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SEP-0002-2022 A- 0 ice:tlse OnIV P ermit Fee: .., .742 SAy Road,.Queembury,`W 12804 ?c 51 -T61-8256 Www. ueeasbury net Invoice:#:.. Ffoocl. one? Y Reviewed By.: E .:TIC DISPOSAL PERIUIIT APPLICATION 1vw Prr�ject;Location L0-1 Al 1. C E U V E Tax:Map# 2 • �- D JAN 3 ?0 TOWN OF QUEENSBUR' RESID.ENCEIIV.F4RMATlONs _ BUILDING &CODES - Yea ::8uiIt": Gallons #of bedrooms. X'gallons per =total daily flower` per day. bedroom Garbage.Grihder Yes: No 198ti.ar:.o. ,ee '150 Installed'?:;(circle n ej.. 1991-1991: 13G SIla:Qr Ho�:Tub Ye's No ...... Insta(lecl?::ci:rcle:i}riix 1992-Present; ..110 PARCEL MORMATI.ON: . .. .................... . Topography i� Flat Rollin Steep:.Slope l Slope; SORNature` Sand Cla C3.ther,.explain;< Loam Groundwater. At'what:deptli? ........ ..:. . e_:_roc fmpeivious,mater[al... At.'vvhat deith? I]ornestie:Water Supply: _ IVlunicipal �Well (if well or lake;water supply:from an.y septicaysfem.abso.rMion Is ft.} PercolatiphleSt< Rate: m45 . p.er minute per Inch (test:ty be'CQrr Mefetl by:a ... . . ... .. .. ...: ... . ........... . ..:`.:licensed engineerhirchitect) 1 ;.PROP05ED:SYSTEM I.NF:ORMATIQiV: Tan....size: _ gal ons .(:nriin. size.1,Q00 gallons, add 254 gallons for eachi:`garbag�e;cyli:nder or ,.. spa , '.ot tub System : A sorptibn'field wu :#2 stone Total Length ft ! Each Trench:: .. ...IS ..._ ft,: Seepage`Ri+t W/0:stone :How':many: . .. Size- ternative System: Bed or other:type. „......... ..;: . . ........ . . .. . .:� Holding Tank system TotaI required capacity? -;:farik . . . # of tanks. septic Application: ReAid 0ecetnber:'020. CONTACT.JNFORMATIO.N:.PLEASE PRINT LEGIBLY.OR TYPE,:PLEA5.E:lNCLUD.E AN: EMAIL •: :A licant: Names) :` ' :.. ` e- (��C�t,.l+n I Mailing Adtlress, Cell .Phorte,. Land Line: jCl Ema i f;: rrYl!Q=Q Cku-I"041 P% 1 -<_--,-e-lDf->I C, • : :Prima . Owner.(s): rY.. Names Uri (.)... Mailing Address; C/SJZ "l-e� ... \ t e�fn.�l�JU�{ . ... ...... Cell Phone:_( } and Line: _( Email: Q. Cherk.if all work wtitl:be performed by property owner onl • ;.Contractor:: Co.ntracto.rTrade: MailingAddress,.0 S Z�. . . :/ ./: . Cell Phone:._(' } Land.Line: Erna i l: . YY\ Cyr?c.u� t c �.C_e�m p **Wo.rkers':Com documentatiorrmust:be submitted with:this:eP P*Ak t p'" ::: .. ...... .: Engineer Names) —3 k ,u. Mailing:Address; C/SJZ:... �., . ° � . Cell Phone: ) `-OoZ� Land tine:: _( Email:�.Jq en ® . ca . . Contact Person.for:Compliance:a regards to this project< �e cxv�t�n............................ .... Cell Rhone: .:.( .��....).�ei.06 h Land Line: Email:. NOTES:,1 :Alarm system and associated.electric must.be:;:inspected �y;a:TavUn ap;proved;e.lectrical . . ....................... . ... inspectiop;agency;2'.:W.e'uiiii no longer all.iiw systems.to tie.covered.:until.su'ch:tim,e as:an.as-built.plan:is received and approved.The installed system must match the.:septic:.l..ayout:on:file;--no exceptions. 3:;;As built drawings must be submitted prior to the..inspection, if there I as b6E nh a`change to th stibri tf'd ... -.. plans..4. If .for.any reason,.the:b.ui.ldi ill g„permit application.is withdrawn, 30%�of the:fee is:retained;by the Town of Queens ury. After 1 year from the initial application,date, 100%o,'the:: ee is retained... Declaration::Any per.mitot approval granted Which:isbased_upon or is_grantedin.;relianee:upon any;mater:iai .: .... :... .: . representation or failure to make a:matedal fact or:circumstance known i.:°or:on eh IFb.f a'n:>app{icant;shali`iie .....: void I have read the regulations and;agree.to abide by these and.all.requirements oft:.e:T6 n of:Que.ensi ury Sanitary Sewage Disposal Ordinance. ` r \ . ..PRINT NAME.: : :.::.. V �. _,.._::::::: ..: .: .. ....::. SIGNATURE: CTATE ;: Septic Application Revised December2.020 TOWN OF Q UEENSB URY 742 Bay Road, Queensbury, NY. 12804-5902 Septic System Checklist Plan to scale Receive. Deep hole pert test results from engineer/Architect if applicable(Town.Approved Engineers and Arc ' acts• une 30 to April 15 Town Engineer for unapproved E ' rs and