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Septic variance SEPTIC VARIANCE office Use Only Received: 'APPLICATION Permit#: 5� �i5_ zo 2 Town .4 r Permit Fee: 742 Bay Road,Queensbury,NY 12804 O, P:518-761-8256 www.aueensbury.net Invoice.#: Approvals: Submittal: I (one)original&8 copies of the completed application package Property Owner(s): �0.eQs Pr•e�. Owner's Agent: ®d9'` a.. � Address: U overoto, Address: 6'3- r-k a le Phone#: j "" ® Phone#: 426 Site Address: 3 6 0 owtr Uo e- u( Tax ID#: 2 ' ` Z s 3 1 Directions to Site: 9 L t.V'er Distance from well on property to septic system(if applicable) feet Is it possible.to install a conforming septic system on this property? Yes No If YES,please explain and attach a diagram: Does the proposed Sys meet setback requirements for distance from wells&septic systems on neighboring properties? Yes No . If NO, please explain: Is the proposed system to be installed under a parking area? Yes o Section of the Sanitary Sewage Ordinance from which you are seeking the variance (i.e. leaching system will be 89 ft. from well in lieu of required 100 ft.): �Q or 04 ?_A) ��_?-�� Co ._A c� � 'l Septic Variance Application �� a�,�/ February 2018 �LFy V b� 1 List the names, parcel addresses, and tax map numbers of all adjoining property owners. You may obtain tax map numbers from the Assessor's Office as well as the names and addresses: North Name �� Address / Y4 Tax Map ID Z 'tI South Name Address Tax Map ID 7 East Name , 3ra Address i 2 Z Tax Map ID West Name i Address IM Tax Map I D OWNER STATEMENT I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at: t 3�le - I/We realize that putting the well,septic tank or leaching system less than the required feet from the may increase the risk of pollution. Owner—Print Name: C' Date: Owner—Signature: Date: ft�- NEIGHBOR OR TENANT RELEASE STATEMENT (if applicable) I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at:' I/We realize that putting the septic tank or leaching system less than the required feet from the may increase the risk of pollution. Neighbor/Tenant—Print Name: Date: Neighbor/Tenant-Signature: Date: Septic Variance Application February.2018 AUTHORIZATION AND SIGNATURE PAGE This page includes the Authorization to Act as Agent form, engineering fee disclosure, authorization for site visits, other permit responsibilities and agreement to provide documentation required. Complete the following if the OWNER is �using an Agent: Owner's Name: Designates: V\Qr4&,, as agent regarding the Septic Variance for Tax Map#: 7_-a- , °t '3 1 e— U OWNER'S SIGNATURE: - DATE: Engineering Fee Disclosure: Applications may be referred to the Town=cerisulting engineer for review of septic design,storm drainage, etc. as determined by the Town Board of Heaffh°: Fees for engineering review services will be charged directly to the applicant. Authorization for Site Visits: By signing this page and submitting the application materials attached herein,the Owner,Applicant and his/her/their agent hereby authorize the Town Board of Health,building and code Enforcement Officers and Town Engineer to enter the subject properties for the purpose of reviewing the application submitted. Please Note: Other permits may be required for construction or alteration activity subsequent to approval by the Town Board of Health. It is the applicant's responsibility to obtain any additional permits. Official-Meeting Minutes Disclosure: It is the practice of the Town Board of Health to have a designated stenographer tape record the proceedings of the meetings resulting from the application, and that the minutes transcribed from those tapes constitute the official record of all proceedings. If there is a discrepancy between such record and the handwritten minutes taken by the designated stenographer,the handwritten minutes shall be deemed the official record. I,the undersigned, have thoroughly read and understand the instructions for submission; agree to the submission requirements and completed checklist: OWNER—PRINT NAME. � OWNER—SIGNATURE: DATE: �a AGENT—PRINT NAME: o,.. AGENT—SIGNATURE: DATE: (o G Septic Variance Application February 2018 7/31/2020 136 Cleverdale Rd-Google Maps Google Maps 136 Cleverdale Rd 4 1,F *.. �',F•»,ar '.i=tti;[,`''pa°.