2013-575 TOWN OF QUEENSBURY
eta. 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
ItioN
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130575 Application Number: A20130575
Tax Map No: 523400-227-018-0001-030-000-0000
Permission is hereby granted to: GARY ZERVAS
For property located at: 85 HANNEFORD Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: ADIRONDACK MIN RIDGE EST., Test Pit/Perc Test Review
136 STONE SCHOOLHOUSE Rd Total Value
LAKE GEORGE NY 12845-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-575
PERC TEST complete. - See BP 2014-104 SFD
$200.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,December 16,2014
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of Queensbury; Monday, December 16, 2013
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury• Building&Codes Enforcement Office•742 Bay Road• Queensbury, NY 12804
DEEP HOLE/PERC TEST
VZ
2p1'3 Request for Town Engineer Review
Property Owner: '7ev-7 Z -
'-v.`t 5 Phone: 5b " "' 86 < <(
Property Owner's 1�
Address: f3b S *tet _QV)c+I114-iSt' 1«�. L 6: , /1/y / eif
Location of Test: /33 ��<� -i r� . Tax ID#: �� t I g -1-30
*Applicant's Engineer: G .5 v C_� Phone: 66- 8— 4i4
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Applicant's Agent: DQv i•) Phone: SS r 715/
Additional Notes:
1. Reason for Request? New Septic System Pc1 Replacement Septic System Failed Septic System
Subdivision Site Plan Review
2.Are Wetlands present? YES Y I NO UNKNOWN
*Note: Applicant is required to engage an engineer for design and testing of the system. The Town
Engineer's responsibility is to witness system testing only.
PLOT PLAN: Plot plan, to scale, to be submitted with application
FEE SCHEDULE:
a. $ 200 Flat Fee Date Paid:
Check No.:
b. OR Fee to be determined during To Be Determined:
Site Plan /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. I also fully understand that additional
engineering fees may be necessary per Town of Queensbury Local Law 136-14D.
SIGNATURE OF APPLICANT: Date:
SIGNATURE OF AGENT: / - Date: (2/164
Original (B&C File) Canary(Planning) Pink(Applicant) Gold (Town Clerk)
j5/75
THE
North Country Office
C
/J Onn 375 Bay Road, Queensbury, NY 12804
P: (518) 812-0513 F: (518) 812-2205
COMPANIES www.chazencompanies.com
Engineers Hudson Valley Office (845)454-3980
Environmental Professionals Capital District Office (518)273-0055
Land Surveyors
Landscape Architects
Planners
December 17, 2013
Dave Hatin, Director, Building and Codes
Town of Queensbury
742 Bay Road
Queensbury, New York 12804
Re: Soil Testing Verification
85 Hanneford Road
Queensbury, NY 12804
Dear Mr. Hatin:
As requested, Chazen has completed an onsite soil testing witnessing for the above referenced location
on December 17, 2013, in regards to subsurface soils conditions for a proposed septic system design.
The testing was performed by Charlie Maine of Queensbury for D.L. Dickinson Associates.The proposed
system is intended to replace the existing system on the property. One test hole and two percolation
tests were performed approximately 100 feet to the east of the existing house.
The initial test hole (TP-1) was performed in the vicinity of the existing septic system. The subsurface
soil was comprised of the following:
0"-8" Topsoil
8"-14" Loamy Sand (mottling observed @ 14")
14"-72" Fine Sand
Stabilized percolation rate,test#1: 3m10s/in.
Stabilized percolation rate,test#2: 3m15s/in.
If you have any questions or require additional information please do not hesitate to call me at (518)
824-1926.
Sincerely,
Sean M. Doty, P.E., LEED AP
Senior Project Engineer
cc: File
Chazen Engineering,Land Surveying&Landscape Architecture Co.,P.C.
Chazen Environmental Services,Inc.
The Chazen Companies, Inc.