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WASTEWATER-SEWEMSet PH\Gottlieb Replacement Components—Absorption Field Sewer Line Tank with ETU to Lines Lake George House—In APA-3-21-2022
RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL
VARIANCE APPLICATION OF JASON A. GOTTLIEB
RESOLUTION NO.: 92022
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, Jason Gottlieb 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 82' from Lake George in lieu of the required 100' setback;
2. Absorption bed to be 1' from the southerly property line in lieu of the required 10'
setback;
3. Absorption bed to be 1' from the easterly property line in lieu of the required 10'
setback;
4. Absorption bed to be 3' from the foundation in lieu of the required 20' setback;
5. Sewer line to be 7' from the easterly property line in lieu of the required 10' setback;
6. Tank to be 1' from the easterly property line in lieu of the required 10' setback;
7. Tank to be 2' from the foundation in lieu of the required 10' setback; and
8. Tank to be 4' from the northerly property line in lieu of the required 10' setback;
and
9. Sewer line to be 2' from the foundation in lieu of the required 10' setback;
on property located at 389 Cleverdale 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, April 41h, 2022 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay
Road, Queensbury, to consider Jason A. Gottlieb's sewage disposal variance application concerning
property located at 389 Cleverdale Road in the Town of Queensbury (Tax Map No.: 226.8-1-2)
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 2 1"day of March, 2022, by the following vote:
AYES
NOES
ABSENT:
ENVIRONMENTAL DESIGN
PARTNERSHIP, LLP. 900 Route 146 Clifton Park,NY 12065
(P)518.371.7621 (F)518.371.9540 edpllp.com
Shaping the physical environment
March 14,2022
Town of Queensbury Board of Health �d� ��6
742 Bay Road
Queensbury, NY 12804 RECEIVED �,..
M
N MAR 15 2022
Attn: John.Strough,Supervisor T- QUEENSBURYG'
CLERK'S OFFICE
Re: Gottlieb Residence—389 Cleverdale Road
BOH Variance Request ''
Dear John:
Submitted for your distribution and review are nine sets of a Board of Health wastewater system
variance application for the Gottlieb residence located at 389 Cleverdale Road. This small lot out
near the north end of Cleverdale cannot meet shoreline setback requirements.(100' min.)to the
absorption field area at any location on the parcel so an enhanced treatment unit(ETU)and
disinfection is part of the design approach. In addition, due to the limited area available,we are
proposing the use of heavy duty,traffic bearing chamber units (infiltrator H-20)for the absorption
trench system In consideration of other approvals granted to properties with somewhat similar
conditions,the Owner has requested that we pursue this modified design that would request
variances required for an in-ground wastewater system. The shoreline setback variance is the most
significant but is mitigated through the use of an ETU system along with the Infiltrator chamber
absorption field.,
The application documents include the following:
• Proposed Wastewater Improvements For Gottlieb Residence
389 Cleverdale Road
Sheet 1 Cover Sheet
Sheet.2 Existing Conditions
Sheet 3 Wastewater Plan
Sheet 4 Wastewater Variance Plan
Sheet 5 Wastewater Details
Sheet 6 Enhanced Treatment Details
• Queensbury Board of Health Application for Septic Variance
• Application Fee-$165 check
I.am available to meet with you and/or other Board members.to further discuss this proposal prior to
the public hearing. Thank you for your consideration of this request.
Sincerely,
-Devlvlis MacElro4
Dennis MacElroy, PE
Environmental Design Partnership
� SEPTIC VARIANCE Office Use Only
Permit#:
APPLICATION Permit Fee:$
Invoice#:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.aueensbury.net Approvals:
Submittal: S (one) original'&8 copiesofthe completed application package
PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
Section 1:
Contact Informfioru
Property Owner(s): Jason A.Gottlieb Owner's Agent: Environmental Design Partnership LLP
Address: 107 Highland Ave Chatham NJ 07928 Address: 900 Route 146 Clifton Park NY 12026
Phone#: 973-865-2270 Phone#: 518-371-7621
Email: jgottliebhome@gmail.com Email: dmacelroy@edpllp.com,cdemyer@edpllp.com
Section 2:
Site Information:
Site Address: 389 Cleverdale Road Tax ID#: 226.8-1-2
Directions to Site: Rt.9L to Cleverdale Road to very north end of Cleverdale point...#389 on left.
Section 3:
Distance from well on property to septic system (if applicable) N/A feet
Section 4:
Is it possible to install a conforming septic system on this property? ❑Yes X❑ 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? ❑X Yes ❑ No If NO, please explain:
Section 6•
Is the proposed system to be installed under a parking area? n Yes n No
SECTION:7
Section of the Sanitary Sewage Ordinance from which you are seeking the variance
V-1:ABSORPTION BED TO LAKE GEORGE-82'REQUESTED VS THE 100'REQUIRED
V-2:ABSORPTION BED TO PROPERTY LINE(S)-1'REQUESTED VS.THE 10'REQUIRED
V-3:ABSORPTION BED TO PROPERTY LINE(E)-I'REQUESTED VS.THE 10'REQUIRED
V-4:ABSORPTION BED TO FOUNDATION-Y REQUESTED VS.THE 20'REQUIRED
V-5:SEWER LINE TO PROPERTY LINE(E)-T REQUESTED VS.THE 10'REQUIRED
V-6:TANK TO PROPERTY LINE(E)-I'REQUESTED VS.THE 10'REQUIRED
V-7:TANK TO FOUNDATION-T REQUESTED VS.THE HY REQUIRED
V-8:TANK TO PROPERTY LINE(N)-4'REQUESTED VS.THE 10'REQUIRED
V-9:SEWER LINE TO FOUNDATION-T REQUESTED VS.THE 10'REQUIRED
� l
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 Queensbury's Assessor's Office:
North Name Paul VercesL Jr.
Address 391 Cleverdale Road
Tax Map ID 226.8-1-3
South Name VlHam Davidson
Address 387 Cleverdale Road
Tax Map ID 226.8-1-1
East Name Jeff Hole
Address 390 QeverdaleRoad
Tax Map ID 226.8-1,7
West Name Lake George
Address
Tax Map ID
Section 9•
OWNER STATEMENT
I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at:
389 Cleverdale Road .I/We realize that putting the well,septic tank or leaching system less than the required 100 feet
from the shoreline may increase the risk of pollution.
Owner—Print Name: JOCS Oil GID41�C'i0
Owner—Signature: DatcZia L.L
Section 10•
NEIGHBOR OR TENANT RELEASE STATEMENT(lf applicable)
I/We do hereby relieve the Town of Queensburyfrom 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/renant—Print Name:.
Neighbor/Tenant-Signature: Date:
ROViSed December 2021
5epvc variance Application
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Section
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: Jason A.Gottlieb
Designates:Environmental Design Partnership as agent regarding the Septic Variance for The Gottlieb Residence
Site Address: 389 Cleverdale Road
Tax Map#: 226.8-1-2
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: QAson /1�5
OWNER—SIGNATURE: DATE:
AGENT—PRINT NAME:
AGENT—SIGNATURE: DATE: 3-1 5-Z2-
Septic Variance Application Revised December 2021
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