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1.1 1.1 WASTEWATER-SEWERIAPPROVE'Kawecki DeRocker—Replacement With Ejector Pump to Home and Lake—8-7-2023 RESOLUTION APPROVING GREGG KAWECKI ON BEHALF OF PENELOPE DEROCKER'S APPLICATION FOR SANITARY SEWAGE DISPOSAL VARIANCES RESOLUTION NO.: 12023 INTRODUCED BY: WHO MOVED ITS ADOPTION SECONDED BY: WHEREAS Gregg Kawecki, on behalf of Penelope DeRocker, (Applicant) filed an application for variances from provisions of the Town of Queensbury On-Site Sewage Disposal Ordinance, Chapter 136 to install a replacement wastewater treatment system with the ejector pump to be located: 1. 30' from Lake George in lieu of the required 50' setback; and 2. 2' from the dwelling in lieu of the required 10' setback; on property located at 53 Knox Road 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 duly conducted a public hearing concerning the variance requests on August 7t', 2023, and WHEREAS, the Town Clerk's Office has 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 variances, the Local Board of Health determines that the variances 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 variances is necessary for the reasonable use of the land and are the minimum variances 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 Gregg Kawecki, on behalf of Penelope DeRocker, for variances from the Sewage Disposal Ordinance to install a replacement wastewater treatment system with the ejector pump to be located: 1. 30' from Lake George in lieu of the required 50' setback; and 2. 2' from the dwelling in lieu of the required 10' setback; on property located at 53 Knox Road in the Town of Queensbury, and bearing Tax Map No: 239.7-1- 11, 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 review by the Adirondack Park Agency during such period. Duly adopted this 7t'day of August, 2023,by the following vote: AYES NOES ABSENT: t a Office Use Only SEPTIC VARIANCE / Permit#: APPLICATION• Permit Fee:$ Town of CZccnibury Invoice#: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.queensbury.net Approvals: Submittal: 1 (one) original & 8 copies of the completed application pac,.-: ► 1 2 a � 4 PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMA 'ti 6, o EC /1/ .0 as Section 1: Contact Information: co Q FENS 2023 C(ER '`�+ EERY Gregg KaweckiEnvironmental Des "art ars' iRFF/CF Property Owner(s): Owner's Agent: Address: 53 Knox Road Address: 900 Route 146 £ Z Queensbury NY 12804 Clifton Park NY 12804 Phone#: 323-270-3169 Phone#: 518-371-7621 x 138 Email: gregg@kawecki.us Email: cdemyer@edpllp.com Section 2: Site Information: Site Address: 53 Knox Road Tax ID#: 239.7-1-11 Directions to Site: From 9L, turn onto Assembly Point, turn left onto Knox Rd Section 3: Distance from well on property to septic system (if applicable) n/a (Lake Water Supply)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? ' ❑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 100 ft.):V-1:EJECTOR PUMP TO LAKE GEORGE-REQUESTING 30'SETBACK IN LIEU OF THE REQUIRED 50' V-2:EJECTOR PUMP TO DWELLING-REQUESTING 2'SETBACK IN LIEU OF THE REQUIRED 10' Septic Variance Application Revised December 2021 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 Roberta Kahan Address 61 Knox Road Tax Map ID 239.7-1-12 South Name 47 Knox LLC Address 47 Knox Rad Tax Map ID 239.7-1-10 East Name Renee West Address 79 Knox Road Tax Map ID 239.7-1-39 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: 53 Knox Road . I/We realize that putting the well, septic tan)or leaching system less than the required 50/10 feet from the shoreline/dwelling may increase the risk of pollution. Owner—Print Name: _____ Owner—Signature: • Date: I Se- Section f Z3 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 December 2021 i. 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: 1 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 and septic systems on neighboring properties g. Adjacent ownerships h. All properties within 500 feet A sample plot plan and location are shown below: 2 f r 'MIl N. {s'ti_ �?' _ �� •..�M1 .. ��"P tk+ �fFA�Sr-trB' t � '-ry ff3r[X4LK �—T I r /�, r. :.," 1 l'.2:.e -,....);\ KA I\ ,...,:::;:, li '.1.' fh ry .. *t 75 \ t.... ', �'f 1 s �.Y NFf ne sh" wili€ .�3 Q .I.• E. r ,* ' I �` a f+ - SIRS i v j, ft,Y F 3 sa c il /(.d G U. [' x r .c 1-4.3.pp ory Wm, Nikita not si4 II 41 ' 1 d *;Z.07 q "- ;1/4fir, ,.. _ .. r. 714240; -- -- idly , _ _� — i -: }� •:Ikla Seth- 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: '`''"`( ( Rockeft-- Designates: Environmental Design Parnership as agent regarding the Septic Variance for DeRocker Residence Site Address: 53 Knox Road Tax Map#: 239.7-1-11 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 NAME: 1-PrGV `(� �'� (-2 ocK4 OWNER—SIGNATURE: DATE: JS 1Z-§ Connor DeMyer AGENT—PRINT NAME: f AGENT—SIGNATURE: ( "r DATE: 6/30/23 Septic Variance Application Revised December 2021 xaea.ewrrx.nvx sx..0 rrnur na ULY PP w x uxr v.urnxn " . wnrry av ac'unnu"s mr.vws v.xox uuu s�✓unnw.vemrrx scone+nxx..a vurzamas.xva r r r. 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