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1.1 w 1.1 SETPH.VAR\Sbrocco Scott Carol-Replacement Leaching System to Lines—8-27-2020 RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL VARIANCE APPLICATION OF SCOTT AND CAROL SBROCCO RESOLUTION NO.: ,2020 INTRODUCED BY: WHO MOVED ITS ADOPTION SECONDED BY: WHEREAS, the Queensbury Town Board serves as the Town's Local Board of Health and is authorized by Town Code Chapter 136 to issue variances from the Town's On-Site Sewage Disposal Ordinance, and WHEREAS, Scott and Carol Sbrocco (Applicants) have applied to the Local Board of Health for variances from Chapter 136 to install a replacement leaching system: l. 8' from the easterly property line in lieu of the required 10' setback; and 2. 5' from the southern property line in lieu of the required 10' setback; on property located at 2952 State Route 9L in the Town of Queensbury, NOW, THEREFORE, BE IT RESOLVED, that the Town of Queensbury's Local Board of Health will hold a public hearing on Monday, September 14th, 2020 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay Road, Queensbury, to consider Scott and Carol Sbrocco's sewage disposal variance application concerning property located at 2952 State Route 9L, Queensbury (Tax Map No.: 239.20-1-13) and at that time all interested persons will be heard, and BE IT FURTHER, RESOLVED, that the Local Board of Health authorizes and directs the Queensbury Town Clerk to publish the Notice of Public Hearing presented at this meeting and send a copy of the Notice to neighbors located within 500' of the applicant's property as required by law. Duly adopted this 171"day of August, 2020, by the following vote: AYES NOES ABSENT: SEPTIC VARIANCE Office Use Only Received: APPLICATION Permit M /<an of C�ixcnstwry Permit Fee: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net Invoice#: Approvals: Submittal: I (one)original &8 copies of the completed application package Property Owner(s):Scott&Carol Sbrocco Owner's Agent:Click or tap here to enter text. Address:423 Wyckoff Ave Address: Click or tap here to enter text. Ramsey, NJ 07446 Click or tap here to enter text. Phone M(917)560-6015 Phone M Click or tap here to enter text. Site Address: 2952 State Route 9L Tax ID#:239.20-1-13 Directions to Site: Click or tap here to enter text. Distance from well on property to septic system (if applicable)_N/A_feet is it possible to install a conforming septic system on this property? ® Yes ❑ No If YES, please explain and attach a diagram: Drawing attached does not meet property setback Does the proposed system meet setback requirements for distance from wells&septic systems on neighboring properties? ❑ Yes ® No If NO, please explain: Does not meet property line setbacks see drawing. 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.): Removing and replacing existing leaching system. New field will be 8'in lieu of required 10'from Easterly property line along State Route 9L and leaching system will be 5'in lieu of required 10'from Southern property line along Edward J. Holohan's property. Septic Variance Application Revised Fahninr Imo 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: North Name Thomas J Mastin Address 41 Bellwood Way,Castleton NY 12033 Tax Map ID 239.20-1-14 South Name Edward J. Holohan Address 363 Pinewood Ave,Troy NY 12180 Tax Map ID 239.20-1-12 East Name Mountainside Grange, LLC Address 423 Wyckoff Ave, Ramsey NJ 07446 Tax Map ID 239.20-1-20 West Name N/A Lake George Address Click or tap here to enter text. Tax Map ID Click or tap here to enter text. OWNER STATEMENT I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at:2952 State Route 9L I/We realize that putting the well,septic tank or leaching system less than the required_10 feet from the Property Line may increase the risk of pollution. Owner—Print Name:_Scott Sbrocco Date:_7/27/2020_ Owner—Signature:_ ! Date:_7/27/2020 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: 2952 State Route 9L I/We realize that putting the septic tank or leaching system less than the required_10 feet from the property line may increase the risk of pollution. Neighbor/Tenant—Print Name: Date: Neighbor/Tenant-Signature: Date: Septic Variance Application Revised F.6r,,.,7m 9 PLEASE ATTACH THE FOLLOWING TO YOUR APPLICATION: 1. A location map showing the site within the Town of Queensbury 2. A plot plan showing existing and proposed features of the property, including: a. Lot dimensions b. North arrow and scale: 1 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 neighboring properties g. Adjacent ownerships h. All properties within 500 feet A sample plot plan and location are shown below: WOO"WA rPoo t lam Pfr0;4 $N SeDtic Variance Awlication Revi_wt r.h—.—,)mo 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: Click or tap here to enter text. Designates: Click or tap here to enter text. as agent regarding the Septic Variance for Tax Map#: Click or tap here to enter text. 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 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:Scott Sbrocco OWNER—SIGNATURE: DATE: 7/27/2020 AGENT—PRINT NAME: Click or tap here to enter text. AGENT—SIGNATURE: DATE: Click or tap here to enter text. Septic Variance Application Revised February 2019 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: North Name Thomas 1 Mastin Address 41 Bellwood Way,Castleton NY 12033 Tax Map ID 239.20-1-14 South Name Edward J. Holohan Address 363 Pinewood Ave,Troy NY 12180 Tax Map ID 239.20-1-12 East Name Mountainside Grange,LLC Address 423 Wyckoff Ave,Ramsey N1 07446 Tax Map ID 239.20-1-20 West Name N/A Lake George Address Click or tap here to enter text. Tax Map ID Click or tap here to enter text. OWNER STATEMENT I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at:2952 State Route 9L I/We realize that putting the well,septic tank or leaching system less than the required_10 feet from the Property Line may increase the risk of pollution. Owner—Print Name:_Scott Sbrocco Date:_7/27/2020 Owner—Signature: Date:_7/27/2020 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:2952 State Route 9L I/We realize that putting the septic tank or leaching system less than the required_10 feet from the property line may increase the risk of pollution. Neighbor/Tenant—Print Name: C�D_vZ WD dLQ -! Date: Neighbor/Tenant-Signature: Date: Septic Variance Application Revlsed February Imo