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SEP-0778-2020 �. SEPTIC VA RIA NCE Office use o�l� " Received: . APPLICATION Permit#: 5E'P= -zozo. Tonn of(&rn. .ry .. Permit Fee: I " 742 Bay Road,Queensbury,,NY 12804 P:518-761-8256 w.aueensbury. Invoice M.,µrw net 32� . Approvals: . Submittal:I(one)original A 8 copies,of the completed application"package n Property Owner's): 4A 14 c Owner's Agent: t . �l�r.;� .'1l,.,r.. Address: v 1.11.L� k� Address: Phone#:f/v 1+�.F, . .7�� �q.,7 3 g �.h Phone#• `74 CZl ECt : 1 If? 4 I. AS Site Address: Iy jSZD� Tax ID#• `?'�F�1 t la — '}- r. Directions to Site: 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 a#fach a diagram: . i Does the proposed system 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 ✓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.): F(Jti �szx_,;, G'IA 111. LI-SI;t T7ir�)I �E"�iCLGtiL� 75 �Elf DEC Q 9 2020 :. Septic Variance Application ����I 11�J� rt' —_- j ' february2016 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: Alorth Name fix,inn I�r:lr ' Aw�t�CZ£44-' r P(rr..i�N t-- Address.. Tax Map ID l:l � LCr South -Name j7:. Th.r jt Address zJ- 7PbS� jtr14r11 Tax Map ID East Name NA%Z Fri Address Tax Map ID West NameGF �i EriP,c Address Tax.Map ID, 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. r i Owner—Print Name: .L k A z I G�... 11 ��• Date: 1/ l a-� Owner- Signature: Date: i 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 PLEASE ATTACH THE FOLLOWING TO YOUR APPLICATIOWI Z. Mocation.map showing the site wi#hin the Town of Queensbury. I A.plot plan showing existing and_proposed features of the property, including: a.' Lot dimensions. . b. .North arrow and scale:,I 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 neighbo.ring properties g. -Adjacent ownerships, h. All properties within_500 feet A.sample.plot plan and location"are shown below; I: - i WAM -ten i4- /TCATd Septic Variance Application February 2618 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:_--M 1,r ..Li t�t:,f1�it�N Designates: C1j 11-J_ � as agent regarding the Septic Variance for Tax Map.#: OWNER'S SIGNATURE: . DATE: 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 herebyauthorize 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.- 4.the undersigned;have thoroughly read and-understand.the instructions for submission.agree to the submission requirements and completed checklist: OWNER-PRINT NAME: - c-.1► lie 1.. C,.; L.p v. e h.fL OWNER=SIGNATURE:. . DATE: AGENT—PRINT NAME: AGENT-SIGNATURE: DATE: .Z— —tc, Sepik Variance Application February Zb18 Company notes: ti " ' l i 1. ,Z.B.S.Septw djr'DrainService, Inc. rlM. - !; DBA CONDON'S SEPTIC SERVICE 2 Lower Warren Street • Queerisbury, NY 12804 I Phone:51:8=7.98-8194 Phone:518=798-8542 • Fax:518-7987-3213 We take pride ii':everything we do! NAME !` ''+ 7 ` 'E• DATE CAL}Fb DAT)= OMPLE ' 1 *: i 1' 1E i �S , `tip r f t, r ••Jr - ' E� S \:.+"!i Jt `y r-.rt; I •' a i :"` } �� } — � ._d � f �')ti C� i ). i5, J �• - STREET I '4;:f?" JOB STARTTIME HOUSE'BACKED UP + f OYES ONO TOWN } �, i f , JOB END TIME. GAL. TANK•UNCOVERED. :' , pYES ONO PHONE:-HOME _ WORK: ,,,. ,CEL-L~ START TIME•SIZE TANK DEPTH TANK-SIZF� CONTACT PERSI;3'N i J ' ¢ ;=�(.,; - END TIME•SIZE QUOTED PRICE_ OSEPTIC +� j (.•d l '=; t 3l GREASE DIRECTIONS SEPTIC EVALUATION TANK: OK YES 171 NO O OUTLET BAFFLE: OK YES O NO O TANK SIZE FIELD: OK YES 9" NO O INLET LINE: OK YES-0— NO O LIQUID LEVVEL':' TANK CONSTRUCTION MATERIAL: NORMAL O HIGH O CONCRETE O'er PLASTIC O METAL O VENTS: OK i ESTAGE OF SYSTEM: EST VISIBLE AMOUNT OF LEACH LINES TESTING OF INLET LINE: FLUSHED TOILET YES6?,•• NO O SEPTIC SYSTEM NOTES: •.DESCRIPTIiON;. -_ .;.., ._, ,. -•. _-.AMOUNT ; PUMPING OF SEPTIC TANK: -""' ~ GALS:.