SEP-0566-2021 SEPTIC DISPOSAL PERMIT office Use only
APPLICATION Permit#: < ai— V25S b - Zo21
TOM ofQLvembury Permit Fee:$
,455
Invoice#: zt�;pQ
742 Bay Road,Queensbury,NY 12804
P:518-751-8256 www.aueensbury.net Septic Variance? N
Flood Zone? Y
Wetlands? Y
Project Location: 1 1 S c""SzL`�Ir;
Rb
D
Tax Map#: ZZ7. 1`7 -? OCT 14 2021
RESIDENCE INFORMATION: TOWN OF QUEENSBURY
Year Built Gallons #of bedrooms: 'X gallons per =total daily flow BUILDING&CODES
per day bedroom Garbage Grinder Yes No
1980 or older 150 Installed? (choose one) ❑
1981-1991 130 130 ) Spa or Hot Tub Yes No
1992-Present 110 Installed? (choose one) I ❑
PARCEL INFORMATION:
Topography 211at Rolling ❑ Steep Slope %Slope
Soil Nature, [] Sand oa'm [�.Clay ❑ Other, explain:
Groundwater At what depth?. KA
Bedrocklimpervious material At what depth? T-AA ��„'
Domestic Water Supply ❑ Municipal ❑Well, - 26ke
(if well or lake, water supply from any septic system absorption is
Percolation Test Rate: per minute per inc (test to be completed by a
licensed:engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size 14500gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
spa/hot tub
System Absorption field w/#2 stone Total length ft.; Each Trench ft.
Seepage Pit w/#3 stone How many: ;Size:
Alternative System Bed or other type:
Holding Tank System Total required capacity? tank size 1 gxp
#of tanks 1 �'
Septic Application Revised April2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant: _
Name(s):
Mailing Address, C/S Ce W 1.•1 � a'21 Lvyyc.�t.v`ZG►� ►rAA
Cell Phone: Land Line: ®1 +l�Z
Email: {"'�'rstz 10 � �,C
• Primary Owners;:
Name(s)-
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
❑Check if all work will be performed by property owner only
• Contractor:
Contact Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
"Workers' Comp documentation must be submitted with this application"
• Enpineer(s): _
Name(s):
Mailing A ress,C/S/Z: 4=1 C20 7er, 1.4. G>I; t'�—�o t� j� j�.�,� 12.0&iz-
Cel) Phone: 511&_=Ca.--,.- .and Line:
Email: ,d�-pil- c_ M
Contact Person for Compliance in regards to this project.
Cell Phone: Land Line:
Email:
NOTES: 1. Alarm system and associated electrical work must be inspected_ ,by a Town approved electrical
inspection agency, 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.4. If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the
Town of Queensbury.After 1 year from the initial application date, 100%of the fee is retained.
Declaration: 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 Queensbury
Sanitary Sewage Disposal Ordinance.
PRINT NAME:
SIGNATURE: 1414 1 G�i 1 DATE:
Septic Application Revised April 2021
TOWN OF QUEENSBURY
742 Bay Road, Queerisbury, NY. 12804-5902
Septic System Checklist
M-Plan to scale
Received Deep hole perc test results from engineer/Architect if applicable(Town Approved Engineers and
Architects;June 30.to April 15 Town Engineer for unapproved Engineers and Architects)
NV All wells on property and adjacent properties shown
ZIwater line shown Municipal or well 10'separation to any part of system
Cam,
%Setback to property line Cshow_A'or more for any part of system
tank and pump stations 10'from foundation- from any well/lake/wetland�10'from any waterline
Wal
I Lkepiit 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)
ADSe.ptic tank sized for number of bedrooms and add 250 gals for Jacuzzi tubs/garbage,grinder eac
4COC
Leech Field 20'from foundation 100'from any well 10''from water. line-
Ak Seepage pit 150'from well 50'from septic tank
Seepage Pits 3-times diameter apart-
'. .
