SEP-000663-2017 lel ` `�� `,P C,(,-3 -,�o (7
Town of Queensbury- Building&Codes Enfdreement Office-742 Bay Road• Queensbury,NY 12804
DEEP HOLE/PERC TEST
Request for Town Engineer Review
Property Owner: b t Goa N ov-- Phone:
Property Owner's c" �U 0_
Address:
Location of Test: % �,otA Tax ID#:
"Applicant's Engineer: 1�N��j p� �1 Phone: 4510 1 -(JGCo�
Applicant's Agent: � �—���/(� Phone:
Additional Notes: se, 7'm Ise
I. Reason for Request? New Septic System Replacement Septic System Failed Septic System
Subdivision 17 Site Plan Review I .<-a ...
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2.Are Wetlands present? � YES � NO F U Ike WN
OCT 23 20
*Note: Applicant is re uired to engage an engineer for design and testin s stem. The ow
0
Engineer's responsibility is to witness system testing only. TOWN OF QUEENSBURY
OOMMUNITY DEVELOPMENT
PLOT PLAN: Plot plan, to scale, to be submitted with application
FEE SCHEDULE:
a. $ 200 Flat Fee Date Paid: 10 �'J /7
Check No.:
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 of Qu ensbury Local Law 136-14D.
SIGNATURE OF APPLICAN : Date: 6� GYT_ZDl�j
SIGNATURE OF AGEN . Date: j�z -Zor7
V.
Original (B&C File) Canary (Planning) Pink(Applicant) Gold (Town Clerk)
THE
North Country Office
Cha est 375 Bay Road, Queensbury, NY 12804
_ P: (518) 812-0513 F: (518) 812-2205
COMPAN I ES www.chazencompanies.com
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Engineers Hudson Valley Office (845)454-3980
Environmental Professionals Capital District Office (518)273-0055
Land Surveyors
Landscape Architects
Planners
October 26, 2017 ��-
Dave Hatin, Director, Building and Codes D LS v l5 F0 W IE
Town of Queensbury
742 Bay Road OCT 2 6 2017
Queensbury, New York 12804
TOWN OF QUEENS13URY
Re: Soil Testing Verification BUILDING& CODES
3 Spruce Court
Town of Queensbury, Warren County NY
91700.41
Dear Mr. Hatin:
As requested, Chazen has witnessed onsite soil testing for the above referenced location on October 26,
2017.The purpose of this testing was to investigate subsurface soils conditions for the relocation of the
existing functioning septic system with a new system.The testing was performed by Ethan Hall of
Rucinski Hall Architecture. One soil test pit was performed in the general area of the proposed septic
field.
TP1
0"-11" Dark Brown Organic Topsoil
11"-26" Medium brown/red sand
26"-49" Light brown sand
49"-64" Light brown sand
Mottling encountered at 54"
Roots encountered at 48"
No groundwater encountered
If you have any questions or require additional information, please do not hesitate to call me at(518)
824-1926.
Sincerely,
Sean M. Doty, P.E., LEED AP, CPMSM
Principal Manager,
Municipal Engineering Services
Chazen Engineering, Land Surveying&Landscape Architecture Co., P.C.
Chazen Environmental Services, Inc.
The Chazen Companies, Inc.