SEP-000289-2017 TOWN OF QUEENSBURY
>- 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: SEP-000289-2017 Date Issued: Wednesday, August 9, 2017
This is to certify that work requested to be done as shown by Permit Number SEP-000289-2017
has been completed.
Tax Map Number: 289.11-1-28
Location: 5 GLEN HALL DR
Owner: Bernard'Bernie'Gansle,Candace Gansle
Applicant: Bernard Gansle
This structure may be occupied as a: Residential Septic Alteration
By Order of Town Board
TOWN OF QUEENNSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, ���(((///(GGii✓✓I�N�" vvv
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
qL 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: SEP-000289-2017
Tax Map No: 289.11-1-28
Permission is hereby granted to: Ellsworth&Son Excavating
For property located at: 5 GLEN HALL DR
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
Tvce of Construction
Owner Name: Bernard Gansle Septic Disposal-Residential $0.00
Owner Address: 43 Clifton Walk Total Value $0.00
Slingerlands,NY 12159
Contractor or Builder's Name I Address Electrical Inspection Agency
Ellsworth&Son Excavating
76 ELLSWORTHLN
Lake George,NY 12845
Plans&Specifications
Residential Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,June 2,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of ens p/riday ne 2
2)
SIGNED BY: - • for the Town of Queensbury.
Director of Building&Code Enforcement
4
SEPTIC DISPOSAL PERM se Only
742 Bay Road,Queensbury,NY 1
rmr„d
P:518-761-8256 u Fe i M ?gq-. /
Tax Ma ID#: Zg9.//— �— 2$ "WNOF
/ /p Lu / iFee: $ ; Invoice#:�>`-'Project Location: G y /Tl4NS tic ariance? Yes No
Primary Owner(s)
Mailing Address 43 GL//�Drfi vtif Z/
Phone & Email �!/ ,3qS. 6 6ffi7/5L C/9P f/f!', l0
Installer/Builder n/0 p/1/�cXC//1/f!T//lam
Mailing Address j O Sj
Phone & Email
Engineer
Mailing Address
Phone & Email �/g 7-yf lNG�j /mai T«� 4%4V.
%4 rto�
Contact Person for Building&Code Compliance: ZOO- Phone: 1 f l
RESIDENCE INFORMATION:
Year Built #of bedrooms X gallons per bedroom =total daily flow Garbage Grinder Yes
1980 or older Installed? (circle one)
1981-1991 Spa or Hot Tub Yes
Installed? (circle one)
1992-Present
PARCEL INFORMATION:
Topography �_Flat Rolling Steep Slope Slope
Soil Nature _Sand _Loam _Clay Other
Groundwater At what depth? y
Bedrock/impervious material At what depth? 604
Domestic Water Supply —Municipal 'CWell (if well,water supply from any septic system absorption i ft
Percolation Test Rate: /iper minute per inch(test to be completed by licensed engineerJarchRect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION:
Tank size gallons(min.size 1,000 gallons, add 250 gallons for each garbage cylinder or spa/hot tub
System Absorption field with#2 stone Total length ft.; Each Trench ft.
Seepage Pit with#3 stone How many: :Size:
Alternative System Bed or other type:
Holding Tank System Total required capacity? 12r,tank size 3 :#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 and approved.
The installed system must match the septic 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: DATE:
SIGNATURE: DATE:
Town of Queensbury Building&Code Enforcement Revised February 2017
IIAY-30-2017 22:30 P.02i02
SEPTIC DISPOSAL PERMIT APPLICATION Office Use Dnly
4742 Bay Road,Queensbury, 120M
TO 'W P:51a-761.9256 WSKJMM1111M011it Permit N:
Tax Map IDN �g Permit Fee:$_ :invoice#
Septic Variance? Yes No
Project Location:
Primary owner(s)
Mailing Address
Phone &Email
Installer/Builder /tom D,r[/ X�i91✓/gT/11��
Mailing Address
Phone& Email
Engineer
Mailing Address
Phone & Email
Contact Person for Building&Code Compliance:
Phone:
RESIDENCE INFORMATION: Garbage Grinder Yes
Year Built #of bedrooms X 621ioni per bedroom =total daily flow installed? (circle one
1980 or older Spa or Hot Tub Yes
1981-1991 Installed? (circle one)
1992-Present 2e:7
PARCEL INFORMATION: �/f%Slope
Topography Flat RollingSteep Sio
Sol] Nature Sand Loam Clay Other
Groundwater At what ?
Bedrock/lm rvious material At what ?
