SEP-0097-2022 r
SEPTIC VARIANCE Office Use Only
Permit#: —�
APPLICATION Permit Fee:$ N15
i'oIm o£f�uccnsbun•
742 Bay Road,Queensbury,NY 12804 Invoice#:
P:518-761-8256 www.Queensbury.net Approvals:
-Submittal:S (one) original& 8 copiesofthe_compfeted application package
PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
Section 1•
Contact information;. REVISED
Property Owner(s): Jason A.Gottlieb Owner's Agent: Environmental Design Partnership LLP
Address: 107 Highland Ave Chatham NJ 07928 Address: 900 Route 146 Clifton Park NY 12026
Phone#: 973-865-2270 Phone#: 518-371-7621
Email: jg4ttliebhome@gm4il.com Email: dmacelroy@edpllp.com,cdemyer@edpUp.com
Section 2:
Site Information: -
Site Address: 389 Cleverdale Road Tax ID#: 226.8-1-2
Directions to Site: Rt.9L to Cleverdale Road to Very north end of Cleverdale point...#389 on left.
Section 3•
Distance from well on property to septic system (if applicable) N/A feet
Section 4•
Is it possible to install a conforming septic system on this property? ❑Yes X❑ No
If YES, please explain and attach a diagram:
Section 5:
Does the proposed system meet setback requirements for distance from wells&septic systems on neighboring
properties? ❑X Yes ❑ No If NO, please explain:
Section 6• _
Is the proposed system to be installed under a parking area? n Yes
SF,CTION:7
Section of the Sanitary Sewage Ordinance from which you are seeking the variance ITIOWN
�� �o�r�yV-l:ABSORPTION BED.TO.LAKE GEORGE-8VREQUESTED VS THE IOUREQUIRED
V-2:ABSORPTION BED TO PROPERTY LINE(S)-1'REQUESTED VS.THE 10'REQUIItEDV-3:ABSORPTION BED TO PROPERTY LINE(E)-I'REQUESTED VS.THE IV REQUIRED
V4:ABSORPTION BED TO FOUNDATION-YREQUESTED VS.THE 2V REQUIRED �/V-6:TEWER LINE TO PROPERTY ANK TO PROPERTY LINE(E)-1'REQUESTED VS.THE to'REQUIREDUIRED Or� Q �C S�jUl�iV-7:TANKToFOUNDATION-TREQUESTEDVS.THEIVREQUIRED DIRIG OOry�`�
V-8:TANK TO PROPERTY LINE(I)-4'REQUESTED VS.THE IV REQUIRED D
V-9:SEWER LINE TO FOUNDATION-2'REQUESTED VS.THE IV REQUIRED
RESOLUTION APPROVING JASON A. GOTTLIEB'S APPLICATION FOR
SANITARY SEWAGE DISPOSAL VARIANCES
RESOLUTION NO.: BOH 29,2022
INTRODUCED BY: Mr. George Ferone
WHO MOVED ITS ADOPTION
SECONDED BY: Mr. Timothy McNulty
WHEREAS, Jason Gottlieb (Applicant) filed an application for variances from provisions
of the Town of Queensbury On-Site Sewage Disposal Ordinance, Chapter 136 to install a
replacement wastewater treatment system with its components proposed to be located as follows:
1. Absorption bed to be 80' from Lake George in lieu of the required 100' setback;
2. Absorption bed to be 3' from the southerly property line in lieu of the required 10'
setback;
3. Absorption bed to be 1' from the easterly property line in lieu of the required 10'
setback;
4. Absorption bed to be 3' from the foundation in lieu of the required 20' setback;
5. Sewer line to be 7' from the easterly property line in lieu of the required 10' setback;
6. Tank to be F from the easterly property line in lieu of the required 10' setback;
7. Tank to be 2' from the foundation in lieu of the required 10' setback; and
8. Tank to be 4' from the northerly property line in lieu of the required 10' setback;
and
9. Sewer line to be 2' from the foundation in lieu of the required 10' setback;
on property located at 389 Cleverdale 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,April 4t',2022, and
� r
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 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 Jason A.
