SEP-0128-2023 t
SEPTIC VARIANCE Office Use Only
Permit#: �—
APPLICATION Permit Fee:s l 1Q5 f
rwn otC�,rt.a
Invoice#:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.aueensburv.net Approvals:
Submittal: l (one) original &8 copies of the completed application package
PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
Section 1:
Contact Information:
Property owner(s): Jeanne L Rollins, Trustee Owner's agent: Hutchins Engineering PLLC
Address: 3 Plover Lane Address: 169 Haviland Road
Mystic, CT 06355 Queensbury, NY 12804
Phone a: Phone It: 518-745-0307
Email: Email: thutchinsChutchinsengineedng.com
Section 2:
Site Information:
Site Address: 377 Cleverdale Road Tax ID#: 226.12-1-56 C Z -
z
Directions to Site: � }
Section 3: W
Distance from well on property to septic system(if applicable) NSA feet "0 rii r+a
I®
G 00 e s
Section 4: W j gg
COC: ( l;i�i 1
Is it possible to install a conforming septic system on this property? ❑Yes ■❑No
If YES,please explain and attach a diagram: a�+
Section 5:
Does the proposed system meet setback requirements for distance from wells&septic systems on neighboring
properties? ❑Yes ❑No If NO,please explain:
Section 6•
Is the proposed system to be installed under a parking area? ❑Yes 0 No
I
i Section 7:
i
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.): Absoption field 16'.from foundation where 20' is required
Absorption field will be 5'from property line where 10' is required
Septic Variance Application Revised December 2021 i
Section 8:
List the names,parcel addresses, and tax map numbers of all adjoining property owners. You may obtain this
information from the Town of Queensbury's Assessor's Office:
North Name William Davidson
Address 387 Cleverdale Road
Tax Map ID 226.8-1-1
South Name Morris Family Irrevocable Trust
Address 371 Cleverdale Road
Tax Map ID 226.12-1-55
East Name Peter Rienzi /Christopher Martin
Address 374 Cleverdale Rd. /370 &372 Cleverdale Rd.
Tax Map ID 226.12-1-60 / 226.12-1-61
West Name Lake George
Address
Tax Map ID
Section 9:
OWNER STATEMENT
I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at:
377 Cleverdale Rd.I/We realize that putting the well,septic tank or leaching system less than the required 20 feet
from the residence may increase the risk of pollution.
Owner—Print Name: Jeanne Rollins, Trustee
Owner—Signature: �� / �_ , Tr v 3 Y.e-e_ Date: 6292023
f
Section 10•
i NEIGHBOR OR TENANT RELEASE STATEMENT(if applicable)
i
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
i from the may increase the risk of pollution.
Neighbor/Tenant—Print Name:
Neighbor/Tenant-Signature: Date:
Septic Variance Application Revised Qecember 2021
I .
i
Section 11:
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: Jeanne Rollins Revocable Trust
Designates: Hutchins Engineering PLLC as agent regarding the Septic Variance for
Site Address: 377 Cleverdale Road
Tax Map#: 226.12-1-56
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 hereby authorize 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.
I,the undersigned, have thoroughly read and understand the instructions for submission;agree to the
submission requirements and completed checklist:
OWNER—PRINT NAME: Jeanne Rollins, Trustee �^
OWNER SIGNATURE:' / r L/S/-C-e— DATE: 03/29/2023
AGENT—PRINT NAME: G. hNnas Hutchins P.E.
AGENT—SIGNATURE: DATE:
Septic Variance Application Revised December 2021
i
f
SEPTIC DISPOSAL PERMIT Office Use Only
�J APPLICATION Permit-#.
Town ofQueensbury Permit Fee: o
I D
0171
L
Invoice#: �
742 Bay Road,Queensbury,NY 12804 k1AY 2 3
-1.4 1 i II
ii ft 2�O 2_6
P:518-761-8256 www.gueensbury.net Septic Variance?19—b
Flood Zone? fS
Wetlands? TV Reviewed By:
Project Location: 377 Cleverdale Road
Tax Map #: 226.12-1-56
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) W [:]
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 110 3 (designed to 4) 110 440 Installed? (choose one) E] U
PARCEL INFORMATION:
Topography Flat Rolling E] Steep Slope % Slope
Soil Nature FE-1 Sand W Loam 0 Clay F-1 Other, explain:
Groundwater At what depth? >78"
Bedrock/Impervious material At what depth? >78"
Domestic Water Supply E] Municipal [—] Well *Lake
(if well or lake, water supply from any septic system absorption is
106+/- ft.)
Percolation Test Rate: 7 per minute per inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size 1,500 gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
spa/hottub
System Absorption field w/#2 stone Total length ft.; Each Trench ft.
Seepage Pit w/#3 stone How many: Size:
Alternative System Bed or other type: 13' x 43' Eljen Bed
Holding Tank System Total required capacity? tank size
# of tanks
Septic Application Revised July 2022
w
0
W
NORTHERLY ALONG THE
MEAN HIGH WATER MARK
OF LAKE GEORGE 215'f
AS IT WINDS AND TURNS
EAVES
36
RETAINING
WALLS 226.8-1-1
LAKE WATER SUPPLY
i
1 (�6.0'
S86'31 00 E
� �k.7-.F114.16't "-
1� i
SU*�gTSUP )1'71ff5TE,5
oOC�
CONCRETE
5TEP5 3Jr
WALKWAY
STEPS
\ 105' TO /
34
LAKE GEORGE O
/
l AREA =
. 1,j l 0. 58E ACRES /
J/ 'Cv o)
0
W/ C\4 In �
� ^N
W
z
Iv
PROPOSED II'
BOATSTORAGE
PROP05ED
24x30 GARAGE
II P.F.I.
JS71NG HOUSE /TP-1-PIPE EY
F`
NT TO NEW SEPTIC TANK
ELEVATION APPROXIMATELY 1 F00
PT-NG
1(�:
' a+
PIPED INTO NEW BUILDING ( j °"
i 1 % I.R.F. \ on I.P.F. /N
— l - ®--_____ l CONCRET
PED. / \84DG
10 PL. SETBACK T /
9'f / —
GENERATOR
l %// I.R.F, —� 135.63' PROPANE
N84 5-0 00"W _TANK
/ 1, R. F /N �=
/ CONCRETE JI
I.R.F. IN
226.12-1-55 / CONCRETE '
• / LAKE WATER SUPPLY / X
' STOCKADE
FENCE
LANDS N/F OF
KIMBERLY M. LARSEN AS TRUSTEE OF THE
MORRIS FAMILY IRREVOCABLE TRUST
31 LIBER 4908 PAGE 278
WASTEWATER SYSTEM PLAN
SCALE: 1 "=20'
GRAPHIC SCALE
10 0 5 10 20 40
( IN FEET )
CONTRACTOR TO FIELD VERIFY LOCATIONS AND DISTANCES
MAP REFERENCE:
BASE MAP INFORMA77ON FROM "MAP OF A SURVEY
MADE FOR JEANNE L. ROLLINS & CHARLES J.