Domestic Water Supply Munld I efl (if well,water Su from a septic m abso tion'
Percolation Test Rate: A per minute per inch(test to be completed by licensed engineer/orddtect)
PROPOSED SYSTEM FOR NEW CONSTRUC11)N:
Tank size gallons min,size 1, gallons,add 250 gallons for each garbage cylinder orspa/hot tub
System Absorption field with#2 stop Total length ft.; Each Trench ft.
Seepage Pit with#3 stone How many: •Size:
Alternative System Bed or other type:
Holdin Tank System Totalrequired ca 7 tank size #of tanks
NOTES:1.Alarm system&associated electat work must be inspected by a Town approved electrical inspection
agency,2.We will no longer allow systems tc 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.
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 abl by these and all requirements of the Town of Queensbury Sanitary Sewage
Disposal Ordinance?.
PRINT NAME: 8Cr1n a r K. T e DATE: 4 3/ 17
SIGNATURE: 1& W K DATE:
TOTAL P.02
ES WASTEWATER SYSTEM DESIGN HOLDING TANK ALARM NOT r'O............THE FOLLOWING I2—BEDROOM DESIGN ALARM PANEL CONTROLS SHALL BE SJE RHOMBUS TANK ALERT DUO ............L�4ca"ated f3lrk TURES AS NEEDED ALARM SYSTEM OR EQUIVALENT, AND PROVIDE 1 V- MONITORING AND CONTROL FUNCTIONS.-WATER SAVING FIXTURES REPLACE EXIST. FIX Deck C1,,, (1.6 GPF MAX FLUSH, 3.0 GPM MAX FAUCETS) a WHEN LEVEL OF TANK REACHES 50% CAPACITY, ALARM WiLL CIP\F By 1,4'Deck DESIGN FLOW 110 GPDIBEbROOM Acijolne r'5 INDICATE "TAW HIGH LEVEL" W!7H A YELLOW LIGHT ON ALARM tear By 3, z PANEL.0 SYSTEM DESIGN FLOW 220 GPD 7�fear EXZST.300.+GAL 0 P 5, 13Y 4 01 Deck C Adjoiner'5 [)Or_k HOLDZNG TANK TO HOLDING TANK DESIGN WHEN LEVEL OF TAW REACHES 95X, CAPACITY, AUDIBLE ALARM POINT WELL BE PUMPED&R -SOUND AND RED LICHT WILL FLASH, INDICATING "TANK NYSDOH SIZING 5—DAYS DESIGN FLOW 1100 GALS VWLL I0 EMOVED HOU5E SHUTOFF LEVEL".TOWN OF QUEENSBURY HOLDING TANK VOLUME REQUIRED:289—.4'(. 3000 GAL §136-11 B.(2)-1-29 ECTRICAL IN7ERLOCK SHALL BE INSTALLED TO DISABLE WATER LANDS OP EL INSTALL (2) 1500 GAL POLYPROPYLENE TANKS IN SERIES flonnan SUPPLY UPON REACHING "'FANK SHUTOFF LEVEL".0 HANNAN 3000 GAL TOTAL TO BE PROVIDED S67/4��0/96 QP i , \, 0 -291 001'15 b SYSTEM KILL RESET AFTER HOLDING TANKS ARE PUMPED DOWN 2 6,'.69 I'I POTABLE WATER SUPPLY IS.EXISTING ON—SITE WELL lot P.L. VEL TO BELOW THE ACTUARON LEVEL OF "TANK HIGH LE ALARM.MAINTAIN 50' MINIMUM SE73ACK TO HOLDING TANKS AN ELECTRICAL INSPECTION BY A CERTIFIED ELECTRICAL INSPECTION TER INSTALLATION. ELEC7RICAL.,INSPEC7ION RELAY TO BE INSTALLED ON WATER PUMP CIRCUIT TO SHUT DOWN AGENCY IS REQUIRED AF LANDS OF ED BY WARNINGISHUT SEAL IS TO BE AFFIXED TO ALARM CONTROL PANEL.AREA WATER SUPPLY TO HOUSE WHEN ACTIVATE 19 3 12 qS4.Tt. GANSLE 4 DOWN ALARM ON PANEL 9 0 es VARIANCE SUMMARY DOCr, THE FOLLOWiNG RELIEF IS REQUES7ED FROM 7HE TOWN OF QUEENSBURY
P] CHAP7ER 136 SEWERS AND SEWAGE DISPOSAL: SITE LOCATION LOCATION MAP 1+r Eff HOLDING TAW INSTALLA71ON — §136-11 A. ..........INSTALL TWO 1500 GALLON WASTEWATER HOLDING TANKS.0 L 77 ANCES — §136-9 D.
