SEP-0343-2021 C--55 - zo 22—
Office Use Only
SEPTIC VARIANCE
Received: -
' APPLICATION Permit#:
Town alcLerrrn5Gury.
Permit Fee:
742 Bay Road,Queensbury,NY 12804 3�2Z
P:518-761-8256 www.queensbury.net Invoice#:
Approvals: .
Submittal: I (one)'original & 8 copies of the completed application package
Property Owner(s): Brett and Pamela West Owner's Agent: Environmental Design Partnership
Address: 4651 Gulf Shore Blvd. N, Unit 104 Address: 900 NY-146 Clifton Park NY 12065
Naples, FL 34103
Phone#: 203=948-5847 Phone t 518-368-2442
Site Address: 108ayParkway Rd Tax ID#: 226.15-1-16
Directions to Site:1 Route 9L to Assembly Point Road,Turn Left onto Sunset Lane,Right on
Honeysuckle,continue onto Bay Parkway,Tip of Assembly Point
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 x 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? x Yes 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.):
The proposed system consists of two 2,000 gallon holding tanks to serve the proposed 4 bedroom guest house
located at 10.8 Bay Parkway Road. The system will be greater than 60 ft from the lake, and is 10' away from
nearest property line. -
pCCEOWE.
MAY 12 2021
Septic Variance Application February 2018
TOWN OF QUEENSBURY
BUILDING&CODES
' List the names, parcel addresses, and tax map numbers-of all adjoining property.owners. You may.obtain tax
map numbers from the Assessor's Office-as well as the names and addresses:.
North Name N/A
Address.
Tax Map ID
South Name Otyokwa.Inc.
Address Lake&Bay Parkway
Tax Map.ID 226.15-1-38
East Name West Point South LLC
Address 108 Lake Parkway
Tax Map ID 226.15-1-16.
West Name O'Keefe,Daniel F
Address 102 Bay Parkway
.Tax Map ID 2215.15-1-18
OWNER STATEMENT
I/We do hereby relieve the Town of Queensbury from any liabilities on the plumbing and septic system located at:
108 Bay Parkway Rd
.I/We realize that putting the well,septic tank or leaching system,less than the required N/Afeet from the N/A
may increase the risk of pollution.
Owner--Print Name: Date:
Owner-Signature: Date: a /d
NEIGHBOR 0RTENANT 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 septic tank or leaching system less than the required feet from the-
may Increase the risk of pollution.
Neighbor/Tenant--Print Name:' Date:
Neighbor/Tenant=Signature: Date:
February 2019
Septic Variance Application
'!) 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:
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Septic Variance Application February 2018
AUTHORIZATION AND SIGNATURE PAGE
This page includes the Authorization to Act as Agent forirt, 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: 'Brett and Pamela West
Designates:- Environmental Design Partnership as agent regarding the Septic Variance for
Tax Map##: 226.15-1-16
OWNER'S SIGNATURE: V DATE: /v Z
i
En ig Hearin Fee Disclosure:Applications maybe 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 Meetine'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:
-f OWNER PAINT NAME: �' .`/ .l� `�
OWNER--SIGNATURE: DATE: /66
AGENT---PRINT NAME: Gavin uil time
AGENT—SIGNATURE: DATE:
Septic Variance Application February 2018
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SITE LOCATION MAP
SCALE: I" = 2000'
N b�-3- 20 21
RESOLUTION APPROVING SANITARY SEWAGE DISPOSAL
VARIANCES FOR BRETT AND PAMELA WEST/WEST POINT SOUTH,
LLC— 108 BAY PARKWAY ROAD
RESOLUTION NO.: BOH 26,2021
INTRODUCED BY: Mr.Anthony Metivier
WHO MOVED ITS ADOPTION
SECONDED BY: Mr.Timothy McNulty
WHEREAS, Brett and Pamela West/West Point South, LLC (Applicants) applied to the
Local Board of Health for a variance from Chapter 136, §136-11 which requires applicants to obtain
a variance for holding tanks, as the Applicants wish to install two (2) 2,000 gallon capacity septic
holding tanks for a total of 4,000 gallons of capacity in lieu of a sewage disposal system to serve a
proposed four(4)bedroom guest house on property situated at 108 Bay Parkway Road in the Town
of Queensbury,and
WHEREAS,the Town Clerk's Office published the Notice of Public Hearing in the Town's
official newspaper and the Local Board of Health conducted a public hearing concerning the
variance requests on Monday,June 7t', 2021, and
WHEREAS, the Town Clerk's Office advised that it duly notified all property owners
within 500 feet of the subject property,
NOW, THEREFORE, BE IT
RESOLVED,that:
1. due to the nature of the variance, it is felt that the variance would not be materially
detrimental to the purposes and objectives of this Ordinance or other adjoining
properties nor otherwise conflict with the purpose and objectives of any Town plan
or policy; and
r
2. the Local Board of Health finds that the granting of the variance is necessary for the
reasonable use of the land and is the minimum variance which would alleviate the
specific unnecessary hardship found by the Local Board of Health to affect the
Applicants; and
BE IT FURTHER,
RESOLVED, that the Local Board of Health hereby approves the application of Brett and
Pamela West/West Point South, LLC (Applicants) for a variance from the Sewage Disposal
Ordinance to allow installation of two (2) 2,000 gallon capacity septic holding tanks for a total of
4,000 gallons of capacity in lieu of a sewage disposal system to serve a proposed four(4) bedroom
guest house on property situated at 108 Bay Parkway Road in the Town of Queensbury and bearing
Tax Map No.: 226.15-1-16, and
BE IT FURTHER,
RESOLVED, that the Town Board authorizes and directs the Town Clerk to forward by
certified mail a certified copy of this Resolution to the Adirondack Park Agency for its review, and
BE IT FURTHER,
RESOLVED, that this approval Resolution shall not be effective until 30 days after such
notice to the Adirondack Park Agency and shall be subject to any lawful action by the Adirondack
Park Agency during such period.
Duly adopted this 7t'day of June,2021,by the following vote:
AYES Mr. McNulty,Mr. Strough,Mr. Metivier,Mr. Freer,Mr. Ferone
NOES : None
ABSENT: None