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2011-581 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 - Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20110581-38360 Date Issued: Tuesday, May 30, 2017 This is to certify that work requested to be done as shown by Permit Number P20110581-38360 has been completed. Tax Map Number: 297.10-1-32 Location: 10 STONEWALL DR Owner: Thomas Bolen Applicant: Thomas Bolen This structure may be occupied as a: Residential Septic Alteration By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the (."-- 4494 property owner of the responsibility for compliance with Site Plan, )4l-At 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 BayRoad,Queensbury,NY 12804-5902 Q ry, (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20110581 Application Number: A20110581 Tax Map No: 523400-297-010-0001-032-000-0000 Permission is hereby granted to: THOMAS &CAROL BOLEN For property located at: 10 STONEWALL 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: THOMAS &CAROL BOLEN 10 STONEWALL Dr Septic Alteration Residential QUEENSBURY,NY 12804 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency MORRISSEY'S CONSTRUCTION INC. 798-6612 242 HADLOCK POND Rd FORT ANN NY 12827-0000 Plans&Specifications 2011-581 septic alteration residential $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,November 29, 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; TO, ,' -november 29, 2011 SIGNED BY t, V IW for the Town of Queensbury. Director of Building&Code Enforcement -----fiir lECEOVE =7'NOV 2011 �/ yised 421/2010 OFFICE USE ONLY TOWN OF Qu'?!..i.N13§07Y BUILDING & : ODES y 0' --�..'---'-- a OF QUEENSBURY TAX MAP NO. PERMIT NO. PERMIT FEE r BUILDING& CODES • 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: (� (40/e-K1 INSTALLER: Me,rrr7/5". b r / =2=�'IC ADDRESS:/D 5 n`C..( j4( (I 0/1 ADDRESS: NQ 1`A ?irei PHONE NOS. S/p //O f —' PHONE NOS. Q Ire f, OF INSTALLATION: RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION = 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 ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? I DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is/s' ft) I PERCOLATION TEST: RATE ISu //), i.5I PER MIINUTE PER INCH[mpi] (Test to b 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: GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder,spa or vhirlpool jub. SYSTEM TYPE: c.54//oo Adly0 n!moi o ABSORPTION FIELD(WITH NO.2 STONE) Total length ft. Each trench X o SEEPAGE PIT(S)(WITH NO.3 STONE) How many? AltSize? o ALTERNATIVE SYSTEM Bed or other type? _ - - �/, e2 •,L I ' te 1I,' 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 circumsk nce 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 QUESTIONS? CALL 761-8256 OR EMAIL Sanitary Sewa•- Dispos-I Ordinance. codesaqueensburv.net Z. / 7f��_:, VISIT OUR WEBSITE FOR MORE INFORMATION Signature of Person Res•Inble Date www•queensburv.net Town of Queensbury* Community Development Office*742 Bay Road, Queensbury NY 12804 ‘V\-t) avy Septic Inspection Report Office No. (518) 761-8256 Date Ins ion req 4 ceiv •: Queensbury Building &Code Enforcement Arrive: 5i a • O %epart: Z,=7� pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: VP— NAME: PNAME: -4(e1 0__i♦e.1 •Ec IT NO.: / /"' 5-S LOCATION: ; C ( 03'06 r SPECT ON: q, 1-13 RECHECK: Comments and/or diagram Soil T •-• ..Il`:,:.:. ' 2Ir. NAY../ Type of Water: MunicipalWell Water Waterline separation distance ft. Well separation distance IOD ft. Other wells: __,10.C2_, Well Casing Length 50' +/ - Y N N/A [150'to well required if NO] E F i O C)`\c-- l O ic,)EE3) QE Absorption Field: Total length 155 ft. Length of each trench LAI:;),,,,'' )K ft. int E3.301-, LooyeD Depth of trenches 1 ft. Size of Stone �dcZ Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box F` -�� Distribution Box to Field/ Pit ✓ y'% p'C -t-c �GQ_F. Opening Sealed: N End Cap t1V01;•''ED Inlet/Outlet Pipes&Baffles Y Manholes 12"or less below grade F �� 71). c� Z R C'�EL [provide extension collar if Yes] Y ,/N `—� © tJJ�C ECT 'F tr UJ e s.: VA Eg- C)0 tip Location/ Separations Foundation to tank Fst,te-,r ft. Foundation to absorption ft.