HORIZONTAL SEPARA ON DIST
KE 841 LA 63.11 -A"KE 60' SIDE SETBACK — 10' REQUIRED, . .. .... ... .I ' PROPOSED — 5' OF RELIEF REQUESTED BUILDING SETBACK — 10' REQUIRED,57 W 7' OF RELIEF REQUESTED I3' PROPOSED I4 �d 1070 55 NEIGHBORING WELL SETBACK — 50' REQUIRED,PROASTONEIBOULDER 4:PROP,4"PVC 42' PROPOSED — 8' OF RELIEF REQUESTED WALL rNING RETAA ........ .HOUSESEWER PROP. (2)1500 GAL UA SYSTEM MATERIAL SPECIFICATIONS 0 POLYPROPYLENE WOOD 5EAWA 110 HOLDZNG TAN HOUSE SEWER PIPE t0-PVC. INSTALL WiTH 114- PER FOOF'EIQUAL LL KS ZN SERZE
ZNFZLTRATOR ZM 1530 OR PIPING TO BE 4" SDR 35 OR SCH-4 co (� ......MINIMUM SLOPE.289.11-1-27 ... . ......HOLDING TANK CONNECTOR PIPE LANDS N/F OF BARRY PIPING TO BE 4" SOR-35 OR SCH-46 Pvc. INSTALL LEVEL ....... ...WELL±VACANT VFWYL FiNaf . .. ....
KITH NO PARTICLES VINYL. BACKFILL MATERIAL C-) BACKFILL TO BE GRANULAR SAND BACKFILL MA 7ERIAL IGREATER THAN 1".' h&7� 289. 11- l' 33, IANDS OF XOWIA_289.,�11-1-26 ........421 MAC K 01 E ISITE LOCATION NEIGHBORHOOD MAP
420 NAIL F....17 67, 9 2017 SEP-,'06018 2801',N52-4 I 'ardr C Gansl - h e ta T`d'WELL± 2911W & Berri
ve �G I Dri id t n en seotit'Altera io e WASTEWATER SYSTEM PLAN I —POLYETHYLENE EXTENSION.. .. .. li7POLYETHYLENE EXTENSION
SCALE: 1"=20' APPROXIMA TE FINISH GRADE TO GRADE WITH TAMPER TO GRADE M TH TAMPER ALE ........ .. .. RESISTANT ACCESS COVER RESISTANT ACCESS COVER.
PHIC SIC GRA 1500 GALLON 40 10 0 5 10 20 12"± VC SDR-35 INJECTION MOLDED
POLYPROPYLENE SEPTIC TAW CONNECTOR PIPE... . . ... 4" P 12 IN FEET INSTALLED LEVEL INSTALLED AS HOLDING TANK 4" SDR-35 PVC 3" SEALED wA7-ER-nGHT INLET LIQUID LEVEL VEL LIQUID LE MIN. SLOPE PER FOO 16' INSTALL FLOAT SWITCHES 114 BOFAIRD OF HEALTH APPROVAL RESOLUTION . TO OPERATE ALARM PANEL 1 507. CAPAC17Y(1500 GAL) AT INDICATED LEVELS, :957. CAPACITY.WATERTIGHT SLEEVE (4275 GAL)WARNING LEVEL AND SEAL (TYR) ALARM LIGHT-ON ALARMISHUT DOWN 1500 GALLON ALARM ON INJECTION MOLDED .......POLYPROPYLENE SEP17C T/RE SOLUTION APPROVING SANITARY SEWAGE DISPOSAL February 27"',the Local Board of Health agreed to INK WHEREAS,at the public hearin-on RESOLVED, that the Local Board of Health hereby approves the application of Bernard INSTALLED AS HOLDING TANK consider the formal approval of tile variance requests provided that the Applicant:remove their VARIANCES FOR BERNARD AND CANDACE GANSLE request for one(1)of the three(3)requested holding tanks,and and Candacc Ganste for variances.from the Sewage Disposal Ordinance to allow installation of two OPY-(2)new 1,500 gallon holding tanks for a total of 3,000 gaHons of capacity with placement of such 6"± PEA GRA VEL 6":� PEA GRA VE'_ FILE C RESOLUTION NO.:BOH 7,2017 WHEREAS,the Local Board of Health,agreed to leave the public hearing open so that it system to bo located: Vi L TRODUCED BY: My. Anthony Metivier IN WHO MOVED ITS ADOPTION may review new plans providing for the elimination of one(1)such holding tank,and HOLDING IT16NKS IN ERIES DETAIL 1. 5'from the side property line in lieu of the required I O'setback; N TS 2017:SECONDED BY: Mr.Brian Clements PlAY 3 1 WHEREAS,the Applicants have accordingly provided an amended application providing 2. 3'from the dwelling in lie6of the required 10'setback;and IG PLOT PLAN% 1. 7 I . I -1 11 z PEPTf�r the,elimination of I (1) of the holding tanks, with pi 3, 42'from the neighboring well in lieu of the required 50'setback; HOLDING TANK NOTES . I . I � I I I aceluent of the two (2)'remaining ) ALL OBJECTS:WHEREAS,Bernard and Candace Gansle(Applicants)filed an application for a variance 176 ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK STA TE RUBBER GASKETS SHALL BE INSTALLED, IN `A% ,t-r§,Y I �AVE $EEN OR OBSERVED ES,ETC_p'-,posed holding tanks to be located: ES LS,TREES,FENC: S SU
