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2010-030 • 1 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: P20100030 Date Issued: Thursday, January 17, 2013 This is to certify that work requested to be done as shown by Permit Number P20100030 has been completed. Tax Map Number: 523400-289-015-0001-046-000-0000 Location: 804 BAY Rd Owner: BRIAN A. & PATRICIA M. BYRNES Applicant: CHARLES DEVRIES This structure may be occupied as a: Septic Alteration Residential Test Pit/ Perc Test Review 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: 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. i TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100030 Application Number. A20100030 Tax Map No: 523400-289-015-0001-046-000-0000 Permission is hereby granted to: CHARLES DEVRIES For property located at: 804 BAY Rd 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: CHARLES DEVRIES C/O SUZANNE DEVRIES Septic Alteration Residential 7 IVY LOOP Rd Test Pit/Perc Test Review LAKE GEORGE,NY 12845-0000 Total value Contractor or Builder's Name/Address Electrical Inspection Agency IBS SEPTIC & DRAIN ATTN: IVAN BELL 2 LOWER WARREN St QUEENSBURY, NY 12804 Plans &Specifications 2010-030 deep hole/perc test $225.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday, February 09, 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 theilew of Que b / esday, February 09,2010 SIGNED BY for the Town of Queens bury. ury. Director of Building&Code Enforcement ' /5: /—�C OFFICE USE ONLY _h 2n 4 TECEDWE TAX MA Fs NO. PERMIT NO2/O U�.Z.iPERMIT FEE I-Ei3 /111 i Li APPROVALS: ZONING TOWN CLERK i' -J •f 1• ' v l'crb> R APPLICATION FOR SEPTIC DISPOSAL SYSTEM P ' .DING& CODES A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. / ( — OWNER: �/ 5 6 Dc [jr ,‘ cc INSTALLER: Y r _ ADDRESS: V r3 6' /3 t Rd 0 ADDRESS: ( l 'tf`) (0(.,...cr Ufi ' ,, &-f ( o d PHONE NOS. , PHONE NOS. ) 9 Y -6 / Y C/ LOCATION OF INSTALLATION: I/ .%2)- ( Ote(yC r j..t,U/rC^, $/ a 6:y RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION= = TOTAL DAILY FLOW BEDROOMS GARBAGE GRINDER 1980 or older X 150 gallon per bedroom = L{�p INSTALLED? 1981 -1991 X 130 gallon per bedroom = SPA OR HOT TUB 1992-present X 110 gallon per bedroom = INSTALLED? PARCEL INFORMATION: / // / ✓ TOPOGRAPHY: Flat rolling\>C Steep slope' %SlopdAv/ ✓ SOIL NATURE: Sand Loam/174- oam/- Clay/VA— Other/? ✓ GROUNDWATER: At what depth? A/711- 1 ,4✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth?/v4 ✓ DOMESTIC WATER SUPLY: Municipal X Well (If well: Water supply from any septic system absorption is/Qd ft.) tt ✓ PERCOLATION TEST: Rate is /, Y S^ minutes 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: / 6c) D 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)OO ft. Each trench X Sa ❑ SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Z(//1--- Size?/_/A ❑ ALTERNATIVE SYSTEM Bed or other type? A/71 71 ❑ HOLDING TANK SYSTEM Total required capacity? ././/1 1/NOTTank size? Number of tanks? ,1/77NOTE: E: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN i APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. , .,.,.,.,.,.,n.,.e..r.,.,.,.,...+:...................e,.,.,.,.e,.,.,.,.,.e,.,..,.,n.,.,.,n.r.e.,.,...r.,.,......,...,.,.,.,.,.,.r...,.,.,.,.,.,.,.,.,.,.,.,.,n.,.,.,.,.,.,n.,.x.,.,.,.,.,.,.,.,.,.,.,n.,.,.e.,.,.,n.,.,.,....n...,.,..,...,n.......,.,.,.,a.,.,n...,.,.,n.a.,.,.,.,.,.,.,.,....,..n.,...,n ,.,.,:.,.,.,.,.,.,,,.,.,.,.,.,.,.,.,.,........,.....e..,.,....,...,.,w.,.,.4,.,...,.,.,.,.,.,I 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. 20/0- 0-3v elsTown of Queensbury• Building&Codes Enforcement Office•742 Bay ' 1 Q...