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2002-366 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building& Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20020366 Date Issued: Thursday, May 09, 2002 This is to certify that work requested to be done as shown by Permit Number P20020366 has been completed. Tax Map Number: 523400-239-012-0002-059-000-0000 Location: 20 HOLLY Ln Owner: WILLIAM CROWELL III Applicant: WILLIAM CROWELL III This structure may be occupied as a: By Order of Town Board Septic Alteration Residential TOWN OF QUEENSBURY if, Director of Building&Code Enforcement 1 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902. (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020366 Application Number: A20020366 Tax Map No: 523400-239-012-0002-059-000-0000 Permission is hereby granted to: WILLIAM CROWELL III For property located at: 20 HOLLY Ln 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: WILLIAM CROWELL III Septic Alteration Residential 20 HOLLY Ln Total Value LAKE GEORGE,NY 12845 Contractor or Builder's Name/ Address Electrical Inspection Agency CRANDALL, CHRISTOPHER 63 WOODCHUCK HILL ROAD LAKE GEORGE,NEW YORK Plans &Specifications 2002-366 SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,May 09,2003 (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 T Quee b ; r day,May 09,2002 SIGNED BY for the Town of Queensbury. Director of Building Co Enforcement Application for Permit—Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,1VY 12804 (518) 761-8256 1. OWNER INFORMATION: _ --- ---- —Office Use y f Location of installation: File Permit NO. ()� LGj Tax Map No. / / C> ;. I { Fee Paid ll e ` Owner's Name: ' I Address: Zo 1a► fre (ram.-zoe- 2. INSTALLER'S NAME C X P� 1,0f9-/1 xC lfi PHONE NO. . 3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s)and multiply# of bedrooms with applicable gallons per bedroom to equal total daily,flow) Year of House: No of Bedrooms x Computation = Total Daily Flow 980 or older x 150 gallbdrm = tS`O Y V ED 0-1991 x 130 gal/bdrm = na 1991—present x 110 gal/bdrm = As, y 0 7 20Q2 Yoi!'i ly OF Q1 JEEN,, Fl3°t' Garbage Grinder Installed yes u / no A i3U11.Q1ft'(ANo CO c Spa or.Whirlpool Installed yes_ / no ej 4. PARCEL INFORMATION: (circle applicable information&.indicate measurements) Topoaraphv Soil Nature Ground Water Bedrock or 1=ervious Material Domestic Water Supply FI s at what depth at what depth municipal RoXXin' loam �f feet 1'7lws, - .k.,-feet well ep slope c if well;water supply �%slope other from any septic-'system depth: absorption is !t b ft other 6-q Irc Percolation Test: (To be completed by licensed professional engineer or architect) Rate; �'Z 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: 601D gallon (min.size 1,000 gal.) Tile Field: each trench Tatar System Length: f1 Seepage Pit(s): number of size of each: ft by }i Size of Stone to be used: # / depth or thickness feet r Bed System Size: z Alternative System: ^ length andlor size 6. HOLDING TANK SYSTEM: (if required) Number oftanks: / Size of each: "'--- gallons /TOTAL Capacity: �` gallons i Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &IN-FORMATION FOR RESPONSIBLE PERSON(please read) For your protection,please note that pursuant to Section 136-29 ofthe Code ofthe 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 I have read;the regulations with respect to this application and agree to abide by these and all requirements ofthe Town of Queensbury Sanitary. Sewage Disposal Ordinance. _ Oz ature of responsible person D to COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.002 Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Permit No. Cert. MO 7 3 47 2 Cut-in Card No. �X Owner e/%2Cr?A Location l L L V 4 e-- y Installation Consistin of. 5 Mien- (26' �� � eCs 9 L s erei-ae_ Installed By g- Lic.No. The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of ma ' 'nspections at any time, and if its rules are violated,the Company shall have the right to ygvok rtifica . Date g-1 O O � INSPECTOR Member N.F.P.A..I.A.E.I TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queen_sburyNY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name C'R.OU3c Cam_ Location Okoc...c_q (_ Date S /p G�Permit # -4 SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) ' . e--inute/Inch TYPE OF SYSTEM: ABSORPTION FIEL' Total ength Length of each ► ,ench Depth of trenche. Size of stone SEEPAGE PITS: N ber- Size - ft x ft. Stone size PIPING: ize Type Bldg. to Tank Tank to Dist. Box Dist. Box to Field/Pit Openings Sealed? Yes No Partial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption feet Separation of Pits _ feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: D SYSTEM USE APPROVED: YENO Arrived: t27() Departed: OP— Building Inspector TOWN OF QUEENSBURY ii BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 l// 0 ; _ 3 S SEPTIC DISPOSAL SYSTEM INSPECTION Name Of04X!--G.L 01 lie...... Location gLc. Y Z', Mlit6.3 Date ° . ?— Permit # SOIL TYPE Sand- oam-Clay- Results of 'ercolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: i7 ABSORPTION FIELD: Total Lengttfj._ 6-0 _ Length of each trench i• en Depth of trenche t Size of stone e L.,. C.h} j tri., . SEEPAGE PITS: Number- Size - ft. x ft. Stone size _— PIPING: '� Sicg A Bldg. to Tan ! ` P� Tank to Dist. Box )• v.Dist. Box to Field/" - Openings Sea' ed? Yes o . Partial LOCATION/SEP;c ION : Foundation ti Tank 7i''.feet • Foundation ti Absorption . - feet Separation o=' 'Pits _ Alkeet Conforms as •er Plot P1 an WOY No LOCATION OF S STEM ON PROPERTY: (circle o e • Front - Rear - Left Side - Right Side Middle f• - Piddle Rear COMMENTS: / - -� 1C /460 CLc-Z . /050-- SYSTEM.USE APPROVED: YES NO Arrived: Departed: 0-' \ii(// . Building Inspector 1t(L1 °CD4 /T6- 645( s::. RESOLUTION APPROVING SEWAGE DISPOSAL VARIANCE APPLICATION OF WILLIAM CROWELL RESOLUTION NO.:BOH 10,2001 INTRODUCED BY: Mr.James Martin WHO MOVED ITS ADOPTION SECONDED BY: Mr.Daniel Stec WHEREAS, William Crowell filed an application for a variance from provisions of the Town of Queensbury On-Site Sewage Disposal Ordinance, such application requesting that the Local Board of Health authorize Mr. Crowell to install an absorption field ninety-five±(95'±)from Lake George instead of the required one-hundred feet (100') setback on property located at 20 Holly Lane,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 request on March 19t',2001,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 variance, it is felt that the variance 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) that the Local Board of Health finds that the granting of the variance is necessary for the reasonable use of the land and that the variance granted is the minimum variance which would alleviate the specific unnecessary hardship found by the Local Board of Health to affect the applicant; and • BE IT FURTHER, RESOLVED, that the Town of Queensbury Local Board of Health hereby approves the application of William Crowell for a variance from the Sewage Disposal Ordinance to allow Mr. Crowell to install an absorption field ninety-five feet ± (95'±) from Lake George instead of the required one-hundred feet (100') setback on property located at 20 Holly Lane, Queensbury and bearing Tax Map No.: 6-3-5. 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