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SEP-000697-2017 LELOPMENT� �TRlgtaw2017 EEP HOLUPERC TEST ENS�D E T FOR TOWN ENGINEER REVIEW Town of Queensbury Building and Code Enforcement 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury, et Property Owner(s): ,I '� C /��`^ Phone#: (S 1r ) 30� 'k Mailing Address (c/s/z): 35 ?,,4A,.. ;L,,e- Fr-� for I ZsYZ� Location of test: (�d -s L,ny S dQ E'y S Tax ID#: *Applicant's Engineer: "'` ��'► Phone#: ( ) Applicant's Agent: Phone #: ( ) Additional Notes: 1. Reason for request? I New Septic System ❑ Replacement Septic System ❑ Failed Septic System ❑ Subdivision ❑ Site Plan Review 2. Are wetlands present? ❑ YES K NO ❑ UNKNOWN *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, must be submitted with application. FEE SCHEDULE: 1. $200 flat fee date paid: check#: a- 2. OR fee to be determined during to be determined: site plan/subdivision review process PLEASE READ BEFORE SIGNING: In carrying out the provisions of Article IV,the Local Board of Health or the enforcement office 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$1500 without proper written notice to the party to be changed the 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 136-14 D. �� G /� , SIGNATURE OF APPLICANT: DATE: SIGNATURE OF AGENT: DATE: Original(B&C File) Canary(Planning) Pink(Applicant) Gold(Town Clerk) Deep Hole/Pert Test App Updated August 2017 THE North Country Office Clea e 375 Bay Road, Queensbury, NY 12804 P: (518)812-0513 F: (518) 812-2205 COMPAN I ES www.chazencompanies.com Engineers Hudson Valley Office (845)454-3980 Environmental Professionals Capital District Office (518)273-0055 Land Surveyors Landscape Architects Planners November 8,2017 Dave Hatin, Director, Building and Codes Town of Queensbury ,p 742 Bay Road c5� Queensbury, New York 12804 Re: Soil TestingVerification D 40 Sunnyside E NOV 2��7 Town of Queensbury, Warren County NY 91700.42 TOWN OF QUENSgUF�Y Dear Mr. Hatin: i3U!s*DING y&CODES As requested, Chazen has witnessed onsite soil testing for the above referenced location on November 8, 2017.The purpose of this testing was to investigate subsurface soils conditions for proposed septic system design.The system is proposed as new construction.The testing was performed by Thomas Center Jr of Nace Engineering, P.C. One soil test was performed in the general area of the proposed septic field at the rear of the site. TP1 0"-2"Topsoil 2"-25" Fine light brown loamy sand with some gravel 25"-55" Fine medium brown/grey loamy sand with some gravel and traces of silt throughout. Soil Compacted at 32" No mottling encountered. Roots encountered throughout. No groundwater encountered. 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, CPMSM Principal Manager, Municipal Engineering Services Chazen Engineering, Land Surveying&Landscape Architecture Co.,P.C. Chazen Environmental Services, Inc. The Chazen Companies, Inc. 6 < 1 : Map Reference: Map of a Survey made for John A . & Deborah P. Shahay _ r 5 December 05, 2001 , n , „ e t Y D �^ s & S .:t B . - ad Surveyors S 3 4 gw aY S' t^ Y~"u• "a of cIR� 0 S> 86052 .00 E Map of a Survey � ;, S 86 'S2 0 E ' be' Retained by , j... ......�..y,.._.........W ».w.�.,�.,.�,..,» .. �..�.......�..�.�. ...�,.... ... ..,. Lands ing to d _; GGtdePost } • 75 88 79 69° Mrs• Florence Hewitt { T P se ) 1 Dated: October 19, 1970 By: Jahn B. Vart C}usen Reference:, Deed R � k�:l _. Martha A. Daugher To w : 1 Thomas Callahan and Callahan _ o c) of 'Mariannes . " story �`,=r1 Via" Lands N/F o Dated: April -19, 2016 f Lands N/F of ® ; , Ufo°'F °e °' John. Austin l 22 2016 a Y C)DSC Recorded: Apr s 9 x Anna Dough-, C31 _ ,0 B:5342 P:143 ca `" �Deck ,c� Lands N/F of Cl) Joshua .D. Fish x i; i Ga ayzatK�� x SPP S 86°19'00`' E �...,.,.,.,..:.. ,�.._.... ......... Guide Post {U e) Guide Post Weed Lin 99.82` Total Area PF cis Feet x x x 163430.0 Sq. 3.8 Acres o ° r 2o,7n2,Ten__., �JInstr 1#2017-3000007 U-1 C0a°� _ v-- ccj- - r _ 0111812017 11:35:07 AM Cv 0 -(0 - Pra►aosed_lot_ 2_ �-- .— T`�' °�_ Proposed Lot 1 *- 1 Pages Area ' MAP s Lands N/F Of _ - °��. ' Area = Strainer -0) 87135.8 Sq Feet et Fe David � • - 762 1 Acres ParnelaJ. r Co Clerk FILED 0 78 � Sq' Vogel Warren G �- .8 Ac r 2 '0' Acres , � r Guide Post ' Lands N/F of e Far �q Brodie r J`' �{� �• � ,��� � S., n r-e� j'r1 Vis, �� �� tT,� °j" ;. �tg = ' q>4£Ja I 7 OV ,• f �i � o r iV i co 264 ry pp C15' ✓,.`. 0 lRP 3.6' 11 i N 83 39 521 W 202.05•_. Guide Yost {Proposed} 5rlea N 830371 S21t "W . -. ' l {Proposed) nds N/F of Lands N/F of dwards Traci Mastroieni Lands N/F of Legend: David C. Nelson Lands N/F of Q ober` Ciana R � F = Iran Rod Found Yd� S ,f . 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M p of a Survey ma r e de fo { _ "UNAUTHORIZED ALIERARON OR ADDITION TO A SUft't£Y _ 1 MAP BEARING A UCEHSED LAND SURVEYORS SEAL IS A _ VIOLATION OF SECRET'7209'SUB-DIVTStON 2.OF THE _ T - NEW YORK STATE EDUCATION LAR-" - - - _ "ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY SHEET I OF I I 7 - - MARKED WTT}i AN O(i{GINAL OF THE LANG SURVEYORS ,. �••V Callahan - `• F�.ls SEAL SHALL eE CONUIDEREp TO DE VAUD TRUE COPIES - •• •.• w », ,,, - "CERrFtCAnONS IhU1CATED HEREON SIGNIFY THAT » S e-V e S , Y WAS P(EPARED iN ACCORDANCE WITH THE _ _ - _ - RVE TS Callahan - THIS SU I E EXISTING Co (0 OF PRACTICE FOR LAND SURVEYORS ADOPTED - ! �� ,I q'7 L^�"�O�A( PR OP OS[,Q �0 BY THE NEW YDRK STATE ASSOCIARON OF PROFESSIONAL - _ _ e ark l f 1 SHOW Siirve Larid . �'°�t = LAND SURVEYORS,yPJD CERTIFICATIONS IS RUN ONLY ',, Warren County, - ...... - ^"' TO THE PERSON FCA WHOM THE SURVEY i5 PREPARED AND - Queensbury,' ar �C311 "✓ f '�� � - � . r g9 �+ _ DING NC1. 7.0 12C 9 Oti HIS BEHALF TO THE KYLE COMPANY,GOVERNMENTAL Town ®j Q� - - AGENCY AND,LENDIlIU INSTiTUNiON LISTED HEREON,AND ;. 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