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1.3 fr 1.3 SETPH.VAR\Stritsman-Replacement System With Components to Well,Foundation,Line—APA- I I-15-2021 RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL VARIANCE APPLICATION OF MORGAN STRITSMAN 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, Morgan Stritsman (Applicant) has applied to the Local Board of Health for variances from Chapter 136 to install a replacement wastewater system with certain of its components to be located as follows: 1. Wastewater Absorption Field to be 71' from the well instead of the required 100' setback; 2. Enhanced Treatment Unit to be 4' from the foundation instead of the required 10' setback; 3. Pump Tank to be 3' from the foundation instead of the required 10' setback; 4. Wastewater Absorption Field to be 11' from the foundation instead of the required 20' setback; and 5. Wastewater Absorption Field to be 7' from the property line instead of the required 10' setback; l ? 9 2, ark on property located at 19 Private Road#1 off of Cleverdale Road in the Town of Queensbury, NOW, THEREFORE, BE IT RESOLVED, that the Town of Queensbury's Local Board of Health will hold a public hearing on Monday, December 6th, 2021 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay Road, Queensbury, to consider Morgan Stristman's sewage disposal variance application concerning property located at 19 Private Road #1, Queensbury (Tax Map No.: 240.9-1-6) 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' of the applicant's property as required by law. Duly adopted this 15th day of November, 2021,by the following vote: AYES : NOES : ABSENT: i SEWER\Stritsman—Replacement-Absorption Pump Tank and ETU to Well Foundation Line—In APA—12-6-2021 NOTICE OF PUBLIC HEARING IN ACCORDANCE WITH TOWN OF QUEENSBURY ON-SITE SEWAGE DISPOSAL ORDINANCE CHAPTER 136, NOTICE IS HEREBY GIVEN THAT THE TOWN OF QUEENSBURY LOCAL BOARD OF HEALTH WILL CONDUCT A PUBLIC HEARING ON MONDAY, DECEMBER 6TH, 2021 AT 7:00 P.M. AT THE QUEENSBURY ACTIVITIES CENTER, 742 BAY ROAD, QUEENSBURY TO CONSIDER AN APPLICATION BY MORGAN STRITSMAN FOR SEWAGE DISPOSAL VARIANCES TO INSTALL A REPLACEMENT WASTEWATER TREATMENT SYSTEM WITH COMPONENTS OF IT TO BE LOCATED AS FOLLOWS: 1. WASTEWATER ABSORPTION FIELD TO BE 71' FROM THE WELL INSTEAD OF THE REQUIRED 100' SETBACK; 2. ENHANCED TREATMENT UNIT TO BE 4' FROM THE FOUNDATION INSTEAD OF THE REQUIRED 10' SETBACK; 3. PUMP TANK TO BE 3' FROM THE FOUNDATION INSTEAD OF THE REQUIRED 10' SETBACK; 4. WASTEWATER ABSORPTION FIELD TO BE 11' FROM THE FOUNDATION INSTEAD OF THE REQUIRED 20' SETBACK; AND 5. WASTEWATER ABSORPTION FIELD TO BE 7' FROM THE PROPERTY LINE INSTEAD OF THE REQUIRED 10' SETBACK; ON PROPERTY LOCATED AT 19 PRIVATE ROAD #1 OFF OF CLEVERDALE ROAD IN THE TOWN OF QUEENSBURY(TAX MAP NO.: 240.9-1-6). TO OBTAIN FURTHER INFORMATION, ALL INTERESTED PERSONS MAY CONTACT THE QUEENSBURY TOWN CLERK'S OFFICE, 742 BAY ROAD,QUEENSBURY(518) 761-8234 OR ON LINE AT: 11'11 W.Q1 ILFNSBURY.N1.1 . AT THIS PUBLIC HEARING ALL INTERESTED PERSONS WILL BE HEARD. PUBLICATION DATE: NOVEMBER_,2021 CAROLINE H.BARBER TOWN CLERK TOWN OF QUEENSBURY Office Use Only SEPTIC VARIANCE Permit#: APPLICATION Permit Fee: $ Town o (Zy enshu,T Invoice#: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.queensburv.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): Morgan Stritsman Owner's Agent: Environmental Design Partnership Address: 240 Town Office Road Address: 900 Route 146 Clifton Troy NY, 12180 Park NY, 12065 12 3 4 6 Phone#: 518-859-0467 Phone#: 518-371-7621 g Email: mostrits@gmail.com Email: nzeglen@edpllp.com, Q. ittC .1 cdemyer@edpllp.com R'l Q��E� t Site Information: � , 5 ya 19 Private Road#1 off of Cleverdale :e Address: Road Tax ID#: 240.9-1-6 9 S b E Directions to Site:From 9L turn onto Cleverdale Road, First Left onto Private Road#1, Stay Right and last property on the left. Distance from well on property to septic system (if applicable) 71 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? ['Yes x❑ 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: WASTEWATER ABSORPTION FIELD TO WELL 71'REQUESTED VS THE 100'REQUIRED V-2: ENHANCED TREATMENT UNIT TO FOUNDATION 4'REQUESTED VS.THE 10'REQUIRED V-3: PUMP TANK TO FOUNDATION 3'REQUESTED VS.THE 10'REQUIRED V-4: WASTEWATER ABSORPTION FIELD TO FOUNDATION 11' REQUESTED VS.THE 20' REQUIRED V-5:WASTEWATER ABSORPTION FIELD TO PROPERTY LINE 7'REQUESTED VS THE 10' REQUIRED Septic Variance Application Revised January 2021 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: orth Name Katherine M. Corney Address 49 Cleverdale Road Tax Map ID 240.5-1-1 South Name Peter Iwanyckyj Address 17 Cleverdale Road Tax Map ID 240.9-1-5 East Name Raymond H. Kraft Address Cleverdale Off Rd Tax Map ID 240.9-1-16.12 West Name Address Tax Map ID OWNER STATEMENT 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. Owner—Print Name: Evan Stritsman Owner—Signature: Date: 10/26/2021 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. ?ighbor/Tenant—Print Name: Neighbor/Tenant-Signature: Date: Septic Variance Application Revised January 2021 , 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: '— I r r l Semple Locefar►Aep •e WO IMrWfllf I J 4 PI fik \.7 r l ii ku,* ttI I. 6_,,, (I_ e.v aA aiYo•f S. i/ ,../ x4 j WI 1 116 n_+oc � t P -Pi':"__."' ,J7 S' oi kw at . i i J SNr l�1/f,11611 / P4�4�IP II + S ill r�11hM Fes{ "9aNOo�O Septic Variance Application Revised January 2021 AUTHORIZATION AND SIGNATURE PAGE lis 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: Evan & Morgan Stritsman Environmental Design Partnership Designates: as agent regarding the Septic Variance for Site Address: 19 Private Road #1 Queensbury NY Tax Map#: 240.9-1-6 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 e 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: Evan Stritsman OWNER—SIGNATURE: DATE: 10/2A/2021 AGENT—PRINT NAME: Nick Zeglen 2 AGENT—SIGNATURE: DATE: 10/26/2021 Septic Variance Application Revised January 2021