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SEP-0219-2022 SEPTIC DISPOSAL PERMIT Office Use Only APPLICATION Permit Town of Qucens ury �Q Permit Invoice#: D 1 3 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net D 7 S p is Variance? . Y F�1 one? Y \� APR Z 7 2622 W aq�ds? Y Reviewed By: Project Location: 5 Ononclage Drive S'O BUII..I i�KICK ii, GO DES Tax Map #: 239.8-1-44 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) ❑ 10 1981-1991 130 Spa or Hot Tub Yes No 1992-Present 110 2 110 Installed? (choose one) 220 ❑ [� PARCEL INFORMATION: Topography Flat Rolling ❑ Steep Slope % Slope Soil Nature ❑ Sand [Z Loam ❑ Clay ❑ Other, explain: Groundwater At what depth? 2-4' Bedrock/Impervious material At what depth? >5' Domestic Water Supply ❑ Municipal V Well ❑Lake (if well or lake, water supply from any septic system absorption is 200+ Percolation Test Rate: N/A per minute per inch (test to be completed by a licensed engineer/architect) PROPOSED SYSTEM INFORMATION: Tank size 1,000 gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or spa/hot tub (septic tank is existing) 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: Holding Tank System Total required capacity? ; tank size ; # of tanks Connect Cabin 5 (5 Onondaga Drive) to Takundewide sewage works community central system Septic Application Revised April 2021 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Takundewide Sewage Works Corp, c/o Bill Mason Mailing Address, C/S/Z: Cell Phone: 518-726-6093 Land Line: 518-656-9573 Email: bill@takundewide.com • Primary Owner(s): Name(s): Takundewide HOA Mailing Address, C/S/Z: P.O. Box 85 Cleverdale, NY 12820 Cell Phone: 518-726-6093 Land Line: 518-656-9573 Email: billatakundewide.com ❑ Check if all work will be performed by property owner only • Contractor: Contact Name(s): Crandall Excavating, Inc. Contractor Trade: Excavation/Installation Mailing Address, C/S/Z: 63 Woodchuck Hill Road Lake George, NY 12845 Cell Phone: Land Line: 518-793-0431 Email: "Workers' Comp documentation must be submitted with this application" • Eneineer(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(a_hutchisnengineering.com Contact Person for Compliance in regards to this project: Tom Hutchins Cell Phone: Land Line: 518-745-0307 Email: _thutchinsCa)hutchisnenaineering.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: Thomas Hutchins,AGENT SIGNATURE: DATE: 4/27/22 Septic Application Revised April 2021 TOWN OF Q UEENSB URY 742 Bay Road, Queensbunj, NY. 12804-5902 Septic -System Checklist Plan to scale $611eceived Deep hole perc test results from engineer/Architect if applicable(Town Approved Engineers and Architects;June 30 to April IS Town Engineer for unapproved Engineers and Architects) . VAll wells on property and adjacent properties shown / Water 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 MSepti,c tank and pump stations 10'from foundation 50'from any well/lake/wetland 10' from any waterline 11 Septic 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 iL Leech Field 20'from foundation 100'from any well 10' from water line Seepage pit 150'from well 50'from septic tank eepage Pits 3-times diameter apart r Septic tank and pump stations over 30 gallons 50' from watercourse or wetland 12ri 16 distance from bottom of trench or system 24"to bedrock or mottling 36"within 1000' of Lake Georg23&q�y��, V/ 1Leech field 100'from watercourse orwetland ggKo vv -� - r JJ1AToe of mound or bottom of retaining wall 10'from property line 100'from well 20' from Foundation Provide Engineer/Architect stamp for bed or design systems 'Department of Health Approval for all mobile home park new systems Flood Plain requirements UZ2' above established flood elevation to bottom of system All tanks anchored or 2' above flood elevation Revised 4/15/2021 169 Haviland Road Queensbury, NY 12804 Hutchins Engineering PLLC Phone: (518)745-0307 Fax: (518)745-0308 April 27, 2022 Town of Queensbury Buildings and Codes 741 Bay Road Queesbury, NY 12804 . Reference; Takundewide Sewage Works Corporation Centralized Wastewater System Connection of Cabin #5 to Centralized System —5 Onondaga Drive Our office designed the centralized wastewater system serving multiple private cottages within the.Takundewide Homeowners Association. The system was.constructed in 2008.and:has a design capacity of 3630 GPD. .Based upon design flow data, water usage information and existing building connections, there is available capacity in the system to serve proposed 2- bedroom, cabin 5. Attached is a system record plan showing proposed connection of cabin.#5. Should you require additional information or wish to discuss, please feel free to contact me. Regards, G. Thomas Hutchins, P.E. Cc. Bill Mason; Takundewide G.Thomas Hutchins, P.E.