ROWNS,- IN THE TOWN OF QUEENSBURY, WARREN
COUNTY, NEW YORK. DATED AUGUST 5, 2020.
PREPARED BY BARDIN LAND SURVEYING, P.C.
WASTEWATER SYSTEM SETBACK REQUIREMENTS
PROPERTY LINE
HOUSE
STREAM, LAKE;
WATERCOURSE,
WETLAND
WATERLINE
SEP71C TANK
10,
1 o'
50'
10'
ABSORP77ON FIELD
1 10'1
20'
1 100'
1 10'
SITE SOILS DATA
TEST PIT
TP-1 - 3/28/2023 BY TOM HUTCHINS, P.E.
0-4" - TOPSOIL
4-26" - DARK BROW MEDIUM AND COARSE
SAND FILL
26-52" - YELLOWISH EtROWN FINE SANDY LOAM
FEW COBBLE AND BOULDERS
52-78" - MED BROWN FINE SAND W/ SOME SILT
PERCOLATION TEST
PT-1 - 312812023 BY TOM HUTCHINS, P.E.
STABILIZED PERCOLATION RATE. 6-7 MIN
GROUNDWATER 0 78"
PROVIDE 24' VERTICAL SEPARATION TO
BOUNDARY CONDITION
w 135' TO
LAKE GEORGE
x
y k226.12-1-59
LAKE WATER SUPPLY
.:._,
442 SF OF BED AREA WTH 16 MODULES
226.12-1-60
ILAKE WATER SUPPLY
7�
1
I
/
4" PVC SDR-35
INLET
MIN. SLOPE
1/4" PER FOOT
4
WATERTIGHT SLEEVE)
AND SEAL (TYP)
PROPOSED 1250 GAL
DUAL COMPARTMENT
PRECAST CONCRETE
SEP71C TANK
APPROXIMATE
FINISHED GRADE
12" MIN.
COVER
a'
2"
6" MIN.
16" 4"H x18"W SLOT,
(2) 4" ELBOWS
4" MIN. TOPSOIL,
ESTABLISH TURF
4" SCH 40 PVC
PERFORATED PIPE
GEO-TEXTILE COVER
WASHED CONCRETE
SAND CONFORMING TO
NYSDOT SPECIFICATION
703-07
IN -DRAIN UNIT
HOLES ® 5&7 O'CLOCK
2' MIN SPACING
BETWEEN LATERALS
WASTEWATER SYSTEM DESIGN
3-BEDROOM RESIDENCE WITH GARBAGE GRINDER
WATER SAVING FIXTURES
(1.6 GPF MAX. FLUSH, 3.0 GPM MAX FAUCETS REPLACE
EXISTING FIXTURES AS NECESSARY)
DESIGN FLOW - 110 GPD/BEDROOM
SYSTEM DESIGN FLOW - 330 GPD
SEPTIC TANK - PROPOSED 1,250 GALLON PRECAST CONCRETE
LEACH FIELD - ELJEN ABSORPTION BED
DESIGN PERCOLATION RATE = 6-7 MINIIN
ABSORPTION BED AREA REQUIRED = 413 LF
15 ELJEN MODULES REQUIRED
(PER ELJEN NEW YORK DESIGN & INSTALLATION MANUAL)
PROVIDE 13'X34' ELJEN BED WITH 2 ROWS OF 8 MODULES
442 SF OF BED & 16 MODULES TOTAL PROVIDED
POTABLE WATER SUPPLY IS LAKE GEORGE
SCALE. NIS
ASTM C33 SAND SPECIFICATION
SIEVE
PERCENT PASSING
318" (9.5-mm)
100%
No. 4 (4.75-mm)
95-100%
No. 8 (2.36-mm)
80-IOOX
No. 16 (1.18-mm)
50-85X
No. 30 (600-µm)
25-60%
No. 50 (300-µm)
5-30%
No. 100 (150-µm)
0-10%
No. 200 (75-µm)
0-5%
(MUST BE OBTAINED BY WASHING)
INSTALLER TO PROVIDE SIEVE ANALYSIS FOR
SYSTEM CONCRETE SAND TO DESIGN ENGINEER
PRIOR TO TRANSPORTING SAND TO THE SITE
VARIANCE SUMMARY
20' REQUIRED
16' PROPOSED
4' RELIEF REQUESTED
-ABSORPTION FIELD TO PROPERTY LINE
10' REQUIRED
5' PROPOSED
5' RELIEF REQUESTED
srrE L°CAn°" LOCATION MAP
SYSTEM INSTALLATION NOTES
CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING AND IN ACCORDANCE WITH THE N.Y.S. DEPARTMENT OF
HEALTH INDIVIDUAL HOUSEHOLD SYSTEMS AND ASI'M F481 INSTALLATION OF THERMOPLASTIC PIPE AND
CORRUGATED TUBING IN SEPTIC TANK LEACH FIELDS
ALL DISPOSAL FIELDS SHALL BE GRADED TO SHED RAINFALL AND DIVERT SURFACE RUNOFF AWAY FROM THE
DISPOSAL FIELD.
DO NOT USE HEAVY EQUIPMENT WITHIN THE ABSORPTION AREA AFTER IN -DRAIN UNITS HAVE BEEN INSTALLED.
ABSORPTION TRENCH NOTES
THIS DESIGN UTILIZES ELJEN CORPORA71ON TYPE B IN -DRAIN GE07EX77LE SAND FILTER UNITS INSTALLED IN
SHALLOW CONFIGURATION. REMOVE EXISTING ORGANIC MATERIAL FROM SURFACE AND GRADE AREA PRIOR TO
PLACING FILL. USE TRACKED EQUIPMENT FOR ALL WORK IN ABSORPTION FIELD AREA. BOTTOM OF TRENCH
(BOTTOM OF CONCRETE SAND) TO BE INSTALLED AT 12" INTO HIGHEST POINT OF EXISTING GRADE, (CLOSEST TO
ROAD).
WASTEWATER SYSTEM MATERIAL SPECIFICATIONS
ASTM C33 SAND
PRESBY SYSTEM SAND TO BE ASTM C33 WASHED CONCRETE SAND. SEE 7AS7M C33 SAND GRADATION" FOR
SPECIFICATIONS
EFFLUENT SEWER PIPE
PIPING TO BE 4" SDR-35 OR SCHEDULE 40 PVC. INSTALL WITH 1/8" PER FOOT MINIMUM SLOPE
FILTER FABRIC
FILTER FABRIC TO BE 4.8 OZ/SY NON -WOVEN SEPARA77ON FABRIC, 7ENCATE MIRAFI 140N OR EQUIVALENT.
HOUSE SEWER PIPE
PIPING TO BE 4" SDR-35 OR SCHEDULE 40 PVC. INSTALL WITH 1/4" PER FOOT MINIMUM SLOPE.