W_ � and pump stations over 30 gallons 50'from watercourse or wetland
/,I`distance from bottom of trench or system 24"to bedrock or mottling 36"within 1000'of Lake George
6—r Leech field 100'from watercourse or wetland
*Toe of mound or-bottom of retaining wall 10'from property line 100'from well 20'from
Foundation
'�LkProvicle Engineer/Architect stamp for bed or design systems
department of Health Approval for all mobile home park new systems Flood Plain.requirements
Kb2' above established flood elevation to bottom of system
c All tanks anchored or 2' above flood elevation
Revised 4/15/2021
ENVIRONMENTAL DESIGN
PARTNERSHIP, LLP. 900 Route 146 Clifton Park,NY 12065
(P)518.371.7621 (F)518.371.9540 edpllp.com
Shaping the physical environment
December 29, 2017
Town of Queensbury Department of Building &Codes q (�
742 Bay Road D
Queensbury, NY 12804 DEC 2 9 ®a�
Attn: Dave Hatin
TO�N�OF u ODES
g RY
Re: Tuzzolo Residence—118 Seelye Rd. �ILDING&
Dear Dave:
In compliance with application approvals granted by the Town of Queensbury I offer the following
regarding the referenced project.
The design plan reviewed and approved by the Town as associated with the wastewater system is as
follows:
Proposed Site Improvements for the Tuzzolo Residence
118 Seelye Rd. October 3, 2021
Town of Queensbury Tax Parcel ID 227.17-2-7
• Sheet 1: Cover Sheet (p(p .2024
• Sheet 2: Existing Conditions -
• Sheet 3: Site Plan
• Sheet 4: Holding Tank Notes
The site improvement involving the wastewater holding tank system has been completed in
compliance with the intent of the site plan as approved. It must be noted (and is reflected on the
attached 'as-built' plan)that the type of holding,tank(concrete)was replaced,at the Owner's request
and with my approval,with a Roth heavy duty polyethylene tank. Manufacturer's info is provided
herein. The alarm system was installed and demonstrated for Town inspection. The residence is a
seasonal property so won't be used again until next year. The Owners are still to complete some
internal plumbing improvements next Spring.
Based on my inspection of the new holding tank system it is my opinion that is in compliance with
the intent of the approved design plan and is ready for a final CO.
Peviviis M&1c:E1ra4
Dennis MacElroy, PE
Environmental Design Partnership
Attachment
Cc:Tuzzolo Family
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Roth MuttiTa.nk@
Septic Tanks
Water Cisterns
P�u mop-�Ta n ks
Holding Tan' lcs
Rain Vtlater Rarvesting
LT ITA-,N. K.
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Rut
MODEL DESIGN TOTAL ACTUAL CAPACITY HEIGHT WIDTH LENGTH WEIGHT
CAPACITY CAPACITY
Gallons Pounds
Gallons 1 Liquid
(Liters) (Li
RMT-300 300(1186) 325(1230) 273(1033)/284(1075) 54(1372) 45(1143) 50(1270) 120(55)
(single layer) .
RMT-500 500(1893) 535(2025) 452(1710)/474 (1794) 51(1295) 62(1575) 60 (1524) 225(102)
RMT-750 750(2840) 1000(3785) 853(3229)/898(3399) 51(1295) 62(1575) 103(2616) 360(163)
RMT-1000E 1000(3785) 1161(4394) 990(3747)/1028(3891) 51(1295) 62(1575) 118(2997) 450(204)
RMT-1060 1060(4013) 1337(5061) 1177(4455)/1227(4645) 51(1295) 62(1575) 133(3378) 520(236)
RMT-1250 1250(4730) 1469(5560) 1259(4766)/1319(4992) 51(1295) 62(1575) 148(3759) 560(254)
RMT 1500 1500(5678) 1771 (6703) 11540(5830)/1601(6060) 51(1295) 162(1575) 1177(4496) 640(291)
I! Environmentally Sound. 100%of
! scrap is recycled and reused. The
most environmentally-sound method
available(no air, water or solid waste
discharge as a result of our process)
-
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Virgin—�
E' Material
S 1�41.
Ai Not all tanks are created equal. Roth's revolutionary
process changes everything.
D.State-of-the-art computer controlled multi-layer blow molding
process produces perfect parts. Repeatable process, repeatable
field performance you can trust.
