BOTH-062-2017 Town of Queensbury• Building&Codes Enforcement Office■742 Bay Road■ Queensbury,NY 12804
refDEEP HOLE/PERC TEST � - tQ2_ ��
I5a
Request for Town Engineer Review
Property Owner: C24A? L l: i.i Phone: J C-j5
Property Owner's
Address: to
Location of Test: 1,0 f } C Crle PO/9 Tax ID#:
*Applicant's Engineer: V I(_, i('H /N3 1,�[(),✓,,J ,f�iedo6 Phone: 797 -0&)7
Applicant's Agent: / Phone:
Additional Notes:
1. Reason for Request? New Septic System 411 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 SCHEDULE:
a. $200 Flat Fee Date Paid:
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 Queensbury Local Law 136-14D.
SIGNATURE OF APPLICANT: Date: -, /
SIGNATURE OF AGENT: Date: y '1 j
Original (B&C File) Canary(Planning) Pink(Applicant) Gold (Town Clerk)
WASTEWATER SYSTEM INSTALLATION NOTES
Lands N/F Of CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING AND IN ACCORDANCE WITH THE N.Y.S. DEPARTMENT OF HEALTH INDIVIDUAL HOUSEHOLD
Francis&Joyce Donohue
y , SYSTEMS AND ASTM F481 INSTALLATION OF THERMOPLASTIC PIPE AND CORRUGATED TUBING IN SEPTIC TANK LEACH FIELDS
14691275 -
`�° SYSTEM TO BE INSTALLED IN ACCORDANCE WITH PRODUCT DESIGN AND INSTALLATION MANUAL, STATE AND LOCAL REGULATIONS FOR
10 PRODUCT INFORMATION OR THE' NEAREST DEALER CONTACT PRESBY ENVIRONMENTAL, INC. 143 AIRPORT ROAD, W4I7EFIELD, NH 03598, PHONE ,
ASPHALT DRI1/E TO BE REMOVED AS NECESSARY 1-800-473-5298 WWW.PRESBYE'CO.COM
..
TO ALLOW INSTALLATION OF WASTEWATER SYSTEM.
REPLACE ASPHALT UPON INSTALLATION COMPLETION. AFTER EXCAVATION OF TRENCHES TO THE DEPTHS REQUIRED, THE WALLS AND FLOOR OF EACH TRENCH SHALL BE CLEANED AND RAKED IN ORDER ,
AREAS OF ABSORPTION FIELD NOT UNDER ASPHALT
TO LOOSEN SMEARED SECTIONS OF TRENCH.
DRIVE TO
BE COVERED WITH 4 MIN.OF TOPSOIL.
SEED d,ESTABLISH TURF. �^i I
PLACEMENT OF PRESBY SYSTEM SAND, PRESBY ADVANCED ENV1R0-SEP71CO PIPE AND STABILIZATION ROAD FABRIC SHALL BE AS SHOWN AND
CARE SHALL BE EXERCISED TO AVOID INCLUSION OF FINE GRAINED SOILS A A �
s AND WASTE MATERIAL IN THE PIPE. "
WELL TO 8E DECOMMISSIONED r._.
CIRS IN ACCORDANCE WITH N.Y.S. ,
DEPARTMENT OF HEALTH MINIMUM OF 6- OF SYSTEM SAND, WITH LESS THAN 7% PASSING A if 200 SIEVE REQUIRED AROUND CIRCUMFERENCE OF ADVANCED ENVIRO-SEPTIC
PROCEDURES. PIPES. (SEE DESIGN AND INSTALLATION MANUAL FOR COMPLETE SAND AND FILL SPECIFICATIONS)
�m s
Concrete
INSTALLER TO PROVIDE SIEVE ANALYSIS FOR PRESBY SYSTEM SAND TO DESIGN ENGINEER PRIOR TO TRANSPORTING SAND TO THE S TE �.
Reta ,n Nail Found
mg
S.I I/2 IRE r
THE PIPE SHOULD BE LAID AT THE GRADES INDICATED MAINTAINING STRAIGHT CONTINUOUS w x.
CIRF Ck\ OU GRADES WITHOUT SAGS, HUMPS, SEPARATED JOINTS, OR k,
OTHER UNSUITABLE CONDITIONS
.i Ca RY
\ P.PRESBYABSORPTIO , r
DISP
OSAL IOSAL FIELDS SHALL BE GRADED TO SHED RAINFALL AND DIVERT SURFACE RUNOFF AWAY FROM THE DISPOSAL FIELD.
TRENCHES,3 TRENCHES*26 LF
o SIO EP f -I
EACH,2 AES PIPES P P 0 25 LF PER I HAS BEEN INSTALLED.
ly !