-....,1,...j,NY 12004 DEEP HOLE/PERC TEST FEB 0 8 2010 Request for Town Engineer Re ie�yt.. TOWN OF QUEENSBURY ,o UILDING_& CQD S _ f5 /' , C Phone: , �! Property Owner: ES 1.— bc � f S ��j Property Owner's / Address: f) / c&y ,f j Location of Test: -**7 pv___. lick P CelTax ID#: 7 /57 / 4‘ __,.., 'Applicant's Engineer: ,p` 1 -. J , ,.5 Phone: 9�- 3,,,\9 Applicant's Agent: t /�c S ,S c, (7 / C Phone: -2 2� t l 9 L " Additional Notes: / r 1. Reason for Request? New Septic System Replacement Septic System Failed Septic System Subdivision Site Plan Review 2.Are Wetlands present? YES NO UNKNOWN *Note: Applicant is required to engage an engineer for design and testing of the system. The Town Engineer's responsibility is to witness system testing only. PLOT PLAN: Plot plan, to scale, to be submitted with application FEE • a. $200 FlatFee) Date Paid: 2--1-/0 Check No.: 16,s-6 b. OR Fee to be determined during To Be Determined: Site Plan/Subdivision review process SIGNATURE: In carrying out the provisions of Article IV, the Local Board of Health or the enforcement officer may engage the services of a qualified professional consultant for expert review and recommendation arising from the carrying out of the provisions of Art. IV, including but not limited to the review of plans, specifications and reports, attendance at inspections, dye tests, deep hole test pits, septic related deep hole and percolation tests, system installations, and any other aspect of any matter contained in this Art. IV, and any costs incurred in such review shall be paid to the Town by the owner of the property before any approval can be granted under this Art. IV shall become effective within 30 days of presentment of an invoice for same, whichever is sooner. Such costs shall not exceed $1,500 without prior written notice to the party to be charged with same. My signature below indicates I have thoroughly read and understand the instructions, agree to the submission requirements and have completed the application. I also fully understand that additional engineering fees may be necessary per Town • •ueensbury Local Law 136-14D. SIGNATURE OF APPLICANT: ,Lir Date: r. b r ©l SIGNATURE OF AGENT: ZDater if i c Original (B&C File) Canary(Planning) Pink(Applicant) Gold (Town Clerk) Septic Inspection Report Office No. (518) 761-8256 Date Inspection r-••- -c-frill y. Queensbury Building&Code Enforcement Arrive: 12.it)• • ..- i+dart: �Z.Z�am/C)--- 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial NAME: D AR1 ' ) P-•MIT NO.: \T — C LOCATION: 1-k ` P,D NSPECT ON: 7 -- I-1—I C RECHECK: Comments and/or diagram Soil T •-: Loam Type of Water: ' unici••.I veil Water, Waterlin- separatio nce c 9 n 1- YAM ft. Well separation distance 1 b0 ft.t Other wells: ft. Well Casing Length 50' + / - Y N N/A Absorption Field: Total length Z0O ft. Length of each trench 1--1P Ab ft. Depth of trenches Z ft. Size of Stone AV-Z Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank (2) LI" ,hCG %Ap Tank to Distribution Box L}% P\NL Distribution Box to Field/ Pit L{" VJL TO PE_ Opening Sealed: Y_N End Cap ' N Inlet/Outlet Pipes&Baffles ^Y N Location/ Separations • Foundation to tank -2 ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot • .n y N Engineer Report and • -Buil , .. Y N Location of System on Property: Front Rear Le Side -'ght Side Middle Front Middle Rear System Use S us: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc we 5 0 / re BVAU Se 1. Il sc ` 5 e TOWN OF QUEE "Atrii,, BUILDING & C'i t L r�. "T. 1 \ /'" .... Reviewed By /4r �t _ e Date: _ Wit . I S,,t, V`s-.' I 2 ' � ti I C- -J I U 171 Ccill. ki OSS✓l 4, 0I le a Y /PC/ I .. i 4 Company notes: e . is lc- I. B.S.Septic 'fDrainService, Inc. • DBA CONDON'S SEPTIC SERVICE „ �-- 2 Lower Warren Street * Queensbury, NY 12804 Phone:518-798-8194 • Phone:518-798-8542 • Fax:518-798-3213 We take p ice in everything we dol NAME DATE CALLED DAT COMP ETED STREET NIIIIIIIW ''INE HOME: "J PHI NE WO K: 1 � U TOWN `v e NTACT PERSON: DIRECTION f - ! 