SEP-0465-2021 j=- SEPTIC DISPOSAL PERMIT Office use Only
6.1.
. Y APPLICAT ON Permit#:
Tocvn of Queensbury
Permit Fee:$
Invoice#: �
742 Bay Road,Queensbury,NY 12804 P:518-761-8256 �5,�vu.c�aecitsuzy.sit4 Flood Zone? YdIV J Reviewed By.
No
Pr®)eft Location: 37 HERALD DRIVE iD C [F:�.-9V- E
JUN 16 2021
Tax Map#: 308.10-2-20 0
TOWN OF QUEENSBURY
BUILDING&CODES
RESIDENCE INFORMATION: -�'---�
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) X
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 114 3 1110 1330 Installed? (choose one) X
PARCEL INFORMATION:
Topography Flat Rolling Steep Slope %Slope
Soil Nature Sand Loam Clay Other, explain:
Groundwater At what depth? GREATER THAN 6 FT
Bedrock/Impervious material At what depth? GREATER.THAN 6.FT
Domestic Water Supply Municipal Well Lake '
(if well or lake, water supply from any septic system absorption is
ft.)
Percolation Test Rate: 1-sMIN per minute per inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size l000 gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
spa/hot tub EXISTING 1000 GAL CONCRETE
System- Absorption field w/#2 stone Total length ft.; Each Trench ft.
Seepage Pit w/#3 stone How many: ;Size:
Alternative System Bed or other type:20 FT X 25 FT_
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
0 Applicant:
Name(s):WILLIAM ROBINSON
Mailing Address, C/S/Z: 37 HERALD DRIVE. QUEENSBURY,NY 12804
Cell Phone: Land tine:
Email:
o 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 ®nly
Contractor:
Contact Name(s):SANITARY SEWER SERVICES
Contractor Trade:
Mailing Address, C/S/Z:LUZERNE RD, QUEENSBURY
Cell Phone: Land Line:5.18-796-3760
Email:
"Workers' Comp documentation must be submitted with this application"
® Engineer(s):
Name(s): CENTER PROJECT SERVICES
Mailing Address, C/S/Z:73 SHERIDAN STREET, GLENS FALLS NY 12801
Cell Phone: Land Line:
Email:
Contact Person for Compliance in regards to this project:GEORGE DRELLOS
Cell Phone: Land Line: 518-796-3760
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 0 ance.
PRINT NAME:GEORG R OS
SIGNATURE: / DATE:
Septic Application Revised January 2021
TOWN OF ®LIEENSBLILY
742 Bay Road, Queensbury, NY. 12804-5902
Septic System Checklist
OPlan to scale
Received Deep hole perc test results from engineer/Architect if applicable(Town Approved Engineers and
Architects;June 30 to April 15 Town Engineer for unapproved Engineers and Architects)12
' T�
Il,,&_AII wells on property and adjacent properties shown J1AJJhAGJ (2r
I&AWater line shown Municipal or well 10'separation to any part of system
Ct-CISSetback to property lines show 10'or more for any part of system
�eptic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10'from any waterline
VJ�Septic tank to foundation crawl space/slab on grade,grade in crawl space must be above top of septic tank
for 0',Separation required (field verification required)
Septic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage grinder each
Leech Field 20'from foundation 100'from any well.10'from water line
O*Li—Seepage pit 150'from well 50'from septic tank
01—Seepage Pits 3-times diameter apart
lft'-SSeptic tank and pump stations over 30 gallons 50'from watercourse or wetland
6'1-C13 distance from bottom of trench o system 24"to bedrock or mottling 36"within 1000'of Lake George
ci r<A- �kW P p3e-1
,Leech field 100'from watercourse or wefland� �
al"
of mound or bottom of retaining wall 10'from property line 100'from well 20'from
Foundation
Provide Engineer/Architect stamp for bed or design systems
Department of Health Approval for all mobile home park new systems Flood Plain requirements
e.(-0 2' above established flood elevation to bottom of system
All tanks anchored or 2'above flood elevation
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LU U BUILDING DEPARTMENT a
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�used on our limited examination,compliance �' W
a L ith our comments shall not be construed as
S � u-_J dicating the plans and specifications are in
! O II compliance with the Building Codes of
ew York State. _
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TOW OF QUEENSBURY
B4 ING & CODES DEPT.
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73 Sheridan Street, Glens Falls,NY 12801
Phone-518-796-2515
June 16, 2021
Project##345
George Drellos
Sanitary Sewer Service
Queensbury,NY 12804 D E C E 9 W E
Re: Proposed Replacement Septic
37 Herald Drive, Queensbury,NY JUN 16 2021 1
Dear George: TOWN OF QUEENSBURY
BUILDING& CODES
At your request, we have reviewed your proposed replacement septic system design of the
existing 3-bedroom house at 37 Herald Drive in Queensbury. As per our conversation the
residence has an existing failed septic system.
We have reviewed the proposed replacement septic system design and we agree that a standard
absorption bed is acceptable. Based upon a design flow rate of 330 GPD and a percolation rate of
1 to 5 minutes, you will need a minimum of 367 sf of absorption area. We recommend using 20
ft wide by 25 ft long absorption bed with 4 —20 ft long laterals. The absorption system can be
constructed with the existing 1,000-gallon septic tank, new distribution box, and 4-inch diameter
perforated pipe and stone.
Please feel flee to contact me at 796-2515 if you have any questions and that you for your
assistance with this request.
Sincerely,
Thomas R. Center Jr,P.E.
AS BUILT
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