fi-om Town of Queensbury On-Site Sewage Disposal Ordinance, Chapter 136, §136-tl, which on property located at 5 Glen Hall Drive in the Town of Queensbtiry, b=ing Tax Map No.: DEPARTMENT -. OF . HEALTH AND SHALL BE OF INJECTION MOLDED &,H AS HOUSES. - AVE PERSONALD 8�6vvNONT OCUM requires applicants to obtain a variance for holding tanks,as the Applicants wish to replace their POLYPROPYLENE AS �MANUFACTURED BY INFILTRATOR WATER TECHNOLOGIES, TANKS ARE NOT APPROPRIATE TO BE INSTALLED JN �TRAm6 APEAs.289,11-1-28, MEASURED ON THr 71M 1. 5'from theside property line.in lieu ofthe required 10'setback; MODEL IM-1530 OR EQUIVALENT. C existing'300 gallon holding tank with three(3)new 1,500 gallon holding tanks fora total of 4,500 1,F- TANKS TO BE BACKFILLED,WITH CLEAN SAND FILL, �NATIVE COBBLY, BOULDER 2. 3'frorn th dwelling in lienofthe required 10'setbark-,and gallons ofcapacity,and ALL STRUCTURES.�.SHALL BE PLACED ON FIRM, COMPACT SAND OR GRA VEL SOILS ARE NOT ACCEPTABLE AS BACKFILL�MATERIAL.' $IG DATE 3 42 from neighboring well in lieu ofthe required 50'setback; Duty adopted this 20"'day of March,2017,by the following vote: BASE. WHERE _EX1S77NG SOIL COND17IONS ARE UNSUITABLE A 12- MIN.COURSE OF CRUSHED STONE SHALL BE PLACED AS NECESSARY ,TO ACHIEVE A ALL SEAMS, PENETRATIONS, CCESS -.COVERS �MUST-BE MAINT41,Nfp,WHEREAS,the Applicants also applied for additional variances from Chapter 136 to allow AYES Mr.Clements,Mr.Irish,Mr.Brewer,Mr.Strough,Mr.Metivier STABLE BASE.. WATER77GHT BY INSTALLER., FIELD COAT �ADD1776�AL PENETRATIoNsi,(WROF QUE N OW,THEREFO BEIT - - :� - I , . . 16 placement ofsuch holding tanks: NOES None NECESSARY KITH WATERTIGHT SEALANT. �BUILDING C D,RESOLVED,that the Town of Queensbury Local Board of Health hereby acknowledges ABSENT: None Revi-9wf§d,B 47'from Glen Lake in lieu of the required 5 O'setback; y 1. Bernard and Candace Gar sle's(Applicants)amended applicatiorl'as presented at this meeting and of NE fiom the side property line in lieu ofthe required 10'setback; 1-1.Barber,Town Clerk of the Town of Queensbury, Warren County,New York,do r" te: .2. 51 that: 1,Caroline TAXMAP # 289.11_1dA 3. 3'from the dwelling in lieu ofthe required 10'setback;and hereby certify that I have compared the foregoing with the original resolution as listed above adopted at Regular meeting oftheTown Board ofthe'rown ofQueensbury held on the 20"'day of PIS ALTERATION OF THIS DOWMENT,EYCEPT BY A LICENSED PROFESSIONAL 4. 42'from the neighboring well in lieu ofthe required 50'setback; March,2017 at which a quorum was present and that the same is a correct transcript there from and 1. due to the nab e of the variances,it is felt that th.e-variances would not be materially Ofthe whole original thereofto date. CO ENGINEER IS A VIOLATION OF NYS EDUCATION LAW.detrimental to the purposes and objectives of this Ordinance or ot her adjoining on property located at 5 Glen Hall Drive in the Town ofQueensbury,and properties no therwise conflict with IN WITNESS THEREOF,I have hereto set my hand and the SEAL of said Town of QueensburY, LL1 r the purpose and objectives of any Town plan or this 2 I't day