Gottlieb for variances from the Sewage Disposal Ordinance to install a replacement wastewater
treatment system with its components to be located as follows:
1. Absorption bed to be 80' from Lake George in lieu of the required 100' setback;
2. Absorption bed to be 3' from the southerly property line in lieu of the required 10'
setback;
3. Absorption bed to be 1' from the easterly property line in lieu of the required 10'
setback;
4. Absorption bed to be 3' from the foundation in lieu of the required 20' setback;
5. Sewer line to be 7' from the easterly property line in lieu of the required 10' setback;
6. Tank to be 1' from the easterly property line in lieu of the required 10' setback;
FJ'
7. Tank to be 2' from the foundation in lieu of the required 10' setback; and
8. Tank to be 4' from the northerly property line in lieu of the required 10' setback;
and
9. Sewer line to be 2' from the foundation in lieu of the required 10' setback;
on property located at 389 Cleverdale Road in the Town of Queensbury and bearing Tax Map No:
226.8-1-2 with the condition of approval that an impermeable barrier be added to the south side of
the proposed system,and
BE IT FURTHER,
RESOLVED,that the Enhanced Treatment Unit (ETU) shall be maintained by the property
owner in accordance with the manufacturer's recommendations for the life of the system, 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 4t'day of April,2022,by the following vote:
AYES: Mr. Ferone,Mr. McNulty,Mr. Strough,Mr. Metivier
NOES: None
ABSENT:Mr.Freer
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit Nor :�0 5�-2oZZ Cert.N 5 0 0 91 Cut-in Card No...................................
...........................
Owner.....................J.,i.5on Garl...;�c;...?..........................................................................................
.......................
.
Location.................. .. q !-�✓cn
..... ........................................................................................
InstallationConsisting of...................................................................................................................................
S /0 utcn. ...........*7—....
.......... .................................................................
..................................................................................................................................................................................
InstalledBy..........47.2....G�................................................Lie.No.................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued i
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon th
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company-shall have the privilege of making inspections at any time, and if it
rules are violated,the Company shall have the right to revoke this certificate.
Date......../ ................ INSPECTOR. ... -r�..'J...........................................................................
V Memher N_F.P_A..I.A.E.1.
Office Use-Only
SEPTIC DISPOSAL PERMIT
APPLICATION Permit#: q�
( [—Z 6Z�i
Tos»of rLccrtahurr r it Fee:$ /��2�O
E E L1 C n o ce#: `(.�3 /
742 Bay Road,queensbury,NV 12804
P.-518-761-8256 www.queensbury.net APR 2 2 202 t c Variance? N
loo Zone. Y
TO IN OF OUEENSBU i
BUILDING, CODE" Wetl rids? Y N Reviewed By:
Project Location: 389C1everdaleRoad
Tax Map#: 226.8-1-2
RESIDENCE INFORMATION:
Year'Built Gallons #of bedrooms: X gallons per =total daily flow
per day bedroom Garbage Grinder Yes No
1980 or older 150 Installed? (choose one) ❑
19-8d4991 130 Spa or Hot Tub Yes No
1992-Present 110 3 ll0 33o Installed? (choose one) El
PARCEL INFORMATION:
Topography [] Flat Rolling ❑ Steep Slope W % Slope
Soil Nature 0 Sand ❑ Loam ❑ Clay ❑ Other, explain:
Groundwater At what depth? >s:
Bedrock/Impervious material At what depth? >5'
Domestic Water Sup_ ply ❑ Municipal ❑ Well OLake
(if well or lake, water supply from any septic system absorption is
Boa ft.)
