2015-473 rA
Town of Queensbury• Building&Codes Enforcement Office•742 say Road• nbur NY 12844
4 i 0 i 2015
DEEP HOLE/PERC TEST
Request for Town Engineer Revie TOWN OF QUl^FNSI3URY
BUILDING & CODES
SOI J 3
Property Owner: Wf .�t�t' } Phone: Y�•dUt�
Property Owner's
Address: D� t �
Location of Test: C—a Tax ID#:
*Applicant's Engineer: Phone: f
Applicants Agent: Q ,• �rlQ
Phone:
Additional Notes:
7. Reason for Request? New Septic System Replacement Septic System Failed Septic System m
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Subdivision ❑ Site Plan Review C
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2.Are Wetlands present? YES NO UNKNOWN 0
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*Note: Applicant is r@guired to engage an engineer for design and testing of the system. The Towi 0 a�
Engineer's responsibility is to witness system testing only. 0 --
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PLOT PLAN: Plot plan, to scale, to be submitted with applicationCD m
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FEE SCHEDULE:
a. $200 Fiat Fee Date Paid: 0// 4
Check No.: �5
b. OR Fee to be determined during To Be Determined:
Site Plan 1 Subdivision review process
SIGNATURE:
In carrying out the provisions of Article IV, the Local Board of Health or the enforcement officer may
engage the services of a qualified professional consultant for expert review and recommendation arising
from the carrying out of the provisions of Art. IV, including but not limited to the review of plans,
specifications and reports, attendance at inspections, dye tests, deep hole test pits, septic related deep
hole and percolation tests, system installations, and any other aspect of any matter contained in this Art.
IV, and any costs incurred in such review shall be paid to the Town by the owner of the property before
any approval can be granted under this Art. IV shall become effective within 30 days of presentment of an
invoice for same, whichever is sooner. Such costs shall not exceed $1,500 without prior written notice to
the party to be charged with same.
My signature below indicates I have thoroughly read and understand the instructions, agree to the
submission requirements and have completed the application. 1 also fully understand that additional
engineering fees may be necessary per Town of Queensbury Local Law 136-14D.
SIGNATURE OF APPLICANT: 4 Date:
SIGNATURE OF AGENT: Date: LoAzzlI5
Original (B&C File) Canary (Planning) Pink(Applicant) Gold (Town Clerk)
THE
North Country Office
Cha ,e4
375 Bay Road, Queensbury, NY 12804
---T P: (518) 8120513 F: (518) 812-2205
COMPAN I ES www.chazencompanies.com
H
Engineers Hudson Valley Office (845)454-3980
Environmental Professionals Capital District Office (518) 273-0055
Land surveyors
Landscape Architects
Planners
October 8, 2015
Dave Hatin, Director,Building and Codes
Town of Queensbury
742 Bay Road
Queensbury, New York 12804
Re: Soil Testing Verification
565 Boy Rood(Old Coach Manor)
Queensbury, NY 12804
Dear Mr. Hatin:
As requested, Chazen has witnessed onsite soil testing for the above referenced location on October 7,
2015. The purpose of this testing was to investigate subsurface soils conditions for a proposed septic
system design. The system is proposed as a replacement for an existing system. The testing was
performed by Ethan Hall of Rucinski Hall Architecture.
Only one soil test was performed on the southeast portion of the property in the open area
approximately 380 feet from the site entrance intersection with Bay Road. The soil profile consists of
the following:
0"-8" Topsoil
8"-28" Loamy sand (moist)
28"-60" Clay(trace to mostly clay)with loamy sand mix (moist)
Mottling at 28"
Groundwater seeps start at 48"
If you have any questions or require additional information please do not hesitate to call me at (518)
824-1926.
Sincerely,
Sean M. Doty,PZ, LEER AP RECEIVED
Associate
Manager, Municipal Engineering Services
cc: File
Chazen Engineering, Land Surveying&Landscape Architecture Co.. P.C.
Chazen Environmental Services, Inc.
The Chazen Companies, Inc.
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