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2010-499 TOWN OF QUEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201 Q r3', Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20100499 Date Issued: Wednesday, December 19, 2012 This is to certify that work requested to be done as shown by Permit Number P20100499 has been completed. Tax Map Number: 523400-295-010-0001-019-000-0000 Location: 9 HILLSIDE Dr Owner: MATTHEW & M ELIZABETH MONTESI Applicant: MATTHEW & M ELIZABETH MONTESI 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, r( i)j)sie Variance, or other issues and conditions as a result of approvals by the Director o Building'&Co. n\cement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY catT 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100499 Application Number. A20100499 Tax Map No: 523400-295-010-0001-019-000-0000 Permission is hereby granted to: MATTHEW & M ELIZABETH MONTESI For property located at: 9 HILLSIDE 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: MATTHEW& M ELIZABETH MO Septic Alteration Residential 9 HILLSIDE Dr QUEENSBURY, NY 12804 Total Value Contractor or Builder's Name/ Address Electrical Inspection Agency SANITARY SEWER DAN DRELLOS PO BOX 224 GLENS FALLS NY Plans &Specifications 2010-499 septic alteration $25:66—PERMIT FEE PAID- THIS-PERMIT EXPIRES: Wednesday, October 19, 2011 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the To�$Queen ury; s Tu,-.day, October 19, 2010 SIGNED BY �) A '� for the Town of Queensbury. Director of Building&Code' nforcement „,,,:itaH, Community Development Office r . , Town of Queensbury • 742 Bay Road • Queensbury, N: w .rk.112804 5 2010 Office Use gnly T�BUILDING - • / // & CODES NIS TAX M- --7, -.1C-') IIIIFF"'''' NO. «( PERMIT NO. /r ....V • 477 PERMIT FEE 1' 2 --- , A APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINEE BEFORE WORK BEGINS. we- APPLICATION IS SUBJECT TO REVIEW =EFORE ISSUANCE •F A VALIPERMIT. OWNER:I' PIT `o5 GS^i INSTALLER: /I: , !„ : 40.7•,(__ • � . SUE ADDRESS: l`1 d L�_ SJR I,tJC� ADDRESS:_i, 42--vY / -• -- -___-_f- S.? PHONE NOS. YF .7_7 9 S PHONE NOS. 7 9' 6��+� LOCATION OF INSTALLATION: 61 Aril Q._-a NO.OF X COMPUTATION RESIDENCE INFORMATION: YEAR BUILT = TOTAL DAILY FLOW BEDROOMS (Gallons per bedroom) GARBAGE GRINDER 1980 or older X 150 = INSTALLED?_ __ 1981 -1991 3 X 130 = J %. SPA OR HOT TUB I �,-‘ 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 WH EPTH?___ __ ✓ 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: 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 5 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 a-” ft. Each trench J'i X ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? ❑ALTERNATIVE SYSTEM Bed or other type? ❑ 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 t : -.ulations with respect to this application and agree to lot e by these n. . requirem. is of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL S itary Sew e nis•.sal��f ance. /� /� /� codes(a,queensbury.net Signature of P: n Responsible Date VISIT OUR WEBSITE FOR MORE INFORMATION www.queensbury.net TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 IF ill Community Development- Building& Codes (518) 761-8256 Inspections per Permit Permit# P20100499 Inspection Date Inspection Type Approved/Denied Comments Permit Type Person Responsible 10/15/2010 Miscellaneous Septic Alteration Residential JENNIFER HENDERSON Staff Misc 2010-499 permit entered 10/19/2010 Miscellaneous Septic Alteration Residential JENNIFER HENDERSON Staff Misc 2010-499 permit issued 06/02/2011 Septic Septic Alteration Residential JOHN O'BRIEN Approved 2010-499 12/19/2012 Miscellaneous Septic Alteration Residential STAFF Misc 2010-499 Septic approved 6/2/11 -never closed out CC issued today Septic Inspection Re. . Office No. (518) 761-8256 Date Inspection r�- , cei - : Queensbury Building &Code Enforcement Arrive: 1 Z =tc; = (�A •-part: I"7_=]c%a 742 Bay Rd., Queensbury, NY 12804 Inspector's In' '- 1,� NAME: c T F RMIT NO.: \C- "' 491 1 LOCATION: dl 1-\ ' 'L !- \1F)F R INSPECT ON: l c.` — 2-. -- RECHECK: Comments and/or diagram Soil Type: i• Loam/ Clay Type of Water unicipalj Well Water Waterlin- -.. on distance 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 95 ft. Length of each trench /-1 2.0 ft. r 0., C) LC © Depth of trenches 7 1 ft. Size of Stone z_ Seepage Pits: Number Size: x Stone Size: Piping Size Type T Building to tank -} 4O Tank to Distribution Box tic Distribution Box to Field/ Pit N " .G,ng 3. TC Spy 3- ? Opening Sealed: ,/f N End Cap "c N n �o`PF Inlet/Outlet Pipes &Baffles ✓YN Manholes 12"or less below grade ? N [provide extension collar if Yes] N Location/ Separations Foundation to tank `?�i,• ft. E a Rb-- vC Foundation to absorption Hu ft. 11— Separation of Pits �` ft. Conforms as per Plot Plan ✓ _N Engineer Report and As-Built N 9 Po ETU Maintenance Contract Y— N provided Location of System on Property: Front R=:r : Left Side Right Side Middle Front Middle Rear System Use Sta s: 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 1°0 .k.. Pi_ 'I 3-A,J6Ca 04° r-- 3' , °°1,c ---3 10' \<5 1215° V2erl cd --- \\VO ___9 clf oc' AS ati ItT G TOWN Of- Qt.)E4' 3/ Y if , , ,• OIY2 ( BUILDING & ( t; E 0,*- t11Reviewed By _ '/ cl(- Date: et(.0-01 i 't ,..... 1 t. -,,,„LI N, 4 N I I g •'')"4' i CN4 , \-...•:3•• '7) .--,.......N, g,4,- •., g • 0 1111111‘,Ns ..7411111111111111‘ „--- -•..„ (i) :16' 6, rti tr) 1 q ....] , • r..........__. , 1 . ......, , ; , .... , _ * E3I N- . J ...„, ..,................... -.44.,, --„... . . ..” c....) ,1 1 rj ) i NI ,...... 1 . 1 ) 1 1 i 11 1 I 1 1 I 1 1 444 I i I CENTER PROJECT SERVICES 73 Sheridan Street, Glens Falls, N Y 12801 Phone-518-796-2515 June 2, 2011 Project # 144 Dan Drellos Sanitary Sewer Services Luzerne Road Queensbury,NY 12804 Re: Proposed Replacement Septic Montesi Residence—9 Hillside Drive, 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 9 Hillside Drive 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 330 GPD and a percolation rate of 1 to 5 minutes, you will need 347 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 1,250 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, ,,,)".„1„v,_ TEMN Clt.. BUILDiNG flio Thomas R. 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