Architects) AI elAlInp prop "Municip"'alor , @well ' ow 0E�v LO��Fi�o� OF vJ��L OQ- Water hown 10'"tion to any part of system, back to.property lines show 10'or more for any part of system pti ank 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 TA Seepage pit 150'from well 50'from septic tank _ Se page Pits 3-times diameter apart ptic tank and pump stations over 30 gallons 50' from watercourse or wetland is ante from bottom of trench or system 24"to bedrock or mottling 36"within 1000' of Lake George c f ,� .Leech field 100'from watercourse or wetland t) Toe of mound or bottom of retaining-wall 10'—from property line 100'from well 20'from Foundation oProvide Engineer/Architect stamp for bed or design systems Department of Health Approval for all mobile home park new systems Flood Plain requirements �2' above established flood elevation to bottom of system 4 1-/ All tanks anchored or 2' above flood elevation Revised 4/15/2021 NEW YORK AdirondackSTATE Of OPPORTUNITY_ Park /t Agency BILEpy : KATHY HOCHUL TERRY MARTINO Governor Executive Director January 26, 2022 Jeffrey C. Mancini- via email imancini@nycap.rr.com 17 Kempton Place Saratoga Springs, NY 12866 RE: Jurisdictional Determination J2022-0041 Tax Map Parcel 239.7-1-32 Land Use Area: Moderate Intensity Town of Queensbury, Warren County Dear Jeffrey C. Mancini: Thank you for your Jurisdictional Inquiry Form, submitted on-behalf of your client and received by the Agency on January 18, 2022. The zoning laws for the Town of Queensbury have been approved by the Adirondack Park Agency pursuant to § 807 of the Adirondack Park Agency Act. This means that certain permitting requirements and the shoreline setback restrictions of the Adirondack Park Agency Act are administered,by the Town. In addition, shoreline setback variances issued by the Town are subject to review and possible reversal by the Agency. The replacement of a failing on-site wastewater treatment system described in your submission and depicted on the revised site plans received electronically on January 25, 2022 titled "Tully Residence — Replacement-On-Site Sewage Disposal System Site Plan-Details-Notes" prepared by Wales Engineering does not require Agency approval; instead, review of this proposal will occur pursuant to the Town's zoning laws. Please be sure to contact the Code Enforcement Officer or Zoning Administrator for the Town of Queensbury to determine compliance with the shoreline setback provisions and all other requirements. This letter makes no representation as to the approvability of your project under the Town's laws. Please also remember that any shoreline setback variance issued by the Town may be reversed by this Agency. Agency staff review of aerial photography indicates that there are wetlands on the property. The attached map shows the approximate location of these wetlands. From the information submitted with your Jurisdictional Inquiry Form, it does not appear that your proposal will impact any wetlands. Please remember that all activities within the P.O.Box 99-1133 NYS Route 86•Ray Brook,NY 12977•Tel:(518)891-4050•www.apa.ny.gov c • 4 Jeffrey C. Mancini January 26, 2022 Page 2 Adirondack Park must comply with the Freshwater Wetlands Act. The attached Freshwater Wetlands flyer contains additional information regarding wetlands in the Adirondack Park. Please contact the Agency if you have any questions about the wetlands on your property. Although your client's proposal does not require Agency approval, please help to prevent the spread of invasive species by ensuring all excavating tools, fill, and other equipment are thoroughly cleaned and that all fill is free of invasive species prior to use on-site. If any portion of the site contains invasives, all construction equipment and vehicles should be thoroughly cleaned prior to moving to other areas. If the proposal will involve any plantings, care should be taken to avoid the introduction of invasive species. Additional information on how to prevent the spread of invasive species in the Adirondack Park can be