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2011-186 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: P20110186 Date Issued: Friday, May 13, 2011 This is to certify that work requested to be done as shown by Permit Number P20110186 has been completed. Tax Map Number: 523400-295-019-0001-058-000-0000 Location: 6 WESTMORE Ave Owner: LINDA ROGGE Applicant: , LINDA ROGGE 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 �. r.Lv 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: P20110186 Application Number: A20110186 Tax Map No: 523400-295-019-0001-058-000-0000 Permission is hereby granted to: LINDA ROGGE For property located at: 6 WESTMORE Ave 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. Tyke of Construction Value Owner Address: LINDA ROGGE Septic Alteration Residential 6 WESTMORE Ave Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency SANITARY SEWER SERVICE Plans&Specifications 2011-186 septic alteration residential $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,May 11,2012 (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 To n Tenslry; eild3y,May 11,2011 wf/ SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement U # 4 Community Development Office �✓ Town of Queensbury • 742 Bay Road • Queensbury, N k • 4 09 Office Use Onl183 y �y OWN O TAX MAP NO.. v f `J(<-9. PERMIT NO. PIF= QO APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM ERMIT: A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. PPLICATION IS SUBJECT TO REVIEW FORE ISSUANCE A VALID y RMIT. OWNER:/( 43A� _ INSTALLER: ADDRESS: ADDRESS: PHONE NOS. PHONE NOS. 7 / i PAD LOCATION OF INSTALLATION: RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW BEDROOMS Gallons per bedroom GARBAGE GRINDER 1980 or older X 150 = J INSTALLED?_" 1981 -1991 X 130 = SPA OR HOT TUB tjQ 1992-present X 110 = INSTALLED? PARCEL INFORMATION:, ✓ TOPOGRAPHY: FLAT ROLLS STEEP SLOPE %SLOPE ✓ SOIL NATURE: SAND / LOAM CLAY OTHER ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCMMPERVIOUS MATERIAL: AT WH DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft) ✓ PERCOLATION TEST: RATE IS - _ PER MIINUTE PER INCH[mpi] (Test to be completed by a licensed professional engineer or architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Ali individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). TANK SIZE:1 060—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: ❑ABSORPTION FIELD(WITH NO. 2 STONE) Total length__—----ft. Each trench—__ X —_ ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many?------___ Size? ALTERNATIVE SYSTEM ed r other type? L�,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. e read the r ulations 'th respect to this application and agree to a d by these n II re ments of the Town o uee sbury CQUEION 761-8256 OR EMAILa ary Se �e ,i pos Ordinance. ensbury.netignature of Person Responsible Date R MORE INFORMATION sbury.net Septic Inspection Report Office No. (518) 761-8256 Date Inspection req i ed: Queensbury Building&Code Enforcement Arrive: a epart: am 742 Bay Rd., Queen ury, NY 12804 Inspector's Initials: NAME: PE IT NO.: LOCATION: c ��2__. IN PECT ON: RECHECK: / Comments and/or diagram Soil Ty am/Clay Type of Water uroci ll Water Wate-rTifi—eseparation distance V, ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N N/A 150'to well required if NO Absor tion Field: Total length ft. Length of each trench Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: _-- Piping Size Type Building to tank 9 Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: N End Ca _ N Inlet/Outlet Pipes&BafFles N Manholes 12"or less below grade _ [provide extension collar if Yes Y N Location Separations Foundation to tank ft L� Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan N Engineer Report and As-Built N ETU Maintenance Contract Y_ N provided Location of System on Property: Qnt R ��LeSide Right Sid Middle Front Middle Rear stem Use S s: Approved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved L:\Pam Whiling\2010\Building Codes Forms\InspecBon Forms\Septic Inspection Report-03 2910.doc Q BUIe��QU�ENS — I y I - " Y I I F- I -J- _Fl I I I I I I J rj I I I I I I I I eve .ee or serve or believe I sa ev ider ce of, t1-o s a,;, i s sesl, we_!A1.S, re s, i races, e c., 1a �' t�1{c , L i L it U aidsI have ersl'ja rneasu,rs I Q I , . {� �r ,�n p A; O--Fro BUS WIN - el Ajeldi - h r - I CENTER PROJECT SERVICES 73 Sheridan Street, Glens Falls,NY 12801 Phone-518-796-2515 May 4, 2011 2t# 139 Dan Drellos LS 0 Sanitary Sewer Services MAY Luzerne Road 09 2011 Queensbury,NY 12804 r BUIL CF QUEE Re: Proposed Replacement Septic DING& COp ESRY Rogge Residence—6 Westmore Avenue, Queensbury,NY Dear Dan: At your request we have reviewed your proposed replacement septic system design at the site of the existing 3 bedroom house of at 6 Westmore Avenue in Queensbury. As per our conversation the residence has an existing failed septic system. We have reviewed the proposed replacement septic system design and we agree that a standard absorption bed is acceptable. Based upon a design flow rate of 450 GPD and a percolation rate of 1 to 5 minutes, you will need 500 square feet-of absorptive area. We recommend using a 15 ft wide by 35 ft long absorption.bed with 3 — 30 foot long laterals, which will provide 525 sf of absorptive area. The absorption bed should be constructed with the existing 1,000 gallon septic tank,new distribution box,4 inch diameter perforated pipe and stone. Please feel free to contact me at 796-2515 if you have any questions and that you for your assistance with this request. Sincerely, Thomas R. Center Jr, P.E.