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BOTH-000143-2015 C Q O N � N O a C/) C3 w O 'J O o ;1, O � o N kn rn U a o a o 4d rad 0 a ai `� CU cq ~ o N �.c x xeq w aF. o _ o '�' � •a. � o °� GA r.. f� TOWN OF QUEENSBURY ray;_ 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 c- /' I Community Development-Building& Codes (518)761-8256 i BUILDING PERMIT Permit Number: BOTH-000143-2015 Tax Map No: 296.6-1-3 Permission is hereby granted to: HARRY BAKER For property located at: 61 BLIND ROCK RD in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance Type of Construction Owner Address: Septic Disposal $0.00 Total Value $0.00 Contractor or Builder's Name/Address Electrical Inspection Agency Jack Straight 1 Myron AVE Plans&Specifications Residential Septic Alteration $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the a iration date. Dated at the Town f Queen 4 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement in) 0 C E il Wii R,-Trr'-' s\—, I SEPTIC DISPOSAL APPLICA , - N Office Use Only OCT 1 9 2015 Received DATE: Tax Map ID v Permit No. 1c},3-?so p TAX MAP ID: t UILuIM.,)6, �.;OL Permit Fee 6 to'. 0Q ZONE: APPLICANTAriev /34 KE,.-1.- PHONE/E-MAIL ADDRESS 6 I R/`/tic/ 6LK INSTALLER/ d1 C—4 o PHONE/E-MAIL -i "f-'Y� BUILDER rT 1 ' J � �I C �L/6 L-Q--- iio _Lt n? .5'f"a. S AAA. t OWNER �y14t-k 5 :�17. , 4 1 y 1\-1— ADDRESS T/ y� it/Y l ADDRESS / /" 'yT i1 go.! . SO,,r+k 6 f(JU_f , ))x !fj./� / 2 O ) CONTACT PERSON FOR BUILDIINGG&CODE COMPLIANCE: Z .K 3 ,5 ,4 i'c At- PHONE/E-MAIL egi( 1 / 17 - 7 3 7 3 -I' RESIDENCE INFORMATION Year Built #of bedrooms X gallons per bedroom =total Daily flow 1980 or older V 1/611 4/1/0 Garbage grinder installed Yes A No 1981-1991 Spa or Hot Tub installed _Yes _No 1992-Present PARCEL INFORMATION Topography ie3 Flat rolling Steep slope %Slope Soil Nature Sand Loam Clay 24 Other /b ,K f l Groundwater At what depth: Al/4 Bedrock/Impervious material At what depth: /A/i4 Domestic Water Supply Municipal DQ Well(if well,water supply from any septic system absorption is 41i ft.) Percolation Test Rate: 6/r►;u 3 per minute per inch(test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION Tank size gallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub System Absorption field with#2 stone Total length ft.;Each Trench Seepage Pit with#3 stone How many: ;Size Alternative System Bed or other type: Holding Tank System Total required capacity? Tank size #of tanks Notes: 1)Alarm system&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&approved. The installed system must match the septic system layout on file—no exceptions. 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: —1/4e--KJ. S41;'* i DATE: 2,0 Dom/ I(S SIGNATURE: /trrirf _ DATE: .2o Q c26 LT- -Town of Queensbury Building&Codes Principal Structure Application Revised September 2014 RESOLUTION APPROVING HARRY AND LINDA BAKER'S APPLICATION FOR SANITARY SEWAGE DISPOSAL VARIANCES RESOLUTION NO.: BOH 28,2015 FILE COPY INTRODUCED BY: Mr. Anthony Metivier WHO MOVED ITS ADOPTION SECONDED BY: Mr. Brian Clements WHEREAS, Harry and Linda Baker filed an application for variances from provisions of the Town of Queensbury On-Site Sewage Disposal Ordinance, Chapter 136 to install a new leach field: 1. 64' from their well in lieu of the required 100' setback; and 2. 81.5' from a neighbor's well in lieu of the required 100' setback; on property located at 61 Blind Rock Road in the Town of Queensbury,and WHEREAS,the Town Clerk's Office published the Notice of Public Hearing in the Town's official newspaper and the Local Board of Health duly conducted a public hearing concerning the variance requests on Monday, October 19th, 2015, and WHEREAS, the Town Clerk's Office has advised that it duly notified all property owners within 500 feet of the subject property, NOW, THEREFORE,BE IT RESOLVED,that 1. due to the nature of the variances, the Local Board of Health determines that the variances would not be materially detrimental to the purposes and objectives of this Ordinance or other adjoining properties nor otherwise conflict with the purpose and objectives of any Town plan or policy; and 2. the Local Board of Health finds that the granting of the variances is necessary for the reasonable use of the land and is the minimum variances which would alleviate the specific unnecessary hardship found by the Local Board of Health to affect the applicants; and BE IT FURTHER, RESOLVED, that the Local Board of Health hereby approves the application of Harry and Linda Baker for variances from the Sewage Disposal Ordinance to install a new leach field: 1. 64' from their well in lieu of the required 100' setback; and 2. 81.5' from a neighbor's well in lieu of the required 100' setback; on property located at 61 Blind Rock Road in the Town of Queensbury and bearing Tax Map No.: 296.6-1-3. Duly adopted this 19th day of October, 2015,by the following vote: AYES : Mr. Clements,Mr. Irish, Mr. VanNess,Mr. Strough,Mr. Metivier NOES : None ABSENT:None 7A. ME G. Peter Jensen 17 West Road South Glens Falls J u L 1 201 a New York 12803 (518) 798—3859 November 1, 2015 To Whom It May Concern: I have designed(plan 15-0803) and observed the installation of the septic system for Bob Baker at bl Blind Rock Road, Queensbury, Warren County,New York. It would appear that the installation is within the intent of the design documents. To the best of my knowledge and belief, no field conditions were encountered that would require a re- design of the septic system. To the best of my knowledge and belief all of the distance separation requirements after variance, have been met. Sincerely, 0 ARC 4b lea G. Peter ensen p,7no2e OF Mf f 1 2X TOWN OF Q #D*-. 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