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SEP-0756-2020 Office Ute.Qhly Permit#. 5ep-O'er(a- ZQ2.0 SEPTIC DISPOSAL PERMIT APPLICATION permit Fee:$ lnvoice.#:.S2-Vb %__2 Septic Varkance? V' 'Yes No Town ofO_uccnsbury 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.aueensbun>.net .net Tax Map ID,#:"210.1T2-7 Project Location: 128 Sunnyside North,Queensbury,.NY 12804 Applicant:. Name(s): 'Robert Stephens Mailing Address, C/S/Z: 128.-Sdnnyside North,,QUeensbury, NY'12804 Cell Phone:_( -518 .)926-0074 Land Line: J N/A Email-- • Primary Owner(s): Name(s): Robert Stephens 'Mailing Address, C/$/Z: 128 SUhnys-ide North,Queensbury, NY 12804 Cell-Phone:—'( 51-8 )996-0074 'Land Line: N/A Email:stockmarket2k5dyahoo.com. ig Check if all wor I kvill be performed by homeowner only o Contractor: Work' must be submitted with this application Contact Name(s): Contractor Trade: L1911 V Mailing-Address, C_/S/Z: Cell Phone: Land Line: Email: ban M" T1 IF/7 � V-'= � U-= U U' L'--3 Engi eee(s): -Name(S,):. Pete SaSankeynk6 DEC 2 8 20270 Mailing Address, C/S/Z: 60 Blind Rock Road QueehsburyjNY 12804 TQ'AIN OF(=PUEENSBURY )I INIG CODES Cell'Phone:_( 518 )232-6017 Land Line: N/A BUILr 'Email:petesankey(giespcxom -Contact Person for Building & Code Compliance:'Rp.bert$tLmppe.ns 0e11 Phone: 518 ),926,0074' Land Line* : ,Em,ail:.r?todkmarkei2k5@yahoo.com, SeptkApplicition Revised February 2019 ,h RESIDENCE INFORMATION: Year Built Gallons #of bedrooms: X gallons per =total daily flow per day bedroom Garbage Grinder Yes No 1980 or older 150 3; 50 150 Installed? ;(circle one) X 1981-1991 130 N/A N/A N/A Spa or Hot Tub Yes No Installed? (circle one) X 1992-Present 110 N/A, N/A N/A PARCEL INFORMATION: Topography x Flat Rolling Steep Slope %Slope Soil Nature Sand X Loam _Clay Other('explain: ) Groundwater At what depth?N/A Bedrock/Impervious material At what depth?N/A Domestic Water-Supply Municipal :X Well (if well;water supply from any septic system absorption is N/A ft.) Percolation Test Rate: N/A per minute per inch(test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: Tank size4000 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 N/A ft.,; .Each Trench N/A ft. Seepage Pit-With#3 stone How.many: N/A ;Size: NIA Alternative System Bed or other type: WA Holding Tank System Total required capacity? 3500 tank size 4000 ;#of tanks 1 NOTES: 1.Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agenc)(; 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. 3. As-built drawings must be submitted prior to the inspection; if there.has been a change to the submitted plans. Dec laration:.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.Queensbu'ry Sanitary Sewage Disposal Ordinance. PRINT NAME: RobertStepnens DATE: 12/24/2020 SIGNATURE:-STEPHENS.ROBERT.WILLIAM.1376803372 DATE: 12/14/2026 Septic Application- Revised February 2019 TOWN OF ®UEENSBURY 742 Bay Road, Queensbury, NY. 12804-5902 Septic 'System Checklist nPlan to scale Wllf� Received Deep hole perc test results from engineer/Architect if applicable(Town Approved Engineers and Architects)(lune 30 to April 15 Town Engineer for unapproved Engineers and Architects) JaAII wells on property and adjacent properties shown l6water line shown Municipal or well 10'separation to any part of system IC-5Setback to property lines show 10'or more for any part of system Septic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10'from any waterline Septic tank to foundation crawl.space/slab on grade,grade in crawl space must be above top of septic tank for 0',Separation required (field verification required) Septic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage grinder each Leech Field 20'from foundation 100'from any well 10'from water line Seepage pit 150'from well 50'from septic tank Seepage Pits 3-times diameter apart Septic tank and pump stations over 30 gallons 50'from watercourse or wetland )q distance from bottom of trench or system 24"to bedrock or mottling 36"within 1000' of lake george Leech field 100'from watercourse or wetland NkToe of mound or bottom of retaining wall 10'from property line 100'-from well 20'from Foundation Provide Engineer/Architect stamp for bed or design systems �ftepartment of Health Approval for all mobile home park new systems Flood Plain requirements ?bJ 2'above established flood elevation to bottom of system All tanks anchored or 2' above flood elevation "Home of Natural Beauty ... A Good Place to Live " l9 J ttr�y —1--8in TOWN OF QUEENSBURY Grimm Building:Materials Co., Inc. 48 in BUILDING & CODES DEPT. 48 in 96 Albain my Avenue CL Reviewed By: Cove P.O. Box 157 Date: 96 in Green Island - Troy, New York 12181 �, � Phone - (5I18) 272-1100 —20 in 24 Diameter Openings 20 in Fax - (518) 272-1100 TOWN OF QUEENSSURY 1 BUILDING DEPARTMENT www.grimmbldg.com Based on our limited examination,compliance with our comments shall not be construed as inclicaung comp is YorK State. 