DO NOT USE HEAVY EQUIPMENT WITHIN THE ABSORP11bN AREA AFTER PIPING
� ENCH,150 LF AES PIPE TOTAL I I
Concrete
..
Reta,mng fl E PROP, DIST.BOX I I 774IS SYSTEM IS DESIGNED FOR WATER CONSERVING FIXTURES AND IS NOT DESIGNED TO ACCOMODATE EXTREME WATER USE OR EXTREME
wau PROP.4"BY VENT PIPEDI I ORGANIC
-FA
SS NT LOADING DEVICES SUCH AS JACJZZI TYPE SPAS OR GARBAGE GRINDERS. "
v
,..,...�.... : ;; .. ::;. CKTO PUMP STATION ! —'� e�, .. �, , � •
_._.-
LOCATION MAP srrE Loca ►
.- PROP.FORCEMAIN J ROOF, FOOTING, GARAGE, CELLAR AND SURFACE WATER DRAINAGE MUST BE EXCLUDED FROM THE WASTFWATER SYSTEM. non
APPROX.LOCATION SYSTEM MATERIAL SPECIFICATIONS
CIRF
EXISTING W/W SYSTEM.
Lands N/F Of C EFFLUENT SEWER PIPE f,
<; DECOMMISSION 8e
'W REMOVE AS NECESSARY. " r
Francs&Joyce Donohue ; ; _ ly,"`� t ;;; PIPING TO BE 4 SCHEDULE 40 PVC. INSTALL WITH� Tl•I 1/8 PER FOOT MINIMUM SLOPE:
g „
604/871 FORCEMAIN
" PRESBY SYSTEM SAND GRADATION m
� g
PIPING TO BE 1-1 2 SDR-9 HUPE. a _ K v � (, PROP.500 GALLON / A � v
Concrete m HOUSE SEWER PIPE
Retamm m` PUMP STATION "
g ' '� o SIEVE PERCENT PASSING u *` ' X
/ 3, PIPING TO BE 4 SCHEDULE 40 PVC. INSTALL WITH 1/4 PER FOOT MINIMUM SLOPE.
Walls PROP.EFFLUENT STABILIZATION FABRIC 3 8" 9.5-mm �t ' s` ®
O SEWER STABILIZATION FABRIC TO BE WOVEN GE07EX77LE WITH POLYPROPYLENE YARNS,
TENCATE M/RAFI HP370 OR EQUIVALENT. No. 4 (4.75-mm) 95-100%
NO WELL ON THIS /orch \ PROP.11000
„4
PRESBY SYSTEM SAND
PARCEL.WATER - f No. 8 (2.36-mm) 80-100%
O PROP. GALLON PRESBY SYSTEM SA T " x
SUPPLY FROM LAKE 4.s ' .._,,,,. ,,: ND 0 8E ASTM C33 WASHED CONCRETE SAND. SEE SYSTEM. '' � . ..
SEPTIC " No. 16 (1.18-mm) 50-85%
a
r HOUSE a, SAND GRADATION FOR SPECIFlC,A110NS �
A �� EWER TANK TOPSOIL No. 30 (600-tun) 25-60%
d nerx i ,> r '
No� s O i/2"IPF
\ PLACE 4 MINIMUM TOPSOIL OVER ENTIRE BACKFILL AREA. SEED MULCH ANDa
us _•ram'.
\_ No. 50 (300-tun) 5-30% � ,
e 2St ias POrcn ESTABLISH TURF. � nk: ep
3 0 0
No. 100 (150-Fun) 0-10% lit
r F,
3 Ousee
3 WASTEWATER SYSTEM DESIGN _ D-3% (MUST BE OBTAINED Y
SIG No. 200 (75 Fun) Y WASHING)
r 3-BEDROOM Bs
BED OOM RESIDENCE
SYSTEM SAND TO BE ASTM CM WASHED CONCRETE ?�
\� WATER SAVING FIXTURES CON ETE SAND 4 aaa,s.
Area +Oy� 0.66 Off Line e
10 040± S . ft. w' (1.6 GPF MAX. FLUSH, 3.0 GPM MAX. FAUCETS) INSTALLER TO PROVIDE SIEVE ANALYSIS FOR PRESBY SYSTEM .
' G SAND TO DESIGN ENGINEER PRIOR TO TRANSPORTING SAND
0.23± acres c+\� DESIGN FLOW - 110 GPD/BEDROOM
t Adfomer's SYSTEM DESIGN FLOW - 330 GPD TO THE GI
House
Axle Found
,2.9 :'+ EXISTING SEPTIC TANK - EXISTING 1,000 GALLON PRECAST CONCRETE TO
r.
