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2011-145 �) TOWN OF QUEENSBURY FOS742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development -Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20110145 Date Issued: Wednesday, December 19, 2012 This is to certify that work requested to be done as shown by Permit Number P20110145 has been completed. Tax Map Number: 523400-316-006-0001-011-000-0000 Location: 3 ARBERGER Dr Owner: STATE OF NEW YORK Applicant: STATE OF NEW YORK 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&Code Enforcement 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: P20110145 Application Number: A20110145 Tax Map No: 523400-316-006-0001-011-000-0000 Permission is hereby granted to: STATE OF NEW YORK For property located at: 3 ARBERGER 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 hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: STATE OF NEW YORK Septic Alteration Residential C/O DEPT. OF AUDIT & CONTROL Total Value GOV.A.E.SMITH OFFICE BLDG 110 STATE STREET ALBANY, NY 12236-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2011-145 septic alteration residential $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, April 25, 2012 (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 Town of Queensbury; Monday,A ri125, 2011 SIGNED BY l j9 4 I ; 'J f for the Town of Queensbury. Director of Building&Code nforctent Revised 4/14/2010 OFFIs�d1S NLY/ A ` / I c4,SP y TMAP N PERMIT NO. // .JMIT FEE jT— • APPROVALS: ZONING TOWN CLERK 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: /t/y c ASC) INSTALLER: /47 S(((--..—, Sr2ra�^— ADDRESS* ? "Y; 04/26R-. \'D tet.. ADDRESS: fC. )9e --. ` GL—, PHONE NOS. if 5', '2' PHONE NOS. LOCATION OF INSTALLATION: -4/3? RESIDENCE INFORMATION: YEAR BUILT NO.OF COMPUTATION X = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRINDER 1980 or older X 150 = INSTALLED? 1981 -1991 X 130 = SPA OR HOT TUB 1992-present X 110 INSTALLED? PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND — LOAM CLAY OTHER r .1GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL Y. WELL (If well:water supply from any septic system absorption is: ft) ✓ PERCOLATION TEST: RATE IS /—� PER MIINUTE PER INCH[mpij (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: f ri"-°o GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,spa or whirlpool tub. SYSTEM TYPE: 0 ABSORPTION FIELD(WITH NO.2 STONE) Total length fi'`' ft. Each trench c 6' X ❑SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size? ❑ALTERNATIVE SYSTEM Bed or other type? O 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 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 requiremepts"of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL Sanitary Sewage Disposal Ordinaric r codesOqueensburv.net !� > . VISIT OUR WEBSITE FOR MORE INFORMATION Signature of Person sponsible Date www.queensburv.net Town of Queensbury * Community Development Office * 742 Bay Road, Queensbury NY 12804 Septic Inspection Report Office No. (518) 761-8256 Date Inspection requ>• -:. Queensbury Building &Code Enforcement Arrive: kl.::4 • p� -:- am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initia{ � NAME: ' 1 • I. •ERMITNO.: —1t� LOCATION: '', ARP E'R6 EP__ INSPECT ON: Co —2_tf -( , RECHECK: Comments and/or diagram Soil Type: Sand / Loam / Clay Type of Water: Municipal / Well Water Waterline separation distance ft. Well separation distance Other wells: ft. Well Casing Length 50' + / - Y N N/A [150'to well required if NO] 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 End Cap _Y N Inlet/Outlet Pipes & Baffles Y N Manholes 12"or less below grade _Y N [provide extension collar if Yes] _Y_ N Location / Separations AS B U I LT Foundation to tank ft. Foundation to absorption ,ft. Separation of Pits / ft. Conforms as per Plot Plan \ 'Y_ N Engineer Report and As-Built / Y N ETU Maintenance Contract Y_ N provided Location of System on Property: Front Re. Left Side Right Side Middle Front Middle Rear S stem Use Stat _Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection ReporL03 29 10.doc )4C A_COM AECOM 518 951 2200 tel 40 British American Blvd 518 951 2300 fax Latham,NY 12110 www.aecom.com June 17, 2011 Mr. Charles Dyer, Building Inspector Queensbury Building&Code Enforcement • 742 Bay Rd. Queensbury, NY 12804 Subject: As-Built Plan Septic System Replacement at 3 Arberger Drive Town of Queensbury, Warren County AECOM project no. 60188136 Dear Mr. Dyer: As you requested during your inspection of April 25, 2011, ae are providing herewith an as-built plan for the septic system replacement at the subject address. Enclosed, please find one (1)full-size and one(1) half-size stamped original. The as-built plan includes a stormwater drywell system completed under the same project. If you have any questions about this project, they should first be directed to Mr. Michael McLear of Capital District Developmental Disabilities Service Office (DDSO) at 518.370.7367. My phone number is 518.951.2327 and email address is stephen.rutkey@aecom.com. Thank you. Sincerely, Stephen J. Rutkey, P.E. Project Engineer cc: M. McLear, CD DDSO FILE Septic Inspection Report Office No. (518)761-8256 Date Inspection t�,�� - ► - Queensbury Building&Code Enforcement Arrive: e`, �► 1"7 - 742 Bay Rd., Queensbury, NY 12804 Inspector's Initla . /� NAME: :L_ •.b i' VA_ 0 PE- ' NO.: I 1 —1 LOCATION: AR I - ON: W —7 5 - 1\ RECHECK: Comments and/or diagram Soil T 41c4s) Ty -pe of Water: - - . ell Water f � Waterline separation distance Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N wN/A [150'to well required if NO] Absorption Reid: Total length ft. Length of each trench $ ft. Depth of trenches "— Size of Stone Seepage Pits: Number Size: x�,.,-._.....r. Stone Size: Piping Size Type Com‘,0 Building to tank 1-"1" j C..A ‘-lb Tank to Distribution Box eta y Distribution Box to Reid/Pit 4 it Tb t'c) -C2-F . Opening Sealed: -,.,. N End Cap N Inlet/Outlet Pipes&Baffles N Manholes 12"or less below grade Y ly/ [provide extension collar if Yes] Y • N Location/Separations ?-0(\k Foundation to tank ''r- .- --tift. *N. 4 \-27`1.\ \ Foundation to absorption - ft. Separation of Pits 1v / Conforms as per Plot Plan Y j kt.3 Engineer Report and As-BuiltY N ETU Maintenance Contract Y N provided Location of System on Property: Front 411105411111, Left Side Right Side Middle Front Middle RR�a -m . - : Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved LAPam Whiting\2010\Bullding Codes Foimsunspectlan Form4Septic Inspection Report_03 2910.doc C I TIE POINT LATERAL DISTANCE TO END (FT) TIE POINT LATERAL DISTANCE TO END (FT) A 1 38 B 6 50 A 2 43 B 7 51.5 A 3 47 B 8 52 A 4 51 A 5 56 T r Nind l�mesv ars arw Ilwyure �� a S310N(INV ! s -- NVId INKSAS 3I1d3S oa AN`Adn8SN3No'3Nt10 mu3HHVS rVv i��c�\ L u iN3W30V d38 PV31HAH01d3S d s Y .l O 0800 iDIUSIO IVAdVO 7 . _ —/1"00 �m §o� ee oso s . Ij r n yi y� J Ddu j i 'll } 1 II II I I� � i II I! o w • ,, ,'v!c dAl z 1d— T — _ y S I N 12�g& u a rc �iou 4�z) v roLL oz 81G QOOM ROAD NU �C oW _ s a$ w Wn i o 32d go mWf ,3 v ra= cK W, LLrm�� a o o