SEP-0056-2023 "�. SEPTIC DISPOSAL PERMIT office use only
APPLICATION
Permit#:
Town of(Zeensbury Permit Fee:$ e)�5'
D. � �`� i�� I� ��t,� !� v ice#: �J�lrj
742 Bay Road,Queensbury,NY 12804 ^°^-a------
P:518-761-8256 www.aueensburv.net ^M1M'o p`tic Variance? Y
409
I
d Zone? Y
TOVVN OF QUEE;NSBUR(w lands? _Y � Iteviewp,
i:711VG&CODES
Project Location: 365Cleverda&--Wc'L—"" r )
Tax Map#: 226.12-1-54FEB 0 93
RESIDENCE INFORMATION: i�;\NH OF OUELi"qSBUR1'
Year Built Gallons #of bedrooms: X gallons per =total daily flow i�Uli-f DING l ---. . z-2
per day bedroom d Garbage Grinder~ Yes No
1980 or older 150 Installed? (choose one) ❑ ❑✓
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 110 5 110 550 Installed? (choose one) ❑ [�l
PARCEL INFORMATION:
Topography Q Flat Rolling ❑Steep Slope % Slope
Soil Nature Sand [ Loam ❑ Clay ❑ Other, explain:
Groundwater At what depth? >72"
Bedrock/Impervious material At what depth? >72"
Domestic Water Supply ❑ Municipal ❑Well OLake
(if well or lake, water supply from any septic system'absorption is
ft.)
Percolation Test Rate: 7:20 per minute per inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size 1.500 gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
spa/hot tub
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: 15X46 Stone Absorption Bed
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): John Mason for Richard O. Mead Revocable Trust
Mailing Address, C/S/Z: Sunsoval. Inc. 2574 Route 9L P.O. Box 86 Cleverdale NY 12820
Cell Phone: Land Line: 518-656-9956
Email: sunsoval@gmail.com
• Primary Owner(s):
Name(s): Richard O. Mead Revocable Trust
Mailing Address, C/S/Z: 80 Country Colony Drive Queensbury, NY 12804
Cell Phone: Land Line:
Email:
❑ Check if all work will be performed by property owner only
• Contractor:
Contact Name(s): Crandall Excavating
Contractor Trade: Excavation
Mailing Address, C/S/Z: 63 Woodchuck Hill Road, Lake George, NY 12845
Cell Phone: 518.470.4694 Land Line:
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 QueensburV, NY 12804
Cell Phone: Land Line: 518-745-0307
Email: _thutchins@hutchinsengineering.com
Contact Person for Compliance in regards to this project:_Tom Hutchins. P.E.
Cell Phone: Land Line: 518-745-0307
Email: thutchins@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: John A. Mason
SIGNATURE: -` DATE: 1/16/2023
Septic Application Revised April 2021
TOWN OF QUEENSBURY
742 Bay Road, Queensbuq, NY. 12804-5902
Septic System Checklist
Plan to scale
beceived 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)
KIGAII wells on property and adjacent properties shown—
waterline shown Municipal or well 10'separation to any part of system
66etback to property lines show 10'or more for any part of system
1(—<�eptic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10'from any waterline
A+Septic tank to foundation crawl space/slab on grade,grade in crawl space must be above top of septic tank
for 0',Separation required(field verification required)
IP'ieptic 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
Seepage Pits 3-times diameter apart
'Septic tank and pump stations over 30 gallons 50'from watercours�,or_wetland
`distance from bottom of trench or system 24"to bedrock or mottli g 36"wit in 1000'of Lake George
Leech field 100'from watercourse or wetland
AA*Toe of mound or bottom of retaining wall 10'from property line 100'from well 20'from
Foundation
ft"'Trovide Engineer/Architect stamp for bed or design systems
Department of Health Approval for all mobile home park new systems Flood Plain requirements
2'above established flood elevation to bottom of system
J All tanks anchored or 2' above flood elevation
DPtrioPA d/1 VX 71
O" Oak
o
15" Hem ock
C >>>) l I
I I O" Pine
/a-, .
