SEP-0394-2023 SEPTIC DISPOSAL PERMIT Office Use Only
APPLICATION Permit#: W-0`.C14‘ — 20 2-3
Town of Quce b ry 6
Permit Fee: $
Invoice#: bj
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.queensbury.net Flood Zone? Y eviewed ByO_`L J
ippEceo \Vi
Project Location: 18 ASHLEY PLACE .,
1111 JUL 05 _2.3_
Tax Map #: 302.14-1-20
TOWN OF QUEENSBURY
BUILDING& CODES
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 ✓ Flat Rolling Steep Slope % Slope
Soil Nature !Sand ✓ Loam Clay Other, explain:.
Groundwater At what depth? GREATER THAN 6 FT
Bedrock/Impervious material At what depth? GREATER THAN 6 FT
Domestic Water Supply 1 Municipal Well Lake
(if well or lake, water supply from any septic system absorption is
ft.)
Percolation Test Rate: 1 MIN per minute per inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size -moo gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
spa/hot tub NEW 1000 GAL PRECAST CONCRETE TANK
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:15FT X 30 FT
Holding Tank System Total required capacity? tank size
# of tanks
`ic Application Revised January 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): RICHARD BOUTELLE
Mailing Address, C/S/Z: 18 ASHLEY PLACE, QUEENSBURY,NY 12804
Cell Phone: Land Line':
Email:
• Primary Owner(s):
Name(s): SAME AS APPLICANT :.
ti
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
Email:
**Workers' Comp documentation must be submitted with this application**
• Engineer(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 • ;'nance.
PRINT NAME:GEORGr DR OS
SIGNATURE: DATE: 1‘-'"2y 3
Septic Application Revised January 20;
TOWN GF
QL'IEENSBI,IRY
742 Bay Road, Queensbury, NY. 12804-5902
Septic System Checklist
Plan to scale
Zeceived
Deep hole perc test results from engineer/Architect if applicable((Town Approved Engineers and
PP 9
Architects;June 30 to April 15 Town Engineer for unapproved Engineers and Architects)
All wells on property and adjacent properties shown
gWater line shown Municipal or well 10'separation to any part of system •
1(4 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
w
. Mn 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)
‘66 Septic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage r'grinder each
14 Leech Field 20'from foundation 100'from any well 10'from water line
'A Seepage pit 150'from well 50'from septic tank
MASeepage Pits 3-times diameter apart
iqSeptic tank and pump stations over 30 gallons 50'from watercourse or wetland
Yqdistance from bottom of trench or system 24"to bedrock or mottling 36"within 1000'of Lake George
10 Leech field 100'from watercourse or wetland
Pik Toe of mound or bottom of retaining wall 10'from property line 100'from well 20'from
Foundation -
1,f[1 Provide Engineer/Architect stamp for bed or design systems
)0\14 Department of Health Approval for all mobile home park new systems Flood Plain requirements
•
NO 2'above established flood elevation to bottom of system
/"" All tanks anchored or 2'above flood elevation
POLYETHYLENE EXTENSION
TO GRADE WITH TAMPER
RESISTANT ACCESS CONK VD2
IF TAIS GREATER THAN
12" BELOW GRADE
(NON —TRAFFIC AREAS)
rTEE BAFFLE
12' MIN. COVER
1/4' PER FOOT
MIN. SLOPE
a
118' PER FOOT 12' MIN. COVER
MIN. SLOPE DISTRIBUTION BOX
4' HOUSE SEWER
PVC SDR-35 OR SCH-40
a LIQUID LEVEL
4' EFFLUENT SEWER
°.'
PVC SDR-35 OR SCH-40 BAFFLE
WATERTIGHT SLEEVE
is'
`
2"MIN.
& SEAL (TYP.)
MIN.
