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 — '}-
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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-
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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