2000-482 TOWN OF +QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8202
Community Development - Building Sc Codes (518) 761-8256
+CER.TIFI+C.ATE OF COMPLIANCE
C/C Number: C20000484 C/C Date: Monday, July 24, 2000
Application Number: 420OW499
Permit Number: P20000482
This is to certify that work requ a done as shown by Permit Number P20000482
has been completed.
This structure may be used as a Septic Alteration Residential
Tax Map Number: 523400-054-000-0002-007-024-0000
Location: CHESTNUT RIDGE Rd
Y Owner: DANIEL J. LOWELL
By Order of Town Board
TOWNS OF QUEENSBURY
Director of Building $Code En€oncement
TONXtrN OF QUEEWSBURY
742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20000482 Application Number: A20000499
}. 6A.
Tax -Nlap No: 523400-054-000-0002-007-024-0000
Permission is hereby granted to: DANIEL J. LOWELL `
Owner of property located at: CHESTNUT RIDGE Rd
in the Town of Queensbury, to construct or place a Septic Alteration Residential
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.
Owner Address: DANIEL J. LO WELL
SR.
164 CHESTNUT RIDGE Rd
QUEENSBURY, NY 12804
Contractor or Builder's Name / Address Electrical Inspection Agency
MCGUIRE. RICK
Type of Construction: Septic Alteration Residential
Plans & Specifications
APARTMENT A MAIN HOUSE
APARTMENT B
$25,Op PERMIT FEE PAID - THIS PERMIT EXPIRES: Sunday, July 14, 2002
(Ifa longer period is required, an application for an extension must be made to the code Enforcement officer
' of the Town of Queensbury before the expiration date.)
Dated at the Town of ,rQueen b yo F y, July 14, 2000
SIGNED BY t C2 �F for the Town of Queensbury.
Director of Building & Code Enforcement
Application for Permit -- Septic Disposal System
Town of Queellabtl y 742 Bay Road Queensbury NY 12804 (518) 761-8256
I . OWNER. INFORMATION:
/ ,p / ,� ..........................._............ _. . ...............-.................._...................._....................
Location of installation: i'�ca 7 e' i!! ,vL.e .-C r c�' !e /`(p Office Use
Tax Map No. / / - ,r)- `4 File Permit NoQac 96"� � r Fee Paid _ `.
Owner's Name: �joi"L� �t�JpQ..., ,�...e�-w-�.. f _...-- �e��?...._
...... ^ `
.
Address. � �y,,� �r.+,rtL � i � ,� fit, {",g•.,�..� "}'�fi'�1�.�
2. tNSTALLER.'SNAME 100 to 15[c2ZA PHONE No. i Q
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate # bedroom(s,) and multiply H of
bedrooms with applicable (gallons per bedroom to equal total dailyflaw)
of B r s x Cqmputaijon = Total Doily Flow
( ,R i •-
1980 or older x ISO gaVbdnn �
1980 - 1991 x 130 gallbdrm = JUL 1 3 200,0
1991 -- present x i 10 gaVbdrm
Garbage Grinder Installed yes � Ina
Spa or Whirlpool Installed yes " ! no
4. PARCEL INFORMATION: (circle applicable information &. indicate measurements)
Tono$ranhy it Nature NatuLe G_mun-d.W pr 8 rack or 1i»pe airs ]vlaterisr�Do:�:Qstic Water upPly
1%nr .rapid at what depth at wheal delJtJp nr tctlJcrf
ltolltn oam /eel fee! weft
Steep slope c ay p well; water stysply
�36 slope other from any septic-.system
depth: absorption ts,6 Off.
f Percolation Test: {To be completed by licensed professional engineer or architect) ether
f !date: 5e c.ate per filch
5. PROPOSED SYSTEM: Far New nstructl n: All individual sewage disposal systems must be designed by a licensed
professional engineer or architect (unless installed in a Nanning Board approved subdivision), Add 250 gallons to the sire
of the septic lank and leach field for each Garbage Grinder, Spa or Whirlpool 'Tub.