USE SPEED LEVELERS TO
ASSURE ALL OUTLETS ARE AT
EXACTLY THE SAME ELEVATION p" MIN. DROP
4' PVC SDR-35 SOLID HEADER BETWEEN INVERTS
TO ABSORPTION FIELD, 118'
PER FOOT MIN SLOPE
SEPTIC TANK NOTES
NEW 1;000 GALLON
ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK STATE
CONCRETE SEP7IC
DEPARTMENT OF HEALTH AND SHALL BE OF PRECAST CONCRETE AS
TANK
'
MANUFACTURED BY UTOPIA ENTERPRISES OR EQUIVALENT.
.,
ALL STRUCTURES SHALL BE PLACED ON FIRM, COMPACT SAND OR GRAVEL BASEr
WHERE EXISTING SOIL COND17IONS 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
a
CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING.
NEW 7,000 GAL PRECAST CONCRETE SEPTIC TANK
ALL JOINTS MUST BE SEALED WITH BUTYL SEALANT. JOINTS BELOW THE LIQUID
LEVEL MUST BE TESTED BEFORE BACKFILLING.
SEPTIC TANK DETAIL
N TS
4" TOPSOIL COVER ABOVE TOP
OF STONE BED;
SEED & ESTABLISH TURF
4" PVC PERFORATED LATERAL INSTALLED
LEVEL, IN BED CONFIGURATION WITH
MANIFOLDED ENDS
5' PIPE SPACING
WASTEWATER SYSTEM DESIGN
3—BEDROOM DESIGN
WATER SAVING FIXTURES
(1.6 GPF MAX. FLUSH, 3.0 GPM MAX. FAUCETS)
DESIGN FLOW - 110 GPD/BEDROOM
SYSTEM DESIGN FLOW — 330 GPD
SEPTIC TANK
NEW 1000 GAL PRECAST CONCRETE TANK
LEACH FIELD STANDARD PIPE —IN —STONE ABSORPTION BED
IN MODIFIED SOIL PROPOSED
DESIGN PERCOLATION RATE = 1-3 MIN/IN
APPLICATION RATE = 0.90 GPD/SF
ABSORPTION BED AREA REQUIRED = 367 SF
450 SF TOTAL TO BE PROVIDED
15 FT WIDE BY 30 FT LONG ABSORPTION BED
PROPOSED
POTABLE WATER FROM MUNICIPAL WATER SYSTEM
Y
�-`ve GpP
FILTER FABRIC
MIRAFI 140N OR EQUAL
2.5' TO EDGE
OF BED
6-12» _
to `.<• ..�. .♦4 4 a'i ''fit.::.:.
,Y
COVER
♦ ht
: e i.•
2 STONE ^
.... .... _ _ . �... ,.. _. 1; - ,.. , :'., � . TOTAL
COVER ,
12
t
i 1 ..�. —e.. .�. �.aj•,. ,.... ,yr r' �+,�"• .—:. y+'r,.+.;�•e ate, ,.,:.', ir' �::'�C T .-rr+. PIPE
j�^T^^'V'' •
�•6 MI S ONE; N�
BED W D H•
,7
15'MINIMUM
2
PIPE;:.-**. BELOW
•:tom 3
SEPARATION
i
N `t
.f:
"'�•� :��' ~;�� CONDITION
t D
. y f'
••i .•
"i
,•; t
- t
3/4"-1-1/2" WASHED
CRUSHED STONE ABSORPTION BED PROFILE
LIMIT OF "
STI
WASTEWATER SYSTEM PLAN
SCALE: 1 "=20't
GRAPHIC SCALE
10 0 5 10 20 40
( IN FEET )
CONTRACTOR TO FIELD VERIFY LOCATIONS AND DISTANCES
THIS IS NOT A FIELD SURVEY.
NTS
A„ rl t-rl rn 1, A Tr-r1 rl l ie% I A rl-r-t A I r-
ABSORPTION BED PLAN
NTS
?POSED
TRIBUTION BOX
TRANSITION FORCE
MAIN TO 4" PVC
OUTSIDE OF D—BOX
FILE COPY
SITE SOILS DATA
F=C__,0Py
TEST PIT
TP-1 — 6119123 BY TOM CENTER, P.E.
