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1.2 1.2 SETPH.VAR\Iwanyckj—New Well Setbacks—In APA-1-23-2023 RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL VARIANCE APPLICATION OF PETER IWANYCKJ RESOLUTION NO.: ,2023 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, Peter Iwanyckj has applied to the Local Board of Health for variances from Chapter 136 to install a new well on property located at 17 Cleverdale Road (Private Road 41) in the Town of Queensbury with the proposed well to be located: 1. 29' from the existing holding tanks instead of the required 50' setback; 2. 83' from the absorption field instead of the required 100' setback; and 3. 77'from the absorption field instead of the required 100' setback; NOW, THEREFORE, BE IT RESOLVED, that the Town of Queensbury's Local Board of Health will hold a public hearing on Monday, February 13th, 2023 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay Road, Queensbury, to consider Peter Iwanyckj's sewage disposal variance application concerning property located at 17 Cleverdale Road (Private Road 41), Queensbury (Tax Map No.: 240.9-1-5) 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 23rd day of January, 2023,by the following vote: AYES NOES ABSENT: i SEPTIC VA 'office Use one T,r^� � � Permit #: town r4wrrn .y PI111.�.A�i �, ► Permit Fee: $ 742 eay lltoad, Queepsbwry, NY f2t304 Invoice #: P, SIS-761-8256 www.gueensbugy.net Approvals: Submittal: 1 (one) original & 8 copies of the completed application package PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL Section 1: Contact Intormat€on: Property Owner(s): Peter Iwanyckj vner's Agent Envirrrnmental Design Partnership . Address: 195 Rose's Grove Rd Address: 904 Route 146 Clifton Park NY,, 121365 Water Mill NY, 11976 Phone #: 631 -278- 1494 Phone #: 518-371 -7621 Email: ldemp19840gmail.com Email: rtze0on0edplip.c4Dm / edemyer0edplip.com Section 2: Site €rrformat€on: Site Address: 17 Private Road # 1 TaxID#: 240 9^1 5 Directions to Site: Take Private Rd 1 off Cleverdaie Section 3: Distance from well on property to septic system (if applicable) Holding Tanks, 29 feet Section 4: Is it possible to install a conforming septic system on this property? [7 Yes ] No If YES, please explain and attach a diagram: Section S: Does the proposed system meet setback requirements for distance from wells & septic systems on neighboring properties? ©Yes ® No If NiIO, please explain_ Need to install new drilled well on Site Section 6: Is the proposed system to be installed under a parking area? ❑ Yes © No Section 7: Section of the Sanitary Sewage Ordinance from which vow are seeking the variance (i.e. leachlne system will be 89 ft. from well in lieu of required 100 ft.): V-1 ' WELL TO EMSTING HOLDING TANKS 29' REQUESTED VS SO' REQUIRED V-2: WELL TO ABSORPTION FIELD 83' REQUESTED VS 1 DD' REQUIRED Septic Variance Application V-3_ WELL TO ABSORPTION FIELD 77' REQUESTED VS 100' REQUIRED revised December 2021 Section 110 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: Peter lwanyckyj Designates: Environmental Design Partnership lwan ck Residence as agent regarding the Septic