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1.5 r 1.5 SETPH.VAR1Seguljic Ronald-Replacement Absorption Field to Well—In AM—11-15-2021 RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL VARIANCE APPLICATION OF RONALD SEGULJIC 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, Ronald Seguljic has applied to the Local Board of Health for a variance from Chapter 136 to install a replacement absorption field 93' from the proposed onsite well instead of the 100' required setback on property located at 32 Forest Road, 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 Ronald Seguijic's sewage disposal variance application concerning property located at 32 Forest Road, Queensbury (Tax Map No.: 226.19-1-41) 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 w�. f or- 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 15"' day of November, 2021, by the following vote: AYES : NOES : ABSENT: a' SEWER\Segulj is—Replacement Absorption Field to Well—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 RONALD SEGULJIC FOR A SEWAGE DISPOSAL VARIANCE TO INSTALL A REPLACEMENT ABSORPTION FIELD 93' FROM THE PROPOSED ONSITE WELL INSTEAD OF THE REQUIRED 100' SETBACK ON PROPERTY LOCATED AT 32 FOREST ROAD IN THE TOWN OF QUEENSBURY(TAX MAP NO.: 226.19-1-41). 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: WW W.QUEENSBURY.NET AT THIS PUBLIC HEARING ALL INTERESTED PERSONS WILL BE HEARD. PUBLICATION DATE: NOVEMBER_,2021 CAROLINE H. BARBER TOWN CLERK TOWN OF QUEENSBURY ENVIRONMENTAL DESIGN alk �• PARTNERSHIP LLP. 900 Route 146 Clifton Park,NY 12065 7• • (P)518.371.7621 (F)518.371.9540 edpllp.com Shaping the physical environment November 8,2021 Town of Queensbury Board of Health a 5 0 8 9 /0 742 Bay Road g Queensbury, NY 12804 ti RECEIVED Attn: John Strough,Supervisor g NOV 10 2021 Re: Mattson—383 Cleverdale Road • QUEENSBURY Seguljic—26 Forest Road y CLERICS OFFICE ,t, BOH Variance Request tit qw °/ 68 L9- Dear John: Submitted for your distribution and review are nine sets each of two(2) Board of Health wastewater system variance applications. Each property is a single family residence located in the Lake George waterfront zoning district(WR). The following summarizes each of the properties and associated variance requests. Mattson—363 Cleverdale Road This property consists of a main house along with a separate guest house. The Owner is proposing a new replacement system which will accommodate the five total bedrooms. The system will consist of a 1500 gallon septic tank, a 1000 gallon pump tank with a duplex pump assembly and time dose controls and an Eljen GSF trench absorption field. There are no wells (this lot or neighboring lots)within 100' of the proposed absorption field. Two (2)setback variances for the absorption field to the main house foundation and to the southern property line will be required for this proposed wastewater system. Seguljic—26 Forest Road This Owner of this property is anticipating a renovation of the existing residence and thus proposes an upgrade of the absorption field. As the property is served by the 'seasonal'Shore Colony Water District the Owner is planning on having a drilled well constructed onsite. Due to the size of the property and other neighboring wells a new onsite well cannot meet the required 100'setback to a proposed absorption field area. A variance is therefore requested for relief from the 100'setback from the new replacement absorption field to the residence's proposed onsite well. I am available to meet with you and/or other Board members to further discuss these proposals prior to the public hearing. Thank you for your consideration of these requests. Sincerely, Dennis MacElroy Dennis MacElroy, PE Environmental Design Partnership SEPTIC VARIANCE Office Use Only Permit#: APPLICATION Permit Fee:$ Town oICLmnsbuny Invoice 742 Bay Road,Queensbury,NY 12804 P:518-761-8255 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): ICa$kAI_3 `5ESu..LJIC Owners Agent. 1 lt V CS-t- "ROI Address: I?Co E a.1.cw )c2.. Address: 9CX:5 f-;r t,-}(o us ttct- vtt -E l C-i- �685 C�t,..tFt"car1 .ZK I WM' 1ZOCc+ Phone#: $(pp -H Z `-1 - 7617 Phone#: ,I S "57Co—,r-I-aLS'S Email: Re no lL.ttskitc.e� oaVc fcn crtht. Email: eJ-mc.cxa-I troy Q.zapl I F Coin' Colin Site Information: Site Address: 32 Fog ► I�t Tax ID#: 2Z(c 19-1--y Directions to Site: r-s'b'DL.MT,t..`{,Th1 T2s djW.tver is Haplate, ouc L, . --ro 1-4o?Ri LK oW-C- 6T p,• Distance from well on property to septic system (if applicable) Si feet r oPn eJ Is it possible to install a conforming septic system on this property? ❑Yes ®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 ❑ No If NO, please explain: Is the proposed system to be installed under a parking area? ❑Yes ® 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.): Vac-r oN MCo -9 --2j V -l Re-r--t z®rtt-p -�asta,ern a:514 m,-t a u I W Eu a 06"-PDef ?las4. 1-1Et_)i ct3 t gsa p-vm—C% V3. 1CZ+1 ltZt�' 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 W 1LGOX — 2E1->I13/44. Address 2-Ca 'F 1Z VT TaxMaplD — 1 ^ �!Z South Name E.LEA-14OR TY\ArLONEY Address ?jto FWeS? E-0-1— Tax Map ID ZZ-<®- 19 —1 — 1-1-0 East Name tC -tAEC. C4-rRYS Address Fs a ur R • Tax Map ID ZZlo. -• 1—�7 West Name JEFF c, wsi000 ) J otn't Hez;fraKtra* Address Z22.- LAKE 1' �Kc.�'( Z 10 L#.bLE e-34g.K.4?re*Y TaxMaplD ZZto_ 19 - 1 -€air> ) ZZC©_ 19-1 - 'Bak 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 or4aching syste less than the required 100 feet from the artatTt W2t.t. //may increase the risk of pollution. Owner—Print Name: f' 4/ .. Owner—Signature: P 4a`z iX, yili Date: tt-5-z 1 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 September 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: t G Designates .sro.-01 4..EL?bps agent regarding the Septic Variance for C. To L�EL os Site Address: 3'02- FC,W -r C , Tax Map#: ZZlo_ 19 — I .-44t 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: Ii[ OWNER—SIGNATURE: � ea i� ;� DATE: I — -Z. AGENT—PRINT NAME: t4 M I G12CPf >AGENT—SIGNATURE: , Ry*y4-0 C2agerf DATE: I tag-ZI Septic Variance Application Revised September 2021