*- Separation of Pits ft. Conforms as per Plot Plan _Y ,IQ Engineer Report and As-Built Y ✓N ETU Maintenance Contract _Y N provided Location of System ••-• ope • Front Kms' -- Sid ' g t Side Middle Front Middle Rear stem Use Statu-. 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 Report_03 29 10.doc Septic Inspection Repo Office No. (518) 761-8256Date Inspection r-• .--iv Queensbury Building &Code Enforcement Arrive: I ; �'�� -part: ]-, a pm ) 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial NAME: l;tel — .ERMITNO.: I LOCATION: A c', e3c vi)R\i, kR INSPECT ON: -1 RECHECK: Comments and/or diagram Soil Type: , P oal, �•;_ ah j< Type of Water: Municipal/, ell Water - Waterline separation distance ft. Well separation distance ---- . �'' UE 1 Ti � � � �'(A1✓l,F Other wells: \ LA,, ft. Well Casing Length 50' + /- Y N N/A [150'to well required if NO] Absorption Field: Total length .;-1:7 ft. Length of each trench ��=_-2*ft. ._ i� F►� �D D � Depth of trenches 1` - e'(Z_ft. Size of Stone Seepage Pits: Number Size: x Stone Size: E - 5 \OG Piping Size Type 5E.Prs c 71\1.\ wilding to tank �� 1-\0 �YA5'`,3G 000 ' Tank to Distribution Box y ► 2otA -pit 1L `i Distribution Boy:to Field/ Pit r �',. - t,. '�1 `t�ZC- �i�QCF M1t Opening Sealed: ' N -70 End Cap N Inlet/Outlet Pipes&Baffles N Manholes 12"or less below grade ' N F 1, 3- Location/ Se. rations �� E c y� i Foundation to tank �-` cc- Foundation to absorption r ¶ �-©M To>\ C Separation of Pits Conforms as •-r Plot Plan 1 1 En•ineer Re.•ri:and As-Built MIIVAKT ETU Maintenance Contract provided -`_ - t) To \ Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Buil'lding Codes Forms\Inspection Forms\Septic Inspection Report_03 29 10.doc Septic Inspection Report Office No. (518) 761-8256 Date In •- 'on • -= ed' _1 Queensbury Building &Code Enforcement Arrive: �`�- P-:.rt: 11,12,0_04;111 742 Bay Rd., Queensbury, NY 12804 Inspectors In',- r.. NAME: CSO LEi PER IT NO.: I LOCATION: i 11:• 1 • INSPECT ON: 1 -ZGt -t t RECHECK: it-k% ,1\v- 1 Comments and/or diagram Soil Type. .i,;.ims.i Type of Water: Municipal/ eN ti Waterline separation distance ft. r "� E�`'L` �- �% t'L Well separation distance ft. Other wells: ft. ©T Well Casing Length 50' + / - Y N N/A [150'to well required if NO] Absorption Field: Total length 1 ft. Length of each trench .,, h ft- f_ ;�� a Z.V Depth of trenches 1 ' '/"i ft. Size of Stone = Seepage Pits: Number Size: -- _ x - Stone Size: 6 Leo Piping Size Type Building to tank ,b1O c tJ5v L $ ' Tank to Distribution Box 121 Distribution Box to Field/ Pit c.' cs,u ' �� �(_F Opening Sealed: Y N �i� 1C End Cap N �C;cR. Inlet/Outlet Pipes&Baffles Y„ N Manholes 12"or less below grade Y.� N [provide extension collar if Yes] -_-_Y N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. \L t • —CZ � `/ Conforms as per Plot Plan Y N � \ �' ` -F-F �� Engineer Report and As-Built —Y N C �� ETU Maintenance Contract Y` N L --- � provided _ Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use S »t 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 Report03 29 10.doc e__7__ isz......i ._ Septic Inspection Report Office No. (518) 761-8256 Date Insp�ctio • -ilv-• Queensbury Building &Code Enforcement Arrive: %Ia- /p fry .