TOPSOIL
PLACE 4" MINIMUM TOPSOIL OVER EN71RE ABSORP7ION FIELD AREA. SEED, MULCH AND ESTABLISH TURF.
4" MINIMUM TOPSOIL ON
ENTIRE BACKFILL AREA;
SEED AND ESTABLISH TURF
APPROXIMATE 13' BED WIDTH
EXISTING GRADE 4' 6' CENTER -TO -CENTER ELJEN SPACING 4'01
F—SLOPE SLOPE
/ �' / '
SCALE: NTS
POLYETHYLENE EXTENSION TO GRADE
K17H TAMPER RESISTANT ACCESS COVER
2" MIN. DROP
BETWEEN INVERTS
SUGGESTED: INSTALL POLYLOK
PL-122 FILTER SUCH THAT IT
IS READILY REMOVABLE THROUGH
12" MAX.
TANK ACCESS COVER
COVER
DISTRIBUTION BOX
4" PVC SDR-35
OUTLET
2" MIN.
MIN. SLOPE BAD
1/8" PER FOOT
DISTRIBUTION BOX NOTES
OR 6" ELBOW _ INVERT USE SPEED LEVELERS TO • PIPE JOINTS TO BE SEALED WITH ASPHALTIC
ASSURE ALL OUTLETS ARE AT MATERIAL OR EQUIVALENT.
EXACTLY THE SAME ELEVATION • INVERT ELEVATIONS OF ALL OUTLET PIPES
w Z x MUST BE EQUAL, USE SPEED LEVELERS
o 4 PVC SDR-35 SOLID HEADER D-BOX TO BE INSTALLED IN CONFORMANCE
�
TO PERFORATED TRENCH PIPING, o o 60-75% OF 25-4D% OF WITH MANUFACTURERS INSTRUCTIONS
o `D TANK VOLUME TANK VOLUME 1/S" PER FOOT MIN SLOPE
SEPTIC TANK NOTES
MINIMUM 2X WIDTH ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK STATE
MA UM 4X W1 TH DEPARTMENT OF HEALTH APPENDIX 75-A AND SHALL BE OF PRECAST
CONCRETE AS MANUFACTURED BY UTOPIA ENTERPRISES OR EQUAL.
ALL STRUCTURES SHALL BE PLACED ON FIRM, COMPACT SAND OR GRAVEL
BASE. WHERE EXISTING SOIL CONDITIONS ARE UNSUITABLE, CRUSHED STONE
SHALL BE PLACED AS NECESSARY TO ACHIEVE A STABLE BASE.
SEPTIC TANK DETAIL SEP71C TANKS INSTALLED IN TRAFFIC AREAS SHALL BE OF EXTRA HEAVY
SCALE: NTS
11Q 1D LEVEL
113
DEPTH
18"
OF OUTLET
MIN.
CONSTRUC71ON DESIGNED FOR H-20 WHEEL LOADING.
ALL JOINTS MUST BE SEALED WITH BUTYL SEALANT. JOINTS BELOW THE LIQUID
LEVEL MUST BE TESTED BEFORE BACKFlLLING.
u�(
I M 3 0 ^7
TOWN OF OIJEE%'v;3tJRY
BUILDING & CODES
226.12-1-56 SEP-0128-2023
Rollins, Jeanne
377 Cleverdale Rd
Septic Variance/Alteration
TAX MAP # 226.12-1-56
Dig 11hafely,
Never/.York
® Call Before You Dig
® Wait The Required Time
0 Confirm Ytli ty Response
E Respect The Marks
E Dig With Care
800-962■7962 0 ISSUED FOR VARIANCE REQUEST 3/29/2023
www.digssfelrwwyork.com
No. __Revisions_ Date
WASTEWATER SYSTEM PLAN & DETAILS
prepared for.
Jeanne L. Rollins Revocable Trust
377 Cleverdale Road
Town of Queensbury, County of Warren, State of New York
Drawn: JRS/WGC Checked: GTH Scale: NOTED Date: 3/24/2023
169 Haviland Road
ALTERA11ON OF THIS DOCUMENT EXCEPT BY Queensbury, NY 12804 292123-01
A LICENSED PROFESSIONAL ENGINEER IS A (518) 745-0307 Phone
VIOLATION OF NYS EDUCATION LAW. Hutchins Engineering PLLC (518) 745-0308 Fax
CONTACT:INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Christopher and Kelly Boucher
Mailing Address, C/S/Z: 44 Sylvan Drive Stow, MA 01775
Cell Phone: 781-258-8468 Land Line:
Email: chris@sagamoreselec#.com
• Primary Owner(s):
Name(s): same as applicants
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): IBS Septic
Contractor Trade: Septic
Mailing Address, C/S/Z: 2 Lower Warren Street, Queensbury
Cell Phone: Land Line: 518.798.8194
Email:
"Workers' Comp documentation must be submitted with this application"
• Engineer(s)•
Name(s): Hutchins Engineering PLLC
Mailing Address, C/S/Z: 169 Haviland Road Queensbury, NY 12804
Cell Phone: Land Line: 518-745-0307
Email: thutchins@hutchinsengineering.com
Contact Person for Compliance in regards to this project. Tom Hutchins, P.E.
Cell Phone: Land Line: 518-745-0307
Email: thutchins@hutchinsengineering.com
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: G Tpomas Hutchins(AGENT)
Q
SIGNATURE: �l`�� DATE: 05/17/2023
Septic Application Revised July 2022
TOWN GE QUEENSBURY }`
742 Bay Road, Queensbury, NY. 12804-5902
Septic System Checklist
Plan to scale
flKlIeceived Deep hole perc test results from engineer/Architect if applicable(Town Approved Engineers and
Architects;June 30 to April 15 Town Engineer for unapproved Engineers and Architects)
All wells on property and adjacent properties shown
ICZWater line shown Municipal or well 10'separation to any part of system
Setback to property lines show 10'or more for any part of system
Aseptic tank and pump stations 10'from foundation 50'from any well/lake/wetland 10'from any waterline.
�LNeptic 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)
Kieptic
tank sized fo r 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 N 4 Phi'-
��eepage pit 150'from well 50'from septic tank
�Aeepage Pits 3-times diameter apart
Septic tank and pump stations over 30 gallons 50'from watercourse or wetland
distance from bottom of trench or system 24"to bedrock or mottling 36"within 1000' of Lake George
nLeech field 100'from watercourse or wetland
P�Toe of mound or bottom'of retaining wall 10,from property line 100'from well 20'from
Foundation
rovide Engineer/Architect stamp for bed or design systems
I".Department of Health Approval for all mobile home park new systems Flood Plain requirements
OP 2'above established flood elevation to bottom of system
All tanks anchored or 2'above flood elevation
N
w
0
w .VF3
NORTHERLY ALONG THE
MEAN HIGH WATER MARK
OF LAKE GEORGE 215'f
AS IT WINDS AND TURNS
36
RETAINING
A` % WALL5 226.8-1-1
I LAKE WATER SUPPLY
j !% �� '..
