2010-257 .411aki TOWN OFQ UEENSBURY
Bay Road
742 Ba Queensbury,,Qu NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20100257 Date Issued: Thursday, June 24, 2010
This is to certify that work requested to be done as shown by Permit Number P20100257
has been completed.
Tax Map Number. 523400-296-009-0002-033-000-0000
Location: 5 CEDARWOOD Dr
Owner. CHRISTOPHER & AMY CLANCY
Applicant CHRISTOPHER & AMY CLANCY
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 ther-D4 , \
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&Code Enforcement
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: P20100257 Application Number. A20100257
Tax Map No: 523400-296-009-0002-033-000-0000
Permission is hereby granted to: CHRISTOPHER&AMY CLANCY
For property located at: 5 CEDARWOOD 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: CHRISTOPHER&AMY CLANCY
5 CEDARWOOD Dr Septic Alteration Residential
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
QUEENSBURY SEWER
JAY SWEET
Plans &Specifications
2010-257
septic alteration residential
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, May 27, 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 Town bu Th , May 27,2010
SIGNED BY air /V
for the Town of Queensbury.
Director of Building&Code Enforcement
_ ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,_
7-2 OFFICE USE ONLY "" .' t -
TAX MAP NO. ��� ; +vo,'l
PERMIT NO. ,53ERMIT � , 1:-,.
:, , °�..'.
APPROVALS: ZONING ' ";
TOWN CLERK •
APPLICATION FOR SEPTIC DISPOSAL SYSTE ' `�
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. P
PERMIT. ' w APPLICATION IS SUBJECT TO REVIEW BEF .' r• 1 t
OWNER: " ORE ISSIIAIVC�dRj�yp ....
n C_ INSTALLER: a
._., 1, ,..c-7.,,.. .
ADDRESS: C
ADDRESS: .ice 3 _
PHONE NOS.
PHONE NOS. C - —
LOCATION OF INSTALLATION: r ri,Ju /
,k_
YEAR BUILT N0.OF
BEDROOMS X COMPUTATION= RESIDENCE INFORMATION:
1980 or older = TOTAL DAILY FLOW
X 150 gallon per bedroom GARBAGE GRIND
1881 1991 X 130 gallon per bedroom .0.--,. INSTALLED?_
SPA OR HOT
1992-present X 110 gallon per bedroom =
TU
PARCEL INFORMATION: INSTALLED? _
✓ TOPOGRAPHY:
Flat rolling_ Steep slope %Slope
✓ SOIL NATURE: /o
Sand___Z__ Loam
,/ GROUNDWATER: Clay Other
At what depth?
✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth?_____ _
✓ DOMESTIC WATER SUPLY:
Municipal_ Well (If well: Water supply from any septic
✓ PERCOLATION TEST: Rate is system absorption is ft.)
� S
per minute per inch.
(Test to be completed by a licensed professional engineer or architect.
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal )
gsystems must be designed by
a licensed professional engineer or architect(unless installed in a PlanningBoard
TANK SIZE: f�� GALLON (MIN. SIZE IS 1,000 GAL.)Add 250approved subdivision).
each garbage grinder, spa or whirlpool tub. gallons to the size of the septic tank for
SYSTEM TYPE:
❑ ABSORPTION FIELD (WITH NO. 2 STONE) Total length
❑ SEEPAGE PIT(S) (WITH NO. 3 STONE How ft Each trench X
many?
❑ ALTERNATIVE SYSTEM BSize?
Bed or other type? a 6
0 HOLDING TANK SYSTEM
Total required capacity?
Tank size? Number of tanks?
il NOTE: ALARM SYSTEM AND
li ,,,,,, • ASSOCIATED ELECTRICAL WOR
•K••
MUST BE INSPECTED BY A TOWN
ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
For your protection, please note that pursuant to Section 136-29 of the Code of the
.......................... ....
