PT-0389-2020 A
Property Transfer Sewage Disposal Information Form
Date: }''13_ d
Town of Queensbury
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.queensburv.net
Pcd-r,c,,cL k (4ctv un ct S Dre s i fl()
(Name of Owner/Applicant)
Re: Onsite Wastewater Treatment System Inspection Information Request for:
I Co Bnu r\oa c lane, t Q u en6bucM , "/. i 3,$0 4
(Site Address)
Thank you for requesting an inspection for the onsite wastewater treatment system (OWTS) located on the
property referenced above. We look forward to completing a thorough inspection for you. You can help us do
the best job possible by providing some advanced information about the site. Prior to our inspection,we request
this completed application, a site map indicating the location of the septic components and confirmation the
pre-inspection preparation (see the last page of this packet) will be completed prior to our arrival.
Enclosed is a Septic System Inspection Information form, which must be completed, signed and returned to
this office, with the appropriate fee(s) and documentation, prior to scheduling an inspection.
Please note the Town of Queensbury's fee for this service is $250. Be advised that all fees must be paid prior to
scheduling the inspection. We require 48 hours notification prior to scheduling the inspection.
If the purchaser is requesting an exemption, please submit this application along with a notarized letter stating
the septic system will be inspected or repaired/replaced within 6 months from the date of the Property
Conveyance or June 15t of the current, or following year (whichever comes first), a map locating the septic
system and payment totaling $2250 ($2000 refundable deposit plus $250 permit fee). The deposit is forfeited
if the owner fails to complete the repairs or installation as stated above.
If you have any questions, please call.
Phone: (518) 761-8256 Email: kated@queensbury.net
Thank you.
[ECGEtIV2 \)
Sincerely, p j
(1.- 4,4 kom, n JUL 1 3 Z0
TOWN OF C�.� . `: rwl� Y
David Hatin, Director BUILDINI: .'�_' ': `'.x--•---•
Building and Code Enforcement
Town of Queensbury
Property Transfer Packet Revised February 2020
Office Use Only
Permit#: fer ' a ac-1,- 20213
h,Nri cppct•ii, Fee: 2
742 Bay Road,Queensbury,NY 12804
P:518-761-8206 or 518-761-8205 Invoice#: 2
www.queensbury.net
SEWAGE DISPOSAL SYSTEM INSPECTION INFORMATION
Individual Residential Wastewater Treatment System
Property and Owner Information: (Please attach property survey or tax parcel map)
Property address: I(, St11)3 kGcboC Lone, Queensbn , N 4, Iz80q
Tax map number: p R 0 G— a 3
Property owner: PGt('IC1 kel mold Qot eS►n0
Mailing Address (c/s/z): /711 Ie 0 ue E-115 p v r j , N)1 / Z807
Cell #: 3 I ?)- 2„22- 3969 Land Line #: /8-- L 09 7(0 o3
Email: Pal' Sore_ci no li \/0.3100 , Coon .
**PLEASE SEE SEPARATE PAGE FOR EXEMPTIONS**
Household Information:
# Bedrooms R. # Bathrooms o2 # Kitchens I Jacuzzi tub(s) ' Garbage grinder
Onsite Wastewater Treatment System:
How many systems are on the property? I i,b 94I 7,
Year system(s) installed: Tanks-11-7/Size of Septic Tank Per•4 a g$ -01I(o 5- 1' -'$
Type of Absorption System: 56nd.
Are all system components wholly within the property boundaries? gYes ❑ No
Are system plans available? El Yes ( f No
Does the system(s) serve multiple properties? ❑ Yes fX1 No
If yes, describe
Maintenance:
Service agreement? El Yes 121 No If yes, vendor name
do
Date of last inspection I N/A El Date tank last pumped N/A M
Frequency of pumping N/A 54
Property Transfer Packet Revised October 2019
List known repairs/replacements, with dates:
Date Type of Repair/Replacement
None
Operation:
• System problems? Yes )X No
• Sewage odors? Yes X No
Direct surface discharge(s)? Yes '( No
• Back-up of toilets? Yes y No
• Back-up of any other fixtures? (e.g. slow drains) Yes X No
• Seasonal ponding or breakout of leach field? Yes y( No
Statement of Acceptance of Conditions:
I agree to:
• Ensure that the septic tank(s),distribution box (es), and/or seepage pit(s), if any, will be uncovered
prior to the requested inspection time;
• Have a septage hauler on site(to pump the tank after*the inspector verifies flow from fixtures);
➢ Tank must be pumped in presence of inspector
• Have an authorized representative present at the site;
• Allow the inspector to verify information provided above, and to conduct an inspection of the
indicated onsite wastewater treatment system(s), including all system components and interior
plumbing in crawl spaces and basements.