Variance for y � Site Address: 17 Cleverdale Road Tax Map #: 240.9- 1 -5 Enaineerina 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: OWNER—SIGNATURE: DATE. AGENT—PRINT NAME: Connor DeMyer AGENT—SIGNATURE: ��`"� DATE: 2022- 12-22 $split Variance Application kevised December 2021 3 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 Evart Stritsrnan Address 19 Private Read 1 Tax Map ID 240.9-1 -6 South Name Michael Serini Address Cloverdale Rd. , Off Tax Map ID 240.9-1 -4 East Name Michael Serini Address Cleverdale Rd., Off Tax Map ID 240.9-1 -16. 12 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: rr Clevrefdale Road . I/We realize that putting the well, septic tank or leaching system less than the required 10,119' feet from the holding tank/field may incrrea'se the risk of pollution . Owner—Print Name: /ja n Owner--signature: Date: 1 .� -- Section 10• NEIGHBOR OR TENANT RELEASE STATEMENT (#rapplicable) I/We do hereby relieve the Town of Queensbury from any IiabHities on the plumbing and septic system located at: . I/We realize that putting the welt, septic tank or leaching system less than the required feet from the may increase the risk of pollution. Neighbor/Tenant--Print Name: Neigh bor/Tenant-Signature: Date: Septic variance Application Revised December 2021 ELECTRIC BOX GATE VALVE HYDRO - PNEUMATIC PRESSURE PRESSURE SWITCH TANK HIGH PRESSURE RELIEF VALVE PRESSURE GAl1GE SPIGOT :. FLUSHING/SAMPLING TAP UNION SPoNG LOADED BALL - CHECK VALVE BEDROOMS 2 3 4 5 PUMP CAPACITY, GPH 250 300 360 450 PRESSURE TANK, GALLONS INSIDE 42 82 82 120 SERVICE LINE FROM PUMP INSIDE OIA.• 3/4- 3/4' 1' 1-1/4' -SERVICE LINE LESS THAN 50 FEET LONG, HDPE PLASTIC OR TYPE K COPPER. TUBING FOR SERVICE LINES 50 FEET TO 150 FEET USE NEXT SIZE LARGER PIPE. NOT TO SCALE _ WGU PUMP MOTOR CABLE IN SEALED CONDUIT CONDUIT CONNECTION 12'-18' - PITLESS ADAPTER STANDARD CABLE -SPLICE/ WATER -TIGHT CONNECTION AT WELL SEAL VENTED r WELL GALV. IRON DROP PIPE 12' MIN. FINISHED GRADE -SIZE DRILLHOLE FOR GROUT SHALL BE CASING SIZE PLUS 4' WITH MIN. 1Yi' BENTONITE GROUT MATERIAL FOR FULL LENGTH OF O WELL CASING oI I MOTOR CABLE 00 8' DIA. x 50' MIN. STANDARD WEIGHT STEEL WATER WELL 30 I CASING PIPE (AWWA A100) ROCK DROP LINE CASING SHOE CHECK/FOOT VALVE SUBMERSIBLE PUMP MOTOR �4' H.P. MIN. TO BE SIZED - BY ENGINEER UPON COMPLETION _ - OF WELL DRILLING. NOTE: ALL PIPE, FRTINGS, PUMPS AND APPURTENANCES WHICH COME INTO CONTACT WITH POTABLE WATER SHALL BE NSF APPROVED STD. TANKS, MEN 10' MIN. SUMP CRUSHED STONE OR FREE FLOWING SELECTED GRANULAR FILL PLACED IN ONE LIFT AND MECHANICALLY COMPACTED TO 95% MODIFIED PROCTOR. CRUSHED STONE WITH HAUNCHES SHOVEL -SLICED. FOR UNSTABLE TRENCH BOTTOM USE ADDITIONAL DEPTH OF STONE AS NECESSARY TO PROVIDE A FIRM FOUNDATION. SUBGRADE SELECTED GRANULAR FILL TO BE PLACED UNDER PAVEMENT (ENTIRE 1 TRENCH DEPTH) 1 3 TRENCH SLOPES ARE GIVEN 3 FOR PAYMENT LIMITS ONLY FOR OPEN CUT AND ARE NOT - INTENDED TO REPRESENT �I STABLE SLOPES I I UNDER FIELD CONDITIONS 0`M,® �{ 0.D.+15" If NOTES: MAX. PAYMENT LIMITS 1. NATIVE EXCAVATED GRANULAR MATERIAL MAY BE BACKFILLED IF APPROVED BY THE ENGINEER. 