SEP-0603-2018 Town of Queensbury• Building&Codes Enforcement Office•742 Bay Road■ Queensbury,NY 12804
DEEP HOLE/PERC TEST i 1I (� (E El 'U [E
Request for Town Engineer Rev'
SEP202018
Property Owner: MY,L /$ Phone: TOWN OF QUEEN3BURY
Property Owner's 1,-,a) _ , , e S4.061 i CODES
Address:
Location of Test: 6! O . t2-0/4O Tax ID#: 3c€.11— —€
*Applicant's Engineer: V4,(6(11/41 `t 14 IL- ikteta Phone: 51e' --OVA
Applicant's Agent: =: ..t Phone: Si$ .. /44 6
Additional Notes: '"i�> it f 4 yi, J \-AL r r L—
bbe - k\kE;i3 OtD ete_ Pie-tale-1 al e- )i
1. Reason for Request? ,New Septic System Replacement Septic System Failed Septic System
Subdivision Site Plan Review
2.Are Wetlands present? YES / 1 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.: °'��tQ.O In°ai k. 0$b t®
' - 0 00.0-2.e IPa
b. OR Fee to be determined during To Be Determined:
Site Plan I 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: AAY/ pate:
SIGNATURE OF AGENT: Date: 224WYg
Original (B&C File) Canary (Planning) Pink(Applicant) Gold (Town Clerk)
THE North Country Office
ChaKT 20 Elm St (Suite 110), Glens Falls, NY 12801
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
September 28,2018 �/J (�'
Dave Hatin, Director, Building and Codes ]5) E C tE un v EE
Town of Queensbury
742 Bay Road -11 OCT 01 2018 flif
Queensbury, New York 12804
TOWN OF QUEENSBURY
Re: Soil Testing Verification BUILDING &CODES
120 West Mountain Road
Town of Queensbury, Warren County NY — IpLfLa2j w,it
91800.38
Dear Mr. Hatin:
As requested, Chazen has witnessed onsite soil testing for the above referenced location on September
28, 2018.The purpose of this testing was to investigate subsurface soils conditions for proposed
wastewater system design.The system is proposed as new construction.The testing was performed by
Ethan Hall of Rucinski Hall Architecture
Two soil tests were performed in the general area of the proposed stormwater design.
TP1—Front area of property
0"-8"Topsoil
8"-26" Medium red sand
26"-50" Light brown sand
50"-72" Light brown course sand
Roots encountered 0"-26"
No mottling encountered
No groundwater encountered
All infiltration tests<30s
TP2—Back area of property
0"-8"Topsoil
8"-26" Medium red sand
26"-50" Light brown sand
50"-72" Light brown course sand
Roots encountered 0"- 16"
No mottling encountered
No groundwater encountered
Chazen Engineering,Land Surveying&Landscape Architecture Co.,P.C.
Chazen Environmental Services,Inc.
The Chazen Companies,Inc.
September 28,2018
• Page 2
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,
Director Municipal Engineering Services
Z:\projects\91800-91899\91800.00-T.Queensbury\91800.38-T.Queens bury-Soil Test Pits-120 West Mountain Road\Soil Test Verification Itr 2018-09-28.do"