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/ ov
ra te-VJalk
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l I I f
--�-� 1178. 23'
N P9°29'10" W
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Lake Georg*
I " Hemlock \
1 krea
BM Top of Nail in 40" stump 1 778 7. $q, F�et
Elev.= I09.44' �
0.411 Acres '
I y
SEP71C TANK TO BE DECOMMISSIONED. INTERIOR
G TO BE RE-ROUTED TO NORTH SIDE BUILDING
EXISTING WASTEWATER SYSTEM PLAN
SCALE: 1 "=20'
GRAPHIC SCALE
10 0 5 10 20 40
( IN FEET )
CONTRACTOR TO FIELD VERIFY LOCATIONS AND DISTANCES
RECORD DRAWING NOTE:
SEPTIC TANK AND PUMP STATION RISERS /NSTAI
APPROXIMATELY 6" BELOW FINISHED GRADE. PROXIMATE
DIMENSION TABLE FOR LOCATIONS _ ISH GRADE
4" PVC INLET
MIN. SLOPE
1/8" PER FOOT
WATERTIGHT SLEEVE -
AND SEAL (TYP)
1,500 GAL PRECAST
CONCRETE SEPTIC TANK
Crushed Stone
Lands N/F of
Mary Mattson
B:1014 P:111 I
226. 12-1-53 U.P. NM4
LAKE WATER SUPPLY I
WASTEWATER SYSTEM SETBACK REQUIREMENTS
PROPERTY LINE
HOUSE
STREAM, LAKE,
WATERCOURSE,
WE7L4ND
WELL
SEP71C TANK
10'
10'
50'
50'
ABSORP77ON FIELD
1 10'
20'
1 100'
100'
POLYETHYLENE EXTENSION TO GRADE
WITH TAMPER RESISTANT ACCESS COVER
12" MIN.
COVER
1/8" PER FOOT
j r 2" MIN. SLOPE
LIQUID LEVEL
DUAL COMPARTMENT. 18"
16" BAFFLE MIN.
CLzx
o g g -
nl M
<. 1. MINIMUM 2X WIDTH I
MAXIMUM 4X WIDTH
OUTLET 4" PVC
°.
e.°
Ga .< ° a 8.
SEPTIC TANK NOTES
ALL UNITS SHALL COMPLY KITH THE REQUIREMENTS OF THE NEW YORK STATE DEPARTMENT
OF HEALTH AND SHALL BE OF PRECAST CONCRETE AS MANUFACTURED BY UTOPIA
ENTERPRISES OR EQUIVALENT
ALL STRUCTURES SHALL BE PLACED ON FIRM, COMPACT SAND OR GRAVEL BASE. WHERE
EXISTING SOIL CONDITIONS ARE UNSUITABLE, CRUSHED STONE SHALL BE PLACED AS
NECESSARY TO ACHIEVE A STABLE BASE.
SEPTIC TANKS INSTALLED IN TRAFFIC AREAS SHALL BE OF EXTRA HEAVY CONSTRUC77ON
DESIGNED FOR H-20 WHEEL LOADING.
ALL JOINTS MUST BE SEALED WITH BUTYL SEALANT. JOINTS BELOW THE LIQUID LEVEL MUST
BE TESTED BEFORE BACKFILLING.
ALARM 3" ABOVE 'PUMP ON'
& LAG PUMP ON
PUMP ON
PUMP OFF
POLYETHYLENE EXTENSION TO GRADE
WITH TAMPER RESISTANT ACCESS COVER
INSTALL FLOAT SWITCHES TO
OPERATE PUMP AND MAINTAIN
LEVELS AS INDICATED
BALL VALVE T
BALL
CHECK
VALVE
FLOAT SWITCHES
° -INSTALL INSIDE
PUMP PIT IN
LOCA77ON ACCESSIBLE
M774OUT PIT ENTRY
DUPLEX
16" MIN. EFFLUENT
PUMPS
4
° ° a G d
RECORD DRAWING DIMENSIONS
TABLE
CORNER "A"
CORNER "B"
S. T. INLET PORT
18.67'
25'
S T. OUTLET PORT
22.5'
21.3'
PUMP STATION PORT
25.8'
19'
DIS7R1BU1TON BOX
36.5'
21 '
1,000 GALLON PRECAST CONCRETE PUMP STATION
SEPTIC TANK & PUMP STATION DETAIL
SCALE. NTS
4" TOPSOIL COVER ABOVE
4" PVC PERFORATED LATERAL __\FILTER
FABRIC
TOP OF STONE BED,
INSTALLED LEVEL, IN BED
MIRAFI 140N OR EQUAL
SEED & ESTABLISH TURF
CONFICURA77ON WITH MANIFOLDED ENDS
5' PIPE SPACING
2.5' TO EDGE
OF BED
8-16"
-
COVER
.::
:..,. ..... .....
