SEP-0099-2023 SEPTIC DISPOSAL PERMIT office use only
APPLICATION Permit#: c� —UwG°i ZS-)QZ
Town ofQ s ucen ry6
Permit Fee:$
Invoice#:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensbury.net septic Varianc �No
Flood Zone?
Wetlands? Reviewed By:
Project Location: 35 Fieldview Road South
pEl F
� E
Tax Map #: 289.12-1-7.23
I I. MAR 10 2023
RESIDENCE INFORMATION:
Year Built Gallons #of bedrooms: X gallons per total daily,flow ��=Linsta:1
:r,!I �✓
per day bedroom ��------�-�..w.� ge Gr)inder Yes No
1980 or older 150 led? choose one) ❑ 0
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 110 3 110 330 Installed? (choose one) ❑ 0
PARCEL INFORMATION:
Topography ❑■ Flat Rolling ❑ Steep Slope % Slope
Soil Nature ❑ Sand ❑ Loam ❑ Clay 0 Other, explain:
Silt and Trace Clay
Groundwater At what depth? >57"
Bedrock/Impervious material At what depth? >57"
Domestic Water Supply ❑ Municipal ❑■ Well ❑Lake
(if well or lake, water supply from any septic system absorption is
ft.)
Percolation Test Rate: 8:46 per minute per inch (test to be completed by 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 existing tank will pumped, inspected and reused if suitable
System Absorption field w/#2 stone Total length ft.; Each Trench ft.
Seepage Pit w/#3 stone How many: ; Size:
Alternative System Bed Bed or other type: 15' x 25' (525 SF total) absorption bed
Holding Tank System Total required capacity? ; tank size ;
# of tanks .
Septic Application Revised July 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Robert and Debbie Welch
Mailing Address, C/S/Z: 35 Fieldview Rd. South Queensbury, NY 12804
Cell Phone: Land Line: 518-792-0532
Email: bob.welch52@gmail.com
• Primary Owner(s):
Name(s): same as applicants
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): IBS Septic
Contractor Trade: Installation
Mailing Address, C/S/Z: 2 Lower Warren Street Queensbury NY 12804
Cell Phone: Land Line: 518-798-8194
Email:
"Workers' Comp documentation must be submitted with this application"
• 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: tutchins@hutchinsengineering.com
Contact Person for Compliance in regards to this project: Robert Welch
Cell Phone: Land Line: 518-792-0532
Email: bob.welch52@gmail.com
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: homas Hutchins, P.E. (AGENT)
SIGNATURE: ) DATE: 03/10/2023
Septic Application Revised July 2022
TOW OF QUEENSBURY
742 Bay Road, Queensbury, NY. .12804-5902
Septic System Checklist
APlan to scale
Icieceived 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)
TgAll wells on property and adjacent properties shown
%water line shown Municipal or well 10'separation to any part of system
_/yetback 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
Pk-Septic tank to foundation crawl space/slab on grade,grade in crawl space must be above top of septic tank
p for 0',Separation required (field verification required)
1
(i Septic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage grinder each
ALeech Field 20'from foundation 100'from any well 10' from water line
`Seepage pit 150'from well 50'from septic tank .
/'" 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 2V to bedrock or mottling 3V within 1000'of Lake George
Leech field 100'.from watercourse or wetland
''"IA-Toe of mound or bottom of retaining wall 10'from property line 100'from well 20'from
Foundation
'EProvide'Engineer/Architect stamp for bed or design systems
) Department of Health Approval for all mobile home park new systems Flood Plain requirements
1vO2' above established flood elevation to bottom of system
YJ19All tanks anchored or 2' above flood elevation
7
WASTEWATER SYSTEM DESIGN-
3-BEDROOM RESIDENCE
DESIGN FLOW ,- 110 GPD/BEDROOM
SYSTEM DESIGN FLOW - 330 GPO
SEPTIC TANK EXIST. 1,000GALLON PRECAST CONCRETE
TO BE PUMPED, INSPECTED, & REUSED IF
SUITABLE. INSPECT INLET BAFFLE. INSTALL
EFFLUENT FILTER ON OUTLET.
DESIGN APPLICATION RA 1E• .7 GPD/SF, BASED ON
8-10 MIN/IN PERCOLATION RATE
ABSORPTION BED AREA REO'D (330 GPD)/(•7 GPD/SF)
= 472 SF
ABSOR TION BED AREA PROWDLD = 15 x35 . = 525. SF
POTABLE WATER SUPPLY IS'ON-SITE WELL
MAINTAIN 50' MINIMUM SEPARATION BETWEEN
SEPTIC TANK & WELL
MAINTAIN. 100' MINIMUM SEPARATION BETWEEN
u cc: ►raw. xnn
/ _ ..... _": I ,- � �r LANDS NIP OF - ABSORPTION FIELD 8e WELL
EXACT ROUTE UNKNOWN•I 10 B F EXISTING
SITE 10G4TION
WEll..t
LOCATION MAP
EXISTING , I .
