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1.1 1.1 WASTEWATER-SEWERIAPPROVE\Black William Trust—Replacement With Absorption Field Septic Tank To Dwellings and Lanes—ETU—In APA-3-4-2024 RESOLUTION APPROVING BLACK FAMILY NOMINEE TRUST'S APPLICATION FOR SANITARY SEWAGE DISPOSAL VARIANCES RESOLUTION NO.: 12024 INTRODUCED BY: WHO MOVED ITS ADOPTION SECONDED BY: WHEREAS William Black, on behalf of the Black Family Nominee Trust, (Applicant) filed an application for variances from provisions of the Town of Queensbury On-Site Sewage Disposal Ordinance, Chapter 136 to install a replacement onsite wastewater treatment system with certain of its components to be located: 1. absorption field 1' from the property line(E) in lieu of the required 10' setback; 2. absorption field 3' from the dwelling(guest house) in lieu of the required 20' setback; 3. septic tank 1' from the dwelling in lieu of the required 10' setback; 4. septic tank 1' from the property line(W) in lieu of the required 10' setback; 5. absorption field 8' from the property line(W) in lieu of the required 10' setback; 6. absorption field 4' from the dwelling (main house) in lieu of the required 20' setback; and 7. absorption field 8' from the neighboring dwelling in lieu of the required 20' setback; on property located at 13 Fielding Lane 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 Monday, March 4t', 2024, 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 William Black, on behalf of the Black Family Nominee Trust, for variances from the Sewage Disposal Ordinance to install a replacement onsite wastewater treatment system with certain of its components to be located: 1. absorption field 1' from the property line(E) in lieu of the required 10' setback; 2. absorption field 3' from the dwelling(guest house) in lieu of the required 20' setback; 3. septic tank 1' from the dwelling in lieu of the required 10' setback; 4. septic tank 1' from the property line(W) in lieu of the required 10' setback; 5. absorption field 8' from the property line(W) in lieu of the required 10' setback; 6. absorption field 4' from the dwelling (main house) in lieu of the required 20' setback; and 7. absorption field 8' from the neighboring dwelling in lieu of the required 20' setback; on property located at 13 Fielding Lane in the Town of Queensbury and bearing Tax Map No: 227.13-2-16, and BE IT FURTHER, RESOLVED, that the ETU shall be maintained by the property owner(s) in accordance with the manufacturer's recommendations for the life of the system, 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 4t'day of March, 2024,by the following vote: AYES NOES ABSENT: SEPTIC VARIANCE Office Use On1y Permit #: APPLICATION Permit Fee: $ 'Town 0eawen ury Invoice #: 742 Bay Road, Queensbury, NY 1ZSO4 P: SIS-761-8256 www,clueensbury.net Approvals: p,� rey Submittal: 1 (one) original & S copies of the completed application kage 4 �. RECEIVEDPLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EM st FES _ 6 2024 QUEE11 SBi1RY Section 1: C ER itS ©FFICE Contact Information: O 9 Property Owner(s): William Black Owner's Agent: Environmental Design Partn Address: 28 Birch Hill Rd. PO Box 17 Address- 900 Route 146 New Lebanon NY 12125 Clifton Park NY 12804 Phone #: 518-376-6462 Phone #: 518-371 -7621 x 138 Email: bblack@sfii.net Email: cdemyer@u edpllp.com Section 2: Site Information: Site Address: 13 Fielding Lane Tax ID#: 227.13-2-16 Directions to Site: From 9L, turn onto Cleverdaie Rd, continue to Cleve rdale, turn right onto Fielding Lane Section 3• Distance from well on property to septic system (if applicable) nla (Lake Water Supply) feet Section 4: Is it possible to install a conforming septic system on this property? ❑ Yes ❑� 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? ©Yes Q No If NO, please explain: Section 6• Is the proposed system to be installed under a parking area? Q Yes 0 No Section 7: V-1 :ABSORPTION FIELD TO PROPERTY LINE (E) - REQUESTING 1' IN LIEU OF THE 1 V REQUIRED V-2:ABSORPTION FIELD TO DWELLING (GUEST HOUSE) - REQUESTING 3' IN LIEU OF THE 20' REQUIRED V-3:SEPTIC TANK TO DWELLING - REQUESTING 1' IN LIEU OF THE 10' REQUIRED V-4:SEPTIC TANK TO PROPERTY LINE (W) - REQUESTING 1' IN LIEU OF THE 1V REQUIRED V-S:ABSORPTION FIELD TO PROPERTY LINE (W) - REQUESTING 8' IN LIEU OF THE 10' REQUIRED V-6:ABSORPTION FIELD TO DWELLING (MAIN HOUSE) - REQUESTING 4' IN LIEU OF THE 20' REQUIRED V-7.ABSORPTIQN FIELD TO NEIGHBORING DWELLING - REQUESTING 8' IN LIEU OF THE 20' REQUIRED S lon 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.ueensburyrs Assessor's Office: North Name Address Tax Map ID South Name STATE OF NEW YORK Address Oleverdale Rd Tax Map ID 227.13-2-20 East Name Sherry M. yearns Address 15 Fielding Lane Tax Map ID 2217.13-2-17 West Name The Van Schalck Lake House LLC Address 11 Fielding Lane Tax Map ID 117.13-2-15 Section 9: OWNER STATEMENT I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at: 13 F7a C&y Lary . I/We realize that putting; the well, septic tank or leaching system less than the required 1000 feet from the dwelling/property line may increase the risk of pollution. Owner—Print Name: William Black owner—Signature; i bL`J tAA- L -koipy . Date: Section Zed• NEiGHEM OR TENANT uF+ L&1 5'rq'iEiNENT ( ram) I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at. 15 Fie"nQ Lane . I/We realize that putting the well, septic tank or leaching system less than the required $' feet from the dwelling ay increase the risk of pollution, Neighbor/Tenant—Print Narvr : Neighbor/Tenant-Signature: �! c '" Date. 7 Septic Varlarom AppM=tFan Revised Decen*er2021 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: William Black age ent reg Environmental Design Partnership LLP as a ardlng the Se p tic Variance for The Black Residence Site Address: 13 Fielding Lane Tax Map #: 227. 13-2- 1 B 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: William Black OWNER—SIGNATURE: /.s/ v%CUaK4., Ir.lacsle. DATE: AGENT—PRINT NAME: Connor DeMyer (EDP) --- 1 /15123 AGENT—SIGNATURE: ,suet "r'� r DATE. Revised December 2021 Septic Variance Application