of March,2017.policy;and WHEREAS,the Town Clerk's Office published the Notice ofPublic Hearing in the own �SEAL Local Boaffl of Health firids that the granting of the variances is nece sary for the 2. the 3128117 SIGNED: 678 official newspaper and the Local Board of Health conducted a public hearing concerning tile reasonable usJof the land and are the minimum variances which would alleviate the Caroline H.Bzirber 2 APPROVAL-RESOLUTION variance requests on Monday,February 27"',2017,and Town Clerk S specific unnecessary hardship. found by the Local Board of,Health to affect,the Town of Queensbury .: t 1 REVISED TO 2—TANK DESIGN, RESUBMIT TO BOARD OF HEALTH 31711 7 Applicants;ant 0 ISSUED,FOR WASTEWATER- VARIANCE 1125117
WHEREAS, the Town Clerk's Office advised that it duly notified all property owners within 500 feet of the subject property,and No. Revisions Date BE IT FURTHER MAP REFERENCES: WASTEWATER SVQTEM PLAN -HOLDING TANKS"MAP OF A URVEY d 1. BASE MAPPING TAKEN FROM: prepare , for,MADE FOR BERNARD K. '& CANDACE R, GANSLE" Gansle- : -Bemard & Candace DATED JUNE 10, 2016, �REVISED SEPTEMBER 1�,2016, PREPARED BY, VAN DUSEN & SIEVES LAND 5 Glen Hall Drive Elm S 43 f e I y SURVEYORS, QUEENSBURY, NY 2. "MAP OF A SURVEY MADE FOR RONALD B. & Lin Town of Queensibury, Warren Co ty, NY NeWPdYo'rk CYNTHIA F. MACKOMAK" DATED SEPTEMBER 29,WASTEWATER SYSTEM SETBACK SCHEDULE III Call Before You Dig 2009 PREPARED BY. VAN DUSEN & STEVES LAND Drawn: LWD Checked: GTH Scale. NOTED Date: 1111512016 El Wait The Required Time SURVEYORS, QUEENSBURY, NY 0 Confirm Utility Response PROPERTY LINE WELLS GLEN LAKE HOUSE 169 Haviland Road 3. "MAP OF A SURVEY MADE FOR BARBARA C.M Respect The Marks I I Queensbury, NY 12804
BARR - DATED SEP7FM8ER 6, 2016 PREPARED By-Y ED Dig With Care 50' 50' 10' 291085-01 HOLDING TA 10, VAN DUSEN & STEVES LAND SURVEYORS, 518) 745-0307 Phone 800-962-7962 www.digsafelynewyorkcom QUEENOU , NY Hutchins Engineering �"(�18) 745-0308 Fox ........... ..............
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Insp. Date: 6/26/2017
Appl #: L17131
ELECTRICAL CERTIFICATE
COMMONWEALTH ELECTRICAL
INSPECTION SERVICE, INC.
176 DOE RUN ROAD, MANHEIM, PA 17545
TELEPHONE: (717) 664-2347
New York Office: (585) 624-2380
Premises of: BERNIE GANSLE as
Address: HALL DRIVE.QUEENSBURY NY JUL 1 4 Nil 6d
011.111tA d, a \RPF�' (Jel Ill it H:
-COWL OF rDCS SBURY
Installed by: FROM81-EY ELECTRIC BUILDING
Apparatus: )L
-PJ I( HOLDING TANK & CONTROLS
Inspected by: DONALD LOVELAND
The conditions following governed issuance of this certificate,and any certificate previously
issued is cancelled. Failure to have the property reinspected when additional equipment or wiling is
added;or within one year from the date of the certificate shall void the certificate in its entirely and the
company shall not be liable for any damages whatsoever;
This certificate does not guarantee efficiency, wearing qualities,maintenance or repair and the
company shall not be liable for any damages resulting from any defect or fault in the plans or specifica-
tions,including repair,reconstruction,personal injury or for the death of any person;and
This certificate only covers visual inspection of wiring and docs not cover manufacture or use
of wiring. irc
Inspectors of this Company shall have the privilege of making inspections at any time,and if
its roles we violated,the Company shall have the right to revoke the certificate. Ic