SYSTEM INSTALLAT
ION NOTES
1 Y 1 - CONSTRUCTION SHALL BE AS: SHOWN ON THIS DRAWING AND '1N ACCORDANCE W17H 774E MY• . DEPARTMENT OF
HEALTH INDIVIDUAL HOUSEHOLD: SYSTEMS AND ASTM F481 INSTALLATION OF THERMOPLASTIC PIPE AND CORRUGATED
r`
CC o TUBING IN SEPTIC TANK LEACH FIELDS
TING o �
CREIE,SEPAC TANK lid BE PUMPED
i. NSPECIED AND .REUSED IF SUITABLE AFTER EXCAVATION OF 15' WID e t E X 35' LONG ABSORPTION BED TO THE DEPTH REQUIRED, THE WALLS AND. FLOOR
e REPLACE INLET BAFFLE IF NECESSARY. SHALL BE CLEANED AND RAKED IN ORDER TO LOOSEN SMEARED AREAS OF SOIL.
INSTALL EFFLUENT FILTER ON.OUiLET..
I PLACEMENT OF CRUSHED STONE, PERFORATED PIPE AND FILTER FABRIC SHALL BE AS SHOWN AND CARE
LANDS NIP OF I CABLE QrVE UN � �„_, o --- 1 SHALL BE
HAUMTON I EXERCISED TO AVOID INCLUSION OF FINE GRAINED SOILS AND WASTE MATERIAL IN THE STONE AND PIPE.
7P-1 I LIMIT OF 15 x35 4 PERFORATED PVC LATERALS
STONE BED INSTALLED NEAR LEVEL IN
BED CONFIGURATION THE PIPE SHOULD BE LAID AT THE GRADES INDICATED MAINTAINING STRAIGHT CONTINUOUS SAGS,
TINUOUS GRADES WITHOUT
I - HUMPS SEPARATED JOINTS, OR OTHER UNSUITABLE CONDITIONS- PIPE SHALL BE LAID IM1H HOLES DOWN POOL PROPOSED IN ALL
C e _ ,...--���;- �. ._. _ .. DISTRIBUTION eox
CASES
PROPOSEWD
. 2.5 _ .-� .. .. � , ;� `�' •: _ _ 4 PVC
TEL
�...
_ PIPE-1N STOW ALL DISPOSAL FIELDS SHALL BE GRADED Tn SH
t t - r W .. _% ...r. .. 7" EFFLUENT ED RAINFALL AND DIVERT SURFACE RUNOFF AWAY FROM THE LANDS N OF: �
LI�VAC% ► .' ABSORPTidV _ - _
yt SEWER DISPOSAL FIELD.
-VACANT,- I ? 7 I ,
Ad.� - •Y"� � I 7;_ v`,
A • � � e, ..>t % f .:� ..tt ...r ._t L� .:_r .._r -f
-,, ,,. ,. `xDO NOT USE H
EAVY EQUIPMENT WITHIN THE ABSORPTION AREA AFTER PIPING HAS BEEN INSTALLED.
..r
1
> r
POOL. N <�~. •- .• �,. •-x`�•-��a��'1� , ,,..�, ... ,. � r°�. a ,_. r.� r _� � .;� 774E WASTEWATER TREATMENT
- -.. Y . ..,. ,,,. �.:.,�. .. Y r' �.. �, �•-�, -s-�" ^. ,. _ , . • .,:-�';.: '� � :.� T SYSTEM IS. DESIGNED .AND APPROVED BASED UPON THE INSTALLATION OF WA
PUMP- � I ��h�; �, ram" �'- �- r• � p-. , . �r'�� -�`.
'L• 27BACK CONSERVING FIXTURES AND A DESIGN FLOW OF 110 GPD PER BEDROOM: 174E SYSTEM
TER
-- 15 - - , -
IS NOT DESIGNED TO
-,..• ,_ -
CA 7W OF <� _ ;� ACCOMMODATE. EXTREME WATER. USE FIXTURES, SUCH AS JACUZZI-TYPE SPA TUBS OR WATER TREATMENT EQUIPMENT.
FAILED ABSORPflL71N FIELD. CQNIRAC - THE INSTA -
_ _T f' ._r ._f .- ._f ._f ._! ._ .. ._f�'r t •• ` ELATION OF NON -CONSERVING WATER FIXTURES OR EXTREME WA1ER U
--T _.. s^ . -,.:. , .,*,.. �,, r �r �r '.-� SE FIXTURES IS CONTRARY TO THE
N -�. TO FIELD VERIFY FIELD LOCATION PRI 89"�q 18"1► _ L y 5= APPROVAL OF THIS WASTEWATER TREATMENT SYSTEM.
TO COMMENCING COINS7RUC110N
--•� ., ., . _ -�-i,. • .-�y. ;_ ;fir• , ~ ,, _ _
_
w
S1/N FIELD . AS NECESSARY
G . ECESSAR TO ALLO LANDS N/�, OF
FOR NEW FIELD /NSTALLA110N ,�.