2 STONE
TO TA
C01/ER OVER
-
P•.
,
STONE DEP1N
PIPE
.
�.,
= / ._; r ;,
. y:®'�° .r:...? .: �:.. BOTTOM OF STONE EL.
102.5 .. .:
-
,r._.
-
6" MIN STONE `.:
BELOW PIPE _
__
BED WIDTH & GEOMETRY
PER PLAN3'
MINIMUM
SEPARATION
...
T 0 BOUNDARY
...
CONDITION
3/4"-1-1/2" WASHED
CRUSHED STONE
A l 1/'•/1 A P1TT/ 0 A ! ^ rr1 nri+-rr^ n
SCALE. NTS
LIMIT or r' .
S7
15'
PROVIDE 5'
FROST
PROTEC77ON
� 4r Al l C n -F
PROPOSED WASTEWATER SYSTEM PLAN
SCALE: 1 "=20'
GRAPHIC SCALE
i
I 10 0 5 10 20 40
( IN FEET )
I
CONTRACTOR TO FIELD VERIFY LOCA77ONS AND DISTANCES
EXTERIOR WEATHERPROOF JUNCTION BOX
(IF NECESSARY). SEAL CONDUIT GAS TIGHT.
INSTALL CONTROL PANEL IN HOUSE. ALL ELECTRICAL
WORK TO BE INSPECTED BY A CER71FIED ELECTRICAL
INSPECTION AGENCY PRIOR TO START-UP OF PUMP STATION.
12" MIN. COVER
DISTRIBUTION BOX
L 2" MIN.
2" MIN. DROP
BETWEEN INVERTS
PUMP STATION NOTES
SEAL ALL TANK OPENINGS W47ER11GHT.
PROVIDE AND INSTALL UL LISTED PACKAGED PUMP
CONTROL PANEL WITH VISUAL AND AUDIBLE ALARM.
1-1 2" SCH-40 PVC PIPING
INSTALL SIMPLEX, DEMAND DOSE CONTROL PANEL
INSIDE WET WELL THROUGH WALL
INSIDE HOUSE IN ACCESSIBLE LOCATION.
INSTALL POWER & CONTROL WIRING TO CONTROLLER
UNION - LOCATE SUCH THAT
WITH ALARM IN HOUSE IN ACCORDANCE WITH
UNION CAN BE DISCONNECTED AND
MANUFACTURER'S INSTRUCTIONS AND NA77ONAL
PUMP REMOVED WITHOUT TANK
ELECTRIC CODE (N.E.G) REQUIREMENTS.
ENTRY
PUMP CONTROL AND FLOAT LEVELS TO BE INSTALLED
REDUCING TEE POINTED DOWNWARD
TO PROVIDE A 50 GALLON DOSE.
WITH 1 " BALL VALVE THROTTLED TO
ALLOW TRICKLE DRAIN BACK INTO
EFFLUENT PUMPS TO BE GOULDS PUMPS WE SERIES,
MODEL WEO3L SUBMERSIBLE EFFLUENT PUMP 1/3 HP,
WETWELL
230 VOLT, 1PH
VERIFY EXISTING ELECTRICAL SERVICE PRIOR TO
PURCHASING PUMP.
ALL ELECTRICAL WORK TO BE INSPECTED BY A
CER77FIED ELECTRICAL INSPECTION AGENCY PRIOR TO
START-UP OF PUMP ST4770N.
