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.