found at www.adkinvasives.com. In addition, please be aware of the following information and requirements: 1. A permit is required for the installation of any new on-site wastewater treatment system within 100 feet of wetlands. The wastewater setback is measured horizontally along the shortest line between the closest point of any leaching component of the system and the edge of the wetland. This letter does not authorize the impairment of any easement, right, title, or interest in real or personal property, and shall not be construed to satisfy any legal obligations of the permittee to comply with all applicable laws and regulations or to obtain any governmental approval or permit from any entity other than the Agency, whether federal, State, regional or local. Again, we recommend that you check with Town authorities, as well as with the New York State Department of Environmental Conservation and other authorities to obtain all necessary approvals prior to commencing the project. Please do not hesitate to contact the Agency with any questions. Sincerely, /s/ Kate-Lyn O. Knight Kate-Lyn O. Knight Project Administrator Attachments: Freshwater Wetlands Flyer and Wetlands Map cc: Town of Queensbury-via email 2 r NEW FORK Adirondack S ATE.OF. oR PORT NtTy. Park Agency FRESHWATER WETLANDS This is a supplement to the Citizen's Guide,which provides basic information about Adirondack Park Agency regulations. Regulated Wetlands Defined in §802 of the Adirondack Park Agency Act, wetlands are.°any land which is annually subject to periodic or continual inundation by water and commonly referred to as a bog, swamp or marsh which are either (a) one acre or more in size or (b) located adjacent to a body of water, including a permanent stream, with which there is free interchange of water at the surface, in which case there is no size limitation'." Section 578.3 of the Agency's regulations provides additional wetland information, and the criteria for identifying wetland areas are provided in the New York.State Wetland Delineation Manual (available at http://www.apa.ny.aov). Wetland Permitting Under the Adirondack Park Agency Act and the Freshwater Wetlands Act, an Agency permit must be obtained for the following activities involving wetlands in the Adirondack Park: 1. Draining, dredging, or excavating2 a wetland; 2. Placing fill, including soil, stone, sand, gravel, mud, trash, structures, pilings, roads, or any other obstruction or substance3, into a wetland; 3. Clearcutting4 more than three acres; 4. Releasing any form of pollution into a wetland, including pesticides and sewage effluent or other liquid waste; 1 Areas that are less than one acre in size and meet the New York State Wetland Delineation Manual criteria are considered wetlands for Agency purposes if. 1)the adjacent waterbody is at least 6.6 feet deep;2)the adjacent waterbody is at least one acre in surface area;3)the adjacent waterbody and the wetland together are at least one acre in surface area;or 4)the adjacent waterbody has a permanent surface water inlet or outlet. 2 With certain exceptions;see section 578.3(n)(4)of Agency regulations and the Agency's flyer titled"Hand Harvesting of Aquatic Plants"for additional information. 3 With certain exceptions;see section 578.3(n)(4)of Agency regulations for additional information. 4 For Agency purposes,a clearcut is generally defined as any cutting of trees over six inches in diameter at breast height over any 10-year cutting cycle,where the average residual basal area remaining is less than 30 square feet per acre within the area harvested. See sections 570.3(f)and 573.7 of Agency regulations for additional information. Page 1 of 4 Revised February 28, 2019 ; . 