67 1/2 in 6 in �22 i�F � 4000 Gallon Seamless 42 in 35 in in Extra Heavy Duty 96 in _ CL (L- L18 in qL _ Plan Septic Tank [Vieml 48 in 6 in CE 48 in Designed For AASH'tO H2O-44 Live Load 22 i Concrete 6 in 34 in 4000 psi @ 28 days 67 1/2 in Concrete Baffle 22 in in Entrained A1r - 5%-8% r6 L6 in +� CK -J Concrete and Reinforcing as Per - 24in" -� ASTA C890 4 in L-3 in rofil All "Holding Tanks" and "Oil/Water Seperators" 78 in 69 in 71 in 69 in 72 in View are supplied without an inlet baffle or i 48 in second compartment baffle wall. It in SEPTIC VARIANCE Office Use Only ow Received: APPLICATION Permit#: SC—P -0 ' � 2©Zo Timm ofQ_ucenshury Permit Fee: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net Invoice#: 3� Approvals: Submittal: I (one) original &8 copies of the completed application package Property Owner(s): Robert Stephens Owner's Agent: N/A Address: 128 Sunnyside North Address: Queensbury, NY 12804 Phone#: 518-926-0074 Phone#: Site Address: 128 Sunnyside North Tax ID#: 279.17-2-7 Directions to site: North on Bay Road, Right onto Sunnyside North Distance from well on property to septic system (if applicable) 51 feet Is it possible to install a conforming septic system on this property? Yes X No If YES, please explain and attach a diagram: see attachment Does the proposed system meet setback requirements for distance from wells&septic systems on neighboring properties? X Yes No If NO, please explain: Is the proposed system to be installed under a parking area? Yes X No 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.): Placement of conforming 4000 Gallon Holding Tank with Alarms C IE � DEC 0 2 2020 TOWN Orr �uIL��sG � � � Septic Variance Application February 2018 y e List the names, parcel addresses, and tax map numbers of all adjoining property owners. You may obtain ta; i map numbers from the Assessor's Office as well as the names and addresses: North Name N/A Address Tax Map ID South Name N/A Address Tax Map ID East Name Peter Goldsmith Address 132 Sunnyside North Tax Map ID 279.17-2-6 West Name Jacob Weaver Address 124 Sunnyside North Tax Map ID 279.17-2-8 OWNER STATEMENT I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at: N/A /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: Robert Stephens Date: 12/1/2020 Owner—Signature: Date: 12/1/2020 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: N/A 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 --1-8 in Grimm Building Materials Co., Inc. 48 in 48 in 96 Albany Avenue CL (L' Cove P.O. Box 157 96 in (�E]� rr_� Green Island - Troy, New York 12181 Phone - (518) 272-1100 -20 in �— 24" Diameter Openings � V2Oin Fax - (518) 272-1100 www.grimmbldg.com }- 192 in �22i 7CL in bin 4000 Gallon Seamless 42 in 35in 6 in Extra Heavy Duty 96 in _ (L' CL 8 in (L' _ Plan Septic Tank [Vieml 48 in 6 in CL 48 in Designed For AASHTO H2O-44 Live Load 22 if j— I : Concrete 6 in 34 in 4000 psi @ 28 days Baffle 7 67 1/2 in Concrete 22 in r �in Entrained Air - 5%-8% EL, 6 in , , � _ Concrete and Reinforcing as Per 24in; ; C ASTM C890 -r� � � r � LJ 4 in -J L-3 in �� 78 in 1 69 in 71 in rofil All Holding Tanks and Oil/Water Seperators 69 in 1 72 in View are supplied without an inlet baffle or 48 in ; ; second compartment baffle wall. in RESOLUTION APPROVING SANITARY SEWAGE DISPOSAL VARIANCES FOR ROBERT STEPHENS AND EXTENSION OF TIME TO COMPLETE WASTEWATER SYSTEM IMPROVEMENTS RESOLUTION NO.: BOH 32,2021 INTRODUCED BY: Mr.Harrison Freer WHO MOVED ITS ADOPTION SECONDED BY: Mr.Tim McNulty WHEREAS, the Queensbury Town Board serves as the Town's Local Board of Health and is authorized by Town Code Chapter 136 to issue variances from the Town's On-Site Sewage Disposal Ordinance,and WHEREAS, by Resolution No.: BOH 61, 2020, the Local Board of Health approved the application of Robert Stephens (Applicant) for a variance from Chapter 136, §136-11, which requires applicants to obtain a variance for holding tanks as the Applicant wished to install a new 4,000 gallon septic holding tank in lieu of a sewage disposal system on properly located at 128 Sunnyside North in the Town of Queensbury and bearing Tax Map No: 279.17-2-7(Property), and WHEREAS, the Applicant again applied to the Local Board of Health for variances from Chapter 136 as the Applicant wishes to install the new 4,000 gallon septic holding tank in lieu of a sewage disposal system with the holding tank to be located on the Property: r 1. 25' from his well in lieu of the required 50' setback; and 2. 