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SEP-0037-2021 Community Development p nt Office Town of Queensbury - 742 Bay Road ■ Queensbury, New York ■12804 Office Use si- Iq 5&P- 00��_ 2p2 � ,'. 85— r�vo�csV:3�55 TAX MAP NO. PERMIT NO. PERMIT FEE APPROVALS: ZONING TOWN CLERK APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT. A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: on Er"SSIS"A INSTALLER: t��[irA-'? C ADDRESS: N+•I l ADDRESS: J^� \ PHONE NOS. y PHONE NOS. E1 LOCATION OF INSTALLATION:_ � No " L m ne. RESIDENCE INFORMATION: YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW BEDROOMS Gallons er bedroom GARBAGE GRIND R 1980 or older X 150 - INSTALLED?N0 1981 -1991 X 130 = SPA OR HOT TUB 1992-present X 110 = ?® INSTALLED? II�Q PARCEL INFORMATION: Q E ✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE D ✓ SOIL NATURE: SAND LOAM CLAY TfERJAU 9 2021 ✓ GROUNDWATER: AT WHAT DEPTH? ✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? �b 'I" TOWN OF QUEENSBURY BUILDING&CODES ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL(If well:water supply from any septic system absorption is: 0 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: 2 O GALLON (MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the a eptic tank for each garbage grinder, spa or whirlpool tub. SYSTEM TYPE: Tt"H-rw for QuileA— 14- r >(ABSORPTION FIELD NE) Total length ft. Each trench X ❑SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Size? �� I ❑ALTERNATIVE SYSTEM Bed or other type? ❑ 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 regulations with respect to this application and agree to ab' these and all requirements of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL nita Sewage Disposal Ordinance, / ( codes0gueensburv.net ( �` VISIT OUR WEBSITE FOR MORE INFORMATION Sig ature of Person Responsible Dat www.aaueensburv.net 0�7- Zp2 'OWN OF QUEENSBURY 742 Bay Road, Queensbury, NY. 72804-5902 Septic System Checklist 9- Plan to scale t_�Received Deep hole pert test results from engineer/Architect if applicable(Town Approved En ineers and Arch tects)(Jone 30 to April 15 ToWn Engi Eger for unapproved Engineers and Architects) ' All wells on property and adjacent properties shown I P"[Water line shown Municipal or well 10'separation to any part of system dh Setback to property lines show 10'or more for any part of system KSeptic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10'from;any r' waterline Nk Se.ptic tank to foundation crawl space/slab on grade;grade in crawl space must be above top of septic tank for 0',Separation required (field verification required) AS Septic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage grinder each XLeech Field 20'from foundation 100'from any well 10'from water line Seepage pit 150'from well 50'from septic tank �!IkSeepage Pits 3-times diameter apart Septic tank and pump stations over 30 gallons 50'from watercourse or wetland distance from bottom of trench or system 24"to bedrock or mottling 36"within 1000'of lake george fv Leech field 100'from watercourse or wetland Toe of mound or bottom of retaining wall 10'from property line.100'from well 20'from Foundation xProvide Engineer/Architect stamp for bed or design systems &�Departrnent of Health Approval for all mobile home park new systems (Flood Plain requirements JQ- 2' above established flood elevation to bottom of system f5 All tanks anchored or 21 above-flood elevation ".Rome of Natural Beauty ... A Good Place to Live" KEVIN L. HASTINGS, P.E. CONSULTING ENGINEER Mailing Address: 3 Jackson Avenue South Glens Falls,New York 12803 Tel: (518)222-1338 August 4,2021 Mr. Charles Dyer Building Inspector 742 Bay Road Queensbury,New York 12804 Be: Sewage Disposal System -Engineer's Certification 7 Nutley Place Red's LG,LLC Dear Mr.Dyer, The construction of a replacement sewage disposal system for the seasonal multi-unit residential cabins at 7 Nutley Place (TM #239.17-1-15) has been completed. The installation was completed by Lou DeRidder of Morning Star Service, who was also present for the final inspection. As the design professional of record, I certify to the following statements: I. Engineering design drawings with material specifications and details were prepared October 22, 2020, revised February 8, 2021 by Kevin L. Hastings, PE for a total of 7 bedroom maximum(770 gpd)peak daily flow; 2. Design