Septic TankrO Cl�' gallon (min. size 1, 000 gal.)
Tile Field: each trench J1. Total System Length:
Seepage Pit(s): number of _ size ofeach: - — ~ fl. by fl.
Size of Stone to be used: ff / detoth or thickness
Bed System Size: x
Alte usfive SyAarn: ----- length and/or size
HOLDING TANK SYSTEM: (if required)
Number of tanks: ' 1 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
Application for Permit -- Septic Disposal System
Town of"Queensbury 742Bay floeadQueertsbury, NY 12804 (518) 761-8256
1 . OWNER INFORMATION:
............ ...... ..-.............................._........................_................
�
Location of installation:
731
Tax Map No. '� / / 0 V
File Permit No. �. 5' � {
Owner's Name: D4, Lo ,,.:. f Fee Paid
..........
-t.-3 o Q. .....................,...,,..
Address: 1�
2. INSTALLER'S NAME r PHONE NO. /� +b ?-
3. RESIDENCE INFORMATION: (circle .War of dwelling, indicate # bedroom(s) and multiply # of
bedrooms with applicable gallons per bedroom to equal rated dailyflow)
Year of House: - No. Qf Bedrooms x Computation, = ,TgfAI Daily Flow
1980 or older � x 150 gaVbdnn = �5 _
1980 — 1991 x 130 gaVbdrm =
1991 — present x 110 gaVbdrm -
Garbage Grinder installed yes no JUL 1 3 zorra
Spa or Whirlpool Installed yes ^ ! no .�
4. PARCEL INFORMATION: (circle applicable information & indicate measurements)
r
T-opograulil.Y Soil Nature Grou e . ro-pk ar Opp rv19us Material DarsirzsSic WatQr Supply
1;7at sand at what depth at what depth nr lcipal
ollin oam feet feet well
Steep slope c ay f well; water .supply
slope other from any septic-system
depth: absorption is,rf ea-ft.
other _
Percolation Test: (To be completed by ffcensed professional engineer or architec)
Rate: 50 5e.C, mintrle per Inch
5. PROPOSED SYSTEM: For NM Construction: All individual sewage disposal systems must be designed by a licensed
proressional engineer or architect (unless installed in a Planning Board approved subdivision). Add 250 gallons to the sire
of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank; pe lac" gallon (min. size 1, 000 gal;)
Tile Field: each trench - 5 :a ft. Total System Length: d
Seepage Pit(s): number of size of each: ft. by fl.
Size of Stone to be used: # / depth or thickness /b :5 feet
Bed System Size: x --- --
Alternative System: length and/or size
HOLDING} TANK SYSTEM: (if required)
Number of tanks: �� A Size of each: gallons / TOTAL Capacity: �Tgai one
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.
An
Fularr
Signature of responsible person Date
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location _
Date '� /1) Permit #
SOIL TYPE: Sand- Loam- Clay-
Results of Percolation Test-
( if applicable ) Rate-Minute/ Inch
TYPE OF SYSTEM:
ABSORPTION FIELD : Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS • Numb . _-
Size - fto x ft .
Stone size
PIPING : Vie Type _
Bldg . to Ta k S�
Tank to Dis . Box . �
Dist . Box to Field/Pit
Openings Seal d? Yes o ai�"rtial
LOCATION/SEPA TIONS :
Foundation to ank ,/> feet
Foundation to A sorption feet
Separation of Pi S feet
Conforms as per P of Pi a - 'Y?s No
LOCATION OF SYST ON PR ERTY:
( circle one )
Front - Bear - Left ' de - Right Side
Middle Front - Middle ear
p COMMENTS : r�
G "? 1 �c.i ` � c J� [J r.f ii d� l qj
SYSTEM USE APPROVED : YES LKO
Arrived :
Departed *
8u� cling nspector
TOWN OF QUEENSBURY
BUILDING_ !i_, CODE ENFORCEMENT
742 Bay Road
Queensisury NY 12804
(519) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location y � �"
Date 7 .2�4 0D Permit Ai
SOIL TYPE : Sand- Loam- Clay-
Results of Percolation Test-
( if applicable ) Rate- Minute/ Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS : Number-
Size � fto x ft .