46' from his neighbor's well in lieu of the required 50' setback: 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 Monday,June 21St,2021,and WHEREAS, the Town Clerk's Office advised that, it duly notified all property owners within 500 feet of the subject property,and WHEREAS, Town Code Chapter 137 requires inspection of Onsite Wastewater Treatment Systems (OWTS) prior to the sale of certain real property and provides that a $2,000 escrow deposit will be forfeited to the Town in the event that completion of a wastewater treatment system meeting all standards is not completed within the time provided as established by Chapter 137, and WHEREAS, a change of deed for the Applicant's property occurred on or about August 12, 2020 and when the required property transfer septic inspection took place, it was found that the existing wastewater system was deficient but the proposed holding tank was not able to be completed within the required six (6)month time period, and WHEREAS, the Applicant therefore applied for a timeline extension or until August 31, 2021 to install the holding tank and extend the date on which the $2,000 escrow deposit he previously deposited with the Town shall be automatically forfeited to the Town and the Director of Building and Codes Enforcement has recommended Town Board approval of this requested extension, NOW,THEREFORE,BE IT RESOLVED,that: 1. 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 other adjoining properties nor otherwise conflict with the purpose and objectives of any Town plan or policy; and 2. the Local Board of Health finds that the granting of the variances is necessary for the reasonable use of the land and are the minimum variances 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 Local Board of Health hereby approves and authorizes the application of Robert Stephens (Applicant) for variances from the Sewage Disposal Ordinance to allow installation of a new 4,000 gallon septic holding tank in lieu of a sewage disposal system with the holding tank to be located: 1. 25' from his well in lieu of the required 50' setback; and 2. 46' from his neighbor's well in lieu of the required 50' setback: on property located at 128 Sunnyside North in the Town of Queensbury and bearing Tax Map No: 279.17-2-7,and BE IT FURTHER, RESOLVED, that the Local Board of Health further authorizes and grants the Applicant additional time to obtain a certificate of compliance from the Town's Building and Codes Enforcement Office as set forth in Chapter 137 to install the holding tank and extends the date on ,which the $2,000 escrow deposit the Applicants previously deposited with the Town be automatically forfeited to the Town until August 315; 2021 and authorizes and directs the Director of Building and Codes Enforcement to take any and all actions necessary to effectuate the terms of this Resolution. Duly adopted this 21St day of June,2021,by the following vote: AYES Mr. Freer,Mr.Ferone,Mr. McNulty,Mr. Strough,Mr.Metivier NOES None ABSENT: None RESOLUTION APPROVING ROBERT STEPHENS' APPLICATION FOR SANITARY SEWAGE DISPOSAL VARIANCE RESOLUTION NO.: SOH 61,2020 D INTRODUCED BY: Mr.Anthony Metivier DEC 2 3 2020 WHO MOVED ITS ADOPTION TOVI(P�OF QUEL6�§SI3URY BUILDING&CODAS SECONDED BY: Mr. George Ferone `� -� WHEREAS, Robert Stephens (Applicant) filed an application for a variance from provisions of the Town of Queensbury On-Site Sewage Disposal Ordinance Chapter 136, §136-11, which requires applicants to obtain a variance for holding tanks as the Applicant wishes to install a new 4,000 gallon septic holding tank in lieu of a sewage disposal system on property situated at 128 Sunnyside North in the Town of 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 duly conducted a public hearing concerning the variance request on Monday,December 215t,2020,and WHEREAS, the Town Clerk's Office has advised that it duly notified all property owners within 500 feet of the subject property, NOW,THEREFORE,BE IT RESOLVED,that 1. due to the nature of the variance, the Local Board of Health determines that the variance would not be materially detrimental to the purposes and objectives of this Ordinance or other adjoining properties nor otherwise conflict with the purpose and objectives of any Town plan or policy; and 2. the Local Board of Health finds that the granting of the variance is necessary for the reasonable use of the land and 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 Local Board of Health hereby approves the application of Robert Stephens for a variance from the Sewage Disposal Ordinance to install a new 4,000 gallon septic holding tank in lieu of a sewage disposal system on property located at 128 Sunnyside North in the Town of Queensbury and bearing Tax Map No: 279.17-2-7. Duly adopted this 2 1"day of December,2020,by the following vote: AYES: Mr.Freer, Mr. Ferone, Mrs. Magee,Mr. Strough,Mr. Metivier NOES: None ABSENT: None