Our tanks are manufactured by a unique and proprietary
1
blow-molding process resulting in the most structurally sound
polyethylene tank on the market.
F
After decades of conventional technology, Roth brings 40 years
• . . ::.::, of blow molding experience to the North American market. In fact,
' '• 1 out of every 2 tanks in Europe is of blow-molded construction.
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FREQUENTLY. ASKED. QUESTIONS
Q:What is the highest vacuum level Roth tanks have Q: Do all manufacturer's vacuum test their tanks?
been tested at?
Q: What happens to the tank"when vacuum testing to
higher levels?
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Q: I noticed a thick rib at the middle of the Roth tanlc.`Is
tha -a'seam?
Q-.If Roth'tan'lcs,:can sustain such-a highjevel of vacuum`,
testing,why d'o:sbme.other ini zid facturers warn not to
test.their.:tanks'above 2.5"iriches.of mercuK -.vacuum i :•,: „ ,..<,;,,= 7+t;J.t:.
pressure?':
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I WorriesLess Handling
No corrosion
expectancyvatertight No water backfill required
Higher life
n"i a rket cistern applications
RothTrue 5tructural integrity !:-
systern,including the popu(ar STAR@ riser
HRPE — the most chemically-resistant material
worldsysterns
'in the
Can be installed LIP to 72" deep (in some states
and Canadian P .
gsit wvR� h—M 'a .� t eiRothM taUers.w u
'Are you-certified? Make:sixre yoiu re:Iisted-on our website!
.
Distribution Box .
i-12-hole distribution box,allows for
I' f parallel pipe runs on 4 sides
Invert drop of 2"between inlet and Plug Covers
"f v outlet pipes Maximum versatility in the
24 I.D.provides plenty of elbow field
room during installation,leveling _•Extra-strong flat-top design
i and maintenance .. 1-Unique anti-slip surface
i Basin can be weighted with Easily secured against
aggregate to maintain level unauthorized entry
Bring to grade using the Star® >Excellent for riser retrofit
threaded riser system " :,Fits alFmajor manufacturer's
Includes a Star-24L(threaded lid),. i8"&24"pipes
gasket and security seal Gasket and two security seals
! included
Riser System
24"I.D.Threaded STAR®Riser.
�r Maximum versatility in the field Ngg
-
w Watertight connection
m Extra-strong flat top design
Unique anti-slip surface
i
Easily secured against unauthorized
entry Plumbing Kit
Excellent for retrofit or cast-in Inlet Tee
Outlet Tee
Plus..... (2)4"pipe seals
e•18 in and 24 inch adapters Riser gaskets
Safetly lids h Butyl sealants
j u•Hanging pump vaults' Partition'assembties
Pipe seals r_•Effluent filters
Security seals
I
RESOLUTION APPROVING RICHARD TUZZOLO'S APPLICATION FOR
SANITARY SEWAGE DISPOSAL VARIANCES
RESOLUTION NO.: BOH 46,2021
INTRODUCED BY: Mr.Timothy McNulty
WHO MOVED ITS ADOPTION
SECONDED BY: Mr. George Ferone
WHEREAS, Timothy Moriarty (Applicant) filed an application for variances 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 replace
the existing wastewater system and install a 1,500 gallon capacity holding tank in lieu of a 3,000
gallon capacity holding tank required to serve as the sewage disposal system on property situated at
118 Seelye Road 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 requests on Monday,August 23`d,2021, 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
URESOLVED,that
1. due to the nature of the variances, the Local Board of Health determines 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 the application of Richard
Tuzzolo for variances from the Sewage Disposal Ordinance to allow installation of a 1,500 gallon
capacity holding tank in lieu of a 3,000 gallon capacity holding tank required to serve as the sewage
disposal system on property situated at 118 Seelye Road in the Town of Queensbury and bearing
Tax Map No: 227.17-2-7, and
BE IT FURTHER,
RESOLVED, that the Town Board authorizes and directs the Town Clerk to forward by
certified mail a certified copy of this Resolution to the Adirondack Park Agency for its review,and
BE IT FURTHER,
RESOLVED, that this approval Resolution shall not be effective until 30 days after such
notice to the Adirondack Park Agency and shall be subject to review by the Adirondack Park
Agency during such period.