NEIGHBORING BE PUMPED, INSPECTED, & REUSED IF f � `
2 ✓' 23.9
WELL* SUITABLE IN, BAFFLES x; y ..
D nd
WASTEWATER
S EW S ATERSYSTEM � <SETBACK SCHEDULE
PUMP ST - :.=F..,
A 1lON PROPOSED 500 GALLON PRECAST CONCRETE
CIRF oeck W ,z .
o O a
,..
N 2ABSORPTION
3 24'W 1.12
ACH FIELD PRESBY® TRENCHES
PROPERTY LINE H
OUSE GLEN LAKE WELL
From Corner
o co G + fire Lands N/F Of DESIGN PERCOLATION RATE = 1-5 MIN/IN 1
z„ a s m e
SEPTIC TANK 10 10 50 50
NEIGHBORHOOD MAP
.P?tp i�1 O pit , 7'0 Michael&Holly Danbury 4' WDE TRENCH LENGTH REQUIRED = 60 LF SITE LOCATION
O 1081/47 (PER PRESBY INSTALLATION MANUAL) ABSORPTION FIELD 10, 20' 100, 100,
PROVIDE 3 TRENCHES ® 26 LF
s
Top I/2"IRE �nt,�. ton ds 5tonWasonry walls
3 ± o wak, � au 78 LF TOTAL TO BE PROVIDED
no."
Dc e wood pek TWO ROWS OF AES PIPE LATERALS REQUIRED PER TRENCH
LENGTH OF AES PROVIDED = 6 ROWS ® 25 LF
_ 150 LF TOTAL TO BE PROVIDEDTie Line ' e POTABLE WATER SUPPLY IS TO BE ON-SITE WELL
Glen Lake Corner SITE PLAN.
Stone/Vasonry $/�0 - MAINTAIN 50' MINIMUM SEPARATION BETWEEN SEPTIC
69'± Along Shore wall SCALE. 1"--20' E TANK AND WELL
- MAINTAIN 100' MINIMUM SEPARATION BETWEEN
,..m
GRAPHIC St/�,,,f�►/�LE 3/4"IPF O ABSORPTION FIELD AND WELL
10
0 5 0 20 ao VARIANCE SUMMARY --
( IN FEET ) -ABSORPTION FIELD SETBACK TO NORTH PROPERTY LINE
FEB 2 2 2017 u
10'REQUIRED
4.6'PROPOSED TC74'�N 617 GUEEI SUURY
5.4'OF RELIEF REQUESTED BUILDING &CODES
-ABSORPTION FIELD SETBACK TO EAST PROPERTY LINE 1+
10'REQUIRED C)
6.7'PROPOSED N
3.3'OF RELIEF REQUESTED T A'T o
-FORCEMAIN SET&4CK TO PROPERTY LINE CS PR 1' 0
10'REQUIRED S Y/ oG6.1'PROPOSED ROGREONE ,r
3.8'OF RELIEF REQUESTED p ION RE ajON o
FAR STR m o 0 L
-DISTRIBU770N BOX SETBACK TO PROPERTY LINE Nca
10'REQUIRED L
5.1'PROPOSED v N M ,FOP,
'
4.8'OF RELIEF REQUESTED NOT VL v0 O
oV, E _
a)
of 0 _
TAX MAP # 289.10-1-32 N m o
ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED
PROFESSIONAL ENGINEER IS A VIOLATION of NYS EDUCATION LAW.
0 ISSUED FOR SEPTIC VARIANCE 2116117
No. Revisions Date
MAP REFERENCE WASTEWATER SYSTEM PLAN •
BASE SURVEY INFORMATION FROM "MAP OF A
SURVEY MADE FOR MARIO FASULO," S17VATED IN preparead for
THE Dig Safely. STATEOM OF OF NEW YORK.ENSBURY, WARREN DATED SEPTEMBER 22,02016.' Carol L Bodette
PREPARED BY. 10 Hemlock Road - Glen Lake
New ,York •
`d►-n s Call Galore YOU Dig D u s e Town of Queensbury, Warren County, New York
■Wait The Required Time Drawn: JRS Checked: GTH Scole: NOTED Dote: 11/29/16
0 Dig VM
■Confirm Utility Re�pome &
Ill Respect The Marks
Cam Steves 169 Haviland Road
800.962.7 9G2 Land Surveyors (518) 7450307 Phone 291083-01-S1
n y NY �
1u1MWa��tilfA♦M1yOrIC.00m 169 Haviland Road Queensbury, New York 12804 Hutchins En meerm
(518) 792-8474 New York Lic. No. 50135 i+ �7 (518) 745-0308 Fox