Stone size
PIPING: - ize ype
Bldg . to Tank
Tank to Dist . Box
Dist . Box to Field/Pit
openings Sealed? Yes 0 art' a
LOCATION/SEPARATIONS : feet
Foundation to Tank
Foundation to Absorption feet
feet
Separation of Pits
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY :
( circle one )
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS : j Y %T"k-� 2-
SYSTEM USE APPROVED : YES No
Arrived:
Departed:
Bui ding Inspector
I
TOWN OF QUEENSBURY
BUILDIN&_A CODE ENFORCEMENT
742 Bay Road
queen_ seury NY 12804
cs�s� �s1-szs�
SEPTIC DISPOSAL SYSTEM INSPECTION
Name reict,
Location
Date Z P' mi t # r
SOIL TYPE : San - Loam-Clay-
Results of Perco ati on Test-
( if applicable ) Rate-Minute/ Inch
TYPE OF SYSTEM:
ABSORPTION FIELD : Total Length 2- 1;Z
Length of each trench
Depth of tree Kes
Size of stoney *
SEEPAGE PITSi Number-
Size - fta x ft .
Stone size
PIPING: s re TypeBldg . to Tan 4/ ';f-D yl�
Tank to Dist . Sox .. �►
Dist.. Box to i el d/P ' � � �• gZ
OpeningsSeal d ? s ,' �To Partial
LOCATION/SEPA TI 40
Foundation to ank feet
Foundation to A)� sorption --;rl feet
Separation of Pits feet
Conforms as per 7 of Plan re) No
LOCATION OF SYS ON PROPER
{ circle
Front - ea - Le S1de - Right Side
Middle F� - Mid le Rear
COMMENTS : 5T --
SYSTEM USE APPROVED : YES NO
Arrived:
Departed: yl s
s
Building Inspector
4 -47=
TOWN OF QUEEKSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury_NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
1
Name b(.r� � {--
Locat42�1
{�
hatePermit # qSOIL Loa Clay-
.
Results of 'Percolation Test- 7
( if applicable ) Rate-Minute/ inch--t-
TYPE OF SYSTEM:
ABSORPTION FIE T al Len t Z:5
Length of each trenc
Depth of tren es
Size of stone
SEEPAGE PITS : Number-
Size - ft . x 4� ft .
Stone size
PIPING . S e ype
Bldg . to Tank ___ F_ _
1 Tank to Dist . ox
Dist . Box to Feld/P �
Openings Seale 7 es o arti al
LOCATION/SEPA ION `
Foundation to T nk :feet
Foundation to A- sorpti on 7 feet
Separation of Pi s eet
Conforms as per lot Plan s No
LOCATION OF SYS ON PROP£RT
{ circle
Front Rear Le t Side - Right Side
Middle - Nei le Rear
COMMENTS :
SYSTEM USE APPROVED : OYEES NO
DepArra red : Tt . 1
Building ' nspector
TOM OF QUEEASSURY
SU I LD IN6 a COD y ENFaORCEWNT
Qiueensbury Ro
HY 1281�4
(518) 761-8256
SEPTIC DISPOSAL SYST 1 INSPECTION
Name
Location
Date - Permit T�
SOIL TYPE Sand- Loam- ay_
l
Results of erc Rateatmatin Test
�Minutefln h #
( if applica le }
TYPE OF SYS :
ABSORPTION F ELD: Total Length
Length of ea trench
Depth of tree hey
Size of stone umber-
SEEPA6E PITS : N t + x ft . ,':
Size - _ M i
Stone size Size lype
PIPING:
Bldg , to Tank �----- --------
Tank to Dist . Sax ___�_--- -----"^
Dist . 'Box to Fiel P ` t NS o artaa
' Openings Sealed?