•� j _Zz= S86 31'00"E�
114.16't
I.P.F.
CONCRETE
Z7 5TEP5
WALKWAY
501gTSUP STEPS
STEPS
/ 105TO
J. LAKE GEORGE
,4P
01 /
/;
AREA —
z O. 5'8f ACRES
^N
16.4'
•�: � z 3
/ %
1\ TP-1
NT TO NEW SEPTIC TANK . TO
ELEVATION APPROXIMATELY 1 FOO
PT-1
PIPED INTO NEW BUILDING SE0
//• / P.L. SETBACK
GENERATOR
135.63PROPANE
%% % I.R.F. LRF R\ N84°50'00' W-- — I _TANK
j L R. F. IN
/ CONCRETE
I / / J LR.F. IN
% j ! / 32 226.12-1-55 / CONCRETE '
O LAKE WATER SUPPLY k
%j• /
STOCKADE
FENCE
a
f
LANDS N/F OF
KIMBERLY M. LARSEN AS TRUSTEE OF THE
31 MORRIS FAMILY IRREVOCABLE TRUST
LIBER 4908 PAGE 278
MAP REFERENCE:
BASE MAP INFORMATION FROM "MAP OF A SURVEY
MADE FOR JEANNE L ROWNS & CHARLES J.
ROLLINS," 1N THE TOWN OF QUEENSBURY, WARREN
COUNTY, NEW YORK. DATED AUGUST 5, 2020.
PREPARED BY BARDIN LAND SURVEYING, P.C.
WASTEWATER SYSTEM SETBACK REQUIREMENTS
PROPERTY LINE
HOUSE
STREAM, LAKE;
WATERCOURSE,
WETLAND
WATERUNE
SEPTIC TANK
10'
10,
50'
10'
ABSORPTION FIELD
10'
i 120' 1
100'
10'
WASTEWATER SYSTEM PLAN
SCALE: 1 "=20'
GRAPHIC SCALE
10 0 5 10 20 40
( IN FEET )
CONTRACTOR TO FIELD VERIFY LOCA TONS AND DISTANCES
SITE SOILS DATA
f1x r.jLA
LI — 312812023 BY TOM HUTCHINS, P.E.
0-4" - TOPSOIL
4-26" — DARK BROWN MEDIUM AND COARSE
SAND FILL
26-52" — YELLOWISH BROWN FINE SANDY LOAM
FEW COBBLE AND BOULDERS
52-78" — MED BROWN FINE SAND W/ SOME SILT
NO GROUNDWATER EVIDENCE TO 78"
PERCOLATION TEST
PT-1 — 312812023 BY TOM HUTCHINS, P.E.
STABILIZED PERCOLATION RATE: 7 MIN11NCH
'�
_ .
" PVC S1
INLET
MIN. SLOPE
1/4" PER FOOT
WATERTIGHT SLEEVE
AND SEAL (TYP)
PROPOSED 1500 GAL
DUAL COMPARTMENT
PRECAST CONCRETE
SEPTIC TANK
4" MIN. TOPSOIL,
ESTABLISH TURF
4" SCH 40 PVC
PERFORATED PIPE
GEO—TEXTILE COVER
WASHED CONCRETE
SAND CONFORMING TO
NYSDOT SPECIFICATION
703-07
IN —DRAIN UNIT
HOLES ® 5&7 O'CLOCK-
2' MIN SPACING
BETWEEN LATERALS
WASTEWATER SYSTEM DESIGN
4-BEDROOM DESIGN WITH GARBAGE GRINDER
WATER SAVING FIXTURES
(1.6 GPF MAX. FLUSH, 3.0 GPM MAX. FAUCETS REPLACE
EXISTING FIXTURES AS NECESSARY)
DESIGN FLOW - 110 GPD/BEDROOM
SYSTEM DESIGN FLOW - 440 GPD
SEPTIC TANK - PROPOSED 1,500 GALLON PRECAST CONCRETE
LEACH FIELD - ELJEN ABSORPTION BED
DESIGN PERCOLATION RATE = 6-7 MINIIN
ABSORPTION BED AREA REQUIRED = 550 LF
20 ELJEN MODULES REQUIRED
(PER ELJEN NEW YORK DESIGN & INSTALLATION MANUAL)
PROVIDE 13'X43' ELJEN BED WITH 2 ROWS OF 10 MODULES
559 SF OF BED & 20 MODULES TOTAL PROVIDED
POTABLE WATER SUPPLY IS LAKE GEORGE
APPROXIMATE
EXISTING GRADE
APPROXIMATE
FINISHED GRADE
12" MIN.
COVER
2" _
6" MIN LIQ ID LEVEL
16"
47H x18"W SLOT,—\
(2) 4" ELBOWS
OR 6" ELBOW
Q.
2
0
60-75% OF
TANK VOLUME
BACKFILL MATERIAL AS NEEDED
TO ESTABLISH GRADES
BOX OUT 1' BELOW BOTTOM OF CONCRETE SAND. BLEND
CLEAN GRANULAR FILL WITH NATIVE SOILS TO BOTTOM OF
CONCRETE SAND PRIOR TO PLACING CONCRETE SAND.
POLYETHYLENE EXTENSION TO GRADE
WITH TAMPER RESISTANT ACCESS COVER
SCALE: NTS
ASTM C33 SAND SPECIFICATION
SIEVE
PERCENT PASSING
318" (9.5-mm)
100%
No. 4 (4.75-mm)
95- IOOX
No. 8 (2.36-mm)
80-IOOX
No. 16 (1.18-mm)
50-85X
No. 30 (600- pm)
25-60X
No. 50 (300-pm)
5-30%
No. 100 (150-pm)
0-10%
No. 200 (75-pm)
0-5%
(MUST BE OBTAINED BY WASHING)
INSTALLER TO PROVIDE SIEVE ANALYSIS FOR
SYSTEM CONCRETE SAND TO DESIGN ENGINEER
PRIOR TO TRANSPORTING SAND TO THE SITE
VARIANCE SUMMARY
—ABSORPTION FIELD TO BUILDING
20' REQUIRED
16' PROPOSED
4' RELIEF REQUESTED
—ABSORPTION FIELD TO PROPERTY LINE
10' REQUIRED
5' PROPOSED
5' RELIEF REQUESTED
13' BED WIDTH
6' CENTER —TO —CENTER ELJEN SPACING
ABSORPTION FIELD SECTION
SCALE: NTS
2" MIN. DROP
BETWEEN INVERTS
INSTALL POLYLOK
PL-122 EFFLUENT FILTER SUCH THAT IT
IS READILY REMOVABLE THROUGH 12" MAX.
TANK ACCESS COVER COVER
DISTRIBUTION BOX
4" PVC SDR-35
OUTLET 2" MIN.