Duly adopted this 23`d day of August, 2021,by the following vote:
AYES : Mr. McNulty,Mr. Strough,Mr. Ferone
NOES Mr. Freer
ABSENT: Mr. Metivier
SEPTIC VARIANCE Office Use Only
Permit#:
APPLICATION Permit Fee:'$ ►log�> —
wof ury
Invoice#:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.aueensbury.net Approvals:
.Submittal: I (one) original &8 copies of the completed application package
Contact Information: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
Property Owner(s): RichardTuzzolo Owner's Agent: Environmental Design Partnership r
Address: 6 Wintergreen Court, Address: 900 Route 146 Clifton Park NY,
Lunenburg MA 014621180 12065
Phone#: Phone#:518-371-7621
Email: rtuzzolo@gmail.com Email:nzeglen@edpllp.com,(NickZeglen)
dmacelroy@edpllp.com(Dennis MaCelroy)
cdemyer@edpllp.com(Connor DeMyer)
Site Information:
Site Address:118 Seeyle Rd Tax ID#:227.17-2-7
Directions to Site: From 9L,turn onto Cleverdale Road,turn onto Rockhurst Road,continue onto Seelye,continue to 118 Seelye
Distance from well on property to septic system (if applicable) N/A feet
Is it possible to install a conforming septic system on this property? ❑Yes Q No
If YES, please explain and attach a diagram:
Does the proposed system meet setback requirements for distance from wells&septic systems on neighboring
properties? QYes ❑ No If NO, please explain:
Is the proposed system to be installed under a parking area? ❑Yes F-� 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.):
V-1 Use of Holding Tank
V-2 Request to use one 1,500 gallon holding tank vs the 3,000 gallon capacity required
Septic Variance Application Revised January 2021
List the names, parcel addresses, and tax map numbers of all adjoining property owners: You may obtain Ogg
information from the Town of Queensbury's Assessor's Office:
North Name 112 Seelye LLC
Address 36 Liberty Street Hawthorne NY,10532
Tax Map]D 227.17-2-8
South Name 120 Seelye LLC
Address 36 Liberty Street Hawthorne NY,10532
Tax Map ID 227.17-2-6
East Name Kenneth Giordano
Address 100 Nancy Street West Babylon NY,11704
Tax Map ID 227.11-1-50
West Name 120 Seelye LLC
Address 36 Liberty Street Hawthorne NY,10532
Tax Map ID 227.17-2-6
OWNER STATEMENT
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 well,septic tank or leaching system less than the required feet
from the may increase the risk of pollution.
Owner—Print Na7A
e:
Owner—Signature: Date
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 well,septic tank or leaching system less than the required feet
from the may increase the risk of pollution.
Neighbor/Tenant—Print Name:
Neighbor/Tenant-Signature: Date:
Septic Variance Application Revised January 2021
i
.-PLEkSE ATTACH THE FOLLOWING TO YOUR APPLICATION:
1. A location map showing the site within the Town of Queensbury
2. A plot plan showing existing and proposed features of the property, including:
a. Lot dimensions
b. North arrow and scale: 1 inch=40 feet
c. Location & dimensions of existing and proposed buildings, showing setback distances and
uses
d. Parking layout to scale (if applicable)
e. Physical features (street, steep slopes, lakes, wetlands, etc.)
f. Location of all wells and septic systems on neighboring properties
g. Adjacent ownerships
h. All properties within 500 feet
A sample plot plan and location are shown below:
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Septic Variance Application Revised January 2021
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: as agent regarding the Septic Variance for
Site Address:
Tax Map#:
Engineering Fee Disclosure:Applications may be referred to the Town consulting engineer for review of septic
design,storm drainage,etc.as determined by the Town Board of Health. 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
AGENT—PRINT NAME: iip� i P.F"
AGENT—SIGNATURE: DATE: 7' .9
Septic Variance Application Revised January 2021