SEP-0233-2021 an
SEPTIC DISPOSAL PERMIT Office Use Only
APPLICATION Permit#: 0733-ZOZI
Town of Queensbury R
Permit Fee:$ v
Invoice#: 56 0 Z
742 Bay Road,Queensbury,NY 12804
P:528-761-8256 www.aueensbury.net Flood Zone? Y N Reviewed By:
rd V OLIV %eW%U--,
Project Location: 61 Peachtree Lane D E CIE BYE
Tax Map #: 301.18-1-54 APR 15 2023
TOWN OF QUEENSEURY
RESIDENCE INFORMATION: L BUILDING &COMES
Year Built Gallons #of bedrooms: X gallons per =total daily flow
per day bedroom Garbage Grinder Yes, No
1980 or older 150 Installed? (choose one)
1981-1991 130 Spa or Hot Tub Yes oNo
1992-Present 110 3 110 330 Installed? (choose one)
PARCEL INFORMATION:
Topography Flat Rolling Steep Slope % Slope _
Soil Nature Sand Loam Clay Other, explain:
Groundwater At what depth?
Bedrock/Impervious material At what depth?
Domestic Water Supply QEnicipal Well Lake
(if well or lake, water supply from any septic system absorption is
ft.)
Percolation Test Rate: 1:00 per minute per inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
spa/hot tub existing 1,000 gallon tank
System Absorption field w/#2 stone Total length ft.; Each Trench ft.
Seepage, Pit w/#3 stone How many: ; Size:
Alternative System Bed r other type:15'x27'Absorption bed per original subdivision plans
Holding Tank System . Total required capacity? ; tank size ;
# of tanks
Septic Application Revised January 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Sherman Pines Homebtv7ners Association
Mailing Address, C/S/Z: P.Cri BW332 Saratoga Springs, NY 12866
Cell Phone: Land Line: 518-331-9369 (Kelly Wolfe)
Email:
• Primary Owner(s):
Name(s): same as applicant
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Check if all work will be performed by property owner only
• Contractor:
Contact Name(s):Stone Installations
Contractor Trade: Installation
Mailing Address, C/S/Z:4305 Route 50 Saratoga Springs NY 12866
Cell Phone: Land Line: 518-232-6707 (Dean Burdick)
Email:
"Workers' Comp documentation must be submitted with this application"
0 Engineer(s):
Name(s): Hutchins Engineering PLLC
Mailing Address, C/S/Z:169 Haviland Road Queensbury, NY 12804
Cell Phone: Land Line: 518-745-0307
Email:thutchins@hutchinsengineering.com
Contact Person for Compliance in regards to this project:John Safford
Cell Phone: Land Line: 518-331-9369
Email:
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.
ka
PRINT NAME: Tc
SIGNATURE: DATE:
Septic Application Revised January 2021
169 Haviland Road
Queensbury, NY 12804
Hutchins Engineering Phone: (518)745-0307
Fax: (518)745-0308
April 13, 2021
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
Re: Sherman Pines Subdivision
61 Peachtree Lane
The existing wastewater system serving the above-referenced residence is in failure and
requires replacement.( We have been asked by the Homeowners' Association to assist with
procuring permits and overseeing this work. The work will be completed by Stone Installations.
As has been the practice with other properties in this subdivision, it is proposed to replace the
existing absorption bed in accordance with the original subdivision plans. In addition, we
propose installation of an effluent filter and a vent pipe on the absorption field, if necessary.
-Attached are a permit application and a mark up -plot plan showing replacement location.
Please contact me if you have any questions or if you require additional information.
Best Regards,
G. Thomas Hutchins, P.E.
Enclosures
Cc: Ms. Kelly Wolfe, Sherman Pines Homeowners Association
Dean Burdick, Stone Installations
t, E EEPR 15 2r1OF OUEENSl3URY
DING& CODES
G.Thomas Hutchins,P.E.
SEPTIC DISPOSAL PERMIT Office Use Only
APPLICATION Permit#: Z A
Town of Queensbury
Permit Fee:$
Invoice#: 56 0 Z
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.aueensbury.net Flood Zone? Y N Reviewed By:
I,d V a.V t G•h v._.,
Project Location: 61 Peachtree Lane D
Tax Map #: 301.18-1-54 APR 15 2021
TOWN OF QUEENSBURY
RESIDENCE INFORMATION: BUILDING&CODES
Year Built Gallons #of bedrooms: X gallons per =total daily flow
per day bedroom Garbage Grinder Yes, No
1980 or older 150 Installed? (choose one)
1981-1991 130 Spa or Hot Tub Yes No
,1992-Present 110 3 110 330 Installed? (choose one)
PARCEL INFORMATION:
Topography Flat Rolling Steep Slope % Slope _
Soil Nature Sand Loam Clay Other, explain:
Groundwater At what depth?