® ,i i - - GREASE RAR GALS.@ _ E! _ CLEANING LINES WITH SNAKE . E1; a WE SWILL SEND YOU A REPUMP REMINDER IN YEARS: SUB TOTAL AUTHORIZED SIGNATURE _ PROCESSING_ FEE TERMS: A Late payment charge of 2%per mo'. A . TAX shall.be payable upori all unpaid balances over 30 days_ Collection Costs,including reasonable Attorney Fees,will be charged to the Customer. There will'be a$50:00 charge4or all returned checks. TOTAL Method of Payment:; O CASH O. 'CREDIT'CARD O CHECK -- Es ; , Please charge t0 Rfy: O MasterCard:?M,Visa Card No, Exp.Date Signature: PUMP. IBS-1 11ev.66111- _ -W=Ouice.'_ *Customer RESOLUTION APPROVING MICHAEL LOUGHREY'S APPLICATION FOR SANITARY SEWAGE DISPOSAL VARIANCE RESOLUTION NO.: BOH 1,2021 INTRODUCED BY: Mr.George Ferone WHO MOVED ITS ADOPTION SECONDED BY: Mr.Anthony Metivier WHEREAS,Michael Loughrey(Applicant) filed an application for a variance from a provision of the Town of Queensbury On-Site.Sewage Disposal Ordinance Chapter 136 to maintain an existing sewage disposal system that does not meet today's current requirements on his property as follows: • Maintain the existing 1,000 gallon holding tank at his seasonal two bedroom residence instead of installing a 3,000 gallon holding tank required of a two bedroom residence; .on property located at U Sign Post 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 request on Monday,January 11t',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 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 Michael Loughrey for a variance from the Sewage Disposal Ordinance to maintain an existing sewage disposal system that does not meet today's current requirements on his property as follows: • Maintain the existing 1,000 gallon holding tank at his seasonal two bedroom residence instead of installing a 3,000 gallon holding tank required of a two bedroom residence; on property located at I Sign Post Road in the Town of Queensbury and bearing Tax Map No: 239.16-1-7, contingent upon the holding tank always having an alarm for when it reaches one-half (1/2) full and an automatic shut-off when it becomes full,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 any lawful action by the Adirondack Park Agency during such period. Duly adopted this I Vh day of January,2021,by the following vote: AYES : Mr.Freer,Mr. Ferone,Mr. McNulty,Mr. Strough,Mr.Metivier NOES : None ABSENT:None RUCINSKI.HALL ARCHITECTURE Ronald Richard Rucinski a �. Ethan.Peter. Hall lip 134 Oix.Avenue Glens Falls NY 12801 Voice, 518 7410268 Fax •518 7410274 Email eohall@nycap.rr;com 11 Sign Post Road 13 November 2020 Dave Hatin:—Town of Ou.eerisbiury,136ilding Department 742 Bay Road Queensbury:NY 12804 Re: Existing sewage disposal system variance application At the above referenced:project location-this office would.like to be.-granted a variance from.the 3,000 gallon,holding tank required of:a two.bedroom residence and maintain the existing 1,000 . gallon holding.tank. Due to.site.conditions there Nino opportunity.to install aseptic field and . additional holding tanks:are simply not:feasible:The current owners of the property are the second . oviiners arid.have been utili2ing the single 1,000 gallon tank since:purchasing with no issue. The . residence is a seasonal 2 bedroom with one bath, small kitchen and no washing machine or.. dishwasher.'Currently the,tank gets.pumped once or twice a.year and the usage of the residence will not be increasing. If not already installed.on.the tank,,we will be adding a half full and high water alarm system and a high water shutoff,as well. Regards; I. Ethan Peter.Hall Architect Vuri , I En s DEC Q-9. 2020 BUILD-If�,lt' s F u ' Y