- ...it: -,.� m/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials. �!' NAME: 0k 5— PE'MIT NO.: l LOCATION: f U `.S1-G 1,._e,;1.,.... c-AL_PSPECT ON: RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/ Clay Type of Water: Municipal/ Well Water ,/` Waterline separation distance _+- ft. /�'�C 6'� ' 1- Well separation distance (DA—;;\;a*> t L��- Other wells: _ ft. Well Casing Length 50' + / - Y N N/A [150'to well required if NO] c �/ vb\f\.L\I N;�' Absorption Field: Total length ft. Length of each trench ft. Depth of trenches a ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size ' Type Building to tank KtAP Tank to Distribution Box \ t �Z f c ?.-L _ iN 1 Distribution Box to Field/ Pit '4}�t, ,C___ t o 4't c7G_V___ Opening Sealed: _Y N End Cap Y N Inlet/Outlet Pipes &Baffles Manholes 12"or less below grade N [provide extension collar if Yes] Y N Location/ Separations ---C O C3eltC.F1 L� F,1 E Foundation to tank ft. Foundation to absorption ft. R p \)01`)P \ it I y k>J) EV-7 Separation of Pits ft. Conforms as per Plot Plan Y N C._f Engineer Report and As-Built ^ Y N ' ,, ETU Maintenance Contract Y N r�ovided - E E) \ t� \14 — RV V MA) Location of System on Property: V' r t N16--k-A LL CI__L__. - Front Rear Left Side Right Side Middle Front Middle �'�`�`� \ ' . stem Us- S ,t — tEz-_- -c. \ �� � -- Approved , (� \�� t Partial Approved and needs to be re-i please call the Building &Codes Office Disapproved ______--------\- L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report_03 29 10.doc ` k I. & , I 2 ss s `''` , rot r l \ '' ' ' ' t f' -14";1 ' "3; : ._,,,,,,,.,..,%,_ ..•Y� °§; - 4 �� 7';':,.:44.,;::<7:: 3 "\ --i .. • 11:-‘''''-. ' v --{' -r. \--.'4 ,' , '4‘.„,,C) '1:44 ,,_ - .. .-r1. - '"'p t %.. -:' ''''''''''' 4- ( iii x s.. .a? .'. r" e.. TV k k ,.... ..� ': rC 4 ' . ' ' . , ,. ,,, . ' ,. : el,',,,,0. . i ��. ..�_.,,._ 'A ) -- 1 - � �'C .` i s `: Map Produced oy Warren County Space!Data Viewer-www co.warren.ny.uslgls data sources parcels-Warren County Real Property Tax.20009 Tentative Roll ,5O�e4e, a/, c'e iiP,ipr Sep 1-11-1e- aerial photography-NYS CSC IC.flown,n April.2008(1-foot color) n IMPORTANT NOTICE AND DISCLAIMER ifs y 1V'Ice L11,i l n P er(115, ._.__ iliTHIS MAP AND INFORMATION IS PROVIDED'AS IS'AND WARREN COUNTY MAKES NO vVARR,ANTIES OR ✓ TOWN OF QUE �r GUARANTEES EXPRESSED OR IMPLIED.INCLUDING.IARRANTIESOFTITLE.NON-INFRINGEMENT yy�Y���r rli� MERCHANTABILITY AND THAT OF FITNESS FORA PARTICULAR PURPOSE CONCERNING THIS MAP AND THE rI R INFORMATION CONTAINED HEREIN USER ASSUMES ALL RISKS AND RESPONSIBILITY FOR DETERMINING R .,� rLfi— , WHETHER THIS MAP IS SUFFICIENT FOR PURPOSES INTENDED BUILDING & O /!1r 1�..� �, - , , 015 MAPS ARE NOT LAND SURVEYS! Reviewed B. • "lei �l1 / d This DIS map.s computer generated usirg software en;en bortalrs niCrm Ptton acqutred oy'Warren County Plarr)ng Date: ,^� �� • � Department from various sources 3r0 s nterded crl for retererce conceptual plarnlr 3rd Creaertatlor purposes a C While Ne NCrk Cara to rclude reltacle data:Cr the stated purposes NaI .Tap S pot.nterded'or 3rd srOuld `et ce.sed � ���:��` MI IIII to estaolian CCundares.'ires :Ccattors Cr:O)ec a Jr'O crc'ode any other nfcrmatton tyCtCally forn r j excavation Cr cry`other pu-Dose Nren ergIneered 113w ngsiplans Cr surveys are i)required dy'aw 2t required for arty legal ICcument or 3)leeded'o assure accuracy 3rd/or:rat certair stardards are net • NACE ENGINEERING, P.C. 169 Hal,iland Road, Queensbury, NY 12804 Phone-518-745-4400 Fax -518-792-8511 September 14, 