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WASTEWATER-SEWER\\Set PH\\Sinatra-Replacement-Absorption Bed Force Main and Septic Tank to Lines and Foundation-IN APA-9-13-2021
RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL
VARIANCE APPLICATION OF FRANK SINATRA
RESOLUTION NO.: ______________________________________________________, 2021
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, Frank Sinatra has applied to the Local Board of Health for variances from
Chapter 136 to install a replacement wastewater treatment system with its components proposed to be
located as follows:
1. absorption bed to be 1’ from the property line in lieu of the required 10’ setback;
2. absorption bed to be 3’ from the property line in lieu of the required 10’ setback;
3. force main to be 3’ from the property line in lieu of the required 10’ setback;
4. absorption bed to be 12’ from the building foundation in lieu of the required 20’
setback; and
5. septic tank to be 6’ from the building foundation in lieu of the required 10’ setback;
on property located at 105 Rockhurst 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
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on Monday, September 27, 2021 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay Road,
Queensbury, to consider Frank Sinatra’s sewage disposal variance application concerning property
located at 105 Rockhurst Road in the Town of Queensbury (Tax Map No.: 227.9-1-4) 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.
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Duly adopted this 13 day of September, 2021, by the following vote:
AYES :
NOES :
ABSENT:
SEPTIC VARIANCE Office Use Only
Permit#:
APPLICATION Permit Fee: $
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Invoice#:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensburV.net Approvals:
Submittal: 1 (one) original & 8 copies of the completed application package
Contact Information: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
Property Owner(s): Frank Sinatra Owner's Agent: Environmental Design Partnership
Address: 33 Sulgrave Road Scarsdale,NY 10583 Address: 900 Route 146 Clifton Park,NY 12065
Phone#: 914-963-5263 Phone#: 518-371-7621
Email: flsinatra@aol.com Email: nzeglen@edpllp.com
cdemyer@edpllp.com
dmacelroy@edpllp.com
Site Information:
105 Rockhurst Rd
Site Address: Tax ID#: 227.9-1-4
Directions to Site: From 9L turn onto Cleverdale Rd,stay right onto Rockhurst,turn left onto Rockhurst.105 on
your left
Distance from well on property to septic system (if applicable) N/A feet
Is it possible to install a conforming septic system on this property? ❑Yes Q No
If YES, please explain and attach a diagram:
Does the proposed system meet setback requirements for distance from wells &septic systems on neighboring
properties? QYes ❑ No If NO, please explain:
Is the proposed system to be installed under a parking area? ❑Yes ❑X No
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:ABSORPTION BED TO PROPERTY LINE-1'REQUESTED VS.THE IU REQUIRED
V-2:ABSORPTION BED TO PROPERTY LINE-Y REQUESTED VS.THE 10' REQUIRED
V-3:FORCE MAIN TO PROPERTY LINE-Y REQUESTED VS.THE 10' REQUIRED
V-4:ABSORPTION BED TO BUILDING FOUNDATION-IT REQUESTED VS.THE 20' REQUIRED
V-5:SEPTIC TANK TO BUILDING FOUNDATION-6 REQUESTED VS.THE 10'REQUIRED
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Septic Variance Application �i2"ri' Revised January 2021
List the names,parcel addresses, and tax map numbers of all adjoining propel ty owners. You rnay obtain this
information from the Totvn of Queens bury's Assessor's Office:
North Name RonuidMilkr
Address db7 Rnckhuro Road
Tax Map ID 227•9-1-5
South Name r•,rr..k•milwk
Address Ulf Ruckhursr Ruud
Tax Map ID 227.1.1-1-3
East Name KevinTheimudt
Address 1M Rockhursr Road
Tax Map ID 227.9.1-11
Name Corey).Uwarxdowski
Address 1021tockhu►siltoad
Tax Map ID 227.961-12
OWNER STATEMENT
l/W'e 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.
Owner—Print Name: fp ANX ) NibI (.A IF-
Owner—Signature: , Date:
NEIGHBOR OR TENANT RELEASE STATEMENT if opplicoble)
I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic systern locateti 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 [bzvi;tti lanu:iry'?U?t
https://mail.google.com/maiVu/0/#inbox/FMfcgzGkZssgQZmdWckpfCZvkvrQJGKr?projector=l&messageParttd=0.2 1/1
PLEASE ATTACH THE FOLLOWING TO YOUR APPLICATION:
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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:
j Sempk LatBtion 1.1�1�=1— .
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Septic Variance Application Revised January 2021
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:
Designates: as agent regarding the Septic Variance for
Site Address:
Tax Map tl:
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: R w S j iN r v A -'T J-
OWNER—SIGNATURE:/ iyv�_6& Z-��� DATE: ( .),
AGENT--PRINT NAME: Aj1(J6k&
AGENT—SIGNATURE: J..... ------ ._. ------- DATE,
Septic Va•tarce App:,cat;on Revised iamjary 2021