MIN. SLOPE BAFFLE
i/8" PER FOOT
DISTRIBUTION BOX NOTES
USE SPEED LEVELERS TO • PIPE JOINTS TO BE SEALED WITH ASPHALTIC
ASSURE ALL OUTLETS ARE AT MATERIAL OR EQUIVALENT.
EXACTLY THE SAME ELEVATION a INVERT ELEVATIONS OF ALL OUTLET PIPES
4" PVC SDR-35 SOLID HEADER MUST BE EQUAL, USE SPEED LEVELERS
TO PERFORATED TRENCH PIPING,
e D—BOX TO BE INSTALLED IN CONFORMANCE 1/8" PER FOOT MIN SLOPE NTH MANUFACTURER'S INSTRUCTIONS,
SEPTIC TANK NOTES
MINIMUM 2X IMDTH ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK STATE
MAXIMUM 4X WIDTH DEPARTMENT OF HEALTH APPENDIX 75-A AND SHALL BE OF PRECAST
CONCRETE AS MANUFACTURED BY UTOPIA ENTERPRISES OR EQUAL
ALL STRUCTURES SHALL BE PLACED ON FIRM, COMPACT SAND OR GRAVEL
' BASE WHERE EXISTING SOIL CONDITIONS ARE UNSUITABLE, CRUSHED STONE
SHALL BE PLACED AS NECESSARY TO ACHIEVE A STABLE BASE
SEPTIC TANK DETAIL SEPTC TANKS INSTALLED IN TRAFFIC AREAS SHALL BE OF EXTRA HEAVY
SCALE. NTS CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING.
ALL JOINTS MUST BE SEALED IMTH BUTYL SEALANT. JOINTS BELOW THE LIQUID
LEVEL MUST BE TESTED BEFORE BACKFILLING.
113 1
DEPTH 18"
OF OUTLET MIN.
INVERT
WE I
-
25-40% OF
TANK VOLUME
SITE LOCATION—' LOCATION MAP
SYSTEM INSTALLATION NOTES
CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING AND IN ACCORDANCE WITH THE N.Y.S. DEPARTMENT OF
HEALTH INDIVIDUAL HOUSEHOLD SYSTEMS AND ASTM F481 INSTALLATION OF THERMOPLASTIC PIPE AND
CORRUGATED TUBING IN SEPTIC TANK LEACH FIELDS
ALL DISPOSAL FIELDS SHALL BE GRADED TO SHED RAINFALL AND DIVERT SURFACE RUNOFF AWAY FROM THE
DISPOSAL FIELD.
DO NOT USE HEAVY EQUIPMENT WITHIN THE ABSORPTION AREA AFTER IN —DRAIN UNITS HAVE BEEN INSTALLED.
ABSORPTION TRENCH NOTES
THIS DESIGN UTILIZES ELJEN CORPORATION TYPE B IN —DRAIN GE07EX71LE SAND FILTER UNITS INSTALLED IN
ASTM C33 CONCRETE SAND. REMOVE EXISTING ORGANIC MATERIAL FROM SURFACE AND BOX OUT FIELD AREA
AREA PRIOR TO PLACING GRANULAR FILL AND CONCRETE SAND. USE TRACKED EQUIPMENT FOR ALL WORK IN
ABSORPTION FIELD AREA.
WASTEWATER SYSTEM MATERIAL SPECIFICATIONS
ASTM C33 SAND
PRESBY SYSTEM SAND TO BE ASTM C33 WASHED CONCRETE SAND. SEE "ASTM C33 SAND GRADATION" FOR
SPECIFICA )TONS.
EFFLUENT SEWER PIPE
PIPING TO BE 4" SDR-35 OR SCHEDULE 40 PVC. INSTALL WITH 1/8" PER FOOT MINIMUM SLOPE
FILTER FABRIC
FILTER FABRIC TO BE 4.8 OZ/SY NON —WOVEN SEPARA77ON FABRIC, TENCATE MIRAFI 140N OR EQUIVALENT.
HOUSE SEWER PIPE
PIPING TO BE 4" SDR-35 OR SCHEDULE 40 PVC. INSTALL WITH 114" PER FOOT MINIMUM SLOPE.
TOPSOIL
PLACE 4" MINIMUM TOPSOIL OVER ENTIRE ABSORPTION FIELD AREA. SEED, MULCH AND ESTABLISH TURF.
4" MINIMUM TOPSOIL ON
ENTIRE BACKFILL AREA;
SEED AND ESTABLISH TURF
TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Based on our limited examination, compliance
with our comments shall not be construed as
indicatng the plans and specifications are in
fall compliance with the Building Codes of
New York State.
TOWN OF QUEENSBURY
BUILDING & CO ES PT.
Reviewe y:
Date:
226.12-1-56 SEP-0128-2023
Boucher, Christopher 8c Kelly
377 Cleverdale Rd FILE COPY
Septic Variance/Alteration
TAX MAP # 226.12-1-56
1 ADDED APPROVAL RESOLUTION (SHEET S2) ISSUED FOR PERMIT 511712023
0 ISSUED FOR VARIANCE REQUEST 3/29/2023
No. Revisions Date
,���e°A y�� WASTEWATER SYSTEM PLAN & DETAILS
O prepared for.
377 Cleverdale Road
Z 4'ir
N
Town of Queensbury, County of Warren, State of New York
067819
9O,cF SI Drawn: JRS/WGC Checked: G774 Scale: NOTED Date: 312412023
169 Haviland Road
ALTERATION 2804
A CENSEDOF S PROFESSIOONNALMENT ENGINEER IS CEPT Ar Queensbury, NY hone 292123-01 -S1
VIOLATION OF WS EDUCATION LAW. Hutchins Engineering PLLC (518} 7745-030 Phone
g g (518) 745-0308 Fax
SEPTIC VARIANCE APPROVAL RESOLUTION - BOH 26, 2023
RESOLMON APPROVING JEANNE L. ROLLINS REVOCABLE Ordinance or other adjoining properties nor otherwise conflict with the purpose and
TRUST'SAPPLICATION FOR objectives of any Town plan or policy; and:
SANITARY SEWAGE DISPOSAL VARIANCE
2. the: Local .Board of Health finds that the granting of the variances is necessary forthe
reasonable use of the land and are the minimum variances which would alleviate the
RESOLUTION NO.: BOH 26, 2023 specific unnecessary hardship found by the Local Board of Health to affect the
INTRODUCED BY: Mr. 'Harrison. Freer Applicant; and
WHO MOVED ITS ADOPTION
SECONDED BY: Mr. Timothy McNulty
WHEREAS, Jeanne L. Rollins, Trustee, on behalf of the Jeanne L. Rollins Revocable Trust,
(Applicant) filed an application for variances from provisions of the Town of Queensbury On -Site
Sewage Disposal Ordinance Chapter 136 to install an absorption field:
I. 16' from the foundation in. lieu of the required 20' setback; and
2. 5' from the property line in lieu of the required 10' setback;.
on propertylocated at 377 Cleverdale'Road in the Town of Queensbury, and
WHEREAS, the Town Clerk's Office published the Notice of Public Hearing in the Towwn's
official newspaper and the Local Board of Health duly conducted a public hearing concerning the
variance request on Monday, ,April 17`h, 2023; and
WHEREAS, the Town ClerVs Office has advised that it duly notified all property owners
within 500 feet of the subject property,
NOW, THEREFORE; BR IT
f d " : MUD#
RESOLVED, that the Local Board of Health hereby approves the application of Jeanne L.
