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WASTEWATER-SEWER\Set PHFFaucher—Replacement with Absorption Field Septic and Pump Tanks to Lake George and Well—In APA-2-12-2024
RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL
VARIANCE APPLICATION OF DENISE AND RONALD FAUCHER
RESOLUTION NO.: 92024
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, Denise and Ronald Faucher (Applicants) have applied to the Local Board of
Health for variances from Chapter 136 to install a replacement onsite wastewater treatment system
with certain of its components to be located:
1. septic tank 27' from Lake George in lieu of the required 50' setback;
2. effluent pump tank 28' from Lake George in lieu of the required 50' setback; and
3. absorption field 85' from the drilled well in lieu of the required 100' setback;
on property located at 7 Sign Post 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, March 4th, 2024 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay Road,
Queensbury,to consider Denise and Ronald Faucher's sewage disposal variance application concerning
property located at 7 Sign Post Road in the Town of Queensbury (Tax Map No.: 239.16-1-6) 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 12t'day of February, 2024,by the following vote:
AYES
NOES
ABSENT:
SEPTIC VARIANCE Office Use Only
Permit U:
APPLICATION Permit Fee: $
14 Invoice #:
742 Bay Road, Queensbury, NY 12804
P: 518-761-8256 www.gueensbury.net Approvals:
Submittal: Z (one) original & 8 copies-ofthe completed applicatiofr�a c" ge
PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN It:MA14r'. .
Section 1:
�C6 _ 62a24
Contact Information
Property Owner(s): Denise & Ronald Faucher Owner's Agent: Environmental Design
:.
Address: 1 Pond Street Paxton MA 01612 Address: 900 Route 146 Clifton Park NY 12065
Phone #: 508-735-6201 Phone #: 518-371 -7621 x 138
Email: don ise.faucher3 c�7r outlook.com Email: cdemyer@edpllp.com
Section 2:
Site Information:
Site Address: 7 Sign Post Road Tax ID#. 239. 16-1 -6
Directions to Site: From Route 9L, northbound from Bay Road intersection +I-0.7 miles Sign Post Rd on East
Section 3•
Distance from well on property to septic system (if applicable) '4'/- 85 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 neighborinp,
properties? []Yes ■❑ No If NO, please explain There are very limited locatlons on the steep property with soils and an area where
a field could be bunt_ The most feasible location for the field is shown for
construction and overall design.
Section 6:
Is the proposed system to be installed under a parking area? ❑ Yes No
Section 7:
V-1 : SEPTIC TANK TO LAKE GEORGE - REQUESTING 27' SETBACK IN LIEU OF THE REQUIRED ST
V-2: EFFLUENT PUMP TANK TO LAKE GEORGE - REQUESTING 28' IN LIEU OF THE REQUIRED 50'
V-3: ABSORPTION FIELD TO DRILLED WELL - REQUESTING 85' SETBACK IN LIEU OF THE REQUIRED 100'
Septic variance Application Revised Decernber 2021
w
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 Q.ueensbury's Assessor's Office:
North Name Michael Loughrey
Address 82-34 212th Street Hollis Hills IVY 11427
Tax Map ID 239A 6- 1 -7
South Name Ervolina Revocable Trust
Address 7 Overlook Dr Queensbury NY 12804
Tax Map ID 239, 16- 1 -3
East Name Ervolina Revocable Trust
Address 7 Overlook Dr Queensbury NY 12804
Tax Map ID 239. 16- 1 -4
West Name
Add ress
Tax Map ID
Section 9:
OWN EEL STAITI ENT
I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at:
7 Sign Post Rd . I/We realize that putting the well, septic tank or leaching system less than the required 100150 feet
from the well/lake may increase the risk of pollution_
Owner- Print Name:
Owner---Signature: Date:
Section 10:
NELGtiBOR OR.TENAN-FRE EASESMTEME T (tfoppiica6fe)
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 bor/Tenant-Signature: Date:
Septic Variance Application Revised December 2021
Section S-
List the names, parcel addresses, and tax map numbers of all adjoining property owners. You may obtain this
information from the Town of Queensburyrs Assessor's office:
North Name Michael Loughrey
Address 82-34 212th Street Hollis Hills NY 11427
Tax Map 10 239.E 6-1 -7
South Name Eirvolina Revocable Trust
Address 7 Overlook Dr Queensbury NY 12804
Tax Map la
East Name Ervolina Revocable Trust
Address 7 Overlook Dr Queensbury NY 12804
Tax Map ID
West Name
Address
Tarn Map 11)
Section 9:
O�iEFt c-rarcr.�r�,rr
;I'We do frert?by relieve the Town of Queensbury fresm::any 1#abiiitres orr tihe plumbing anc#sep rr
tres at.
1/We realize that putting i#te well ' se 1. pTfc tank or% learl�rng systrem less than
f orn the Wet# akle
may Increase the risk of poilutron.. -
Ovmer—Print Names
Owner-Signature:
5ec#lon I
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Section 12:
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: Denise & Ronald Faucher
Designates: EDP as agent regarding the Septic Variance forWastawaler Replacemeni Plan Faucher
Site Address: 7 Sign Post Rd
Tax Map M. 239. 1 B- 1 -F
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 these tapes constitute the officlaI 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: 44�Vl7J 10g4o
OWNER—SIGNATU • x DATE: I ILI +
AGENT—PRINT NAME: Connor DeMyer
-- 1 /2/24
AGENT—SIGNATURE: " " " ' r� DATE:
2
septic Variance Application Revised December 2021
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