46' '
ABSORPTION BED PROFILE
SCALE. NTS
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Lands N/F of
Mary Mattson
B:1014 P:111
226.12-1-53
LAKE WATER SUPPLY
WASTEWATER SYSTEM DESIGN
5-BEDROOM RESIDENCE
DESIGN FLOW - 110 GPD/BEDROOM
SYSTEM DESIGN FLOW - 550 GPD
SEP71C TANK - NEW 1,500 GALLON PRECAST CONCRETE
PUMP STATION - NEW 1,000 GALLON PRECAST CONCRETE
DESIGN APPLICATION RATE: 0.8 GPD/SF, BASED ON
6-7 MIN/IN PERCOLA77ON RATE
ABSORP71ON BED AREA REWD = (550 GPD)/(0.8 GPD/SF)
= 688 SF
AB E77QU BED AREA PROVIDED = 15 z46' = 690 SF
POTABLE WATER SUPPLY IS LAKE GEORGE
MAINTAIN 10' MINIMUM SEPARA7ON BETWEEN WATER SUPPLY
LINE(S) AND ALL WASTEWATER SYSTEM COMPONENTS
SITE SOILS DATA
TEST PIT
TP-1 - 121912022 BY TOM HUTCHINS, P.E.
GRADE EL. 105.3'
0-4" - WOODS DUFF/TOPSOIL
4-20" - LIGHT BROWN FINE SAND, LITTLE SILT
20-38" - RED -BROWN LOAMY FINE SAND,
VERY OLD FILL
38-72" - MEDIUM BROWN GRAVELLY SILTY FINE
srTE LOCATION --J LOCATION MAP
SYSTEM INSTALLATION NOTES
CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING AND IN ACCORDANCE WITH THE N.Y.S. DEPARTMENT OF
HEALTH INDIVIDUAL HOUSEHOLD SYSTEMS AND ASTM F481 INSTALLATION OF THERMOPLASTIC PIPE AND CORRUGATED
TUBING IN SEPTIC TANK LEACH FIELDS.
AFTER EXCAVATION OF 15' WIDE X 46' LONG ABSORPTION BED TO THE DEPTH REQUIRED, THE WALLS AND FLOOR
SHALL BE CLEANED AND RAKED IN ORDER TO LOOSEN SMEARED AREAS OF SOIL.
PLACEMENT OF CRUSHED STONE, PERFORATED PIPE AND FILTER FABRIC SHALL BE AS SHOWN, AND CARE SHALL BE
EXERCISED TO AVOID INCLUSION OF FINE GRAINED SOILS AND WASTE MATERIAL IN THE STONE AND PIPE.
THE PIPE SHOULD BE LAID AT THE GRADES INDICATED, MAINTAINING STRAIGHT CONTINUOUS GRADES WITHOUT SAGS,
HUMPS, SEPARATED JOINTS, OR OTHER UNSUITABLE CONDITIONS PIPE SHALL BE LAID WITH HOLES DOWN IN ALL
CASES.
ALL DISPOSAL FIELDS SHALL BE GRADED TO SHED RAINFALL AND DIVERT SURFACE RUNOFF AWAY FROM THE
DISPOSAL FIELD.
DO NOT USE HEAVY EQUIPMENT WITHIN THE ABSORPTION AREA AFTER PIPING HAS BEEN INSTALLED.
THE WASTEWATER TREATMENT SYSTEM IS DESIGNED AND APPROVED BASED UPON THE INSTALLATION OF WATER
CONSERVING FIXTURES AND A DESIGN FLOW OF 110 GPD PER BEDROOM. THE SYSTEM IS NOT DESIGNED TO
ACCOMMODATE EXTREME WATER USE FIXTURES, SUCH AS JACUZZI-TYPE SPA TUBS OR WATER TREATMENT EQUIPMENT.
THE INSTALLATION OF NON -CONSERVING WATER FIXTURES OR EXTREME WATER USE FIXTURES IS CONTRARY TO THE
APPROVAL OF 7HIS WASTEWATER TREATMENT SYSTEM.
ROOF, FOOTING, GARAGE, CELLAR AND SURFACE WATER DRAINAGE MUST BE EXCLUDED FROM THE WASTEWATER
SYSTEM.
CONSTRUCT DRAINAGE SWALE UPGRADE OF SYSTEM IN ORDER TO DIVERT SURFACE RUNOFF AROUND ABSORPTION
FIELD.
