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1.4 1.4 WASTEWATER-SEWER\SetPH\Weannan Replacement System With Components to House—In APA-2-13-2023 RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL VARIANCE APPLICATION OF LINDA WEINMAN 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, Linda Weinman has applied to the Local Board of Health for variances from Chapter 136 to install a replacement wastewater system with the: 1. Absorption bed to be located 15' from the building foundation in lieu of the required 20' setback; and 2. Septic tanks to be located 5' from the building foundation in lieu of the required 10' setback; on property located at 71 Assembly Point Road 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, February 27t", 2023 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay Road, Queensbury, to consider Linda Weinman's sewage disposal variance application concerning property located at 71 Assembly Point Road in the Town of Queensbury (Tax Map No.: 239.12-2-23) 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 February, 2023,by the following vote: AYES NOES ABSENT: Office SEPTIC .� ARIIA CE Permit Use C]nly a � Y 1V Permit #: APPLICATION Permit-Fee: � invoice #- 742 Bay Road, Queensbury, NY 228G4 p: 528-761-8256 www. ueens'bu .net Approvals: Submittal: I (one) original & 8 copiesrofthe completed app PLEASE PRINT LEGIBLY OR TYPE, PLEASE 1NCLU17 LD 4P RE Section 14 *' FEB - 1 2123 0 co QUEENSBUR'Y Contact Information CLE�FFM -• Property Owner's): Linda Weinman Owner's Agent: Enviro des P sip Address: 30 Rockrose Way Apt 204 Address: 900 Route 146 Ballston Spa NY 12020 Clifton Park NY, 12065 Phone #: 518-656-9390 Phone #: 518-371 -7621 x 138 Email: jweinmanCaa)nycap.rr.com Email: cdernyerCcbedpllp.com Section 2• Site. lnformaitlon: Site Address: 71 Assembly Point Rd Tax ID#: 239A2-2-23 Directions to Site: Section 3: Distance from well on property to septic system (if applicable) n/a feet Section 4: is it possible to install a conforming septic system on this property? © Yes 0 No if YES, please explain and attach a diagram: Section 5• Does the proposed system meet setback requirements for distance from wells & septic systems on neighboring properties? QYes ❑ No if No, please explain: Section 6- is the proposed system to be installed under a parking area? Q Yes ❑ 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 100E ft_): V-1: ABSORPTION BUD TO B[:iEL DING FOUNDATION - 151 RUQUESTED Vs. THE 2U R.ECt1-11tu~D V-2: SFIMC TANKS TO BUILDING FOUNDATION - 51 .fiBQUFSTED VS_ THE 10' 'REQUXRIED Septic Variance Application Revised December 2021 v 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 Queensbun/s Assessor's Office: North Name Robert Vanderhye Address 73 Assembly Point Rd Tax Map ID 239. 12-2--24 South Name Dambrosio Family Trust Address 67 Assembly Point Rd Tax Map !D 239. 12-2-22 East Name Mirada LLG Address fib Assembly Point Rd Tax Map ID 239. 12-2-46 West Name Address Tax Map 1D Section 9- OWNELi SnkTEL ENr 1/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at: 71 Assembly Point Rd . I/We realize that putting the well, septic tank or leaching system less than the required 20/10 feet from the building foundation may increase the risk of pollution. Owner—Print Name: V1 a JkJ Owner—Signature: L .x- ,c - ' 3 �`"'���.+� � Date: .��� Section 10: NgG SO&OR-EM AN'tRF.LEASESDUEAl ENT W&pp fr-�le) 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. Neighbor/Tenant—Print Name: Neigh bar/Tenant-Signature: Date: Septic variance Application Revised December 2021 PLEASE ATTACH THE FOLLOWING TO YOUR APPLICATION: 1. A location map slowing 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=44 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.) C 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: .! ... .~�_.. �' � asnplgt.eraeai�nMeov NI rsotix•,eK "clue K VOW 1 # ,� ... ..R. " rwdbF,k 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: Ownerrs Name: Designates: Environmental Design partnership Weinman Residence as agent regarding the Septic Variance for Site Address: 71 Assembly Point Road Tax Map #: 239. 1 2_2-'23 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. 1, the undersigned, have thoroughly read and understand the instructions for submission; agree to the submission requirements and completed checklist: OWNER--PRINT NAME: _,..._. ,. PJ fl Ylf'I_..A a. OWNER—SIGNATURE. 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