Rollins, Trustee, on behalf of the Jeanne.. L. Rollins Revocable Trust, for variances from the Sewage
Disposal Ordinance to install an absorption field;
1 16' from the foundation in lieu of the required 20' setback; and
2. 5' from the property line in lieu of the required 10' setback;
on property located at 377 Cleverdale Road in the Town of Queensbury and bearing Tax Map No:
226,12-1-56, and
s
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 17" day of April, 2023, by the following vote.
AYES Mr. Freer, Mr. Ferone; Mr. McNulty, Mr. Strough,
NOES : .None
ABSENT: Mr. Metivier
Town of Queensbury
0
EA VES
SUNDEC BOgTSUP
36
! RETAINING
/ l WALLS 226.8-1-1
LAKE WATER SUPPLY
t I 6.0' /
•�`. - HOH
S86'31'00"E °H��"-
l.,
114.16't
i I.P.F.
CONCRETE
STEPS 35
WALKWA Y
STEPS I
STEPS %
104' TO
CE GEORGE 34
V
PROPOSED s�
BOAT STORAGE
PROPOSED
24x30 GARAGE
0 '
"
jfISQ� :. II I.P.F.
EXISTING HOUSE SEWER
NORTHERLY ALONG THE
MEAN HIGH WATER MARK !s •�/
OF LAKE GEORGE 215't °i IQr
AS IT WINDS AND TURNS
14.R.E4
/ :� / PORCH
z � 0. 5-8- �4CR..�',S 14.7'
CIV
RE -PIPE EXISTING HOUSE SEWER FROM �, ; / ,TP 1
BASEMENT TO NEW SEP77C TANK TO RAISE
ElEVA77ON APPROXIMATELY 1 FOOT
MAP REFERENCE:
WASTEWATER SYSTEM PLAN
SCALE 1 "=20'
GRAPHIC SCALE
10 0 5 10 20 40
( IN FEET )
CONTRACTOR TO FIELD VERIFY LOCATIONS AND DISTANCES
BASE MAP INFORMATION FROM "MAP OF A SURVEY
MADE FOR JEANNE L. ROLLINS & CHARLES J.
ROLLINS," IN THE REN
COUNTY, NEW YORK. NDATEDOF UEAUGUST Y'5,WA2o 0 SITE SOILS DATA
PREPARED BY BARDIN LAND SURVEYING, P.C. TEST PIT
TP-1 - 3/28/2023 BY TOM HUTCHINS, P.E.
WASTEWATER SYSTEM SETBACK REQUIREMENTS 0-4" - TOPSOIL
4-26" - DARK BROWN MEDIUM AND COARSE
STREAM, LAKE, SAND FILL
PROPERTY LINE HOUSE WATERCOURSE, WATERLINE
WETLAND 26-52" - YELLOWISH BROWN FINE SANDY LOAM
SEPTIC TANK 10' 10' 50' 10' FEW COBBLE AND BOULDERS
ABSORPTION FIELD 10' 20' 100'
52-78" - MED BROWN FINE SAND W/ SOME SILT
10'
NO GROUNDWATER EVIDENCE TO 78"
PERCOLATION TEST
PT-1 - 312812023 BY TOM HUTCHINS, P.E.
STABILIZED PERCOLATION RATE: 7 MIN/INCH
135' TO
LAKE GEORGE ----
226.12-1-59
LAKE WATER SUPPLY
" PVC SDR-35
INLET
MIN. SLOPE
1/4" PER FOOT
WATERTIGHT SLEEVE
AND SEAL (TIP)
PROPOSED 1500 GAL
DUAL COMPARTMENT
PRECAST CONCRETE
SEPTIC TANK
APPROXIMATE
FINISHED GRADE
12" MIN.
COVER
2"
6" MIN.
16"
4 M Xla W JLUI,--\
(2) 4" ELBOWS
OR 6" ELBOW
i
a
Zx
o
�i
b o 60-75% OF
o
`D TANK VOLUME
J
MINIMUM 2X WIDTH
4" MIN. TOPSOIL,
ESTABLISH TURF
4" SCH 40 PVC
PERFORA TED PIPE
Celxi�'1'i►:i�l iitK�P/�:i
WASHED CONCRETE
SAND CONFORMING TO
NYSDOT SPECIFICATION
703-07
IN -DRAIN UNIT
HOLES ® 5&7 O'CLOCK
2' MIN SPACING
BETWEEN LATERALS
[:RECORD DRAWING DIMENSIONS TABLE
CORNER "A"
CORNER "B"
CORNER "C"
S. T. INLET PORT
19,
19,
-
S T. OUTLET PORT
26'
26'
-
DISTRIBU77ON BOX
-
18.2'
1 59'
WASTEWATER SYSTEM DESIGN
4-BEDROOM DESIGN WITH GARBAGE GRINDER
WATER SAVING FIXTURES
(1.6 GPF MAX. FLUSH, 3.0 GPM MAX. FAUCETS. REPLACE
EXISTING FIXTURES AS NECESSARY)
DESIGN FLOW - 110 GPD/BEDROOM
SYSTEM DESIGN FLOW - 440 GPD
SEPTIC TANK - NEW 1,500 GALLON PRECAST CONCRETE
LEACH FIELD - ELJEN ABSORPTION BED
DESIGN PERCOLATION RATE = 6-7 MIN/IN
ABSORPTION BED AREA REQUIRED = 550 LF
20 ELJEN MODULES REQUIRED
(PER ELJEN NEW YORK DESIGN & INSTALLATION MANUAL)
PROVIDE 13'X43' ELJEN BED WITH 2 ROWS OF 10 MODULES
559 SF OF BED & 20 MODULES TOTAL PROVIDED
POTABLE WATER SUPPLY IS LAKE GEORGE
APPROXIMATE
EXISTING GRADE
,(--SLOPE
POLYETHYLENE EXTENSION TO GRADE
WITH TAMPER RESISTANT ACCESS COVER
SCALE. NTS
ASTM C33 SAND SPECIFICATION
SIEVE
PERCENT PASSING
3/8" (9.5-mm)
1009
No. 4 (4.75-mm)
95-1007.
No. 8 (2.36-mm)
80-100%
No. 16 (1.18-mm)
50-85%
No. 30 (600-µm)
25-607.
No. 50 (300-µm)
5-30%
No. 100 (150-µm)
0-10y.