1,.. .,.::____ Town of Queenshi,ry ten„
permit or approval granted which is based upon or is nranrcrl ;.
failure to make .,.,,.__:_, ,
Septic Inspection Report
Office No. (518) 761-8256 Date In• : io :•=0. ,� c ' ed:
Queensbury Building&Code Enforcement Arrive: .= , part: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's I A`
NAME: C l A t►�G` PE-1 IT NO.: _
LOCATION: I PECT ON:
RECHECK:
Comments and/or diagram
Soil T oam/Cla
T •- of Water, Well Water
Water ine separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' +/ - Y N N/A
[150'to well required if NO] 4$ eintr
Absorption Field: Total length ft.
p 9
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: _Y N
End Cap Y N
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
Separation of Pits _ ft.
Conforms as per P • - -n f_N
Engineer Report a As-B ' V Y N
ETU Maintenanc- -- -ct _Y_ N
provided
Location of System on Property:
Front ar Left Side Right Side Middle Front Middle Rear
stem Use S us:
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 ReporliO3 29 10.doc
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Septic Inspection Report
Office No. (518) 761-8256 Date Ins•- on r-•u- :•: .�
Queensbury Building&Code Enforcement Arrive: 6`..�: .�'1i / -part: t►i •�� =
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia s:
NAME: CTC= t\1C'1 'E' IT NO.:
LOCATION: ( S)F 4 NV ` EQ;F I .PECT ON: 5—zscs-l(T
RECHECK:
Comments and/or diagram
Soil Ty•-• oam/Clay
Type of Water: Muniapal Well Water
Watery •.ration 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 ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
LEAu1 PO) soinguatftretwielf
Size: 7:67-7(-7.2-1
Stone Size:
Piping Size Type
Building to tank 4, 14
Tank to Distribution Box 1;t „,"
'�
Distribution Box to Field/ Pit vt
Opening Sealed: N
End CapN
Inlet/Outlet Pipes&Baffles / N
Manholes 12"or less below grade ✓ Y_
[provide extension collar if Yes] Y
Location/ Separations p� t
Foundation to tank ____ _.ft. �t
Foundation to absorption t ft. ,J
67
Separation of Pits ��
Conforms as per Plo an Y "jd.
Engineer Report an -Built Y 17N4,-
ETU Maintenance Y •,
provided
Location of System on Property:
Front Re. Left Side Right Side Middle Front Middle Rear
-m 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 Report..03 29 10.doc
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury,NY 12804
Phone-518-745-4400 Fax -518-792-8511
May\19, 2010
Project# 49313
Mr. Jay Sweet
Queensbury Sewer
f j
P.O. Box 4283
17)
Queensbury,NY 12804 •
•Re: Proposed Replacement Septic System € _
Chris Clancy Residence— 5 Cedarwood Drive, Queensbury,NY
Dear Jay:
At your request we have reviewed your proposed replacement septic system design at the site of
the existing 4 bedroom house of Chris Clancy at 5 Cedarwood 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 440 GPD and a percolation rate of
1 to 5 minutes, you will need 464 square feet of absorptive area. We recommend using a 20 ft
wide by 24 ft long absorption bed with 4 — 19 foot long laterals, which will provide 480 sf of
absorptive area. The absorption bed should be constructed with a new distribution box, 4 inch
diameter perforated pipe and stone.
Please call me if you have any questions.
Sincerely,
Thomas W. Nace, PE
Cc: Dave Hatin, Town of Queensbury
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection r.• r eiv
Queensbury Building &Code Enforcement Arrive: 1 •L P-part: am
742 Bay Rd., Queensbury, NY 12804 I spector's Initials - .
NAME: �'� ��EKT P • IT NO.: -
LOCATION: \ C,Eu A DGL21(ISPECT ON: ,7 Q
RECHECK:
Comments and/or diagram
Soil Ty•;Ole.m/Clay
Type of Water: :,1A A - I Water
Wate •.ration distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' +/ - Y N N/A
[150'to well required if NO] 1---b
Absorption Field: Total length ft. M 1-') Zjf '
Length of each trench ft.
Depth of trenches ft. V�
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type b \ \
Building to tank
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: _Y N
End Cap Y_•_N
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.
Conforms as per Plot Plan —Y_N
Engineer Report and As-Built Y^N
ETU Maintenance Contract _Y_N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
em Use Stat •:
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 Repor03 29 10.doc