SEP-0296-2021 SEPTIC DISPOSAL PERMIT APPLICATION Office Use Only
s 742 Bay Road,Queensbury,NY 12804
Tocni at'2icensfinrp P:518-761-8256 www.gueehsbury.net Permit#: c�6l ®Z�j�p
Tax Map ID#: 302.6-1-36 Permit Fee: $ �� J : Invoice#:
Project Location: 6 BIRCH LANE Septic Variance? Yes No
Primary Owner(s) WALTER BROWN
Mailing Address 6 BIRCH LANE QUEENSBURY,NY 12804
Phone & Email
Installer/Builder SANITARY SEWER SERVICE E
Mailing Address LUZERNE ROAD,QUEENSBURY NY
Phone & Email 518-796-3760 APR 2 9 2021
Engineer CENTER PROJECT SERVICES
Mailing Address 73 SHERIDAN STREET,GLENS FALLS,NY BUILDING&CODES
Phone & Email " 518-796-2515 TCENTER36@)YAHOO.Cbff
Contact Person for Building&Code Compliance: GEORGE DRELLOS Phone: 518-796-3760
RESIDENCE INFORMATION:
Year Built Gallons #of bedrooms X gallons per =total daily flow
per day bedroom Garbage Grinder Yes No
1980 or older 150 Installed? (circle one)
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 110 2 1110 220 1
Installed? (circle one)
PARCEL INFORMATION:
Topography ✓ Flat Rolling Steep Slope %Slope
Soil Nature ✓ Sand Loam Clay Other
Groundwater At what depth?
Bedrock/Impervious material At what depth?
Domestic Water Suppl _Municipal _Well (if well, water supply from any septic system absorption is_ft.)
Percolation Test Rate: 1-5 per minute per inch (test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION:
Tank size 1,000 gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or spa/hot tub
System Absorption field with#2 stone Total length ft.; Each Trench ft.
Seepage Pit with#3 stone How many: ; Size:
Alternative System Bed or other type: 20x20 pipe-in-stone absorption bed
Holding Tank System Total required capacity? :tank size ;#of tanks
NOTES: 1.Alarm system &associated electrical work must be inspected by a Town approved electrical inspection
agency; 2.We will no longer allow systems to be covered until such time as an as-built plan is received and approved.
The installed system must match the septic layout on file—no exceptions.
Declaration:Any permit or approval granted which is based upon or is granted in reliance upon any material
representation or failure to make a material fact or circumstance known by or on behalf of an applicant,shall be void. I
have read the regulations and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage
Disposal Ordinance.
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PRINT NAME: DATE:
SIGNATURE:
Town of Queensbury Building&Code Enforcement Revised March 2018
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Based o our limited examination,compliance.
with our comments shall not be construed as
indicating the plans and spe ifications are in
full compliance with the Building Codes of yy
New York State L- COPY
SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone- 518-796-2515
April 13,2021
Project# 334
George Drellos
Sanitary Sewer Service
Queensbury,NY 12804
Re: Proposed Replacement Septic
6 Birch Lane Queensbury,NY
Dear George:At your request, we have reviewed your proposed replacement septic system design of the
existing 2-bedroom house at 6 Birch Lane 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 220 GPD and a percolation rate of
1 to 5 minutes, you will need a minimum of 245 sf of absorption area. We recommend using 20
ft wide by 20 ft long absorption bed with 4 — 15 ft long laterals. The absorption system can be
constructed with the existing 1,000-gallon septic tank, new distribution box, and 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,
Thomas R: Center Jr, P.E.
E E E
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APR 2 9 2021
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TOWN OF QUEENSBURY
BUILDING&CODES