SEP-0268-2022 -i
SEPTIC DISPOSAL PERMIT office use Only
APPLICATION Permit#:
Town ofQucansbury Permit Fee:$
Invoice M 05
742 Bay Road,Queensbury,NY 12844
P:518-761-8256 www.gueensbury.net Septic Variance? Y
Flood Zone?-Y_ Q.
59 Bean Road, Wetlands?� IfY �N!rRevewed�By✓
Project Location: Queensbury NY I' II;`i
t �Jy�
Tax Map #: 227.10-1-1�4 J +
RESIDENCE INFORMATION:
Year Built IGallons #of bedrooms: x gallons per =total daily flow
per day bedroom Garbage Grinder Yes No
1980 or older 150 2 110 220 installed? (choose one) ❑ ❑X
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 110IR
Installed? (choose one) ❑
PARCEL INFORMATION:
Topography XD Flat Rolling ❑Steep Slope 5 % Slope
Soil Nature ❑X Sand ❑X Loam ❑ Clay ❑ Other, explain:
Groundwater At what depth? +/-3
Bedrock/Impervious material At what depth? +/-3
Domestic Water Supply ❑ Municipal ❑Well ❑X Lake
(if well or lake, water supply from any septic system absorption is
>200 ft.)
Percolation Test Rate: 12 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/hottub
System Absorption field w/#2 stone Total length ft.; Each Trench ft.
Seepage Pit w/#3 stone How many: ; Size:
Alternative--Sy -BL-d-ur-other-type:-E11'en-G-SFshai —
Holding Tank System Total required capacity? ; tank size ;
# of tanks
Septic Application Revised April 2021
.j
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
V
• Applicant:
Name(s): Chris Martell
Mailing Address, C/S/Z: 40 Franklin Street, Saratoga Springs NY
Cell Phone: 518-894-3668 Land Line:
Email: chris@druthersbrewing.com
• Primary Owner(s):
Name(s):
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):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
"Workers' Comp documentation must be submitted with this application"
• EnRineer(s):
Name(s): Nick Zeglen (EDP)
Mailing Address, C/S/Z: 900 Route 146 Clifton Park NY 12065
Cell Phone: 518-371-7621 Land Line:
Email: nzeglen@edplip.com
Contact Person for Compliance in regards to this project: Nick Zeglen (EDP)
Cell Phone: 518-371-7621 Land Line:
Email: nzeglen@edpllp.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: ��� a,
SIGNATURE: DATE: L/_a q—,A2-
Septic Application Revised April 2021
TOWN OF QUEENSBU.RY
742 Bay Road, Queensbury, NY. 12804-5902
Septic System Checklist
Plan to scale
trch
Received Deep hole perc test results from engineer/Architect if applicable(Town Approved Engineers and
�� itects;June 30 to April 15 Town Engineer for unapproved Engineers and Architects)
l�All wells on property and adjacent properties shown
VWater line shown Municipal or well 10'separation to any part of system Lq K-P,
Setback to property lines show 10'or more for any part of system
*Septic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10' from any waterline
qM 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) 1�,)I
SSeptic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage grinder each
Leech Field n 100'from any well 10'from water line
V Seepage pit 150'from well 50'from septic tank
N 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
Toe 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
K/(] 2' above established flood elevation to bottom of system
06 All tanks anchored or 2' above flood elevation
c(- F [6
Revised 4/15/2021
i
Mark Smith
From: Nick Zeglen <nzeglen@edpllp.com>
Sent: Thursday, May 19, 2022 8:46 AM
To: Mark Smith
Cc: Kate Deck
Subject: Re: 59 bean road
Attachments: 2022-5-19-MARTELL-WWPLAN.pdf
Good morning Mark,
Please find attached revised plans for the replacement septic system at 59 Bean Road. The design of
the system is a shallow trench system with eljen laterals stepped down the slope. The test pits
indicated 3 feet separation to bedrock so the bottom of the eljen trenches will be at existing grade
level. I have updated all aspects to more accurately indicate this and revised the cross section
accordingly. Hopefully these changes address items #1 and #2 that this isn't intended to be a mound
or raised system.
Our client, the buyer of the property, does not know the exact location of the existing water supply
line, and doesn't believe the prior owner does either. In order to ensure that the water supply line is
10' minimum from any septic component I have added a proposed water line and called for the
contractor to verify in the field the location and make sure it is 10 feet away from septic system
components. Is that acceptable? Also I just want to add that this is a "temporary" replacement plan
as the new owner's plan is to tear down the existing structure and build a new structure with a larger
bedroom count and the design will be starting sometime later this year or next.
If you have any questions let me know and I can also re-submit hard copies if/when you are good
with the plans.
Thanks,
Nick Ne pas enlever avant la
livraison au consommateur
Not to be removed until
delivered to the consumer
Nicholas Zeglen,P.E. Cet article contient des
Project Engineer MATERIAUX NEUFS
SEULEMENT
This article contains
NEW MATERIAL ONLY I.
Cette etiquette est apposee
On Thu, May 12, 2022 , conformement b la loi de la province isbury net>wrote:
This label is affixed in compliance
Nick, with Provincial Law
Fabrique par Made by
I have reviewed the ply No de permis:171OA41 Reg.No. 59 Bean road. The items listed below will need
to be addressed before Contenu Content
Mousse Polyurethane
de polyurethane Foam
Exigence federale/Federal Requirement
Tissu exterieur Outer covering
100%Polyester 100%Polyester
Bas tissu Bottom fabric
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U 2-�g 8-20 Z 2- Inspector's No.: 1) 1) 13
G--1-2
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC.