FISS - 4. ROOF, FOOTING, GARAGE,. CL7.L,4R AND SURFACE WATER DRAINAGE MUST BE EXCLUDE
� - � - D FROM 174E WASTEWATER
-VACANT-
- - - - - - - -
_ SYSTEM.
WASTEWATER
AS TER SYSTEM PLAN ,. . ,..s,. ... CONSRUCT DRAINAG
E SWALE UPGRADE OF SY51EM IN ORDER TO DIVERT SURFACE RUNOFF AROUND ABSORPTION
SCALE: 1 =30
35 FIELD.
GRAPHIC SCALD ABSORPTION BED SEPTIC TANK do ABSORPTION BED MUST BE INSPECTED BY LOC
AL CAL BUILDING DEPARTMENT AND DESIGN ENGINEER PRIOR
N15 TO BACKFILL AND FINAL GRADING IT IS THE RESPONSIBILITY OF THE CONTRACTOR TO IDENTIFY THE NECESSARY
15 0, 7.5 15 30 60 PARTIES AND REQUEST INSPECTIONS
IN. FEET )
- SYSTEM MATERIAL SPECIFICATIONS
CONTRACTOR TO FIELD VERIFY LOCATIONS AND DISTANCES
PRIOR TO START OF CONSIRUCTIQN. ABSORPTION BED AGGREGATE
i- TO " 1/2" WA
STONE IS TO BE 3/4SHED -CRUSHED. STONE.
EFFLUENT FILTER
EFFLUENT FILTER TO HAVE 1/16 INCH FILTRATION, POLYLOK PL 122 OR EQUIVALENT..
EFFLUENT SEWER PIPE
PIPING TO BE 4" SOR-35. " OR SCHEDULE PVC. INSTALL IMTH-1/8 PER FOOT MINIMUM SLOPE.
FILTER FABRIC
FI
LTER FABRIC TO BE 4.8 OZ SY NON -WOVEN SEPARA11ON FABRIC, TENCATE MIRAFl 140N OR EQUIVALENT..
/
HOUSE SEWER PIPE
4"
MINIMUM TOPSOIL ON
APPROXIMATE PIPING TO BE 4 - SOR. 35 OR SCHEDULE 40 PVC INSTALL WITH 1/4" PER FOOT MINIMUM SLOPE.
EN71RE BACKFILL AREA; EXISTING GRADE TOPSOIL w N
SEED AND ESTABLISH TURF c0 cn 00
PLACE 4" MINIMUM TOPSOIL OVER ENTIRE BACKnU AREA. SEED, MULCH, AND ESTABLISH TURF. cn
35' BED -- -n —
a � IV A �y
LENGTH sue--, m
- _ TO
WN OF U
I,1 .: __ ,
Q EENSBURY
I ii.r�.�s-.r?_�.I_..�`.�~r�:
I1i1:i , .r�., 4i.:.i.,. BUILDING &CODE
4 TOPSOIL. COVER ABOVE 4 PIS PERFORATED' LATERAL .� r�:—� ,..: ;_ 1 ._ ,_ __, __ r..___ DE PT.
FILTER FABRIC r :. �-�- , , :. , � r , _r,-......_ .:_- ..__ :.....r .:_....: ; ..:.._ _..: _.__r �...:.._>.. _.> � : -, r� . r_ _� � I I I t
�-- Y, ,v •.. . MIRWAFl 144 0N OR
` E.QUAL .._... :1_.
r—.r1
, -
Reviewed B SEED &ESTABLISH TURF CONFIGURATION WTH MANIFOLDED ENDS 25. TO EDGET — I 1
_;-,5 PIPE SPACING Date:OF BED 4" SDR-35 PVC PERFORATEDTOP �'STONE .BED.INSTALLED LEEL,IN BED FILTER FABRIC, TENCATE
LATERAL INSTALLED NEAR M1RAFT140N OR EQUIVALENT
In►�'cav ecn nnA►nn►►oann►i
- - - - - - -- -
WASTEWATER SYSTEM SETBACK REQUIREMENTS
PROPERTY LINE
HOUSE
STREAM, LAK&
WATERCOURSE,
WETLAND
WELL
SEP71C TANK
10'
10'
S0'
50,
ABSORPTION FIELD
10'
20'
100'
100'
:3 a�
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w Robert & Debbie Welch
35 Fieldview Ro
ad
d South
10 067879 Town'. of Queembury, County of Warren, State of New York
Rp
Drawn: JRSIWGC Checked. GIN Scale. NOTED Date 212712023
169 Haviland Road
ALTERATION OF THIS. DOCUMENT EXCEPT 8Y Queensbury, NY 12804
_o 92110
01
CENSELT PROFESSIONAL ENGINEER IS A 518 745-0307 Phone
wo LA11ON OF Nn EDUCATION LAW. Hutchins Engineering
eer�n PLLC
9 9 _ 518
_ 745 0308 Fax