5. Installing any sewage drainage field or seepage pit or any sewer outfall in or within 100 feet of a wetland; 6. Undertaking any other activity within or outside of a wetland that substantially impairs the functions served by or the benefits derived from the wetland, including the diversion of surface or subsurface drainage or natural water flow that adversely affects the natural hydrological regime of or substantially increases erosion of or siltation or sedimentation into the wetland; or 7. Creating by subdivision any lot that contains wetlands and any lot adjoining a lot that contains wetlands, as well as all land use and development related to these subdivision lots, unless the Agency issues a letter finding that: • All lot boundaries will be located at least 200 feet from all wetlands; • All new roads providing access to more than one lot will be located at least 50 feet from all wetlands; • All non-wetland areas of the wetland subdivision lots will be accessible by road without crossing or causing adverse impacts to wetlands5; and • Any lot containing a lawfully existing principal building will also contain its associated water supply, wastewater treatment system, and an adequate replacement site for the on-site wastewater treatment system that is located at least 100 feet from all wetlands6. When a regulated activity is proposed, a wetland biologist will determine the value rating for the wetland. As described in §578.10 of Agency regulations, the standards for approval of activities involving wetlands depend on the value rating, with stricter standards for activities in high value wetlands. Please note that development is generally prohibited in wetlands with a value rating of"1." For specific locations, the Agency will determine whether wetlands are present and will delineate wetlands upon the request of any person having a legal interest in the property. These determinations involve examination of maps at Agency headquarters, interpretation of aerial photographs, and/or field visits by Agency wetland biologists. Please contact the Agency for additional information. WETLAND IDENTIFICATION AND IMPORTANCE Deep Water Marsh Areas of open water filled with plants that float freely or are rooted are called deep water marshes. The leaves of the rooted plants are either submerged or floating. Such plants as pondweeds, duckweeds, and wild celery are important food for waterfowl. The shallow waters of a deep water marsh and the protecting vegetation make them important areas for fish spawning and nurseries. 5 This requirement is generally applied to mean that access roads could be constructed at least 50 feet from wetlands to reach all non-wetland areas of the subdivision lots. 6 This requirement is generally applied to mean that the lot contains a potential replacement wastewater treatment system site that: 1)is at least 1,500 square feet in size;2)is no more than 60 feet in length;3)has slopes of 15%or less;and 4)and is located greater than 100 feet from all waterbodies. Page 2 of 4 Revised February 28, 2019 Deciduous Swamp These are wetlands where the covertype contains mostly live deciduous trees, twenty feet or more in height. The trees grow on hummocks or in seasonally or permanently flooded areas. Swamp maples and willows are evident in lowland deciduous swamps. These swamps are spotted with dead trees which are used by flying squirrels and chickadees. The swamps provide a habitat for nesting waterfowl and a great variety of birds and wildlife. Their soils are usually very fertile, promoting rapid plant growth and a wide diversity of plants and. animals. Because these swamps filter great quantities of water, they play a very important role in purifying water and maintaining high water quality. Wet Meadows Wet meadows are wetlands where most of the cover is composed of sedges, rushes, and coarse grasses, most of which tend to grow in clumps. Groundwater is at or near the surface for much of the year, including significant parts of the growing season, creating saturated soils. These meadows are often found in the flood plains of lakes and rivers and in the areas once flooded by beaver dams or other impoundments. Their soils are mostly mineral in structure. Boa A bog is a closed wetland from which drainage is either extremely slow or absent and where the vegetation grows on a saturated mat of peat. The mat sometimes covers all