Loading...
PT-0102-2023 n Property Transfer Sewage Disposal Information Form ) E � Ifl 11 Town of Qwensbury MAR i 3 2023 e: ,1oR3 742 Bay Road,Queensbury,NY 12804 TOWN OF QUEENSSUF''t P:518-761-8256 www.queensbury.net BUILDING & CODES �evi/2 6101T L.c.//e (Name of Owner/Applicant) Re: Onsite Wastewater Treatment System Inspection Information Request for: /2k LJ � A1) /a (Site Address for Inspectib+) Thank you for requesting an inspection for the onsite wastewater treatment system (OWTS) located on the property referenced above. We look forward to completing a thorough inspection for you. You can help us do the best job possible by providing some advanced information about the site..Prior to our inspection,we request this completed application, a site map indicating the location of the septic components and confirmation the pre-inspection preparation (see the last page of this packet) will be completed prior to our arrival. Enclosed is a Septic System Inspection Information form, which must be completed, signed and returned to this office,with the appropriate fee(s) and documentation, prior to scheduling an inspection. Please note the Town of Queensbury's fee for this service is$275. Be advised that all fees must be paid prior to scheduling the inspection. We require 48 hours notification prior to scheduling the inspection. If the purchaser is requesting an exemption, please submit this application along with a notarized letter stating the septic system will be inspected or repaired/replaced within 6 months from the date of the Property Conveyance or June 1st of the current, or following year (whichever comes first), a map locating the septic system and payment totaling$2275 ($2000 refundable deposit plus $275 permit fee). The deposit is forfeited if the owner fails to complete the repairs or installation as stated above. If you have any questions, please call. Phone: (518) 761-8256 Email: kated@queensbury.net Thank you. Sincerely, OidArP16 John O'Brien, Director BuJding and Code Enforcement Town of Queensbury Property Transfer Packet Revised July 2022 ,,g.\.\- 00--A3 ) Building & Code Enforcement \ �f 742 Bay Road, Queensbury, NY 12804-5902 QQ -.'Zt\LA) Town of Queensbury P: 518-761-8256 www.queensbury.net br-,` cat b`ko Notice of Violation � oCJ� � ro _ loE 0 V 1 C 1/9/23 ' (5 r Evelyn Jaeger & Shirley Mockel ©J 950 Route 9 Castleton NY 12033 � � �� � Q3\c8\7..-3 Dear Evelyn Jaeger & Shirley Mockel, On 10/14/22 you changed the deed at 180 Lake Pkwy in the Town of Queensbury. The Town of Queensbury has a requirement that prior to changing of the deed of the property in a Water Front Residential Zone (WR-1A) you must obtain a permit to inspect the existing septic system by the Town of Queensbury as required by Chapter 137 entitled 'Septic System Inspection upon Property Transfer.' You have not submitted for the permit in order to do the inspection. This letter is to advise you that the inspection must be done within 6 months of this violation notice dated January 9, 2023 per Chapter 137-6 (A&B), see below. The compliance date is July 9, 2023. Please file for the permit and schedule an inspection before June 9, 2023. 137-6. Notice of Violation: penalties for offenses. If a property owner fails to complete an inspection required by the article, or to allow access to the property for the required inspection, or if the property owner fails to comply with any other provision of this article, a notice of violation may be issued by the Building and Codes Enforcement Office mandating the compliance with the inspection requirements. A.In the event the property owner in its capacity as grantor was issued a notice of violation and such violation continues for a period of six months, the current property owner (or grantee) too shall be deemed to be in violation of this article and may be subject to enforcement proceedings. B.An offense against any provision of this article shall constitute a violation, punishable by a fine not exceeding $950, or imprisonment for a term not exceeding 15 days, or both. Each week such violation continues after notification to the person in violation shall constitute a separate violation. Thank you for your anticipated cooperation. 19/6 yip., John O'Brien, Director Building and Codes Enforcement 5 V8-761-8255 johno@queensbury.net Office Use Only r Permit#: 2023 TOM]ofQrrcrnabuzy Fee:_$ ZZ1-t3 742 Bay Road,Queensbury,NY 12804 P:518-761-8206 or 518-761-8205 Invoice#: `Z) (� www.queensbury.net SEWAGE DISPOSAL SYSTEM INSPECTION INFORMATION Individual Residential Wastewater Treatment System CONTACT INFORMATION (please print legibly or type and include an email address) Property and Owner Information: (Please attach property survey or tax parcel map) Property address for inspection: /3.0 LPf j , z 417 / e-73 Tax map number: 6, /q- /-Q). Property owner: NO LJe_ Pkw �L '� i /1�%vi%1 efb % Mailing Address(c/s/z): 767 Co ain6i4 I k Cell#: ,Fjg -L/,5d_0( Land Line#: Email: hel/I7) e.