2011-388 ..4111A 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: P20110388 Date Issued: Friday, August 12, 2011
This is to certify that work requested to be done as shown by Permit Number P20110388
has been completed.
Tax Map Number: 523400-302-018-0002-042-000-0000
Location: 130 GRANT Ave EXT
Owner: ROBERT BROOKS
Applicant: ROBERT BROOKS
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 d 1 /
property owner of the responsibility for compliance with Site Plan, ' f : " Fr a
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: P20110388 Application Number: A20110388
Tax Map No: 523400-302-018-0002-042-000-0000
Permission is hereby granted to: ROBERT BROOKS
For property located at 130 GRANT Ave EXT
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: ROBERT BROOKS
130 GRANT Ave EXT Septic Alteration Residential
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans&Specifications
2011-388
septic alteration residential
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,August 08,2012
(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,•. • Queensberry; Monday,August 08,2011
` ,� /
SIGNED BY �' for the Town of Queensbury.
,z r- M` 174
Director of Building 7 od nforcement
ilECEOWE -:\N
�o»
-.,_ Development AUG 0 3 J
_ i' { Town of Queensbury . 742 Bay Road . Queensbury, New York 12804
TOWN OF QUEENSBURY
Office Use Only _ BUILDING & CODES
TAX MAP INCE. ' , _-^- PERMIT NO. ,' ` ' , PERMIT FEE '-;`t` 4
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW ORE ISSUANCE OF A VAL�PERMIT.
OWNER: 6 e.6.4_,.--- 4 .ie01<s" INSTALLER: , 4te!7-- ree„..-c.__/e,t_of CL
ADDRESS: 1�� 0 6P---W 4l X/ ADDRESS: e 0� 30)4._ .2-2-Y b F
PHONE NOS. 32/ 5)5 7/ 6-62-,,L0' PHONE NOS. 7 ( 6 I s-7,:--'
'
LOCATION OF INSTALLATION: 1 3 '' k /Tx 7
RESIDENCE INFORMATION:
NO. COMPUTATION
YEAR BUILT BEDROOMS X (Gallons per bedroom) = TOTAL DAILY FLOW GARBAGE GRIND_%
1980 or older 3 X 150 = 75- INSTALLED? /t
1981-1991 X 130 = SPA OR HOT TUB s)
1992-present X 110 = INSTALLED? it-rip
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROW STEEP SLOPE %SLOPE
I SOIL NATURE: SAND LOAM CLAY OTHER
I GROUNDWATER: AT WHAT DEPTH?
I BEDROCK/IMPERVIOUS MATERIAL: AT W/.T DEPTH?
I DOMESTIC WATER SUPLY: MUNICIPAL' WELL (If well:water supply from any septic system absorption is: ft)
I 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: I OOt) 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
o SEEPAGE PIT(S)(WITH NO.3 STONE) How manyyJ''many? ,, °�Size?
cv
LTERNATIVE SYSTEM Cr other type? v f JL ..)--•5- ' ('r I'd'
❑ 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
•y then. . • II requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
S, it.,r Sew. -D •osal r. finance. codesAgueensburv.net
FAL-..-4 E(ilf VISIT OUR WEBSITE FOR MORE INFORMATION
Si s nature of P- •n Responsible Date www.queensburv.net
1/ .-
VISION Engineering SOIL BORING & DEEP TEST HOLE FIELD LOG
Project: 247-TOQ Deep Test Holes 2009 Location: Backyard
Date: 10/05/09 Temperature: 60 °F Weather: Cloudy Test Hole#: 1
Address: 130 Grant Avenue Ext. '
Soil Survey Map
Queensbury, NY 12804 Designation: 1 2
County: Warren 1 Soil Series:
2 Slope Class:
Remarks: (site description,usage,anticipated daily wastewater flow,etc.) L.
New septic system.
Buried topsoil layer to be removed upon construction.
Percolation at 24 inches: 0:46/0:52/1:08/1:05/1:10
Boundary Color Soil Soil Moisture
Depth(in) Condition MatrixConsistency Stickiness
Mottling Texture Structure State
0-4 black -- topsoil -- -- -- dry
clear
4-18 light brown brownloamy rawourn
around single-grained loose -- dry
clear
18-28 black — buried topsoil — dense — dry
clear
28-83 tan red-brown-orange med.fine sand single-grained loose -- dry
gradual
83-109 tan — coarse sand single-grained loose — moist
**NOTE: Mineral staining at 47 inches;does not appear to be mottling related to SHWT.
1. Describe and record the average thickness of each horizon.
2. Record each horizon boundary in terms of distinctness. Designate as Very Abrupt(<0.5 cm),Abrupt(0.5.2 cm),Clear(2-5 cm),Gradual(5-15 cm)
or Diffuse(>15 cm).