of the surface of a shallow pond, sometimes it covers only a portion leaving open water. The peat is formed by species of sphagnum moss which die, but do not decay.because of the acidity and low oxygen levels of the bog. All processes in_ a bog including nutrient recycling are slowed down by the stagnant acid water. This is why bogs are so sensitive. It takes centuries to recover from disturbance. Emergent Marsh Emergent marshes are shallow wetlands that are flooded with standing or running water Much of the year. Their cover consists of such plants as cattails, bulrushes, pickerel weed, loosestrifes, and arrowheads. Emergent marshes have the most valuable covertype and one of the highest levels of productivity and habitat diversity. Not only does the vegetation in these wetlands provide nesting habitat, food, and cover for many waterfowl and other wildlife, but it adds large quantities of nutrients to food chains. These marshes are attractive to muskrat, ducks and geese, herons, and egrets, mink and deer. Page 3 of 4 Revised February 28,.2019 Shrub Swamp A shrub swamp is a wetland where woody shrubs, less than twenty feet in height, make up most of the covertype. Shrub swamps are often found in floodplains, in frost pockets and other depressions, on the edges of ponds, lakes and bogs, along meandering streams, and in hillside drainages. These areas have two things in common: fresh water flowing through them and a high level of productivity. Alders, hollies and viburnums typify these swamps and have berries which are eaten by a wide variety of birds. The shrubs are the nesting habitat of such diverse species as the rose-breasted grosbeak and kingbirds, and game birds, including woodcock, pheasant and grouse. It is also the habitat of beaver and otter, and waters adjacent to shrub swamps are essential to spawning northern pike. Coniferous Swamp A coniferous swamp is a.wetland where most of the plant cover consists of live coniferous trees over twenty feet in height. The trees often grow on hummocks in deep organic deposits with pockets of water or sphagnum moss between them. Coniferous swamps are most important because they give off large quantities of water over much of the year. In summer, this process helps keep surrounding soil temperatures low. This, combined with the cooling effects of the swamps, dense shade, helps maintain low water temperatures critical to the survival of cold water fish in streams running through these swamps. The shelter offered by coniferous swamps creates clear wintering fields so important to the survival of deer and other animals and birds. This flyer is intended to provide general information regarding Agency jurisdiction. Other provisions or restrictions.may apply if an Agency permit or variance is required or if the property has previously been subject to Agency review. Please contact the Agency with any questions at 518-891-4050. For a-binding written response as to whether a specific proposal requires Agency review, please submit a Jurisdictional Inquiry Form (JIF). The JIF form is available on the Agency website at www.apa.nv.qov/Forms/miform.pd . Page 4 of 4 Revised February 28, 2019 TABLE 5 REQUIRED LENGTH OF ABSORPTION TRENCH (based upon 2 ft. wide trench) Flow Rate (Gals/Day) Percolation Rate 2 bedrooms 3 bedrooms 4 bedrooms 5 bedrooms 6 bedrooms Min./Inch 220 260 300 390 450 440 520 1 600 550 650 7-50 660 1780 900 1 - 5 92 108 125 138 162 187 1.84 216 250 .230 270 312 275 325 374 - 7_ 195 225 220 260 300 275 325 375 330 390 450 -v 8 - 10 123 145 167 184 217 250 245 290 333 306 360 417 367 433 500 11 - 15 138 162 188 207 J244 281 275 325 375 344 406 469 413 488 563 0 16 - 20 158 186 214 236 279 ' 321 315 372 429 393 464 536 472 557 643 21 - 30 184 217 250 275 325 375 367 433 500 459 542; 625 550 650 750 31 - 45 220 260 300 330 390 450 440 520 600 550 650 750 660 7,80 900 46 - 60 245 290 333 367 433 500 489 578 667 612 722 833 734 867 1000* Dosing Not Required Dosing or Alternate Design Required *Greater than 1;000 ft. of trench requires Alternate Dpsing