(Consulting and Fire Inspection Services)
(incorporated in the states of New York, Pennsylvania, and West Virginia)
Desiring Certificate of Approval,application is made for inspection of electrical installation in the premises described below. On
demand,applicant agrees to pay for inspection service in accord with schedule of charges.
Owner: 1 �; 1/�i'1:� i-k
Type Building:Dwelling Other(please specify):
--
Job Location: 'i; f� +-.:� f, i? City: (.), ` State: zo ;
County: W,"g a Permit From: Permit#
Swimming Pool: Inground: Aboveground: Bonding Date:
Work-New Additional BIdg.- New Old Ready for Inspection
Applicants Signature: License A
Please Print Name: Phone#:
Applicants Address: Name of Utility:
City: Office To Be
State: Zip: Notified: Job#:
SPACE BELOW FOR USE OF INSPECTORS ONLY
Switches Water Heater Service Equipment Other list below
Receptacles Paddle Fanlight Control Service Equipment
GFCI Rece t Paddle Fan Panel
AMP Rece t Paddle Fan/Eight D er Rec
Lights Vent Fan Washer Rec
Lights Air Conditioner Dishwasher Rec
Smoke Detectors AFCI Breaker Microwave Rec
Smoke/CO Detectors GFCI Breaker Garbage Disp Rec
AFCI(GFCI Breakers Refrigerator Receptacle
Additional apparatus for certificate:(Not listed above) Inspector Job Notes:
RONMUMBLO ,
nechiml Impactor J li ft/ 0 8
1 Stebe Street
Glens Falls,NY 12801 --
(51 S)758-0805 TOWN Of .;-I:NSSURY
BUILUiNG r CODES
Installed By(if other than applicant):
OFFICE USE ONLY
Extra tripdates Ins ection Fee$ A-S 0-00
Date Received: Service Date: 1 CASH
Certificate No: R.W.Date: 2 Check No. J
Final Date: C,•`r•?`a 3 Invoice
Certificate Needed? 4 CC
Date Sent: Yes--pup— Inspector sign in }
r' r�
next space � J'i�''i„at�.,h;•:`j,+
Please print name Inspector:
Original Progress Final
'T MQ A PPT UN A lrrnwr
900 Route 146 Clifton Park, NY 12065
(P) 518.371.7621 (F) 518.371.9540 edpllp.com
June 13, 2023
Town of Queensbury Building & Codes
742 Bay Road
Queensbury, NY 12804
Attn: John O’Brien, Director
Re: Martell Residence – 59 Bean Road
Dear Mr. O’Brien:
In compliance with application approvals granted by the Town of Queensbury I offer the following regarding
the referenced project.
The design plans, prepared by this office, reviewed and approved by the Town of Queensbury Board of
Health and Town Building Department as associated with the wastewater system application, are as follows:
Proposed Wastewater Improvements For The Martell Residence
59 Bean Road, Town of Queensbury
April 25, 2022
Sheet 1- Wastewater Plan
Sheet 2- Wastewater Details
During the course of construction Environmental Design Partnership LLP was on the job site to observe key
components of the system installation on June 6, 2023. Components inspected include, 1,000 gallon precast
concrete septic tank, 1,000 gallon precast concrete pump tank with duplex pumps, PE forcemain, precast
concrete distribution box with speed levels and two Eljen GSF laterals twelve (12) modules total. I have
provided an ‘as-built’ plan which indicates the system component locations, in accordance with the approved
Town plans.
Based on my inspection of the system installation it is my opinion that the wastewater system is in
compliance with the intent of the approved design plan and is ready for operation.
Sincerely,
Connor DeMyer, Project Engineer.
Attachment
Cc:
PROPOSED WASTEWATER IMPROVEMENTS FOR
59 BEAN ROAD
TOWN OF QUEENSBURY
APRIL 25, 2022
MARTELL RESIDENCE
WARREN COUNTY, NEW YORK
TAX MAP. No. 227.10-1-14900 Route 146 Clifton Park, New York 12065
edpllp.com(518) 371-7621
E N V I R O N M E N T A L D E S I G N
P A R T N E R S H I P, L L P.
1" = 20'
WASTEWATER
ASBUILT
1 of 1
1" = 20'
WASTEWATER
PLAN
1 of 2
PROPOSED WASTEWATER IMPROVEMENTS FOR
59 BEAN ROAD
TOWN OF QUEENSBURY
APRIL 25, 2022
MARTELL RESIDENCE
WARREN COUNTY, NEW YORK
TAX MAP. No. 227.10-1-14900 Route 146 Clifton Park, New York 12065
edpllp.com(518) 371-7621
E N V I R O N M E N T A L D E S I G N
P A R T N E R S H I P, L L P.
N.T.S.
WASTEWATER
DETAILS
2 of 2
PROPOSED WASTEWATER IMPROVEMENTS FOR
59 BEAN ROAD
TOWN OF QUEENSBURY
APRIL 25, 2022
MARTELL RESIDENCE
WARREN COUNTY, NEW YORK
TAX MAP. No. 227.10-1-14900 Route 146 Clifton Park, New York 12065
edpllp.com(518) 371-7621
E N V I R O N M E N T A L D E S I G N
P A R T N E R S H I P, L L P.
1,000 GALLON SEPTIC TANK
DISTRIBUTION BOX
ELJEN GSF CROSS SECTION
TYPICAL ELJEN GSF TRENCH SYSTEM
DUPLEX PUMP TANK
ELJEN GSF SHALLOW TRENCH CROSS SECTION