2011 Project # 49339 Mr. Dave Hatin Town of Queensbury Queensbury,NY 12804 Re: Proposed Replacement Septic System Tom Bolen Residence — 10 Stonewall Drive, Queensbury,NY Dear Dave: On September 14, 2011, we performed a deep soil test pit and percolation test at the Tom Bolen residence located at 10 Stonewall Drive in Queensbury. The tests were performed to the northeast of the existing residence in the location where construction of a replacement leach field is proposed. The current residence has an existing failed septic system which will be decommissioned upon completion and certification of the replacement system. The results of the testing are as follows: Test Pit Percolation Test 0 —2" Topsoil Stabilization percolation rate - 1" in 8 min., 51 sec. 2 — 12" Loamy Medium Fine Sand Some Silt 12 — 24" Fine Sand Some Silt 24—48" Medium Fine Sand w/gravel and cobbles Mottling w/ seepage observed at 24" The 12 inch deep hole was presoaked and the test was run 6 times; at a depth of 6 inches, until it stabilized with three consecutive runs of 8:15, 8:36 and 8:51 respectively. The design flow for this 4 bedroom residence at 110 gpd per bedroom (440 gpd design flow), requires 630 sf of absorptive area. The replacement septic system should be a shallow absorption bed system installed at the existing grade. The topsoil should be removed and replaced with a minimum of 4 inches of loamy medium fine sand fill. The replacement shallow absorption bed system should consist of the existing 1,000 gallon septic tank, a 5 foot diameter concrete pump station and a 20 foot wide by 40 foot long absorption bed with a distribution box & 4 — 35 foot long laterals located to the west side of the building. Please note that we highly recommend that after the system is constructed that topsoil and seeding be immediately performed so that a permanent lawn can be established to allow stormwater to be directed around the system. Please call me if you have any questions. Sincerely, Thomas R. Center Jr., PE Cc: Dave Hatin, Town of Queensbury COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Permit No................. Cert. N® 2 0 2 5 8 Cut-in Card No..................................... �y.................. Owner.................... a. L, .................. ................................................................................................................ Location.............. ......... /.. t2.G�c�1 r,:.....13. ............................................................................. Installation Consisting of.............. .d'.c .... °.........;? 4— .;...-................................... ................................................................................................................................................................... ............................................................................................................................................ InstalledBy.fl .. ............. ..................Lia No..................................... .............. The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of making inspections at any time, and if its rules are violated,the Company shall have the right to revoke this certificate. Date.........�" p`. .1............. INSPECTOR Member N.F.P.A.,I.A.E.1. cn U "0 M 2N,h Z dao po cn 86 w z< WmZ R m t =1 I oz O i <wo iffi- IZ < 6 83 j It X5� 0. cz gi 2j zozF Igo 0.6<w 6 o 6 0—F=, w Mug M ,,0 :3.08< d 1. on Q. �w <<.I;;0Z 12� 0" .:1 ism w'O M 10, Sw ;5 I MR .9 ozwr III` 1! 61.2 6Iez 83 �2iE w 5 3iz�- �'.2 ..I.oP 1. M w wo 0,�6. w 0o W z M rj) Zz W=W vEi w (.) Z) < 20 I'l ............. 7, 3,13 21 w7 85, 0,�Ir -