2010-416 ..441111‘Lk TOWN OFQ UEENSBURY
742 Ba Road Queensbury,NY 12804-5902 (518) 761-8201
Y ,
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20100416 Date Issued: Wednesday, September 08, 2010
This is to certify that work requested to be done as shown by Permit Number P20100416
has been completed.
Tax Map Number. 523400-301-008-0002-023-000-0000
Location: 29 COTTAGE HILL Rd
Owner. KATHLEEN JANE HUGHES
Applicant KATHLEEN JANE HUGHES
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,
Variance, or other issues and conditions as a result of approvals by the Director of Building& a'de E*' rcement
Planning Board or Zoning Board of Appeals.
��` TOWN OF QUEENSBURY
`p 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100416 Application Number. A20100416
Tax Map No: 523400-301-008-0002-023-000-0000
Permission is hereby granted to: KATHLEEN JANE HUGHES
For property located at: 29 COTTAGE HILL 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: KATHLEEN JANE HUGHES
PO BOX 4228 Septic Alteration Residential
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
2010-416
septic alteration residential
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday,August 23, 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 of eens o . ugust 23,2010
4
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
Community Development Office
ow
.r, °' Town of Queensbury • 742 Bay Road • Queensbury, New York •12804
Office Use Only,
TAX MAP NO.4-7f /9-/-3Z PERMIT1
NO. 0--44., � PERMIT FEE
2-
APPROVALS: ZONING __ __ TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT: A PERMIT MUST BE OBTAINED
BEFORE WORK`BEGINS. APPLICATION/IS SUBJECT TO REVIEW FORE ISSUANCE 0 A VALID PERMIT.
OWNER: KAT 4, .2_ of 1,,1 14(1,('j.QI INSTALLER: Er 1 i_ —A.-t1
ADDRESS: _032. `� le_ ie'I/ le() ADDRESS:_ C a„ ' C.i r 4 F
PHONE NOS. 7 9)-- ,c-CLJ PHONE NOS. 7 2_6, - b r S-)
LOCATION OF INSTALLATION:2-9 tl 017217(.._ /1 Ler') / gyp 7/Z-5k3
NO.OF COMPUTATION Er
RESIDENCE INFORMATION:
YEAR BUILT BEDROOMS X (Gallons per bedroom) = TOTAL DAILY FLOW
GARBAGE GRINDER
1980 or older X 150 = INSTALLED?
1981 -1991 X 130 = SPA OR HOT TUB t
��
1992-present X 110 = INSTALLED? 1""'
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLI .."G STEEP SLOPE____ %SLOPE
✓ SOIL NATURE: SAND LOAMCLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT.pEPTH?
✓ 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 b 04 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
0 SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size?
❑ALTERNATIVE SYSTEM 11'. . .r other type? 2-•0 ' y. / - I c b LA-r u_o C- t'
❑ 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 r-.. .tions with respect to this application and agree to
a.'.- by these . I equirem-nts of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sa ita Sewa D'-..salt l r•• ance. / codes(�ilqueensburv.net
1���� r-! //� VISIT OUR WEBSITE FOR MORE INFORMATION
nature of Person Responsible Date
www.queensburv.net
Septic Inspection Report
Office No. (518) 761-8256 Date Insion r-• -- rec: •: 11 d
Queensbury Building &Code Enforcement Arrive: , t -f'�a • i''epart: i •p• •-
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials , /
NAME: i'iV U k e S f S'�°v i �e.cc k'Jj P • IT NO.: /0 ® l 6
LOCATION: -act im H; ( ( iZ. I .PECT ON: 01 ///1
D
RECHECK:
Comments and/or diagram
Soil Ty• �� oam/ Clay
Type of Water: unicipal -II Water
Wate ine se•- - on distance ft.
- •-ration distance ft.
Other wells: _ft.
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches
Size of Stone ?i
Seepage Pits: Number (�
Size: 7X x C6?
Stone Size: ?�
Piping Size Type
Building to tank `t 1L.34L,'0
Tank to Distribution Box `r
Distribution Box to Field/ Pit rr i7VT.Ij Ef'6 1-1 r °Ce
Opening Sealed: N
End Cap N
Inlet/Outlet Pipes&Baffles Y_N
Location/ Separations
• Foundation to tank \V ft.
Foundation to absorption
Separation of Pits -- / ft.
Conforms as per Plot Plan \/Y N
Engineer Report and As-Built Y N
Location of System on Property:
Front Re-r Left Side Right Side Middl Front IA' le Rear
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
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CENTER PROJECT
SERVICES
73 Sheridan Street, Glens Falls, NY 12801
Phone-518-796-2515
August 18, 2010
Project# 129
Dan Drellos
Saniatry Sewer Services
Luzeme Road
Queensbury,NY 12804
Re: Proposed Replacement Septic
Kathleen Hughes Residence
Dear Dan:
At your request we have reviewed your proposed replacement septic system design at the site of
the existing 3 bedroom house of Kathleen Hughes at 29 Cottage Hill Road 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 348 square feet of absorptive area. We recommend using a 20 ft
wide by 20 ft long absorption bed with 4 — 15 foot long laterals, which will provide 400 sf of
absorptive area. The absorption bed should be constructed with a 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,
i
Thomas R. Center Jr, P.E.
Cc w/encl.: Dan Drellos