LOCATION/SEPARATI feet
Foundation to Tank ------ feet
Foundation to Abso tion feet
Separation o¢ Pits - --- s Na
Conforms as per Pl a PI an
LOCATION OF SYSTEM PROPERTY :
( circle one ) Left ide - Right Side
Front - Rear
Middle Front - Middl Rear
COMP"TS: OV A) l i - '
SYSTEM USE APPROVED -
YES NO
Arrived: de
7
I Departed :
3 nspector
1 Building
q
i
- TOWN OF QUEEKSBURY
BUILDING &_ CODE ENFORCEMENT
742 Bay Road 4
Queensbury NY 12804
{ (SFS) 761-8256
! SEPTIC DISPOSAL SYSTEM INSPECTION 1
Name +� d7.t crCG
Location
Date S Fq 6D Permit #
SOIL TYPE: Sand- Loam- Clay-
Results of percolation Test-
( if applicable ) Rate- Minute/ Inch
TYPE OF SYSTEM:
ABSORPTION FIELD : Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS : Number-
? Size - ft , x ft .
Stone sTze� '
PIPING : Sized e�
Bldg . to Tank
Tank to Dist . 'Box
Dist , Box to Field/Plt
Openings Sealed ? Yes Na anti a�T
LOCATION/SEPARATIONS :
Foundation to Tank feet
Foundation to Absorption feet
Separation 16t . Pj is feet
Conforms as per PI ot, PI an des No
LOCATI()Nd OF :SYSTEM ON PROPERTY :
{ _ (�i rcl e one )
1 Front, - Rear - Left Side - Right Side
Middle Front - Middle Rear *,
fk
dw
i
i
i
SYSTEM . USE APPROVED: YES CNO
Arrived.
Departed : _
Building Inspector
TABLE 2
jj�$ NTS
7 i R i
REQUIRED SEPARATION DISTANCES FROM WASTEWATERS 5
To Stream, Lake Drainage
--PwPertY.:_
We1i (f) or
Watercourse (b}, Line
Wetland or yr �_��
Suction Lone "�3* ~ 10"
System Components 25'
25' if cast iron
House Sewer or PVC with d-ring
(watertight ;joints) joints, 50' otherwise 10'
50'
14" ia'
50'
Septic tank 50' 10 10" 10'
Effluent fine to SOP
l0' 20'
distribution box i00' 20"
140" 100 20'
Distribution box 100' 20"
Absorption Field 1000 20"
Seepage pit 20' 10, 10,
Dry well (roof 54• 25'
20'
and footing) 10' 20'
taa�
Raised or Mound System ic1 . 10a'(a)
20. 10' 20'
intermittent Sand 1001a} 1131]
Filter (c) l4" 24'
50' 24'
Evapotranspiration- l Oo'(a} 14'
absorption system (c) 24' 10'
`,'0 � 10' 20'
Composter 5a, 2a'
Sanitary Privy Pit 100' , 24" 100 100
50
Privy, Watertight Vault
54'
NpTES:
stems are located in coarse gravel or upgrade and in the
(a) When sewage treatment sy art a( the treatment system shalt be at least 20
general path of drainage to a well, the closest p
feet away from the well.
k.
(b) Mean high water mar
oration distances are
(c) For all systems involving the placement of fill material, separation
ressure (i.e., public water supply main, household
measured from the toe of slope of the fill. absorption field.
(d) Any water serv'sce line under p rated
privy shall is installed inside a larger diameter water main to p
service line, well
esana sanitary pehyld service tine) located within ten feet o any
seepage p ublic wat with one full
er supply main, household
the potable water supply. p
(e) Any water service tine under pressure (i.e., a sewer shall be installed
service line, well to household service tine) crossing
Section 8.6 of the GLUMRB Recommended
St and for
ewers.
length of water main centered above the sewer so both water
connecting joints are water
as far public
possible from the sewer. b
separation distance between a septic tank and a community type pu
Works: chalk be followed for 5eparation of water mains, son
(f) The m`in'smv m sep
stems. mound systems, etc.) should be
water supply well should be too feet,
e t• ttQ,i Dist
sy 'boxes and absorption facilit'ses e.g-.
absorption trencheslbeds, seepageP
public water supply wells.
located at feast 200 feet from community typep
(g) Recommended separation distances-
Page 106
i
TABLE 2
jNTS
REQUIRED SEPARATION DISTANCES FROM WASTEWATER 5 S 4 y { �-
Lake ` Drainage
�o Stream, - -'-pt�+operty-:.