•Sv°�w .rt�_ „y�t'r`vW.�:M '�'r,r.-, s: as zws? *,.,. rvi..�y�i..&5y.:,�)�• s nia°"4. a ',�`•' uhiO.Abld 61W" "M . ......... 4Q tt .. ........ J:. A ....... ... ........... m ISM ,�Igg do M V4, EM Map data @2020 200 ft hit`ps:klwww.google.,.m/maps/place/l 36+Cleverdale+Rd,+Queensbury,+NY+l 2804/@43.4644285,-73.6414511,17z/data=14m5l3m4il sOx89dfdcc65f4ce7df.-Ox6a2b8cea65b37ae8!8m2l3d43.46402... 1/2 Morgan J. Gazetos 57 Chapman Street•Ballston Spa,NY 12020 Phone:(518)260-9878•E-Mail:morganbuilds@hotmail.com August 27, 2020 RE: 136 Cleverdale Rd., Queensbury,NY To whom it may concern, I'm writing this statement as directed by Town of Queensbury Building and Codes Dept. I am the agent, friend, and buyer-under-contract for the residence referenced above and at issue, which is currently owned by James Broda of 122 Cleverdale Rd, Queensbury,NY. The purpose is to explain my request-for a septic variance for a 1,220 square foot seasonal 2-bedroom camp located 136 Cleverdale Road in the town of Queensbury,NY for a pre-existing non-conforming septic system without proposed changes or input form an NYS licensed engineer. All of that is true,but it leaves out some very pertinent information. The current system is conforming per the UNOFFICIAL COMPLIATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK TITLE 10. DEPARTMNET OF HEALTH. CHAPTER H. PART 75. STANDARDS FOR INDIVIDUAL ONSITE WATER SUPPLY AND INDIVIDUAL ONSITE WASTEWATER TREATMENT SYSTEMS. APPENDIX 75-A with regards to the size of the septic tank(table 3)and the size of the seepage pit (tables 6&7)for a year-round 2-bedroom domicile. As far as my research has led me, I cannot find specific codes for seasonal 2-bedroom cottages, camps, guesthouses, etc. In September of 2019, the town building and codes office conducted a septic inspection per regulations required for a transfer of sale. The septic tank and seepage pit were uncovered, and the septic tank was pumped out. The inspector visually inspected the unit while it operated. The system was passed as operational. The hand-drawn bird's eye view done by the building inspector is included in this application; that drawing combined with the included survey was the basis for a plot plan containing all the required elements for the application. The inspector did not include any notes. The reason for my application is the current leaching system is 65 ft from the existing well when current code requires it to be 150 ft. The current leaching system is also 10 ft from the dwelling when it is required to be 20ft. The hardship created by the pursuit of conformity is that the lot and the adjacent lot next door are+/- .2 acre lots,which would already be non-conforming building lots Page 2 in the water front zone that requires 2.2 acre lots. There is not enough acreage to construct a fully conforming traditional system that meets all current DOH setbacks and requirements. I am applying for a variance so that I may acquire a building permit to replace approximately 80 sq. ft. of bathroom floor that rotted as a result of a leaky tub drain. Until the floor is replaced, there is no other bathroom, and the house is rendered unusable. The hardship created by investing thousands to pursue another avenue seems unnecessary when compared to the scope of the project and nature of the property. I ask you to grant this variance, which would allow me to fix the bathroom, finish painting and cleaning up the house, and purchase this home from my friend. Very Truly Yours, Morgan I Gazetos ......... ... ... ............................. ............ '7`................... .... .......... ........... Fly Ll -LZ '71 .......... . ......... s. 0­0 1 I..... • AKE A OIL LAI ............ t. A:L 1-- F TJ ­'rq--T-- 1oil Vol VIAw. ZA ............. ............. AW I W w. .......... WK, nu -Awn Link 1, 1 Nil ZZAati ........... ALI 7 71 401 I............. T171 z A TOM oil-,VIA ................... W� "POW ..........