SEP-0400-2022 r
SEP—TI"IaS OSAL PERMIT Office Use Only
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O AP ' I ATION Permit#: !PAO10
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Town o cue str�ry AUG 0 4 2022 Permit Fee:$
lu, L s Invoice#: 5Z(O?i
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742 Ba Road' eensbury;Nt-FiN043LIRY
P:518- 61-825631wvuv3.+q6eerasbu uD` G Septic Variance? ® N
Flood Zone? Y
Wetlands? Y RNeviewed By.
Project Location: 2999 State Route 9L(Dunham's Bay Resort)
Tax Map #: 252.-1-75.1
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) ❑ x❑
1981-1991 130 Spa or Hot Tub Yes No
1992-Present 110 4 110 440 Installed? (choose one) ❑ 0
PARCEL INFORMATION:
Topography ❑■ Flat Rolling ❑ Steep Slope % Slope
Soil Nature ❑ Sand ❑ Loam ❑ Clay ❑ Other, explain:
N/A- Holding Tank
Groundwater At what depth? N/A
Bedrock/Impervious material At what depth? N/A
Domestic Water Supply ❑ Municipal - ❑■ Well []Lake
(if well or lake, water supply from any septic system absorption is
ft.)
Percolation Test Rate: NSA per minute per inch (test to be completed by a
licensed engineer/architect)
PROPOSED SYSTEM INFORMATION:
Tank size gallons (min. size 1,000 gallons, add 250 gallons for each garbage cylinder or
spa/hot tub
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:
Holding Tank System Total required capacity? ; tank size ;
# of tanks 2 existing 500 gallon+ New 1,500 gallon
Septic Application Revised July 2022
i
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Swordfish Realty LLC
Mailing Address, C/S/Z: 2999 State Route 9L Lake George NY 12845
Cell Phone: (518)932-1145(Rich Gordon) Land Line:
Email:
• Primary Owner(s):
Name(s): same as applicant
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): Sanitary Sewer Service
Contractor Trade: excavation/installation
Mailing Address, C/S/Z: 144 Luzerne Rd#7947,Queensbury, NY 12804
Cell Phone: (518)796-3760 Land Line:
Email: gdrellos@gmail.com
"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: tutchins@hutchinsengineering.com
Contact Person for Compliance in regards to this project: Rich Gordon
Cell Phone: (518)932-1145 Land Line:
Email:
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
SIGNATURE• Zll -i&
DATE: .
Septic Application Revised July 2022
Ap
,SEPTIC VARIANCE office use tlnly
Permit#: _cPa(2/�.O® -ZCI 2�
APPLICATION Permit Fee:
Timm 4of(Zhctobiirp
Invoice
742 Bay Road,Queensbury,NY 12804
P:518-761-9256 wMv:nueeMIi6f_y.net Approvals:
Submittal: 1(one)original &8 copies of the completed application package
PLEASE PRINT LEGIBLY OR TYP EMAIL
Section l: FIL17 COPY
Contact.I nform at i o n
Property Owner(s):,_ Swordfish_Realty LLC owner's Agent: Hutchins Engineering PLLC
Address: 2999 Route 9L Address:- 169 Haviland Road-
Lake George, NY. 12845 Queensbury, NY 12804
Phone#: 518-932-1145 _ = Phone#: 518-745-0307
Email: (?.��Gt�..,�-r rle
COS Email: .tutchins@hutchinse_ngineering.com
Section 2.
Site Information;
Site Address: 2999 Route 9L Tax ID#:.252.-1-75:1 Qc
- - �.(0
-Directions to Site: Dunhams Bay Lodge Property U
.Section 3• 71g
_a C�
Distance from well on property to septic system(if applicable) 170'well to propsed holding tank LL ES
feet p a
zE5
Section 4• m
Is it possible to install a conforming septic system on this property? ❑Yes ❑■'No
If YES;please explain and attach a diagram:
-Section 5:
Does the proposed system meet 5etback.requirements for distance from wells&septic systems on neighboring
-properties? KYes ❑ No If NO,please explain:
Section 6•
Is the proposed-system to be installed under a parking area? ❑Yes Q No
Section 7:
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 too ft.): .In_stall additional holding,tank.to serve three seasonal cabin rental units
Septic Variance Application. Revised December 2021
M
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 Assessors Office:
North Name see attached page for information _
Address.
Tax Map ID
South Name
Address
Tax Map ID
East Name
Address
Tax Map ID
West Name
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:
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.
Owner—Print Name: SWordfshR�eai Richard Gordon authorized signature)
Owner—Signature: . `(i (/ Can. i''rl.Ato j '�ai I r 'I A4 f, Date:
Section 10•
R OR TENANT RELEASE STATEMENT(if applicable)
/We do hereby relieve _ n of Queensbury from any liabilities on the plumbing and septic s cated at:
I/We realize t the well,septic tank or leaching s ss..than the required feet
from the may increase the risk of
Neighbor/Tenant—Print Name:
Neighbor/Tena 'ature: Date:
Septic Variance Application Revised December 2021
i
DUNHAMS BAY SEPTIC VARIANCE APPLICATION—ADJOINING PROPERTY OWNERS.
