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2002-195 TOWN OF QUEENSBURY
742 Ba Road,Queensbu ,NY 12804-5902 518 761-8201
om Y r3 )
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20020591 Date Issued: Wednesday, October 09, 2002
This is to certify that work requested to be done as shown by Permit Number P20020591
has been completed.
Tax Map Number: 523400-226-012-0001-055-000-0000
Location: 371 CLEVERDALE Rd
Owner: ROBERT & SUSAN MORRIS
Applicant: ROBERT & SUSAN MORRIS
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
( 4412 4
Director of Building&Code Enforcement
0�` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
tom� � FIB. E C -77
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020591 Application Number: A20020591
Tax Map No: 523400-226-012-0001-055-000-0000
Permission is hereby granted to: ROBERT& SIJSAN MORRIS
For property located at: 371 CLEVERDALE 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 Value
Owner Address: ROBERT& SUSAN MORRIS
P.O. BOX 211 Septic Alteration Residential
Total Value
CLEVERDALE,NY 12820-0211
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2002-591
Septic alteration
Board of Health Resolution No. 32/2002
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,July 10, 2003
(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 ueens j edn s+a / . 10,2002
i
SIGNED BY Nk for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Permit-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION: 1- - cv 1 a -I- 5S
Location of' llation:t/ C( Lici ca (C (W
Tax Map No. Office Use
�1 _/ l - File Permit No. /:)," S
Fee Paid gS P" /
Owner's Name: R 0 (c-f"/ Al-0 0 r'/` , C
Address: C CC c U c ( Ja (6-._ ('cZ
II
2. INSTALLER'S NAME A. c f/ c PHONE NO, �I{ 1 r) -
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multi 4i,e ;.
�bedrooms with applicable gallons per bedroom to equal total dailY'llow) 4. ==r'.wg 1
Year of House: No. of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdrm =
1980- 1991 x 130 gal/bdrm =
1991 -present x 110 gal/bdrm =
Garbage Grinder Installed yes / no
Spa or Whirlpool Installed yes / no -
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
6) C raptly ure Ground Water Bedrock or Impervious Material Domestic Water Supply
Flat
sand at w t depth at what depth �__�ipal
ing foam feet 1�eet '
Steep slope clay `-i well; water supply
_%slope other from any septic-system
depth: absorption is ft.
other to
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: minute per inch
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed
professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size
of the septic tank and leach field for each Garbage Grinder,Spa or Whirlpool Tub.
Septic Tank:/660 gallon (min. size 1,000 gal)
Tile Field: each trench ft. Total System Length: ft.
Seepage Pit(s): number of size of each: ft. by ft.
Size of Stone to be used: # / depth or thickness feet
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)
For your protection,please note that pursuant to Section 136-29 of the Code of the Town
of Queensbury, any permit or approval granted which is based upon or is granted in
reliance upon any material misrepresentation 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 with respect to this application and agree to abide by these and all
requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Si nature of responsible person Date
t. I
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name OV,i /j1 c- ( 0
Locati on3I C N3 f; eDgD
Date (-\b-- 7 Permit # ZoDZ- ,
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test- `1
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number- 1
Size - ft. x ft//
Stone size '
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS: I
Foundation to Tank / feet
Foundation to Absorptio1 feet
Separation of Pits feet
Conforms as per Plot plan , $L , o
LOCATION OF SYSTEM Oar PROPER ' :
(circle one)
Front - Rear - Left/ Side - Right Side
Middle Front - Middle Rear
COMMENTS:
•
SYSTEM USE APPROVED: YE NO
Arriv- .
Depa, ed: „�:�
v.,/44.
"1111
:1 7 ding I p ctor
/
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JAR RE`} 4u e sTII 1 EtWOLINIMMIO, TII1C LETTER OF TRANSMITTAL
Prof i s Tonal Engineering
12 East Washington Street
Glens Falls, NY 12801 DATE R0
1 ,z JOB Q 2 _ 10
TEL 518-792-2907 ATTENTIO
FAX 518-798-1864 RE:
M ors WAInsythil3a SY sctswv
TO vJltr D F 0 a et((ZY (Iwo&oAu
B�� 5 C�o�-3 IN O . Q v--�s4a�,�►
u : Des 1- nf,1
WE ARE SENDING YOU Attached ❑ Under separate cover via ( iJO 0EZ.4.e1"7 the following items:
❑Shop drawings ❑ Printsans ❑Samples ❑Specifications
❑Copy of letter ❑Change order ❑
COPIES DATE NO. DESCRIPTION
1 (-4-?,JD S fe:FTL(-4 5 E-15 w,/.1G 2.Ecct .O L. C,'.aps S
S'( c ron c.c.s O PrtE RO.