„ Re/i lk 61; 60177 Applicant (if different than above): Mailing Address (c/s/z): Cell #: Land Line#: Email: ): ['Proposed Owner ❑ Realtor ❑ Attorney ❑ Other(explain: Septic Contractor: l , D Mailing Address (c/s/z): Cell #: Land Line#: Email: Reason for Inspection Request: ❑On the market ❑ Future listing ❑Sale Pending ❑ Deed Transfer Other: D7rC_.. Rephcerneii Property Transfer Packet Revised July 2022 HOUSEHOLD INFORMATION **PLEASE SEE SEPARATE PAGE FOR EXEMPTIONS** -#-Bed ooms Bathrooms , # Kitchens / Jacuzzi tub(s) Garbage grinder Onsite Wastewater Treatment System: How many systems are on the property? I NO Year system(s) installed: Tank Size of Septic Tank Type of Absorption System: 11� Are all system components wholly within the property boundaries? ET s ❑ No Are system plans available? ❑ Yes ErNo — A/ecv-547-etn p`&i) blh j delhed Does the system(s) serve multiple properties? ❑ Yes p'6o If yes, describe ): Maintenance: Service agreement? El Yes ❑ No; If yes, business' name Date of last inspection N/A ❑ Date tank last pumped N/A ❑ Frequency of pumping N/A El List known repairs/replacements, with dates: un//kv Date Type of Repair/Replacement Operation: System problems? ❑ Yes 1 o • Sewage odors? ❑ Yes lI No • Direct surface discharge(s)? ❑ Yes pKo • Back-up of toilets? ❑ Yes E0No • Back-up of any other fixtures? (e.g. slow drains) ❑ Yes lI 4 o • Seasonal ponding or breakout of leach field? ❑ Yes EM Igo Property Transfer Packet Revised July 2022 Statement of Acceptance of Conditions: I agree to: • Ensure that the septic tank(s), distribution box (es), and/or seepage pit(s), if any, will be uncovered prior to the requested inspection time; • Have a septage hauler on site (to pump the tank after*the inspector verifies flow from fixtures); > Tank must be pumped in presence of inspector • Have an authorized representative present at the site; • Allow the inspector to verify information provided above, and to conduct an inspection of the indicated onsite wastewater treatment system(s), including all system components and interior plumbing in crawl spaces and basements. To the best of my knowledge, the information provided above is accurate and I acknowledge the following: After 1 year from date of submission and there is no activity on this permit, the permit will expire and will be subject to submission of a renewal application and payment of the renewal fee based on the current fee schedule. All fees must be paid PRIOR TO SCHEDULING any inspections. In addition, if the permit is withdrawn 30% of the fee is retained by the Town of Queensbury. Signature of property owner or authorized agent: Affiliation: UA°Wner ❑agent ❑other: Please print name: $ 9 'ice er-,it. Signature: , "-------,7. ` Date: 3/F/, Prior to scheduling with the Town of Queensbury, you MUST: 1. Schedule a sewage hauler to be on site to pump tank while inspector is on site. Hauler should arrive 30-45 minutes after scheduled time with the Town of Queensbury's Code Enforcement Officer. 2. Expose inlet and outlet of septic tank, and/or pump station, expose d-box, expose any seepage pit covers. 3. Excavate test hole in leach field if there is no d-box. Property Transfer Packet Revised July 2022 • EXEMPTION CONDITION OPTIONS Due to one of the conditions listed below, I am requesting an exemption from the Septic Inspection Upon Property Transfer by the Town of Queensbury: PLEASE CHOOSE ONLY ONE CONDITION BELOW IF YOU ARE REQUESTING A WAIVER El The property to be sold or transferred will not be inhabited, and the new owner plans to demolish the existing structure. In order to qualify for the exemption, a notarized affidavit must be submitted to the Building and Codes Enforcement Office stating that the dwelling will not be inhabited and that it will be demolished with no immediate plans to rebuild or the dwelling will not be inhabited, it will be demolished and rebuilt, in which case the affidavit shall be accompanied by a site plan, including adequate detail to demonstrate a lawful OWTS,together with a check payable to the Town of Queensbury in the amount of$2,000. Such funds will be held in a non-interest-bearing escrow account and will be released, in the former case, upon issuance of a demolition permit and, in the latter case, upon issuance of a certificate of compliance from the Building and Codes Enforcement Office. If the Property Transfer inspection is not completed within that 6 (six) month timeframe, the $2000 will be forfeited. El An OWTS inspection was not able to be completed prior to the conveyance of real property due to inclement weather. In order to qualify for the exemption, a notarized affidavit from the new property owner to complete the requisite OWTS inspection within six months of the date of the conveyance of real property, or June 1,whichever comes first, must be filed with the Building and Codes Enforcement Office. A check payable to the Town of Queensbury in the amount of$2,000 will be held in a non- interest-bearing escrow account and shall be released upon the completion of a satisfactory OWTS inspection from the Building and Codes Enforcement Office. If the Property Transfer inspection is not completed within that 6 (six) month or June 1st timeframe, the $2000 will be forfeited. ' The property to be sold or transferred contains an existing OWTS that does not comply with the provisions of this article, and the prospective purchasers and/or the Seller wish to forgo an inspection in favor of installing an approved OWTS within six months of the transfer of property. In order to qualify for the exemption, a notarized affidavit must be submitted to the Building and Codes Enforcement Office stating that the existing OWTS will be replaced within six months from transfer of property. The affidavit must be accompanied by a site plan, including adequate