documents were compliant with the Town sanitary health codes, NYS Health Department standards, and NYSDEC design standards for intermediate sized wastewater treatment facilities (2014), as applicable; 3. Field observation of constructed works on various dates: May 3, May 7, May 11, May 12, and May 17, 2021, by Kevin L. Hastings, PE and prior to earth backfill of trenches and structures; 4. Completion of the work appeared to be in substantial conformance with the design engineering documents,with the following exceptions: - field approval was given for the pipeline relocation due to utility conflicts; - final turf stabilization& lawn maintenance to be completed in 2021 by owner. The as-built schematic of the replacement sewage disposal field with location ties to the building corners is attached for your records. The owner is advised to read, comprehend and comply with the "Septic System Operations & Limitations" notes on the as-built drawings, especially notes #15,916, and#17 regarding the recommended system maintenance. If you have any questions or require additional information,please contact me immediately. Sincerely, U-144. Be` ' Kevin L.Hastings,PE �r i i 7 IN%• IN ta 07 A Ftix t�.. y;• � -�" � ''pia ��'• �` l,'1� .i, �, � j-"+w; � ° r_y .� "t r �t,Y,z�±. ,lf..'�". � r G ''•'c .L��33'Jr.. �r`^.- H. ,.7. :.�.�� .:-:`.. + is; #may - r;�3a�a?"•�'. :ero ��� r a4. f- ~ram �`;a: "��, �,✓�kk�'."`t�r� 'Cep ,„• y• _�•'''^rr�:::`,.., rlw� �i - �•,�•1"eft � 7,., '�:•!:+ r 4r �, � �• ram' .a P`: :�'. " . �xt , tFrr _ :� - +ni' — �a»i•b,yf,' �i �':tiR' °'"�`?:-'s'rH,�ij" r� ?� Yr'..{,. y.,. {fib �� '.�E;r ter; '._?'��;' �21*::: j• j ��'�.._`,?+ .?�y.6 � :`���5r'JY• gyp.,«f ri y r } r,r �'tj �--WMRPN m NO iz. • .11 p� IS PR PUF:h,,� t7 Of 14) 7L"il-! 14 IV;5 f tea, i.3a0t{ Y.': 44 VY i "LIBERTY"PRO-VORE 380 SEWAGE GRINDER PUMP "UTOPIA"CONCRETE H-20 TRAFFIC RATED,(2)-1,000 GALLON SEPTIC TANKS IN-SERIES, _ w/HIGH LEVEL ALARM PANEL(TYPICAL-3) TOTAL CAPACITY=2,000 GALLONS, w/EFFLUENT CARTRIDGE FILTER, 't� f _ (PERIODIC MAINTENANCE-SEE NOTES#5&#15) A y SP LAKE GEORGE '� \� L_ At r • ELEV. = 353.0' 5 III o° z J O I I ® -- 4"PVC COVERED VENT z Ill o 3 O a 0 L-- j ©oz 4 1 ss LF( (TYPICAL-3) I 1. o W ALARM a m 0, / 1 i .9 I1 m 0 6 ® GP-a PANEL tdl 8 W a G 6 17. I O aL V4 LF I I III © GP-z® 7 N GP-3 D m0 O2 433/4 GF I 4 a O N U a F so GF III O PANEL® O 6.LF FM FM soGF 3 E�Ay I Q I 2"H.D.P.E.DR-11 FORCE MAIN 5 (ANNUAL MAINTENANCE-SEE NOTES#16&#17) \ I I a OA © = S.E.CORNER FRAMED CABIN N09MCIE4 TO OWNER ® QG = N.E.CORNER FRAMED CABIN I I THIS SEWAGE DISPOSAL SYSTEM HAS BEEN CONSTRUCTED WITH AN EFFLUENT FILTER IN THE SEPTIC TANK. © Q = N.W.CORNER FRAMED CABIN "INFILTRATOR"QUICK-4 GRAVELLESS CHAMBER, YOU MUST CHECK THE FILTER ON A PERIODIC BASIS, H-20 TRAFFIC RATED,TOTAL TRENCH=250 FEET, AND CLEANING AS REQUIRED FOR PROPER FUNCTION. OD QF = S.W.CORNER FRAMED CABIN 40 UNITS,TOTAL INSTALLED CAPACITY=770 GPD (SEE NOTES#5&#15) SEPTIC SYSTEM OPERATIONS & LIMITATIONS NODE ITEM A B C D E F G H w I. The best designed and Installed septic disposal system will eventually fall to function properly wllhout adequate maintenance. ca+ Inedegaat.septic tank..bt......con result In dogging of the tank and sewage back-up into the home and/or sewage overflew 1 SEPTIC TANK - INLET 41.5' 49.8' ___ ___ ___ ___ ___ ___ �m onto the ground surface. The failure to periodically clean a septic tank commonly results to clogging of the sol that surrounds 0 cell the absorption french by system siding sonde not removed by the septic lank 2 90' BEND w 2. This replacement system was intended by design to provide subsurface sewage disposal for a 7 bedroom mull( me residenital 56.1 35.0 --- -- ne toNily. No addition,involving living or sleeping ore?,may be added to the dwelling unit(.)without the approval of the Coda aN Enforcement officer and the system redesign b licensed Prafa..!...I En The seal and ei any drawing 3 VENT RISER 96.9' 86.4' n 9n Yo 9ineer. 9nalure an --- --- --- --- --- --- specifically excludes certillcation for future e,panshn or field replacement. Zi o a. No sump pump,water softener backwash,spas.hot tubs,whirlpools,or condensate wrote shall be drolned into the system. 