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SEP-0608-2022 SEPTIC DISPOSAL PERMIT Office use Only APPLICATION Permit#: �?' Tm++of QuecnsAun• Q� � Permit Fee:$ ©GJ 742 Bay Road,Queensbury,NY 12804 D a' ' ~�� ice#: bu �C �/ P:518-761-8256 www.oueensrv.net ii[od Zone? Y N Reviewed By SEP 3 0 2022 Towru o� ,[�r�,-r, Project Location: 381,WESIB ATA)#� QA�BURY GODES Tax Map#: 308.9-1-14 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 110 3 330„ installed? (choose one) X 110 PARCEL INFORMATION: Topography ./ Flat Rolling Steep Slope %Slope Soil Nature Sand VrLoam 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: 1-5MIN 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 NEW 1000.GAL CONCRETE System Absorption field w/#2 stone Total length. ft.;.Each Trench Seepage Rit w/#3 stone How many: ; Size:. Alternative System Bed or other type:20 FT x 30 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 • Applicant: Name(s):ANDREW CRONQUIST. Mailing Address, C/S/Z:381 WEST MOUNTAIN RD.QUEENSBURY,NY 12804 Cell Phone: Land Line:. . 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):SMITHS EXCAVATING _Contractor Trade: Mailing Address,C/S/Z: eUEENSBURY. . Cell Phone: -L .ine:518-361-0956 Email: **Workers' Comp documentation must be submitted with this,application** • Enaineer(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: r�o Inc o�Rf1 . Cell Phone: Land Line.s' '" �2Ec) 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 priorto the inspection,.if-there-has been a-change to the submitted- .plans.4. If,for any reason,.the building.permit agplication 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 factor 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:FRED ��J SIGNATURE: DATE: 1 . � 1,?�);�2_ Septic Application Revised January 2021 TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY. 12804-5902 Septic System Checklist %Plaq to scale NL_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) }� All wells on property and adjacent properties shown ,Ur�,� t FO (A4-�-, Water line shown Municipal or well 10'separation to any part of system 6 Setback to property lines show 10'or more for any part of system Septic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10'from any waterline �J 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) A 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 �✓ . Seepage pit 150'from well 50'from septic tank N. Seepage Pits 3-times diameter apart Septic tank and pump stations over 30 gallons 50'from watercourse or wetland distance from bottom of,trench or system 24"to bedrock or mottling 36"within 1 00'of Lake George 4�eech field 100 from watercourse or wetland 4 Toe of mound or bottom of retaining wall 10'from property line 100'from well 20'from /n Foundation Iv 0/ Provide Engineer/Architect stamp for bed'or design systems �& Department of Health Approval for all mobile home park new systems Flood Plain requirements J0 2' above established flood elevation to bottom of system N 6 All tanks anchored or 2' above flood elevation �� �� Z � D -SEP 30 2022 P , - r � ., ��,`-`' I,• ,.• , �,��r;'. i '' - -, -,-- TOWN OF QUEE cL I i �JS 1RY BUILDING CODES - - '' \ - - W, - Da - - - c� C a d , , , , - ' 1 - - -- -- -- - -i- --- -- -i - !A308.9-1-14 SEP-0608-2022 - - Cronquist, Andrew - - -- - - - •- - , - - --- ---I--- - ---- -- ---�—�_�,,--;4j-�, 381 W Mountain Rd ' Residential Septic Alteration - i -- - 'f CENTER PROJECT SERVICES 73 Sheridan Street, Glens Falls,NY 12801 Phone-518-796-2515 September 26, 2022 Project#383 Fred Smith Smiths Excavating Queensbury,NY 12804 �" IE 0 E Re: Proposed Replacement Septic SEP 3 0 2022 381 West Mountain Road, Queensbury,NY TOWN_Off'OUEENISSURY Dear Fred: BUILDING Q CODES At your request, we have reviewed your proposed replacement septic system design of the existing 3-bedroom house at 381 West Mountain Road 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 l.to 5 minutes,you will need a minimum of 367 sf of absorption area. We recommend using 20 ft wide by 30 ft long absorption bed with 4 — 25 ft long laterals. The absorption system can be constructed with the new 1000-gallon septic tank, new distribution box, and 4-inch diameter perforated pipe and stone. Please feel free 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. 1 t I'UI r,i..`,• i :; r," - it/lEi�T Wi(:` CG;1?piiAf1C8 EEP a,i .:ions are in 3 0 2022 yJ,i ; ! ;1`J:;n COrs-^ o 1 TOWS! OF QUEENSBURY BUILDING & CODES Ou c 7�E00 _ CIZ C ca i � ` • �-rah.�� i .:.' `� �` Q L t'"a 308.9-1-14 SEP-0608-2022 Cronquist, Andrew s 381 W Mountain Rd " - Residential Septic Alteration