detail to demonstrate that the replacement OWTS will comply with this article,together with a check payable to the Town of Queensbury in the amount of$2,000. Such funds will be held in a non-interest-bearing escrow account and will be released upon issuance of a certificate of compliance from the Building and Codes Enforcement Office. If the Property Transfer inspection is not completed within that 6 (six) month timeframe, the $2000 will be forfeited. Property Transfer Packet Revised July 2022 ❑ During the OWTS inspection, a failure of the septic system was determined. Due to winter and frozen conditions,the repair to an existing OWTS could not occur or a new OWTS could not be installed before the conveyance of real property. In order to qualify for the exemption, a notarized affidavit from the new property owner to complete the installation or repair of the septic system within six months from the date of the conveyance of real property, or June 1,whichever comes first,must be filed with the Building and Codes Enforcement Office. A check payable to the Town of Queensbury in the amount of$2,000 will be held in a non-interest-bearing escrow account and shall be released upon the completion of the repair or installation of a new septic system and a satisfactory OWTS inspection from the Building and Codes Enforcement Office. If the Property Transfer inspection is not completed within that 6 (six) month or June 1st timeframe, the $2000 will be forfeited. ❑ There is a record of a septic system inspection upon property transfer permit and inspection completed and passed within the last three years. Please provide a copy of this record. PLEASE READ NOTICE THOROUGHLY: Failure to complete the inspection, obtain the permit or complete all repairs/installations identified in the preceding subsections of this section within the time provided or any subsequent deadline established by the Building and Codes Enforcement Office will result in forfeiture of the moneys held in escrow, and the Town may use such funds toward abating the conditions caused by each such violation of this article. Inspections must take place within one (1) year of submission of a completed application. Inspections scheduled to take place after the one year period will be subject to submission of a renewal application and payment of the renewal fee based on the current fee schedule. ***ONLY SIGN THIS PAGE IF YOU ARE OPTING FOR A WAIVER REQUEST!!*** I have read and understand the above notice regarding the expectations and possible forfeiture of moneys submitted to the Town of Queensbury for an exemption request. Seller: Print Name: Sign Name: Date: Buyer: Print Name: e� L-' '/ Sign Name: i Date: 3/S"70; Property Transfer Packet Revised July 2022 Kevin Cioffi 180 Lake Pkwy Lake George,NY 12845 March 8,2023 r © LEUVEn Town of Queensbury 742 Bay Road MAR 9 3 2023 Queensbury,NY 12804 TOWN OF QUEENSBURY BUILDING &CODES Dear John O'Brien With this letter I am submitting the Property Transfer Sewage Disposal Information Form as well as a check in the amount of$2,275 ($2000 refundable deposit plus$275 permit fee). Also,included is the Exemption Conditions Options form on which I have opted to forego the inspection in favor of replacing the existing system with an approved OWTS,to be completed within 6 mos. The system is currently being designed by a Licensed Engineer who will provide a site plan with adequate detail to demonstrate that the replacement OWTS will be in full compliance. Please call me with any questions or concerns. Sincere] yours, Kevin Cio On this e" day of MQrCh ,20 23, before me,the undersigned a Notary Public in for said State,personally appeared, K iM CiO % , Personally known and known to me or proved to me on the basis of satisfactory evidence to be the individual-whose name is subscribed to the within instrument,and acknowledged to me that he executed the same in this capacity,and that by his signature on the instrument,the individual,or the person A ridual acted, executed the instrument. Notary Public-State of New York NO.01RA6446127 Qualified in Schenectady County ( My Commission Expires Jan 9,2027 aft JJJViçcP, Notary Public PROPERTY TRANSFER SEWAGE DISPOSAL INSPECTION LETTER V Satisfactory Compliance Notice Town of Qyccnsbury Building&Codes Enforcement 742 Bay Road,Queensbury, NY 12804-5902 P: 518-761-8256 www.gueensbury.net Date: 15 November 2023 To: Kevin Cioffi (Applicant) Re: System Inspection Site Report for: 180 Lake Pkwy,Town of Queensbury, NY (Site Address) As requested, the Town of Queensbury's Building and Code Enforcement Department has made an inspection of the wastewater system components serving the property referenced above. All system components have been found, and are noted in the System Inspections Findings Worksheet. Inspector's observations: The system appears to have functioned adequately under past and present loading. There can be no assurance or guarantee of future performance for any period of time. Numerous factors, such as household water usage, leaking toilets, soil characteristics and seasonal ground water table fluctuation, as well as owner failure to manage and maintain the system, will affect its performance. This approval is valid for five (5) years from 15 November 2023, the date of the inspection. Sincerely, A John O'Brien, Director Budding & Codes Enforcement Town of Queensbury /kd Revised August 2023