4 VENT RISER r� 4. Septic tanks shall be inspected annually to determine the scum and sludge accumulation by the homeowner or a qualified 8 7.3' 88.3' ___ ___ ___ ___ ___ __ e ! hauler. The amount o/bind-up noted of each Inspection shall be recorded and maintained In a record book. The septic , tank shall b.pumped whenever the boIt-of the scum layer Is wihin three inches of the bottom of the outlet baffle or to,,or 5 DISTRIBUTION BOX 42.8 38.6' ___ ___ ___ ___ ___ __ �m the top of lh,sludge Is within ten inches of the bottom of the outlet boffie or fee. The pump-out clearance.also apply to any chamber in multi-compartment tanks and to any tanks in series(I.,pump out all tanks/chambers as soon as any tank or 6 GRINDER PUMP UNIT #1 mum clearance). Most tanks should be pumped out every two to five years. 2D.0 14.9 chamber fails the mini mo sur 5. When.spare lank is pumped,the septic tank inlet fie or tee baffles/tees,house sewer connection,tank outlet connection, 7 GRINDER PUMP UNIT #2 37.7 12.6' and effluent cartridge filter shall be inspected. An baffle or tee that have deteriorated and no Ion loon as designed must ' os g pea y longer per gne be replaced. Cracked to broken lines mad be repaired s or pt,spanked. P p ge 8 GRINDER PUMP UNIT #3 34.0 12.0 6. i employed to Neon and service line septic tank and t r ' =w y company crop aye p system,must be a permitted ea to hauler,with --- --- --- --- --- --- °uz ,landing with the New York Stela Depvrlmanl of Environmental Conservation a/flea. Septic tanks should not be washed or disinfected after being pumped out. 7. Sepik lank additives shall not be used in the septic splem. Addilins era unnecessary for the proper operation of household systems and may cause the sludge and scum in the septic lank to be discharged Into the absorption field.resulting In premature a.loon not dispose or excess household grease and fat in the septic system. WARREN COUNTY TAX MAP # 239.17-1-15 9 Whenever septic tank,are to be abandoned(Le.when public sewers are installed to handle household wastes),the tanks shall be pumped out and refilled with sail to prevent future collapse. o. Da flat pear.r dump chemical cleaner.(loss ammonia)In the sinks or toilets. 7 Bedroom Multi-Unit Residential It. Do not discharge roof drains,or allow stormwater runoff to collect on the absorption field area. 7 NUTLET PLACE cr 12 No whicle parking or traffic shall be allowed on any portion of the sewage disposal system. DRAWING NOTE: I 1 The.swage disposal system I.designed far domestic wastewater only,with the design of the absorption field on the projected TOWN OF GUEENSBURY COUNTY OF WARREN STATE OF NEW YORK Mows. Any use of the dwelling unit(.)that has o greater discharge of wastewater flow then designed lull require a redesign of the OF ISIS ell,pcoal system by a lie....d Professional Engineer. THE AS-BUILT DIMENSIONS SHOWN WERE ti iqe t 14. Tha stamp seal and signature of the design engineer is for the Intended use only,and any change of use Invalidate,the seal. DERIVED FROM ACTUAL MEASUREMENTS ~PJ� ''p�9 REPLACEMENT i 15. The effluent cartridge fllter shall be checked and cleaned If necessary during each inspection of the septic tank. A written %ryy m cord of the fill,,cleaning is r*comm,"d,d so to better manna,m,amount of solid,trapped In Ian,filler ca,trldg,. DURING CONSTRUCTION WITH ACCURACY ON-SITE SEWAGE DISPOSAL SYSTEM n= 1li. "us to shollaw ledge rock and other sit,h sail limitations,the 2'HOPE force mein was installed with 36•to 48'varying SUITABLE FOR OWNER'S USE. THESE ARE ++ a ground cover. This installed depth may not provide winter(frozen ground)protection to allow the year-round occupancy of the "4'p Na.07066 a AS-BUILT PLAN residential its. The force main shall be winterized annually and prior to freezing weather conditions so to prevent the NOT SURVEYED DIMENSIONS. THE MAP IS o qa � catastrophic ruplum of the pipeline. The pipeline contains raw untreated human sewage,which If spilled or leaked Into Lake George NOT TO SCALE. SEE THE SURVEYOR'S 3 n due to operator neglien gce,could result in,ignificart lines and de...is expense.. DATE: 5/17/21 SCALE: NONE DWG.NO.: 7nulley.dwg 17. Any liquid glycol product...ad for winterization shall be purged from the pipeline,contained,and removed from the it,. Do MAP FOR ALL BOUNDARY LINES AND 1% flat discharge any glycol In(.the septic tank a,all..It to enter the diep...I field. LEGAL DESCRIPTION OF THE PROPERTY. hEVJiV L. HASTINCS, P.E. rn.vcrt.nwr,err,Gvrren SHEET 1 OF 1 LIC.N0.076269 3 u,,asae AKNUE,slum eels rAus,x6w.aa rzem -