0 0 ° 1 JOB WORK ORDER 1 0 AMOUNT 7°e- l Ok a I HAVE READ AND UNDERSTAND THE CHARGES LISTED ABOVE. SIGNED f»:* BILL AMOUNT i AUTHORIZED SIGNATURE SUB TOTAL' TERMS: A Late payment charge of 2%per mo. TAX°/o shall be payable upon all unpaid balances over 30 days. Collection Costs,including reasonable Attorney Fees,will be charged to the Customer. There will be a$50.00 charge for all returned checks. TOTAL Method of Payment O CASH O CREDIT CARD O CHECK Please charge to my: O MasterCard O Visa Card No. Exp.Date Signature: nnnwenc+ n n... nines .....0•__ ....--_._____ 4 ..-v . 7 .,' I OWN °rr UE";.' r a • , 0 BUILDING & #011,". / 0 Reviewed B ° :301+Afr ii, ' 1 Date: --.0 ..., o — 1, ' o ______ ._... gri _____ :?.... ' n I \ ----- t , , . , 1 e5 T o • 1)c, u I i'c , : -ci ,.. . , c----- ., 1 .•,_ --„, : : .._..i ''sji d r IV C W'"1 0 RUCINSKI HALL ARCHITECTURE v°`' , Ronald Richard Rucinski � , Ethan Peter Hall ca C 627 Maple Avenue °" ti ¢ . Saratoga Springs NY 12866 P" Voice 518 5801905 Fax 518 584 5012 Email ronrIgnycapsr.com ephall©nycap.rr.com Defry Estate—804 Bay Road 12 February, 2010 John O'Brien—Town of Queensbury—Building Department 742 Bay Road Queensbury NY 12804 Re: Replacement of sewage disposal system—IBS Septic& Drain John, At the above referenced project location we performed a test pit and perc test on this date which was witnessed by Clark Wilkinson of Paragon Engineering. The soils were found to be well drained loamy sand to a depth of 90". Color varied from light brown/red to a light brown/grey with traces of loam from the topsoil level to the bottom of the test pit. Percolation rate stabilized at 1 min 45 sec.—we will use a 5 min perc rate for the new system design application rate. The existing residence is a three bedroom single family residence with water saving fixtures. A new 1,000 gal septic tank will be installed in the back of the residence(minimum separation from the house to the new tank will be 10'-0")and a new tile field consisting of 3--50'4' laterals will be installed in the back yard of the residence(minimum separation from the house to the new tank will be 20'-0") The field will actually be installed at approximately 80'-0"from the building foundation to provide a minimum 100'separation from the existing well in the front yard of the building. The residence is connected to the municipal water system and the existing well is used only for irrigation purposes, however the 100' separation will be maintained as a matter of compliance with the DOR standards. Calculation for tile field size: 3 bedroom residence with water saving fixtures at 110 gaUday=330 gal/day of sewage produced. Percolation rate of the soil is 1-5 min soil= 1.2 gal/day/sq. ft. or 275 sq. ft. of tile field required at 2'wide lateral= 3—50'laterals or 300 sq. ft. of tile field provided. The installer will be IBS, , ,&Drain and we will be providing the as-build drawing for the property. If there are.any:sews please call to discuss. R n ,40, d., ,s / - - . ---- 'iii.-1 ,tom ' an Peter Ha \- = . _ ,` ., Architect a a . Cc: Ivan Bell—UBS &"brain Y:11van Bell Septic(IBS)tDefry septic systenttl etter 12 Feb 2010.doc 1 2° ° 9 40 411111401P401,,,,,_ 1 41111"4104* i 46.44, i/ 3944e AO I .1 i ,Kiti 4„ i .4t. 77 i Alp/ 41IF 3.17 NO 37 IP' 4.44 l* 9 *44 * 45 A'' y if k 0 v 0 224 AP) 36 1 09 A 0 , --K i ,-. ..... 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