SEP-0180-2021 SEPTIC DISPOSAL PERMIT Office Use only
_ APPLICATION Permit#:. c�h ' Okbp
of t Town ZucensGup S5
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Permit Fee: $
Invoice#: Z
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensbury.net Flood Zone? Y N) Reviewed By:�UY
Project Location: 38 Russell Harris Rd. 0 V IE
Tax Map #: 239.8-1-1 D
APR 01 2021
RESIDENCE INFORMATION:
Year Built Gallons #of bedrooms: X gallons per =total daily flow TOWN OF QUEGOIDES Y
per day bedroom es No
1980 or older 150 3 150 450 Installed? (choose one)
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 110 Installed? (choose one)
PARCEL INFORMATION:
Topography Flat Rolling Steep Slope % Slope varies
Soil Nature Sand Loam Clay Other explain:
Sandy loam above rock
Groundwater At what depth?
Bedrock/Impervious material At what depth?
Domestic Water Supply Municipal . Well Lake
(if well or lake, water supply from any septic system absorption is
ft.)
Percolation Test Rate: N/A per minute per inch (test to be completed by a
N/A licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size 1,000 gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
spa/hot tub (2 x 500 gal.)
System Absorption field w/#2 stone Total length ft.; Each Trench ft.
N/A Seepage Pit w/#3 stone How many: ; Size:
N/A Alternative System Bed or other type:
Holding Tank System Total required capacity? ; tank size ;
N/A # of tanks
Septic Application Revised January 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Joan Colangione
Mailing Address, C/S/Z: 32 Middlesex Road, East Greenbush, NY 12061
Cell Phone: Land Line: Cell 518-496-5196 Land Line 518-477-6904
Email: N/A
• Primary Owner(s):
Name(s): Joan Colangione
Mailing Address, C/S/Z: 32 Middlesex Road, East Greenbush, NY 12061
Cell Phone: Land Line: Cell 518-496-5196 Land Line 518-477-6904
Email: N/A
Check if all work will be performed by property owner only
• Contractor:
Contact Name(s): Jared 0' Neil
Contractor Trade: O'Neils Property Improvement
Mailing Address, C/S/Z: 285 New Road, Nassau, NY 12123
Cell Phone: Land Line: Cell 518-858-2155
Email: oneilspropertyimprovement@gmail.com
**Workers' Comp documentation must be submitted with this application**
• Engineer(s):
Name(s): N/A
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Contact Person for Compliance in regards to this project:
Cell Phone: Land Line: James McMahon 518-322-0103
Email: McMahonFamily6@gmai1.com
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 Ordinance.
PRINT NAME:
SIGNATURE:yA C" U 3' 31-a\ DATE:
Septic Application Revised January 2021
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APR 01 2021 °3 TOW14 OF QUEENSBURY
BUILDING & CODES DEPT.
TOWN OF QUEENSB RY Reviewed By: C74
BUILDING&COD S /'
--o_ �-: Date: y Z
/ TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Based on our limited examination,compliance
y� ##38� with our comments shall not be construed as
f indicating the plans and specifications are in
full compliance with the Building Codes of
j New York State.
t
10' setback line o o.
Proposed I FILE COPY
500 Gallon Septic Tanks
` Existing Pump
S 239,8-11
SEP-0180-2021
I Colangione, Joan
38 Russell Harris Rd
Residential Septic Alteration
#36 Russel Harris Road
#44 Russel Harris Road John McDougall
Jason Brown SBL: 239.8-1-1 SBL: 240.5-5-1-4
SBL: 239.8-1-2
Proposed Septic Tanks
#38 Russel Harris Road ,1
Lands of Joan H. Colangione
April 1, 2021
Scale: W5
RussellHarris Road
L.a Ke v e u i g`e
APR 20-21
�, TOWN OF QUEENSBURY
- - BUILDING & CODES DEPT.
TC�l/VN UF-C';�r�Ni �_J R Y
B[[ll,�s �-,°:.F," :,� ,-�c`E.;°, _ Reviewed By: . 1
U11L .c?',, , tom; J; EE 1,
_,.,.__....._.-.x,�....m�._c..,�..,__... Dated
TOWN OF QUEENSBURY
BUILDING DEPARTMENT
11 Based on our limited examination,compliance
y..� #38� with our comments shall not be construed as
indicating the plans and s .ecifications are in
full compliance with the uilding Codes of
New York State.
10' setback line o o.
Proposed l FILE COPY
I 500 Gallon Septic Tanks
Existing Pump
I If SEP-®1.80-2021
239.84-1
Colangione, .loan
38 Russell Harris Rd
Residential Septic Alteration
#36 Russel Harris Road
#44 Russel Harris Road
John McDougall
Jason Brown
SBL: 239.8-1-1 SBL: 240.5-5-1-4
SBL: 239.8-1-2
REVTSED
r�Gv
Proposed Septic Tanks
#38 Russel Harris Road
Lands of Joan H. Colangione
April 1, 2021
Scale: DID' 1" 10
RussellHarris Road 11