Bedrock/Impervious material At what depth?
Domestic Water Supply QLUnicipal Well Lake
(if well or lake, water supply from any septic system absorption is
ft.)
Percolation Test Rate: 1:00 per minute per inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size gallons (min. size 1,000 gallons, add 250 gallons for each garbage_cylinder or
spa/hot tub existing"1,000 gallon tank
System Absorption field w/#2 stone, Total length , ft.; Each Trench ft.
Seepage, Pit w/#3 stone How many: ; Size:
Alternative System Bed)D r other type:15'x27'Absorption bed per original subdivision plai is
Holding Tank System Total required capacity? ; tank size ;
# of tanks
Septic Application Revised January 2021
t i .
€ 169 ryndRoad
Queeaensbubury,NY 12804
Phone:(518)745-0307
i Hutchins Engineering Fax:(518)745.0308
` May 3,2021
Mr Charles Dyer
Town of Queensbury Buildings and Codes �]
j 742 Bay Road V
D E C E 9 E
Queensbury,NY 12804
Re: Sherman Pines Subdivision ` EAY
61 Peachtree Lane 0.3 2021
Our office prepared plan and application for an absorption field replacement serving the TOWN OF QUEENEEURY
referenced residence. I visited the site during construction and inspected the installation work. BUILDING&CODES
The failing absorption field was replaced with a 15'x27'absorption bad in accordance with the
original approved subdivision plans, and the application materials prepared by our office.
Additionally,an effluent filter and outlet riser to grade were installed on the existing septic tank.
Attached is a record drawing showing measured locations of the components installed.
Installation work was completed by Stone Installations, Inc. It is my opinion that the
components were installed in conformance with the original subdivision plans and the attached T BUILT
record drawing. Final surface grading,topsoiling and turf establishment work is ongoing. Feel ` /�`C
free to call if you wish to Discuss. I /�J
• 1
Best Regards,
G.Thomas Hutchins,P.E:
Enclosures
Cc: Ms.Kelly Wolfe,Property Manager,Sherman Pines
Dean Burdick,Stone Installations
G.Thomas Hutchins,P.E.
i
r I PROPOSED 4' VENT TO GRADE
WITH CHARCOAL FILTER IF BED /
B '\ I— �- I IS GREATER THAN 1.5' C
7 TOP. .ST01 CO LE D /
24•i@0,14 EXISTING 1,000 GALLON � 4 29/21 � "
�jl-- CONCRETE SEPTIC TANK TO
f/ BE PUMPED, INSPECTED AND I
g/I RE—UTILIZED. INSTALL I / —
+00 EFFLUENT F7 ! R - 15'X27'ABSORPTION BED TO BE --- - -
COMPLETED' ' f REPLACED IN ACCORDANCE WITH
4/29121 P 1 ON PLAN
62 `. COMPLETED,4 29/21 !
as \ I
62' y REPLACE EFFLUENT S 1 //
/ S TI COP D
61 PEACH TREE LANE
�'. QUEENSBURY(T)
36 RESIDENCE /• \ /
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\ 67 PEACHTREE LANE
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C MAY 0 3 2021
iE y39•/5 . I6.1W.95 / TOWN OF QUEENSBURY
BUILDING&.CODES
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\ 73 PEACEAC T /
HTREE LANE
t /` \`\ •/ / - A IRATIDN OF 7N0 DOCUMENT DW T En A UCENSED PROFF59GtIR.ENGINEER 6
A NOTATION OF N1S EDUCATION LAW.
WASTEWATER SYSTEM REPLACEMENT.PLAN -
SCALE 1"--40' 1 RECORD ORAWNG 51JI21
No. Date
WASTEWATER SYSTEM REPLACEMENT
MAP REFERENCE: Prep..d5,
BASE INFORMATION FROM "SHERMAN AS U I LT Dig NSef01y.
NOW Y Sherman Pines
PINES SITE PLAN & UTILITIES" BY MORSE o'k 61➢eadt&w Lane
ENGINEERING, P.C. OF QUEENSBURY, NY n�r�.•�.,—ft Town otQuEens",WenenLbunty,NY
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AND DATED AUGUST 1, 1995. •c.m..umax••o•.. a,.,.PH mewedGiH --Fs-.NG1ED o.e. az1
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13W. - 1D9 H.vB.N RIND,120
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- Hutchins Engineering PLLC (51e)7.5-0J05 Fax