SEP-0386-2022 SEPTIC DISPOSAL PERMIT Office use Oniy
APPLICATION Permit#: �
Toum of Qizcens6urr
Permit f Fee:$
E C E 9 E Invoice#: 4230
8
742 Bay Road,Queensbury,NY
p:518-761-8256 rraww. ueensi: € t JUIv Q 20�2 Flood Zone? Y N Reviewed By:
TOWN OF GUEENSBURY
BUILDING&CODES
Project Locatio 2"CMRK'STRE8T
Tax Map#: 302.17-2-73
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 Spa or Hot Tub Yes No
1992-Present 110 3 110 330
Installed? (choose one) X
PARCEL INFORMATION:
Topography V Flat Rolling Steep Sldpe -%Slope"
Soil Nature Sand' ✓ Loarn 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
Percolation Test Rate: 1-5MIN per minute_per.inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size Exi000 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/93 stone . How.many: ; Size:.
Alternative System Bed or other type:20 FT x 25 FT
Holding Tank System Total required capacity? ; tank size ;.
# of tanks
Septic Application Revised January 2021
CONTACT INFORMATION: PLEASE PRINT LEGI.RLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s):JOHN HAMILTON
Mailing Address, C/S/Z:32.CLARK STREET,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 work 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
y
Email:
**Workers' Comp documentation must be submitted with this application**
• Enaineer(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 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 0 'Hance.
PRINT NAME:GEORG REL
SIGNATURE: DATE:
Septic Application Revised January 2021
TOWN OF Q UEENSB URY
742 Bay Road, Queensbury, 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 and Architects)
WAII wells on property and adjacent properties shown "
79water line shown Municipal or well 10'separation to any part of system
16etback to property lines show 10'or more for any part of system
,tSeptic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10'from any waterline
Mnseptic 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)
lAseptic 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
Ak—Seepage pit 150'from well 50'from septic tank
Seepage 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
Leech field 100'from watercourse or wetland
�Jlkoe of mound or bottom of retaining wall 10'from property line 100'from well 20'from
Foundation
6' rovide'Engineer/Architect stamp for bed or design systemsAA
Department of Health Approval for all mobile home park new systems Flood Plain requirements
N2' above established flood elevation to bottom of system
AJy All tanks anchored or 2' above flood elevation
All G/n AI17
302.17-2-73 SEP-0386-2022
Hamilton, John
32 Clark St
Residential Septic Alteration
TOWN OF QUEENSBURY f
BUILDING & ODES EPT. 1
Reviewed 3 �-
3-' s s
� Date:
6U4Y-ef y
TOWN F QUEENSBURY
~' BUILDI G DEPARTMENT
Based on our limit d examination,compliances
with our commen shall not be construed a —"
indicating the pla s and specifications are i
full compliance rith the Building Codes f
New York State.
# s
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i
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D ECC C
JUN 2 0 2022
TOWN O NSBURY
BUILDING &CODES
3
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CENTERTROJECT
73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
June 16, 2022
Project#375
George Drellos
Sanitary Sewer Service
Queensbury,NY 12904
Re: Proposed Replacement Septic
32 Clark Street, Queensbury,NY
Dear George:
At your request, we have reviewed your proposed replacement septic system design of the
existing 3-bedroom house at 32 Clark Street 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.
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.
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