1.4 1.4
SETPH.VAR\Shearer Linda—New Well Setbacks—10-17-2022
RESOLUTION SETTING PUBLIC HEARING ON SEWAGE DISPOSAL
VARIANCE APPLICATION OF LINDA SHEARER
RESOLUTION NO.: ,2022
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, Linda Shearer has applied to the Local Board of Health for variances from
Chapter 136 to install a new well on property located at 3 Sullivan Place in the Town of Queensbury
with the proposed well to be located:
1. 46' from the existing septic tank instead of the required 50' setback;
2. 70' from the absorption field instead of the required 100' setback; and
3. 72'from the absorption field instead of the required 100' setback;
NOW, THEREFORE, BE IT
RESOLVED, that the Town of Queensbury's Local Board of Health will hold a public hearing
on Monday, November 7t", 2022 at 7:00 p.m. at the Queensbury Activities Center, 742 Bay Road,
Queensbury, to consider Linda Shearer's sewage disposal variance application concerning property
located at 3 Sullivan Place, Queensbury (Tax Map No.: 289.9-1-32) 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 17t'day of October, 2022,by the following vote:
AYES
NOES
ABSENT:
SEPTIC VARIANCE
Office Use OnI
Permit#:
APPLICATION Permit Fee:.$
1ex:�r zsi t�_srsr!,�?tsq '
Invoice#:
742 Bay Road,Q,ueensbury,NY 12804
P; 518-761-8256 arrwvv.gg_-ensbury.net Approvals:
12P
Submittal: 1 (one) original,& 8 copies of the completed appiicatio package,
PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL RECEWED
Section 1: MCI 1':12 22 .
c ; QUEENSBURY o
CLFW8 OFFICE
Contact Information: Pr)
Property Owner's): knm6A)KA\ SRC Owner's Agent: men cad D iP
Address: � tZ "v ri l(� Address: qQQ NY CUTn Park
New Yock,
Phone#: w ' i - <x �I' Phone#: (515 371-76al
Email:_ k`- •- --i',I I^ ' t' ' �; Email:c�2mVe,rd e tt cool
Section 2:
Site Information:
Site Address: �a '� Tax ID#:2.!EB A--
Directions to Site:
Section 3:
Distance from well on property to septic system (if applicable) 70 feet
Section 4•
Is it possible to-install a conforming septic system on this property? F-1 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 X No If NO, please explaim ORZI)6 `-gam 1 ��
Secttiion%tTVA
6 ~IJ k,,, _ ,_...- 1 % OtA�� O(Zl\ED
Is the proposed system to be installed under a parking area? Yes 9No
Section 7:
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.): -- a S tic' AI W �rom well. in Ir o gIrr irec� �® F4,
Septic Variance Application V-4 a A5y cp�'o�A wi 1I /jU {Ft 4f-o Y! we.11 111 I-ea 9� re �r'�d� b ��
3a A&C �10�i IL' 1R11�1 1 Tl e� iVol I � wlerl � � '_p4dDecember2021
Section S:
List the names, parcel addresses, and tax map numbers of all adjoining-property owners. You may obtain this
information from the Town of Quee-nns„bury's Assessor's Office:
North Name l o l l -5, t G'(, of-s oi°I
Address B01 Glen �gk P& Lake GeD Alr ims
Tax Map ID _ o-(s -1 � '33
South Name
Ad d ress
Tax Map ID
East Name 1 l`�{'i'�esa Chrl^sfi' e
Address �Wullivaola' r 'NY' laws
Tax Map ID
oZgq.,q' 1`,55
West Name �.L.L_��� a
Address 301 Glen Lakc Rd, Wee aeom.e- AIK lant15
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:
3SUII'i c'Van place . I/We realize that putting the well,septic tank or leaching system less than the required feet
from the 1`c- ut>IS�(t van TfAmay increase the risk of pollution.
Owner—Print Name: ,€; .G f1 -
Owner—Signature: - -err �� " '' "'. Date: 10106c
Section 10:
NEIGHBOR OR TENANT RELEASE STATEMENT(if applicable)
/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 December 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: I 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 well's and septic systems on neighboring properties
g. Adjacent ownerships
h. All properties within 500 feet
A sample plot plan and location are shown below:
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Septic Variance.Application Revised December 2021
2
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:
'Owners Name: �, i {J IIff
Designates: .Enuff,0111rnentaI B�IIA �ac rsl���as agent regarding the Septic Variance for_ 3 5411i'Vaii Place
Site Address: 3 Sullivan Place-, LAe Crt4r,,-e NVNJ
18�i 5
Tax Map#: ggsq _3a
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.
1, the undersigned, have thoroughly read and understand the instructions for submission; agree to the
submission requirements and completed checklist:
OWNER—PRINT NAME:
, F �
OWNER—SIGNATURE: DATE: 10 D6boaa
AGENT—PRINT NAME: f_
AGENT—SIGNATURE: ,.-� tom- �y� -- DATE: (0 + �-'
Septic Variance Application Revised December 2021
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SITE GARAGE _`�- � Q
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SITE LOCATION MAP SITE VICINITY MAP Q co w
SCALE: I" = 2,000' SCALE: 1" = 200' LL 0 Om
VARIANCE REOUES T.• z F'
SURVEY NOTE: 0 a
U THE PROPOSED PROJECT INVOLVES THE DRILLING OF A NEW WELL FOR THE F-
BOUNBABY OBTAINED FROM MAP TIRED "MAP ALO EXISTING SEPTIC TANK RESIDENCE AT 3 SULLIVAN PLACE. THE EXISTING WELL POINT IN HOME HAS
OF PART OF THE LANDS OF JOHN H. V-1 DRIED OUT SO A NEW WELL WILL NEED TO BE INSTALLED.DUE TO TNF"LIMITED
SULLIVAN AND OTHERS"DATED MAY 28M LOT SIZING AND EXISTING CONDITIONS.A WELL 15 NOT FEASIBLE BEING � E
1947 BY SURVEY&MAP BY LESLIE W. GREATER THAN 50'FROM THE EXISTING TANK AND 100'FROM THE LOCA PON
COULTER.EXISTING SITE CONDITIONS OBTAINED OF 7HE EXISTING ABSORPTION AREA. THEREFORE THE SHEARER RESIDENCE WILLui
NA NYS ORTHOMAPPING AND NOT DEEMED REQUIRE VARIANCES FROM THE STATED SETBACK STANDARDS.BASED ON THE Il'1
SURVEY ACCURATE. V-3 PROPOSED WELL LOCATION THE FOLLOWING VARIANCES ARE REQUESTED. uIi
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EXISTING 72- V-1: WELL TO EXISTING SEPTIC TANK- 46'REQUESTED VS. THE 50'REQUIRED
DWELLING 70 V-2 V-2: WELT. TO ABSORPTION FIELD- 70'REQUESTED VS. THE 100'REQUIRED N
EXl TING �.l V-3: WELL TO ABSORPTION FIELD- 72'REQUESTED VS/ME 700'REQUIRED O Iw N
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REVISION DATE BY a
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ALO EXISTING ABSORPTION FIELDS
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GLEN LAKE ROAD SCALE: _
1" =20'
SHEET TITLE:
SITE PLAN WITH
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VARIANCES
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20 o zo co SHEET NO.
GRAPHIC SCALE (IN FEET) 1 of 1
1 INCH = 20 FT.
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