To the best of my knowledge, the information provided above is accurate and I acknowledge the following:
After 1 year from date of submission and there is no activity on this permit,the permit will expire and will be
subject to submission of a renewal application and payment of the renewal fee based on the current fee
schedule. All fees must be paid PRIOR TO SCHEDULING any inspections. In addition, if the permit is
withdrawn 20% of the fee is retained by the Town of Queensbury.
Signature of property owner or authorized agent
Please print name: Ra`i mo nt) Q , Soc-e5'no
Affiliation: X owner agent
•
Signature: 4,011e, UQpd,, 7 Date:
Prior to scheduling with the Town of Queensbury, you MUST:
1. Schedule a sewage hauler to be on site to pump tank while inspector is on site.
Hauler should arrive 30-45 minutes after scheduled time with the Town of Queensbury's
Code Enforcement Officer.
2. Expose inlet and outlet of septic tank, and/or pump station, expose d-box, expose
any seepage pit covers.
3. Excavate test hole in leach field if there is no d-box.
Property Transfer Packet Revised October 2019
RESOLUTION APPROVING SEWAGE DISPOSAL VARIANCE
APPLICATION OF PATRICIA AND RAYMOND SORESINO
RESOLUTION NO.: 29,2013 BOH
INTRODUCED BY: Mr. Tim Brewer
WHO MOVED ITS ADOPTION
SECONDED BY: Mr. Anthony Metivier
WHEREAS, Patricia and Raymond Soresino filed an application for variances from provisions
of the Town of Queensbury On-Site Sewage Disposal Ordinance, such application requesting that the
Local Board of Health allow installation of a seepage pit:
1. 58' from their well,
2. 110' from a neighbor's well; and
3. 142' from a neighbor's well;
instead of the required 150' setbacks on property located at 16 Snug Harbor, 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 conducted public hearings concerning the variance
requests on Monday, October 20 and Monday, November 4th, 2013, and
WHEREAS, the Town Clerk advises that property owners within 500 feet of the subject
property have been duly notified,
NOW, THEREFORE,BE IT
RESOLVED,
a) that due to the nature of the variances, it is felt that the variances would not be materially
t
detrimental to the purposes and objectives of this Ordinance or to other adjoining
properties or otherwise conflict with the purpose and objectives of any plan or policy of the
Town of Queensbury; and
b) that the Local Board of Health finds that the granting of the variances is necessary for the
reasonable use of the land and that the variances granted are 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 Town of Queensbury Local Board of Health hereby approves Patricia
and Raymond Soresino's application for variances from the Sewage Disposal Ordinance to install a
seepage pit
1. 58' from their well;
2. 110' from a neighbor's well; and
3. 142' from a neighbor's well;
instead of the required 150' setbacks on property located at 16 Snug Harbor, Queensbury and bearing
Tax Map No.: 290.5-1-23. and
BE IT FURTHER,
RESOLVED, that approval be conditioned upon UV Max system be installed in the
homeowners cellar.
Duly adopted this 4th day of November, 2013 by the following vote:
AYES : Mr. Metivier, Mr. Clements, Mr. Strough, Mr. Brewer, Mr. Montesi
NOES : None
ABSENT: None
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PROPERTY TRANSFER SEWAGE DISPOSAL INSPECTION LETTER
Satisfactory Compliance Notice
742 Bay Road, Queensbury, NY 12804
P: 518-761-8256 www.queensbury.net
Date: 15 July 2020
To: Pat & Raymond Soresino
(Applicant)
Re: System Inspection Site Report for:
16 Snug Harbor Ln, Queensbury NY 12804
(Site Address)
As requested, I have made an inspection of the wastewater system components serving the property
referenced above. All system components have been found, and are noted in the System Inspections
Findings Worksheet.
Inspector’s observations:
System appears to have functioned adequately under past and present loading. There can be no
assurance or guarantee of future performance for any period of time. Numerous factors, such as household
water usage, leaking toilets, soil characteristics and seasonal ground water table fluctuation, as well as owner
failure to manage and maintain the system, will affect its performance.
Sincerely,
David Hatin, Director
Building & Code Enforcement
Town of Queensbury
Building & Code Enforcement January 2019