3. Record the topography of the horizon boundary. Designate as Smooth,Wavy,irregular(undulating boundary),or Broken(discontinuous or
intermingled horizons or irregular pockets).
4. Indicate the color of each horizon. The matrix color is the majority color within the pads,and the mottle color is the minority color within the pads.
Record ped surface color where colors exist that are associated with an organic coat/clay film/carbonate mass/etc. Record the percent of mottles
as Few(<2%),Common(2-20%),or Many(>20%). Record the mottle contrast as Faint,Distinct,or Prominent.
5. Soil texture:Designate as Sand,Loamy Sand,Sandy Loam,Loam,Silt Loam,Silt,Sandy Clay Loam,Clay Loam,Silty Clay Loam,Sandy Clay,
Silty Clay,or Clay. Sand,loamy sand,and sandy loam may be further classified into coarse,medium fine,fine,and very fine.
6. Soil Structure:Designate peds as Grenuel,Blocky,Prismatic,Columnar,Platy,Single-Grained,or Massive. Structure grade shall be described for
pads as Weak,Moderate,or Strong.
7. Soil Consistency:Designate as Loose,Friable, Firm,or Extremely Firm. Indicated ND for not determinable,if too wet for test.
8. Record stickiness as Non-Sticky(little or no soil adheres to fingers after release of pressure),Slightly Sticky(soil adheres to both fingers with little
stretching upon separation),Moderately Sticky(soil adheres to both fingers and stretches some on separation),or Very Sticky(soil adheres and
stretches greatly).
9. Record the moisture state of each horizon. Designate as Dry or Moist.
10. Roots:Record the quantity,size,and locations of roots. Record quantity as Few,Common,or Many. Record size as Very Fine(<1 mm),Fine(1-2
mm),Medium(2-5 mm),Coarse(5-10 mm),or Very Coarse(>10 mm). Location shall be noted to be Between Peds,In Cracks, Throughout,In Mat
at Top of Horizon,or Matted Around Rock Fragments.
Boundary Condition Observed at Depth:
Bedrock: N/A ft. Groundwater: 109 in. ft. Impervious Strata: N/A ft. Mottling:**see note ft.
Slope of Site: 0 % Ground Cover: m Grass 0 Wooded 0 Barren 0 Crops 0 Shrubs
Landscape Position: 0 Depression 0 Hill Top ❑Side Slope 0 Foot Slope
Describe Roots: (Quantity, Size, and Location) fine roots from grass,common to 10 inches
16 Pearl Street•Suite 200•Glens Falls, NY•12801 •P:518.792.9264•F: 518.792.9282
www.visionengineering.org
CENTER PROJECT
SERVICES
73 Sheridan Street, Glens Falls, NY 12801
Phone-518-796-2515
August 3, 2011
Project # 146
Dan Drellos
Sanitary Sewer Services
Luzerne Road
Queensbury, NY 12804
Re: Proposed Replacement Septic
Brooks Residence— 130 Grant Avenue Extension, 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 130 Grant Avenue Extension 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 473 square feet of absorptive area. We recommend using a 20 ft
wide by 25 ft long absorption bed with 4 — 20 foot long laterals, which will provide 500 sf of
absorptive area. The absorption bed can be constructed with a new 1,000 gallon septic tank, new
distribution box, and 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.
•
TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Based on our limited examination,compliance
with our comments shall not be construed as
indicating the plans and specifications are in
full compliance with the Building C..-_
New York Stare.
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Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: rob am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:(ht& l r
NAME: f L-C f SPERMIT NO.: ;' Y
LOCATION: 1 �.3' /��"-� - / fit's. INSPECT ON:
RECHECK:
�� Comments and/or diagram
Soil Type: rte• Loam/Clay
Type of Water: unici P. Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50'+/- Y N N/A
[150'to well required if NO]
Absorption Field: Total length 1. l ft.
Length of each trench
Depth of trenches 2 ft.
Size of Stone
Seepage Pits: Number
Size: r x
Stone Size:
Piping S'ze Type
Building to tank t`
Tank to Distribution Box ,5Aj2•
Distribution Box to Field/ Pit i' n <
Opening Sealed: —., _N
End Cap _3_,‘Y N
Inlet/Outlet Pipes&Baffles
Manholes 12"or less below grade Y ,!
34
[provide extension collar if Yes] Y N
Location/ Separations
Foundation to tank IT ft.
Foundation to absorption ft.
Separation of Pits 1W ft.
Conforms as per Plot Plan
Engineer Report and As-Built Y V N
ETU Maintenance Contract _.Y r,N
provided
Location of System on Property:
Front Rear Left SideRight S Middle Front Middle Rear
System Use Sta
A. 'pro -•
Partra Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspecdon Fomrs\Septic Inspection Report`03 29 10.doc