2. ALL STONE TO BE CRUSHED TYPE, NOT TO EXCEED #2 IN SIZE. 3. ALL STONE SHALL BE WRAPPED IN AREA TO BE PAVED. NOT TO SCALE PAVEMENT OR ORIGINAL GROUND 6" WIDE PLASTIC WATER (BLUE) LOCATION TAPE APPROX. 12" OVER MAIN 2" THICK PRE -SCORED RIGID XPS INSULATION, MIN. COMP. STRENGTH 40 PSI, FOAMULAR 400 BY 0-C OR EQUAL (ALL LOCATIONS WITH LESS THAN 5-FT. COVER). EXTEND VERTICALS TO MIN. 5-FT BELOW GRADE, TYP. — V PIPE O.D. — 6" FOR PIPE 12" DIA. AND SMALLER 12" FOR PIPE 14" DIA. AND LARGER INSTALL GEOTEXTILE FABRIC WRAP WHERE WET CONDITIONS ARE PRESENT — TO PREVENT MIGRATION OF FINE SILTY SANDS INTO STONE BEDDING VOIDS, GEOTEX 451 OR APPROVED EQUAL. C7 N 0 c a W J o 0 3 13 z U @ W p W Z U (� ~ V N � CD a ) 0_ p O N u_ LL W O N � N 0 N OW LL Z m U) Z d W QW U Lij z UJ Q 0 W Q ~ W (n �W O G W � Y O rF— vJ LLI Q W D m Z Qzco I- 0 W � Q WOO LL 0 O �z� � L.L ~ O RECORD OF WORK DATE BY SUBMITTAL TO TOWN 12/22/22 CD SCALE: 111=20' SHEET TITLE: SITE DETAILS HEET NO. 2of2 VARIANCE REQUEST. LAKE GEORGE THE PROPOSED PROJECT INVOLVES THE DRILLING OF A NEW WELL FOR THE RESIDENCE AT 17 CLEVERDALE ROAD. DUE TO THE LIMITED LOT SIZING AND EXISTING CONDITIONS, A WELL IS NOT FEASIBLE BEING GREATER THAN 50' FROM THE EXISTING HOLDING TANKS AND 100' FROM THE LOCATION OF THE EXISTING AND APPROVED NEIGHBORING ABSORPTION AREAS. THEREFORE THE IWANYCKY RESIDENCE WILL REQUIRE VARIANCES FROM THE STATED SETBACK STANDARDS. BASED ON THE PROPOSED WELL LOCATION THE FOLLOWING VARIANCES ARE REQUESTED. V-1: WELL TO EXISTING HOLDING TANKS - 29' REQUESTED VS. THE 50' REQUIRED V-2: WELL TO ABSORPTION FIELD - 83' REQUESTED VS. THE 100' REQUIRED V-3: WELL TO ABSORPTION FIELD - 77' REQUESTED VS. THE 100' REQUIRED SITE LOCATION SITE LOCATION MAP - SCALE: OCK) LANDS N/F OF EVAN STR/TSMAN BOOK 6430 'OF DEEDS AT PAGE 300 TAX MAP SBL# 240.9-1-6 EXISTING WASTEWATER SYSTEM ` ELEV=t338.0 EXISTING ETU k PUMP TANKS NEIGHBORING DWELLING UEXISTING DRILLED WELL 100' PROPOSED WELL SETBACK s \ EXISTING DWELLING LANDS N/F OF 1 \ �oa�E PETER IWANYCKY✓ BOOK 1240 OF DEEDS AT PAGE 8C TAX MAP SBL# 240.9-1-5 \�jb IPF LANDS N/F OF'� MICHAEL & SHARON NI BOOK 6596 OE DI EDS' AT PAGE N 111 „ TAX MAP SBL# 240.9-1-47rD n h APPROVED WASTEWATER SYSTEMS ELEV=t339.0 lN\ Z \ N N \ O R C) WOOD 83 EDP GARAGE r—T— L— J X�34Q V 341 338 EXISTING (2) 2,000 GAL HOLDING TANKS APPROVED SEPTIC TANK NOTE: ALL PROPERTIES SHOWN IN WIR ZONE SITE PARCEL LAKE GEORGE X SITE VICINITY MAP C� SCALE 1. 200' NOTE, I \ THE PROPOSED WELL IS TO BE UPGRADIENT OF ALL NEIGHBORING \ SEPTIC ^SYSTEMS Ov W \ \❑ 1 1 1 I I PROPOSED WELL I I LOCATION I ELEV-t340.5 340- 339 \ of \% 0TH R LANDS OF MICH EL SERINI A)VD �- SH RON SERINI `, BOOK 648 OF DEEDS AT PAGE\85 TAX MA SBL# 240.9-1-16.12, / 1 Z 0 LOE N V Tn d. Q Y Q W -� J o >- Z Q _ in M OL W w p.. 0 L W Z Z v ., Q ~ T N > CL IY Z W p°r rn `�. Ln N N � O O N � W oN N 0 N N L.L U D W Z m r^ Z d W VJ QW U Z UJ Q° Q ~ 5W G � W (n ui O I..L. r of W ID O N } o W c Q m Z 3 �Z� -o �W' VJ 00,W� 3 D0 wa0 LL O Q Z o <0z L/�L a.Z� lL3� a I L aQ> -o O > m ZECORD OF WORK DATE BY a IUBMITTAL TO TOWN 12/22/22 CD SCALE: 111=20' SHEET TITLE: WELL VARIANCE PLAN SHEET NO. 1 of 2