNITS ADIDSITTIOGNAL 1000 GAL PRECAST SEPTIC TANK (4 BEDROOMS TOTAL) 20'--0" .......__I SEPTIC TANK EFFLUENT FILTER (MIN.) PROVIDE DENI)MODEL A1801-022,"ZABEL-RESIDENTIAL FILTER. EAST,END OF BUILDING EFFLUENT FILTER TO BE INSTALLED ON OUTLET OF SECOND SEPTIC TANK BE CONFIRMED LEACHING SYSTEM(FIELD) 440 GPD/0.9 GPD/SO.FT,=488.9 SO.F.REQ'D UNIT 15 (<10 MINUTE/INCH PERCOLATION RATE SOIL) PROVIDE 8 FT DIA,.5 FT,DEEP DRYWELLS WITH 4 FT.OF STONE ALL AROUND 16 FT x pi=50.27 SO.FT,/VLF.,5 F.-251.33$0.FT. 251,33 SQ.FT.x 2 DRYWELLS=502.65 SO, 7.TOTAL GRAPHIC SCALE EFFLUENT DISTRIBUTION 0 41 GRAVITY DOSING/DISTRIBUTION FROM SEPTIC TANK VIA DISTRIBUTION BOX. TEST PIT RESULTS: PERMANENT WATEREGN JOINT(TYPI MARKER WATERTIGHT MANHOLE FRAME&COVER; OVERCOVER ) SYRACUSE CASTINGS i I GLQ C R EOUNALIENT; GRADE TO GRAIN AWAY FROM COVER T.P.#1 -DEPTH-qj Er TREATED LUMBER MARKER 4'DISTRIBUTION PIPE ABOVE L MEDIUM TO COA SE SAND&GRAVEL WITH SOME FINE SAND, AL BURIED COVERS WATERTIGHT SEALED SET I GRADE MIN, CONCRETE PLUG �FNJSHEG GRADC TRACE OF SILT ENISHED GRAGE—_. AWAY NO EVIDENCE OF GROUNDWATER SLOPE UY, (,P.) ",..FROM COVER UYIP.) _--PRECAST CONCRETE RISER AS REQUIRED ---_[I- SOIL LINE FROM EXISTING SEPTIC 12 MIN 24• FORT MILLER DRYWELL 17 SLOPE(MIN.) NON-WOVEN GEOTEXTILE OR EQUIRALIENT FOR SEPARATION INLET 3' N-TO 2R'CRUSHED i I- — .—C, - -_ -_ V -- H-20 TRAFFIC COVER 5'-0' T-O" STONE:FREE OF FINES THORO NATIVE BACRIFULL 15" 'S" — EFFLUENT UNE AND STONE DUST UCHUY COMPACTED _T INSTAL NEW OUTLET PIPING 12' AS SHOWN ON DRAWING Cl ---- ,.,.,,_FORT MILLER PRECAST MIN, D SEPTIC TANK OR DOUNALENT CRUSHED STONE FOUNDATION SEE NOTE 2. 2'MIN, AS FIRM NATIVE SOIL �SFA4ONAL HIGH GROUND WATER CRUSHED STONE FOUNDATION ATOP FIRM NATIVE MATERIAL AB__ I A TREATED LUMBER MARKER ABOVE ALL BURIED COVERS: 12/0$W A REVISED PER TOWN COMMENTS SET ljGGI GRADE 11)29102 /A\ SU6MTERE13 FOR PERMIT TO CONSTRUCT 4"OUTLET TEE GROUT NON-SHRINK DATE REV# ISSUED REVSIONS A—REMOVAB COVER MODEL A1801-4.18 REGIDENTA__-Z "C" SATF.PLANMFIARs PROVIDE ADJUSTABLE LEVELING "Wrl'FILTER OR FOUNALENT PIT INLET ONCE ON EACH OUTLET 'I, C PIPE WASTEWATER REPLACEMENT SYSTEM GRAVITY DISTRIBUTION LATERAL MAPLEWOOD APAITrMENT.",-UNIT 15 WEST —0 0.5%MIN.SLOPE MANOR DRIVE ��l 2'MIN,OF C SAND NOTE; QUEENSBURY,NEW YORK 2"MINOR PEA GRAVEL FOUNDATION IF EX STING ORYWELL CONTAINS A PRECAST CONCRETE TEE OUTLET "Iff EST AD OF A 4'PTAGPO GARITARY TEE SUBSTITUTE LABEL FILTER FORT MILLER DISTRIBUTION MODEL A1807-18 FOR MODEL A1801-4.18. 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