Application =,> SEPTIC DISPOSAL PERMIT Office Use Only
APPLICATION Permit ft: �-CP— b t '2Z21
irnm of Qeccns6ury
Permit Fee:$ 16 5
Invoice#: &
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensbury.net Septic Variance? Y O
Flood Zone? Y N
Wetlands? Y N _Reviewed By:
Project Location: Bean's Country Store- 1128 Ridge Road D rr S tea
fl
Tax Map#: 290.6-1-65.1 J lb�L '7
f JUN 16 2021
RESIDENCE INFORMATION: ***Commercial property*** TGLLLWN���OF 0
BUf' r•!! EENSeU
Year Built Gallons #of bedrooms: X gallons per =total daily flow �b;.4G$ n RY
per day bedroom Garbage Gn-6-d F—,' Yes No
1980 or older 150 Installed? (choose one) ❑ 56
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 110 Installed? (choose one) El R1
Commercial design flow is 955
PARCEL INFORMATION:
Topography Flat Rolling ❑ Steep Slope % Slope
Soil Nature ❑ Sand ❑ Loam ❑ Clay [1 Other, explain: silt
Groundwater At what depth? 22"
Bedrock/Impervious material At what depth? >38"
Domestic Water Supply ❑ Municipal V Well ❑Lake
(if well or lake, water supply from any septic system absorption is
tiD ft.)
Percolation Test Rate: 5-10 per minute per inch (test to be completed by a
licensed engineer/architect) 5-10 in fill material
PROPOSED SYSTEM INFORMATION:
Tank size gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
Spa/hot tub existing 1,000 gal.for apartment;existing 1,000 gal.for store;existing 1,000 gal.pump;proposed 1,500 gal.grease trap
System Absorption field w/#2 stone Total length ft.; Each Trench ft.
ElSeepage Pit w/#3 stone How many:____; Size:
Bed rthe
Alternative System or type: two-20'x 60'pipe-in-stone
Holding Tank System Total required capacity? ; tank size ;
# of tanks
Septic Application
Revised April 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Jeff Bean for 1128 Ridge Associates, LLC
Mailing Address, C/S/Z: 3 Fieldview Rd S Queensbury NY 12804
Cell Phone: Land Line: 518-792-9541 (Jeff)
Email:
• Primary Owner(s):
Name(s): 1128 Ridge Associates, LLC
Mailing Address, C/S/Z: 3 Fieldview Rd S Queensbury NY 12804
Cell Phone: Land Line:
Email:
❑ Check if all work will be performed by property owner only
• Contractor:
Contact Name(s): David Howard, Howard's Excavating
Contractor Trade: Excavation/Installation
Mailing Address, C/S/Z: 470 W Mountain Rd Queensbury, NY 12804
Cell Phone: (518)792-0222 Land Line:
Email:
"Workers' Comp documentation must be submitted with this application"
• Ensineer(s)•
Name(s): Hutchins Engineering PLLC
Mailing Address, C/S/Z: 169 Haviland Road Queensbury, NY 12804
Cell Phone: Land Line: 518-745-0307
Email: tutchins@hutchinsengineering.com
Contact Person for Compliance in regards to this project: Tom Hutchins
Cell Phone: Land Line: 518-745-0307
Email: tutchins@hutchinsenaineering.com
NOTES: 1.Alarm system and 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. 3. As-
built drawings must be submitted prior to the inspection, if there has been a change to the submitted
plans. 4. If, for any reason, the building permit application is withdrawn, 30% of the fee is retained by the
Town of Queensbury. After 1 year from the initial application date, 100% of the fee is retained.
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.
PRINT NAME: G. omas Hutchins, PE. ent)
SIGNATURE: �� 1 DATE: 6/16/21
Septic Application Revised April 2021
John O'Brien
From: Tom Hutchins<thutchins@hutchinsengineering.com>
Sent Friday,June 25,2021 4:50 PM
To: John O'Brien;beanstore@outlook.com
Cc: Dave Hatin
Subject: RE:(No Project Found)-Septic-1128 RIDGE RD Queensbury,NY, 12804-Signed Inspection Report(Fri Jun 25,2021
at 4,14 PM).pdf
John
As discussed,the field modifications have to do with the location of the tankage.... Existing store kitchen septic tank to
be converted to grease interceptor with grease filter and a new septic tank installed downstream of the converted
grease interceptor. Apartment septic tank will remain as is. We intend to document piping and orientations. Some
pump station upgrades are also planned.
One bed is installed and being covered and finished. This will be put on line as soon as the grease interceptor work is
completed.
Regards,TH
G. Thomas Hutchins, P.E.
Hutchins Engineering
169 Haviland Road
Queensbury, NY 12804
(518) 745-0307
From:John O'Brien<JohnO@queensbury.net>
Sent: Friday,June 25, 20214:14 PM
To: howard35_2000@yahoo.com; beanstore@outlook.com;Tom Hutchins<thutchins@ hutch insengineering.com>
Cc: Kate Deck<KateD@queensbury.net>; Dave Hatin<DaveH@queensbury.net>
Subject: (No Project Found) -Septic- 1128 RIDGE RD Queensbury, NY, 12804-Signed Inspection Report(Fri Jun 25, 2021
at 4:14 PM).pdf
6/25/21 Septic System Partial Approval
-South Raised Absorption Bed installed ok to backfill as per Tom Hutchins who was on site.
Note:The South bed will be temporarily hooked up to the existing force main to keep the store operational.
Tom Hutchins will submit field report for today with changes to system he discussed with me.
Sent from my iPad
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