Welt (f) or Watercourse {b}, 3 Dwelling Unar
suction Una or Wetland 10
System components 25'
25' if cast iron
House Sewer, or pvc with 0-ring
(watertight joints) joints, 50' otherwise
54' 10,
10" too
54'
Septic tank 14,
Ftfluent line to Sop 54
14` #a'
distribution box 1000 1 a0" 20' 100 20'
Distribution box 104' 20, 10• 20'
Absorption field 140' (a) 20' t4' 24'
154' (a) 100'
Seepage Pit 24' toe 10"
Dry well (roof we 2s
and footing) 20' 10' 24'
t 40"{a) 140'
Raised or Mound System (c) 240
intermittent Sand t00'{a) 100'
20,
10'
Filter (c) 20"
Evapotranspiration- 100'(a) 50
z4' t4
absorption system (c) 10, We
cornposter 54Y 20
104' ' 44' 24'
sanitary Privy Pit 54' 20• 10" 10•
Privy, Watertight Vault
5a'
NOTES:
treatment systems are located in coarse gravel or upgrade and in the
(a) When sewageart of the treatment system shalt be at least 20
general path of drainage to a welt, the closest p
feet away from the well.
(b) Mean high water mark.
lacement of fill material, separation distances are
(c) For all systems involving the {� 1 main, household
measured from the toe of slope of the fill. isure (i.e., public water supply
(d) Any water service line under p field,
shall is installed inside a larger diameter water main to protect
service line, well to household service line) located within ten feet of any absorption
seepage pit or sanitary privy i main, household
the potable water supply• i e., public water supply installed Y
(e) Any water service line under pressure (' " shal Dints are as far as
service fine, well to household have a i.e) croe sewerssing
boa sewer c nnecting with one full
length of water main centered a
oration of water mains, sanitary sewers and storm sewers,
possible from the sewer. 'Section t3.6 0€ the Gl-{1MR8 Recommended Standards for Water
Works, shall be followed fora et+an distance between a septic tank and a community typ p
(f) The minimum sep
water supp Y stems, mound systems, etc.) should be
1 well should be 100 feee#'pits, raisedi sy bo%es and absorption facilities e. ,
absorption trenchestbeds, seepage 13 a public water supply wells.
located a# least
200 feet from community typ
(g) Recommended separation distances.
Page 106
4
PERMEABLE GEOTEXTILE, UNTREATED
BUILDING PAPER,OR 4' OF HAY
OR STRAW
GRADE
UNUSEABLE SOIL 4 a " 4 13ACKFILL
n A 4 t+ �` 4
> 60 MINANCH 4 4 0L 4 a 44 Oa 4 44 0e 4
PERCOLATION RATE &a4 4A4 1 h, Odd 4a4 4
AGGREGATE (I v
t+a• �'e �a a �'d �a 4 4 �e Nn a d DISTRIBUTOR
1 / 1
USABLE FILL COMPARABLE TO USABLE SOIL BELOW
Z z
N USABLE SOIL
ilia MINANCH PERCOLATION RATE
N GROUND WATER, BEDROCK, OR IMPERMEABLE STRATA
til
N
NOTE G(} t jj �j/L I bob 74 ThA)K
On sloped sites, a diversion ditch shall be constructed uphill from the fill
and trench area to prevent surface runoff from entering the absorption area. M N
See Figure 17 for Absorption Trench Detail
Figure 26
Cut and Fill System
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