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval
For your use ❑ Approved as noted ❑ Submit copies for distribution
❑ As requested ❑ Returned for corrections ❑ Return corrected prints
>
❑ For review and comment ❑
❑ FOR BIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
TCfV Y-t. -i L1 7 ( r•../L L_, ,d`: tJ i .. 1
9
BUILDING ►/ b • a—
REVIEWED Bof
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DATE i
� % (1It fl,
ease..T ii Sush,J 1 o2P—Gs v✓l r 1
COPY TO `
105 Seenc- SIGNED: -
If enclosures are not as noted,kindly notify us at once.
s JARRETT - MARTIN ENGINEERS, PLLC Job
/ Oki-i-AS c//14 o2- O5
PROFESSIONAL ENGINEERING Sheet# / of l
12 East Washington Street Calculated by /-ti7`r Date 9f%c'
Glens Falls, New York 12801 Checked by Date
518-792-2907 Fax 518-798-1864 Scale /1/7`a"
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TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION -II<<
-235
Name b f4o s
Location 31)/ ��eff�.p,J6(.e /2
Date 0 4Y Permit # 2,002-5 7
SOIL TYPE: San oam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length I k L_ =
Length of each trench mJL Eo A6-42,01i:
Depth of trenches Z`
Size of stone 'Z,.
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank Ex-v-)T+ ---3
Tank to Dist. Box y" Q\)C.,
Dist. Box to Field/Pit ►" F
Openings Sealed? 440 No Partin
LOCATION/SEPARATIONS:
Foundation to Tank inkVleett,bVe.pa
Foundation to Absorption a t\NVAAAI
Separation of Pits
Conforms as per Plot Plan Ye No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
ron ae Rear - Left Side <Cilet Side '
.. e ront - Middle Rear
COMMENTS:
SEE. REv1)Th -CD 1\6-v50C\
Ve_c up\YV_
SYSTEM SE APPROVED: NO
Arriv-- . t ,i%
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RESOLUTION APPROVING SEWAGE DISPOSAL VARIANCE
APPLICATION OF ROBERT AND SUSAN MORRIS
BOARD OF HEALTH RESOLUTION NO.: 32,2002
INTRODUCED BY: Mr.Theodore Turner
WHO MOVED ITS ADOPTION
SECONDED BY: Mr. Roger Boor
WHEREAS, Robert and Susan Morris have 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 leach field ninety feet (90') from
Lake George instead of the required one-hundred feet (100') setback and seventeen feet (17') from
the house foundation instead of the required twenty feet (20') setback on property located at 371
Cleverdale Road, 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 a public hearing concerning the
variance requests on June 3rd,2002, 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,that
a) due to the nature of the variances, it is felt that the variances would not be materially
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) 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 Robert
and Susan Morris' application for variances from the Sewage Disposal Ordinance to locate a leach
field ninety feet (90') from Lake George instead of the required one-hundred feet (100') setback
and seventeen feet (17') from the house foundation instead of the required twenty feet(20') setback
on property located at 371 Cleverdale Road, Queensbury and bearing Tax Map No.: 14-1-4.
Duly adopted this 3rd day of June,2002 by the following vote:
AYES : Mr. Boor,Mr. Turner,Mr. Brewer,Mr. Brower
NOES : None
ABSENT: Mr. Stec
I, Caroline H. Barber, Deputy Town Clerk I of the Town of Queensbury, Warren County, New
York, do hereby certify that I have compared the foregoing with the original resolution as listed
above adopted at a Regular meeting of the Town Board of the Town of Queensbury held on the 3ra
day of June, 2002 at which a quorum was present and that the same is a correct transcript therefrom
and of the whole original thereof to date.
IN WITNESS THEREOF, I have hereto set my hand and the SEAL of said Town of Queensbury,
this 4th day of June,2002.
SEAL SIGNED:
Caroline H. Barber
Deputy Town Clerk I
Town of Queensbury