Percolation Test Rate: . 8 per minute per inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size W. gallons (min. 'size 1,000 gallons, add 250 gallons for each,garbage cylinder or
*FCT7I Clean
spa/hottub CES
System Absorption field w/#2 stone Total length ft.; Each Trench ft.
Seepage Pit w/#3 stone How many: ; Size:
n i ator - rave ess pen- o om
Alternative System ' Bed or other type:: Chamber,Enhanced Treatment Unit
Holding Tank System Total required capacity? ; tank size ;
#of tanks
septic Application Revised April 2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): -a-'on Gottlieb
M a i l i n g Ad d ress, C/S/Z: 107 Highland Ave Chatham N7 07928
Cell Phone: 973-865-2270 Land Line:
Email: Jgottliebhom@gmail.corti
• Primary Owner(s):
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): CrandalExcavating
Contractor Trade:
Mailing Address, C/S/Z: 63 Woodchuck Hill Road,Lake George 12845
Cell Phone: 5187470-4694 Land Line:
Email:
*Workers' Comp documentation must be submitted with this application"
• Engineer(s.):
Name(s): Environmental Design Partnership LLP
Mailing Address, C/S/Z: 900 Route 146 Clifton Park NY 12065
Cell Phone:518-371-7621 Land Line:
Email: dmacelroy@cdpllp.com cdemyer@edpllp.com
Contact Person for Compliance in regards to this project: Dennis Macelroy
Cell Phone:518-376-4485 Land Line:
Email: dmacelroy@edpllp.com
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: i 0 "-5)n- /Z'
SIGNATURE: DATE: Cal
Septic Application Revised April 2021
Charles Dyer
From: Edward Carr <epcarrs6@gmail.com>
Sent: Tuesday, November 15, 2022 5:06 PM
To: Charles Dyer
Subject: Electrical inspections
389 Cleverdale Road,Jeff Hole
TOWN OF QUEENSBURY WARNING: This is an external email.Do not click links or open attachments unless you
reco nize the sender and know the content is safe.
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ENVIRONMENTAL DESIGN
PARTNERSHIP, LLP. 900 Route 146 Clifton Park,NY 12065
(P)518.371.7621 (F)518.371.9540 edpilp.com
Shaping thesphysical environment
November 22, 2022
Town of Queensbury Building&Codes D E C E 9 v E
742 Bay Road
Queensbury, NY 12804 NOV 2 2 2022
Attn: John O'Brien, Director I TOWN OF QUEENSBURY
BUILDING&CODES
Re: Gottlieb—389 Cleverdale Road S oog,'}- 2
Replacement Wastewater System
Dear John:
In compliance with application approvals granted by the Town of Queensbury 1 offer the following
regarding the referenced project.
The design plans, prepared by this office, reviewed and approved by the Town as associated with
the wastewater system application,are as follows:
Proposed Site Improvements For Gottlieb Residence
Applicant: Jason Gottlieb
389 Cleverdale Road Town of Queensbury
April 21, 2022
• Sheet 1 Cover Sheet S 8• Sheet 2 Existing Conditions
• Sheet 3 Wastewater Plan `
• Sheet 4 Wastewater Variance Plan
a Sheet 5 Wastewater Details
• Sheet 6 Enhanced Treatment Details
During the course of construction I was on the job site to observe key components of the system
installation. The pretreatment unit(Fuji Clean),the pump tank and the absorption field have been
constructed at the location as required of the design; compliant with the variance setbacks. I have
provided an `as-built' plan which indicates those locations. The pump tank installed is a 500 gallon
rectangular tank vs. a 4' ID concrete manhole section on the approved plan. All other aspects of the
work were constructed as designed and using the materials as specified. The pump system was set
up for operation and testedlinspected on November 18th.
Based on my inspection of the system installation it is my opinion that the wastewater system is in
compliance with the intent of the approved design plan and is ready for operation.
Sincerely,
s acElroy, PE
Attachment
Cc:Jason Gottlieb