SEP-0169-2022 %M =s
SEPTIC'DISPOSALPERMIT office Use Only
APPLICATION Permit#: ��p—®� , - �)2Z
Permit Fee:$
Invoice#:
742 Bay Road,Queensbury,IVY 12804 T
P:518-761-8256 www.aueensbury.net Flood Zone? Y ` N Reviewed By:
D - �
Project Location: 31 MOUNTAIN VIEW LANE APR 782
Tax Map #: 295.14-1-57 TOWN OF QUEENSBURY
BUILDING & CODES
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? (choose one) X
1981-1991 130 Sp .or Hot Tub Yes, No.
1992-Present 110 3 110 330 Installed? (choose one) X
PARCEL INFORMATION:
Topography Flat Rolling Steep Slope %Slope
Soil Nature Sand: Loam Clay . - Other, explain;
Groundwater At what depth? GREATER THAN 6 FT
Bedrock/Impervious material At What depth? GREATER THAN 6 FT
Domestic Water Supply Municipal Well Lake
(if well or lake, water supply from any septic system absorption is
ft.)
Percolation Test". -Rate: 1-5Mw.per minute per inch (testid be`completed',by a"'
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size xl000-- gallons (min.,size 1,000 gallons; add-250 gallons for each garbage cylinder or
Spa/hot tub EXISTING 1000 GAL CONCRETE
System Absorption field.w/#2 stone; -Total length ft.; Each Trench ft.
Seepage Pit w/#3 stone - :How many: ; Size:-
Alternative System Bed or other type:20FTX,25 FT
Holding Tank System Total required capacity? tank size
# of to n ks
Septic Application Revised lanuary 2021
fiz
CONTACT INFORMATION::PLEASE PRINT LEGIBLY OR TYPE,. PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s):-Tj,/-
Mailing Address, C/S/Z: 31 MOUNTAIN VIEW LANE, QUEENSBURY,NY 12804
Cell Phone: Land-Line:
Email:
• Primary Owner(s):
Name(s):SAME AS APPLICANT
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Check if.,all_wor-k will be performed_by property owner only
• Contractor:
Contact Name(s):SANITARY SEWER SERVICES
Contractor Trade:
Mailing Address, C/S/Z:LUZERNE RD, QUEENSBURY
Cell Phone: Land Line:518-796-3760
Email: _.
**WorkerV-Comp documentation must be submitted with this application**
• Engineer(s):
Name(s):CENTER PROJECT SERVICES
Mailing Address, C/S/Z:73 SHERIDAN STREET, GLENS FALLS NY 12801
Cell Phone: _ Land Line:
Email:
-Contact Person for Compliance in regards to this project: GEORGE DRELLOS
Cell Phone: Land Line: 518-796-3760
Email: .
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 isoranted 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:GEOR ELL
SIGNATURE: DATE: /— 7_
Septic Application Revised lanuary 2021
T'OWW OF QUEENSBURY
742 Bay Road, Qteensbury, NY. 12804-5902
Septic System Checklist
Plan to scale
Received Deep hole perc test results from engineer/Architect if applicable(Town Approved Engineers and
Architects;June 30 to April 15 Town Engineer for unapproved Engineers a�n/d�Architects)
/��D All wells on property and adjacent properties shown K b
later line shown Municipal or well 10'separation to any part of system
.Setback to property lines show 10'or more for any part of system
ii6 Septic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10'from any waterline
Mbseptic tank to foundation crawl space/slab on grade,grade in crawl space must be above top of septic tank
for0',Separation required (field verification required)
Septic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage grinder each
*Leech Field 20'from foundation 100'from any well 10'from water line
Seepage pit 150'from well 50'from septic tank
445eepage Pits 3-times diameter apart
VA Septic tank and pump stations over 30 gallons 50' from watercourse or wetland
Vdistance from bottom of trench or system 24" to bedrock or mottling 36"within 1000' of Lake George
Leech field 100' from watercourse or wetland
/JJA--Toe of mound or bottom of retaining wall 10' from property line 100'from well 20'from
Foundation
X—Provide Engineer/Architect stamp for bed or designs stems '
Y
Department of Health Approval for all mobile home park new systems Flood Plain requirements
2' above established flood elevation to.bottom of system
NV All tanks anchored or 2' above flood elevations� '�' �7,
Revised 4/15/2021
JO
BUILDING & CGGES EPT.
Revlewe
Date'
Aeal 1
�A-
a
o f+
CD
to 5 u1
r� d !°1 !S m L rue
V
U
APR 0 7 2022 t�
1 D CJ
TOWN OF QUEENSBURY oh
BUILDING&OODES o O
0�
N
TOWN OF QUEENSBURY .� N
BUILDING DEPARTMENT
Based on our limited examination,compliance '
with our comments shall not be censirued as
indicat,�;g the plans <,nd specifications are in
full compliance with the wilding Codes of
New York State.
f _ 'w
SERVICES
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
April 6, 2022
Project# 361
George Drellos
Sanitary Sewer Service
Queensbury,NY 12804 E C El V E
Re: Proposed Replacement Septic
31 Mountain View Lane, Queensbury,NY APR .0 7 2022
Dear George: TOWN OF QUEENSBURY
BUILDING&CODES
At your request, we have reviewed your proposed replacement septic system design of the
existing 3-bedroom house at 31 Mountain View 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 330 GPD and a percolation rate of
1 to 5 minutes, you will need a minimum of 367 sf of absorption area. We recommend using 20
ft wide by 25 ft long absorption bed with 4 — 20 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. A vent will be required due to the depth of the existing septic tank.
Please feel free to contact me at 796-2515 if you have any questions and that you for your
assistance with this request.
Sincer ly,
Thomas R. Center Jr, P.E.
----------------
AIS UILT
r ----- '`*
f
tJiy
A5 'BUILT