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WASTEWATER-SEWER\Set PI FGilchrist Replacement System With Absorption Field to Well Lanes Foundat on Stream Wetland Well—In APA-6-27-2022
RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL
VARIANCE APPLICATION OF ROBERT AND LOUISE GILCHRIST
RESOLUTION NO.: ,2022
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, Robert and Louise Gilchrist have applied to the Local Board of Health for
variances from Chapter 136 to install a wastewater replacement system with its absorption field to be
located:
1. 74' from the well in lieu of the required 100' setback;
2. 10' from the foundation in lieu of the required 20' setback;
3. 8±' from the property line in lieu of the required 10' setback;
4. 37' from the intermittent stream in lieu of the required 100' setback; and
5. 90' from the wetland/MHWL in lieu of the required 100' setback;
on property located at 2483 Ridge Road(State Route 9L) in the Town of Queensbury,
NOW, THEREFORE, BE IT
RESOLVED, that the Town of Queensbury Local Board of Health will hold a public hearing
on Monday, July IIth, 2022 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay Road,
Queensbury, to consider Robert and Louise Gilchrist's sewage disposal variance application
concerning property located at 2483 Ridge Road in the Town of Queensbury(Tax Map No.: 240.E-1-
10) 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 feet of the property as required by law.
Duly adopted this 27t'day of June, 2022,by the following vote:
AYES
NOES
ABSENT:
SEPTIC VARIANCEOffice Use Only
1� x
Permit#:
APPLICATION Permit Fee:$
Invoice#:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.clueensbury.net Approvals:
Submittal: 1 (one) original & 8 copies of the completed application p%,Kape
PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN ENIA:I'k;;•;::: �
Section 1: SMAN9
co
Contact Information: . , ofiF
s
Property Owners);Robert&Louise Gilchrist Owner's Agent:Environmental Design ' rtl�ersl�p
Address: 39 Longview Drive Apt. IQS Address: 900 Route 146 Clifton Park NY,12065
Queensbury NY,12804
Phone#: Phone M 518-371-7621 .
Email: rob i1@roadrunnerrr.com Email: nzeglen@edpllp.com,cdemyer@edpllp.com
Section 2:
Site Information:
Site Address: 2483 Ridge Road(Route 9L) Tax ID#: 240.6-1-10
Directions to Site: Corner of 9L and Pilot Knob,head south and first house to the west
Section 3•
Distance from well on property to septic system (if applicable) 74 feet
Section 4:
Is it possible to Install a conforming septic system on this property? ❑Yes []x No
If YES,please explain an,d attach a diagram:
Section 5:
Does the proposed system meet setback requirements for distance from wells&septic systems on neighboring
properties?. E]Yes .0 No If NO,please explain: Proposed system 74'from existing well
Section 6:
Is the proposed system to be installed under a parking area? ❑Yes Ej No
Section 7:
Section of Sanitary Sewage Ordinance from which you are seeking the variance
V-1:WASTEWATER ABSORPTION FIELD TO WELL 74'REQUESTED VS THE 109 REQUIRED
V-2:WASTEWATER ABSORPTION FIELD TO FOUNDATION 10'REQUESTED VS THE 20'REQUIRED
V-3:WASTEWATER ABSORPTION FIELD TO PROPERTY LINE t8'REQUESTED VS THE 10'REQUIRED
V-4:WASTEWATER ABSORPTION FIELD TO INTERMITTENT STREAM 37'REQUESTED VS.THE 100'REQUIRED
V-5:WASTEWATER ABSORPTION FIELD TO WETLAND/MHWL 90'REQUESTED VS.THE 100'REQUIRED
Section 8:
List the names, parcel addresses, and tax snap numbers of all adjoining property owners. You may obtain this
Information from the Town of Queensbury's Assessor's Office:
North Name Paul Ryan
Address 15 Hanneford Road
Tax Map ID 240.5-1-19
South Name David Dickey
Address 2445 Ridge Road
Tax Map ID 240-.6-1-2
East Name Steven Zaccari.
Address 11 Hauneford.Road
Tax Map ID 240.6-1-20
West Name David Dickey
Address 2445 Ridge Road
Tax Map ID 240.6-1-2
Section 9:
OWNER STATEMENT
I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic System.located at:
2483 Ridge Road , I/We realize that putting the well,septic tank or leaching system less than the required 100 feet
from the existing well may increase the risk of pollution.
Owner--Print Name:Owner has granted N.Zeglen (EDP) authorization to sign form on their behalf
Owner--Signature:
Date:
Section 10:
NEIGHBOR OR TENANT RELEASE STATEMENT(if applfcabie)
I/We do hereby relieve the Town of Q.ueensbury 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
from the may increase the risk of pollution.
Neighbor/Tenant'—Print Name:
Neighbor/Tenant-Signature: Date:
Septic Variance Application Revised December 2021
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: I 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 andseptic systems on neighboring properties
g. Adjacent ownerships
h. All properties within 500 feet
A sample plot plan acid location are shown below:
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Septic Variance Application Revised December 2021
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: Robert&Louise Gilchrist
Environmental Design Partnership
Designates: as agent regarding the Septic Variance for Wastewater Replacement System.for
Site Address: 2483 Ridge Road(Route 9L) Gilchrist Residence
Tax Map 240.6-1-10
En, gineerihg 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 discrepancy
between such record and the handwritten minutes taken by the designated stenographer,the handwritten
minutes shall be deemed the official record.
1,the undersigned, have thoroughly read and understand the instructions for submission; agree to the
submission requirements and completed checklist:
OWNER—PRINT NAME: Owner-has granted N.Zeglen (EDP) authorization to sign form on their behalf
OWNER—SIGNATURE:
DATE:
AGENT—PRINT NAME: Nicholas Zeglen
AGENT—SIGNATURE:. DATE:
�,Z
Septic Variance Application Revised December 2021
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