0-9" — TOPSOIL
9-31" — LOAMY MEDIUM FINE SAND
31-70" — MEDIUM FINE SAND.
NO MOTTLING OR GROUNDWATER OBSERVED
PERCOLATION TEST
PT-1 — 6119123 BY TOM CENTER, P.E.
—TEST AT 24 INCHES BELOW GRADE IN A 30 INCH DEEP HOLE
STABILIZED PERCOLATION RATE: 1 MINUTES 15 SECONDS
Wf W 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 BED TO THE DEPTH REQUIRED, THE WALLS
AND FLOOR OF THE BED SHALL BE CLEANED AND RAKED IN ORDER
TO LOOSEN SMEARED SECTIONS OF EXCAVATION.
• PLACEMENT OF AGGREGATE SHALL BE AS SHOWN, AND CARE SHALL
BE EXERCISED TO AVOID INCLUSION OF FINE GRAINED SOILS AND
WASTE MATERIAL IN THE ABSORPTION TRENCHES.
• THE PIPE AND STONE SHALL BE LAID AT THE GRADES INDICATED,
MAINTAINING STRAIGHT CONTINUOUS GRADES WITHOUT SAGS, HUMPS,
SEPARATED JOINTS, OR OTHER UNSUITABLE CONDITIONS.
• 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 BED HAS BEEN INSTALLED.
ONSE VING FIXTURES AND
THIS SYSTEM IS DESIGNED FOR WATER C R
IS NOT DESIGNED TO ACCOMMODATE EXTREME WATER USE OR
EXTREME ORGANIC LOADING DEVICES SUCH AS JACUZZI TYPE SPAS
OR GARBAGE GRINDERS.
• ROOF FOOTING GARAGE, CEL
LAR AND SURFACE WATER DRAINAGE
MUST BE EXCLUDED FROM THE WASTEWATER SYSTEM.
ATERIAL
SYSTEM M
SPECIFICATIONS
ABSORPTION BED AGGREGATE
STONE IS TO BE 3/4" TO 1-1/2" WASHED CRUSHED STONE.
EFFLUENT SEWER PIPE
PIPING TO BE 4" SDR-35 OR SCH-40 PVC. INSTALL WITH 118"
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.
TOWN OF QUEENSBUF Y SEP-0394-2023
BUILDING DEPARTMEN_ 302.14-1-20
Based on our limited examination, telle, Richard
with our comments shall not be cc
indicating the plans and sppecifica! shley PI
full compliance with the Building'
New York State. Residential Septic Alteration
JUL 0 5 2123
TOWN OF 0 1-ENSBURY
SUIL DING &CODES
I OWN OF CUEENSBURY
BUILDING & CODES DEPT.
Reviewed By: �._.
Date
TAX MAP # 302.14-1-20
ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED PI
ENGINEER IS A VIOLATION OF NYS EDUCATION LA
Dig "Safely.
NewlYork
M Call Before You Dig
® Wait The Required Time
® Confirm Utility Response
® Respect The Marks
IM Dig With Care
800.962.7962
www.digsafFlynewyark.com
REFERENCE:
BASE-
MAPP MAP INFORMATION FROM WARREN COUNTY GIS
PROD ING AND FIELD MEASUREMENTS BY CENTER
ACT SERVICES
FILE C, 0��
0 ISSUED FOR SEPTIC PERMIT 06126123
No. Revisions Date
WASTEWATER SYSTEM PLAN & DETAILS
prepared for:
LANGWORTHY RESIDENCE
18 ASHLEY PLACE
Town of Queensbury, Warren County, NY
Drawn: TRC Checked: TRC Scale: NOTED Date: 612512023
73 Sheridan Street
CENTER Glens Falls, NY 12801 398
PROJECT SERVICES (518) 796-2515 Phone