NORTH
Lake George
SOUTH
Swordfish Realty LLC
2999 State Route 9L Lake George,NY 12804
252.1-775.4
EAST
Robert Gray
P.O.Box 101 Cleverdale, NY 12820
252.-1-74
Mirada 7, LLC
PO Box 341769 Tampa, FL 33694
252:1-75.3
Peter E. Booth
32 Day School Drive Middlefield, CT 06455
252:1-73
Robin Benak
3321 Westminster Ave. Dallas,TX 75202
252.-1-72
William Hallock
3 Werner Way.Lebanon,NJ 08833.
252.-1-75.7
William Hallock
3 Werner Way Lebanon, NJ 08833
252.-1-75.6
WEST
John Schriner
410 Garfield Road Troy,NY 12180
239.20-1-24
10 Dunham's Bay Road LLC
4 Primrose Circle Saratoga Springs, NY 12866
252:1-67 .
Swordfish Realty LLC
2999 State Route 9L Lake George,NY 12804
252.1-75.4
�1
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:
Owners Name: Swordfish Realty LLC
Designates: Hutchins Engineering PLLC as agent regarding the Septic Variance for Holding Tank Installation
Site Address: 2999 Route 9L
Tax Map#: 252.-1-75.1
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"fVAME�J�U4` Ii4�.. (`.`E�tt I'r 1 I "' �d (T(S t 4"
.OWNER'_=SIGNATURE; I ' ;iU/. .✓ i,�'I - ;DATE_:;, I �
AGENT-PRINT NAME:� (AQ- '\C-H I
AGENT-SIGNATURE: . XDATE:
Septic Variance Application Revised December 2021
169 Haviland Road
Queensbury, NY 12804
Hutchins Engineering PLLC Phone: (518)745-0307
Fax: (518)745-0308
June 24, 2022
Town of Queensbury Local Board of Health
742 Bay Road
Queensbury, NY 12804
Re: Dunham's Bay Resort, Swordfish Realty LLC D
2999 Route 9L
Tax Map ID: 252.-1-75.1 JUN 2 4 2022
Dear Supervisor Strough & Board Members: TOWN OF QUEENSBURY
BUILDING& CODES
This office represents Swordfish Realty LLC with respect to the pursuit of wastewater variance
to.add an additional holding tank to an existing holding tank system to serve two seasonal
cabins at Dunham's Bay Resort located at 2999 Route 9L. The proposed holding tank is a
1,500-gallon polyethylene tank to be installed in series with the existing 500-gallon holding tank.
The proposed wastewater system requires a variance from the Town of,Queensbury Chapter
136 Sewers and Sewage Disposal; 136-11 A. to install a holding tank.
Enclosed please find ten submission packages for this project. We respectfully request that this
item be placed upon the agenda of the next available town board meeting. Please contact me if
you have any questions or if you require additional information.
Best Regards,
G. Thomas Hutchins
Enclosures
Cc: Rich Gordon
RESOLUTION APPROVING SANITARY SEWAGE DISPOSAL
VARIANCES FOR SWORDFISH REALTY LLC
RESOLUTION NO.: BOH 64,2022
INTRODUCED BY: Mr.Timothy McNulty
WHO MOVED ITS ADOPTION =ECOPY
SECONDED BY: Mr. George Ferone
WHEREAS, Swordfish Realty LLC (Applicant) applied to the Town of Queensbury Local
Board of Health for a variance from Chapter 136, §136-11 which requires applicants to obtain a
variance for holding tanks,.as the Applicant wishes to add an additional 1,500 gallon capacity
holding tank to an existing holding tank system to serve two (2) seasonal cabin rental units at the
Dunham's Bay Resort located on property situated at 2999 Route 9L 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 conducted a public hearing concerning the
variance requests on Monday, July 25t',2022,and
WHEREAS, the Town Clerk's Office 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 variance, it is felt that the variance 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 variance is necessary for the
reasonable use of the land and is the minimum variance 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 Swordfish
Realty LLC (Applicant) for a variance from the Sewage Disposal Ordinance to allow installation of
an additional 1,500 gallon capacity holding tank to an existing holding tank system to serve two (2)
seasonal cabin rental units at the Dunham's Bay Resort located on property situated at 2999 Route
9L in the Town of Queensbury and bearing Tax Map No.: 252.-1-75.1, 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 any lawful action by the Adirondack
Park Agency during such period.
Duly adopted this 25th day of July,2022,by the following vote:
AYES Mr. Ferone,Mr. McNulty,Mr. Strough
NOES None
ABSENT: Mr. Metivier,Mr. Freer
P.O. Box 99 • 1133 NYS Route 86 • Ray Brook, NY 12977 • Tel: (518) 891-4050 • www.apa.ny.gov
August 2, 2022
John O'Brien
Director, Building & Codes
Town of Queensbury
742 Bay Rd
Queensbury, NY 12804
Re: LV2022-0064
Variance Application: Swordfish Realty, LLC
Town Resolution: BOH 64, 2022
Tax Map Number: 252.0-1-75.1
Dear John O'Brien:
Adirondack Park Agency staff review of the above referenced variance determination
has been completed. The applicant proposes to add a 1,500 gallon holding tank to an
extisting tank system. Relief is required from the Town for use of a holding tank.
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