SEPTIC TANK, PUMP STA77ON & ABSORPTION BED MUST BE INSPECTED BY LOCAL BUILDING DEPARTMENT AND DESIGN
ENGINEER PRIOR TO BACKFILL AND FINAL GRADING. IT IS THE RESPONSIBILITY OF THE CONTRACTOR TO IDENTIFY THE
NECESSARY PARTIES AND REQUEST INSPECTIONS.
SYSTEM MATERIAL SPECIFICATIONS
ABSORPTION FIELD AGGREGATE
STONE IS TO BE 3/4" TO 1-1/2" WASHED CRUSHED STONE.
EFFLUENT FILTER
EFFLUENT FILTER TO HAVE 1/16-INCH FILTRATION, POLYLOK PL-122 OR EQUIVALENT.
EFFLUENT SEWER PIPE
PIPING TO BE 4" SDR-35 OR SCHEDULE 40 PVC. INSTALL WITH 1/8" PER FOOT MINIMUM SLOPE.
FILTER FABRIC
FILTER FABRIC TO BE 4.8 OZ/SY NON -WOVEN SEPARATION FABRIC, TENCATE MIRAFI 140N OR EQUIVALENT.
HOUSE SEWER PIPE
PIPING TO BE 4" SDR-35 OR SCHEDULE 40 PVC. INSTALL WITH 1/4" PER FOOT MINIMUM SLOPE.
TOPSOIL
PLACE 4" MINIMUM TOPSOIL OVER ENTIRE BACKFILL AREA. SEED, MULCH, AND ESTABLISH TURF.
SAND RECORD DRAWING NOTE:
A REPRESENTATIVE OF OUR OFFICE VISITED THE SITE
BOTTOM OF TEST PIT EL. 99.3' DURING CONSTRUCTION AND IT IS MY OPINION THAT
NO GROUNDWATER TO 72" THE SYSTEM IS INSTALLED IN GENERAL CONFORMANCE
NO MOTTLING WITH THE APPROVED PLAN AND THIS RECORD
ROOTS ENTIRE DEPTH DRAWING FINAL SURFACE FINISHING AND TURF
ESTABLISHMENT IS ONGOING
PERCOLATION TEST G. THOMAS HUTCHINS, P.E.
PT-1 - 12/9/2022 BY TOM HUTCHINS, RE 6/30/2023
STABILIZED PERCOLA77ON RATE. 7.20 PER INCH
RECORD DRAWING
INSTALLATION DATE: 6/30/2023
ALLED BY - CRANDALL EXCAVATING INC.
TAX MAP # 226.12-1-54
)POSED
TIBU77ON BOX
7FSafely.
RANS ON FORCE
MAIN TO 4" PVC
FA
Dig
NdwFffork
OUTSIDE OF D-BOX
® Call Before You Dig
03 Wait The Required Time
® Confirm Utility Response
1
RECORD DRAWING
61301202
EM Respect The Marks
Dig With Care
8®®'962'796�
0
ISSUED FOR PERMIT
1/16/202.
www.d igsafelynewyork.com
No.
Revisions
Date
WASTEWATER SYSTEM PLAN DETAILS
prepared for:
Richard 0. Mead Revocable Trust
365 Cleverdale Road
Town of Queensbury, County of Warren, State of New York
MAP REFERENCE:
BASE MAP INFORMATION FROM "MAP OF A
TOPOGRAPHIC SURVEY MADE FOR RICHARD &
MADELINE MEAD," IN THE TOWN OF QUEENSBURY,
WARREN COUNTY, NEW YORK. DATED APRIL 12, 2022.
PREPARED BY.
n D us e
&
S t e V@ S
LOLild S1.1Y'VeyO3r8
169 Haviland Road Queensbury, New York 12804
(518) 792-8474 New York Lie. No. 50135
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ALTERATION OF THIS XCEPT BY
A LICENSED PROFESSION ' ENGINEER IS A
VIOLATION OF NYS EDUCATION LAW.
Drawn: JRS
Checked: GTH
Scale: NOTED
Date: 51212022
169 Haviland Road
Queensbury, NY 12804
(518) 745-0307 Phone
Hutchins Engineering PLLC (518) 745-0308 Fax
291967-01