No. 200 (75-µm)
0-5q
(MUST BE OBTAINED BY WASHING)
INSTALLER TO PROVIDE SIEVE ANALYSIS FOR
SYSTEM CONCRETE SAND TO DESIGN ENGINEER
PRIOR TO 7RANSPOR77NG SAND TO THE SITE
VARIANCE SUMMARY
-ABSORPTION FIELD TO BUILDING
20' REQUIRED
16' PROPOSED
4' RELIEF REQUESTED
-ABSORPTION FIELD TO PROPERTY LINE
10' REQUIRED
5' PROPOSED
5' RELIEF REQUESTED
13' BED WIDTH
46' CENTER -TO -CENTER ELJEN SP,
! —/ 7f
ABSORPTION FIELD SECTION
SCALE. NTS
2" MIN. DROP
BETWEEN INVERTS
INSTALL POLYLOK
PL-122 EFFLUENT FILTER SUCH THAT IT
IS READILY REMOVABLE THROUGH
12" MAX.
°
TANK ACCESS COVER
COVER
'
DISTRIBUTION BOX
4" PVC SDR-35
LIQUID LEVEL
OUTLET
2" MIN.
1/3
MIN. SLOPE BAFFLE
18"
1/8" PER FOOT
DEPTH
OF OUTLET
MIN.
DISTRIBUTION BOX NOTES
INVERT
USE SPEED LEVELERS TO
• PIPE JOINTS TO BE SEALED WITH ASPHALTIC
—
ASSURE ALL OUTLETS ARE AT
MATERIAL OR EQUIVALENT.
EXACTLY THE SAME ELEVATION
• INVERT ELEVATIONS OF ALL OUTLET PIPES
4" PVC SDR-35 SOLID HEADER
MUST BE EQUAL, USE SPEED LEVELERS.
TO PERFORATED TRENCH PIPING,
• D-BOX TO BE INSTALLED IN CONFORMANCE
25-40% OF
1/8 PER FOOT MIN SLOPE
INSTRUCTIONS.
TANK VOLUME
TANK
SEPTIC TANK NOTES
ALL UNITS SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK STATE
DEPARTMENT OF HEALTH APPENDIX 75-A
AND SHALL BE OF PRECAST
CONCRETE AS MANUFACTURED BY UTOPIA ENTERPRISES OR EQUAL.
ALL STRUCTURES SHALL BE PLACED ON FIRM, COMPACT SAND OR GRAVEL
8 BASE. WHERE EXIS71NG SOIL CONDITIONS ARE UNSUITABLE, CRUSHED STONE
SHALL BE PLACED AS NECESSARY TO ACHIEVE A STABLE BASE.
SEPTIC TANK DETAIL SEP77C TANKS INSTALLED IN TRAFFIC AREAS SHALL BE OF EXTRA HEAVY
SCALE. NTS
CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING.
ALL JOINTS MUST BE SEALED W17H BUTYL SEALANT. JOINTS BELOW THE LIQUID
LEVEL MUST BE TESTED BEFORE BACKFILLING.
SITE LOCATION LOCATION MAP
SYSTEM INSTALLATION NOTES
CONSTRUC77ON SHALL BE AS SHOWN ON THIS DRAWING AND IN ACCORDANCE WITH THE N.Y.S. DEPARTMENT OF
HEALTH INDIVIDUAL HOUSEHOLD SYSTEMS AND ASTM F481 INSTALLATION OF THERMOPLASTIC PIPE AND
CORRUGATED TUBING IN SEP77C TANK LEACH FIELDS.
ALL DISPOSAL FIELDS SHALL BE GRADED TO SHED RAINFALL AND DIVERT SURFACE RUNOFF AWAY FROM THE
DISPOSAL FIELD.
DO NOT USE HEAVY EQUIPMENT WITHIN THE ABSORP77ON AREA AFTER IN -DRAIN UNITS HAVE BEEN INSTALLED.
ABSORPTION TRENCH NOTES
THIS DESIGN U71LIZES ELJEN CORPORATION TYPE B IN -DRAIN GE07EXTILE SAND FILTER UNITS INSTALLED IN
ASTM C33 CONCRETE SAND. REMOVE EXIS77NG ORGANIC MATERIAL FROM SURFACE AND BOX OUT FIELD AREA
AREA PRIOR TO PLACING GRANULAR FILL AND CONCRETE SAND. USE TRACKED EQUIPMENT FOR ALL WORK IN
ABSORPTION FIELD AREA.
WASTEWATER SYSTEM MATERIAL SPECIFICATIONS
ASTM 03 SAND
PRESBY SYSTEM SAND TO BE ASTM C33 WASHED CONCRETE SAND. SEE "ASTM C33 SAND GRADATION" FOR
SPECIFICATIONS.
EFFLUENT SEWER PIPE
PIPING TO BE 4" SDR-35 OR SCHEDULE 40 PVC. INSTALL WITH 1/8" PER FOOT MINIMUM SLOPE
FILTER FABRIC
FILTER FABRIC TO BE 4.8 OZ/SY NON -WOVEN SEPARATION FABRIC, TENCATE MIRAFI 140N OR EQUIVALENT.
HOUSE SEWER PIPE
PIPING TO BE 4" SDR-35 OR SCHEDULE 40 PVC, INSTALL WITH 1/4" PER FOOT MINIMUM SLOPE.
TOPSOIL
PLACE 4" MINIMUM TOPSOIL OVER ENTIRE ABSORPTION FIELD AREA. SEED, MULCH AND ESTABLISH TURF.
4" MINIMUM TOPSOIL ON
ENTIRE BACKFILL AREA;
SEED AND ESTABLISH TURF
'f SLOPES
RECORD DRAWING NOTE:
A REPRESENTA77VE OF OUR OFFICE VISITED THE SITE
DURING CONSTRUCTION AND IT IS MY OPINION THAT
THE SYSTEM IS INSTALLED IN GENERAL CONFORMANCE
IMTH THE APPROVED PLAN AND THIS RECORD
DRAWWG. FINAL SURFACE FINISHING AND TURF
ESTABLISHMENT IS ONGOING.
G. THOMAS HUTCHINS, P.E.
61212023
INSTALLATION DATE: 61212023
INSTALLED BY - IBS SEPTIC & DRAIN SERVICE
TAX MAP # 226.12-1-56
2 RECORD DRAWING 61212023
ADDED APPROVAL RESOLUTION (SHEET S2) - ISSUED FOR PERMIT 17 20
0 ISSUED FOR VARIANCE REQUEST 3/29/2023
No. Revisions Date
-�� CIF, _ WASTEWATER SYSTEM PLAN & DETAILS
CJ ��O prepared for.
