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1.1 1.1 SETPH.VAR\Lakeside Chapel-Holding Tank Replacement System —In APA-7-10-2021 RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL VARIANCE APPLICATION OF LAKESIDE CHAPEL, INC. 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, the Lakeside Chapel, Inc. (Applicant) has applied to the Local Board of Health for variances from Chapter 136, §136-11 which requires applicants to obtain a variance for a holding tank system, as the Applicant wishes to replace a wastewater system by installing a holding tank system consisting of two (2) holding tanks each with a capacity of 1,000 gallons for a total capacity of 2,000 gallons on property located at 360 Cleverdale 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, July 24th, 2023 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay Road, Queensbury, to consider the Lakeside Chapel, Inc.'s sewage disposal variance application concerning property located at 360 Cleverdale Road in the Town of Queensbury and bearing Tax Map No.: 226.12-1-65 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 I0t'day of July, 2023,by the following vote: AYES NOES ABSENT: 169 Haviland 'Road Queensbury, NY 12804 Hutchins Engineering Phone: (518) 745-0307 Fax: (518) 745-0308 June 30, 2023 Town of Queensbury, Local Board of Health 742 Bay Road G �, .� Queensbury, NY 12804 Ca Re: Lakeside Chapel, Inc. U � 360 Cleverdale Road, Queensbury .� Tax Map ID #: 226. 12-1 -65 Dear Supervisor 5trough and Town Board Members: Attached please find our wastewater system ,plan and application for septic variance to allow a replacement septic system to be installed for the Lakeside Chapel, at the above-referenced parcel. Our office represents the Lakeside Chapel, Inc. in an effort to develop a modern and compliant WW system to serve the 60-seat chapel on Cleverdale. The building is seasonal use only and is typically used one to two days per week during the summer months. The only water usage within the facility consists of one small bathroom with one small hand sink. It is proposed to replace the existing antiquated cesspool system with (2) 1 , 000-galIon precast concrete holding tanks. The tanks will include a high-level warning alarm and high-high level alarm with interlock to disable the water supply. The water supply is from Lake George The holding tanks will be compliant with all setback requirements_ The variance request is simply for the installation of holding tanks at this unique and historic facility. We respectfully request to be placed on the next available board meeting agenda. Please contact me if you have any questions or if you require additional information. Best Regards, G. Thomas Hutchins, P.E. Cc: John Mason G_ Thomas Hutchins, P. E. thutchins(Phutchinsengineering.com SEPTIC VARIANCE O fficese Only 4irken T414„ rAPPLICATION ee: $ 742 Bay Road, Queensbury, NY 12804 ; P: 518-761-8256 yvww aueensburY 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 Information. Property owner(s): lakeside Chapel, Inc. Owner's Agent: Hutchins Engineering, PLLC Address: 360 Cleverdale Road Address: 1 +69 Haviland Read Queensbury, NY 12804 Queensbury, NY 12804 Phone #: Phone #: 51 g� ) 7 45-03fJ7 Email- Email: Section 2 Site Information: Site address: 360 Cleverdale Road Tax 117#: 226. 11-1 -65 Directions to Site: Section 3• Distance from well on property to septic system (if applicable) NIA feet Section 4: Is it possible to install a conforming septic system on this property? © Yes F01 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 prcpc^r Lees? i■ Yes Q No If No, please explain: 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 ou are seekin the variance {{i.e. leaching system will be 89 ft. from well in lieu of required 100 ft.): Install (2) 1 ,006 gallon hol Ing tanks; ali setbacks maintained Septic Variance Application Revised December 2021 Section 8: List the names, parcel addresses, and tax reap numbers of all adjoining property owners. You may obtain this information from the Town. of Queensbury's Assessors Office: North Name Larry Steinhart Address 362 Cleverdale Road Tax Map ID 226. 12- 1 -64 South Name Sherry Family Irrevocable Living Trust Address 358 Cleverdale Road Tax Map ID 226. 12-1 -66 East Name Lake George Address Tax Map ID West Name William H. Montgomery, Jr. Address 359 Cleverdale Road Tax Map ID 226. 12-1 -52 Section 9 OWNER STATEMENT I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at: 360 Cloverdale Rd I/We realize that putting the well, septic tank or leaching system less than the required N/A feet from the N/A may increase the risk of pollution. Owner—Print Name: John A. Mason , Trustee owner--Signature: Date: Section 10: 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: . 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 oecernber 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 Dame: Lakeside Chapel Inc. Designates: Hutchins Engineering as agent regarding the Septic Variance for Holding Tank Installation Site Address: 3+60 Cleverdale Road Tax Map It, 226- 12- 1 -65 Enigineering 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: Jahn A. Mason , Trustee OWNER—SIGNATURE: DATE: AGENT—PRINT NAME: G . Thomas Hut ins, P. E . AGENT—SIGNATURE. DATE: 6/26/23 Septic Variance Applicatiun Revised December 2021