377 Cleverdale Road
Town of Queensbury, County Warren, of State of New York
0 \�
�°0 C'?879 Drawn: JRS/WGC Checked: GTH Scale. NOTED Date: 312412023
169 Haviland Road
ALTERATION OF THIS D CUM NT EXCEPT BY Queensbury, NY 12804 292123-01-S 1
A LICENSED PROFESSIONAL ENGINEER IS A (518) 745-0307 Phone
VIOLATION OF NYS EDUCATION LAW. Hutchins Engineering ELLC (518) 745-0308 Fax
New York State
Adirondack
Park Agency
KATHY HOCHUL BARBARA RICE
Governor Executive Director
April 21, 2023
John O'Brien
Director, Building & Codes
Town of Queensbury
742 Bay Rd
Queensbury, NY 12804
Re: LV2023-0038
Variance Application: Jeanne L. Rollins Revocable Trust
Town Resolution: 1301-126, 2023
Tax Map Number: 226.12-1-56
Dear John O'Brien:
Adirondack Park Agency staff review of the above referenced variance determination
has been completed. The applicant proposes to install an absorption field. Relief is
required from the Town for:
1. Absorption field setback to the foundation (16 feet proposed, 20 feet required);
2. Absorption field setback to the property line (5 feet proposed, 10 feet required.)
Based on the information presented in the record, no further Agency review is required
for this variance since the project does not involve provisions of the Adirondack Park
Agency Act.
Thank you for your referral of this variance determination.
Sincerely,
Robyn Burgess
Principal Adirondack Park
Local Planning Assistance Specialist
cc: John Strough, Supervisor, Town of Queensbury
Craig Brown, Zoning Administrator, Town of Queensbury
Caroline Barber, Town Clerk, Town of Queensbury
P.O.Box 99-1133 NYS Route 86•Ray Brook, NY 12977•Tel:(518)891-4050•www.apa.ny.gov
SEPTIC VARIANCE APPROVAL RESOLUTION - BOH 26, 2023
RESOLUTION APPROVING JEANNE L. ROLLINS REVOCARLE
Ordinance or other a4:loining properties nor otber�,vise conflict with the purpose and
TRUST'S APPLICATION FOR
objectives of any Town plan or policy, and
Dulyadopted this 17'h day of April, 2023by the following vote:
SANITARY SEWAGE DISPOSAL VARIANCE
2. the Local Board of HMfh finds that the granting of the variances is necessary for the
AYES Mr. Freer, Mr. Ferane, Mr. McNulty, Mr. Strough
reasonable use of the land and are the minimum variances which -would alleviate the
NOES None
RESOLUTIONNO.: BOH 26,2023
specific unnecessary hardship found by the Local Board of Health to affect the
INTRODUCED BY: Mr. Harrison Freer
Applicant: and
ABSENT: Mr. Metivier
�✓ MOVED ITS ADOPTION
g iJ
4tt(ix&�ge..}#~ Ll4ad�D.¢&Ib.+L.. $�q o¢��y�Ly�e�Town
W�g€a�ird+(s(,y'^tiya;VtF}-�Yd�+.+y4y}gvyNaw�)�FFyaAs�.€'..?g^�d�yo
` �
�Caroline
+.�..�sSi.-t
y
a�%�(V�yi'YF�Xcompared with
hereby
2 RECORD DRAWING 61212023
AD ED AP 0 AL ES LU ON — S D OR E lT 17 20
0 ISSUED FOR VARIANCE REQUEST 3/29/2023
No. Revisfons Date
APPROVAL RESOLUTION
OAS
��
Co �\X prepared for:
377 Cleverdale Road
rr
LIU Town of Queensbury, County of Warren, State of New York
067879 Drawn: JRS/WGC Checked: GTH Scale: NOTED Date: 312412023
169 Haviland Road
ALTERATION OF I DOCUMENT EXCEPT BY Queensbury, NY 12804 292123-01-52
A LICENSED PROFESSIONAL ENGINEER IS A (518) 745-0307 Phone
VIOLATION OF NYS EDUCATION LAW. Hutchins Engineering ing PLLC (518) 745-0308 Fax
�sy
B.�:i.�FUS HLtR}
y
A.4ylwb¢py�k�.w�}i sd Eiw�3iiu46s.3gty.}. EE
dE6bYia_ypy�gy�yy;gg� iydgC�+`i¢Vi}i��gry.X.dlY�'�iLd�Aq,
gym ya gy��yy�
g�++ Timothy
SECONDED BY: Mi a .L iSh%oth McNulty
p6ipg3�*gapl�gr�q /b�yC:�Yq�4y
y�#`ygy�ry+yp4b�++�p ry6y+Cdp�o6.¢L�yggyiyd.C'CT4'ry
adopted Gbi 4#l,AidLS0. J..4�iG:C&VbAGL mk+'6;�ti1.Ag X�i, iir Town kIGRI. LF the t.4i�� o t.ilalEJL�a f�� &EeL+ VAd
the � t2 `efLl�2023 at , f�il�i �2 t�LiC;tEiT`1 i�<� :?iesetlr r�tl $�t t1 same is s �?iTeG
WHEREAS, Rollins, Trustee,
�T1E� .a< ��i`L kip}1�t���1 ��;I`'i L. ��ti1S Revocable i'L€�i,
p < Jeanne
of
t t ii ,�}C;•�. t?c`i'34� �} die ci �` tii application L.
RESOLVED, �1 Health
�°i ����'If)I2i �i2t eit �'vC)� i`1i�1c"!� >~�l�ft3�i� �-
L"4r � ii�'iiS�t2l
� NATNESS THEREOF, have �l£'ttt� Si',t Ili hand � the Sr��:a t°� sIC� Town E) `�';�
F < �,.
. }.6 (�. .gA
�q On -Site
�^q Queens
�+,�,'�» variances
,r y ygy.q�+ �pq provisions
/��} ivy } �^ �-�y the
ga applicationTown
b{,R�Dy,�4(qqpp�+ filedan
�ppy�ytq.�dAy�p��+A&A�ae+rO�,A 3,.�{.�(;.�ggq���l+k&4�i3yp[..:g8yg3 E:?F��:?ya'�S�y�i¢RR;ri+pJ§�¢,.y�dSA�g�gk�4g✓�gY���JyS ��1�y.J ip�h��Lp:�t>y✓�.i ki��TP3! SJ 4&W&+i i*3uY� aS 4a ��a�:
a3pyg��d Rollins �s �+�3 y� . `, � {`p^�p+ , }gyp° yq `�' 'p'y� g�yq �-f'4�i`i ems,
} Jeanne
�qyy behalf
t.,'�aitAilg 1.�+'YZLidx 4XdE Lii.iG13L V'L�eLr48k.:i&Far L. cFA�iw�Mi6�V �..��X E�,dd. �if3E��.� 6:V� the *v. C i»�
Rollins,Trustee,
, < of February, ,��
��,�v,Y .m.. yY. aw�.e
F�y..,� y2.
L#Q.Gty �ke3.?&� Ordinance iF E� �dt�if$� an absorption 4&S%3V ��k�tA. A[AaR£..
¢q�yp� p f�
¢�^+� install
#�+ `'� Ordinance
�Yil�V� dIiF 63sd.�iv i%d EsJ K$� € a`aw&�414F,&i �§,+ii...
absorption
pyg� ry4
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