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SUPERVISOR’S REPORT
Office of the Supervisor
Shaun Gillilland
Spring has finally arrived after a long and
bitter winter, and not soon enough. As the lawns and
fields green up quickly it reminds me that life
around our town is going to accelerate into a
fantastic summer. Our summer residents and
snowbirds are starting their return and we welcome
them back. It is amazing to see how the town
transforms from winter to summer, almost like a
recurring emergence of a chrysalis.
There is a lot happening and a lot planned as
we work into the summer season. The festivities of
the 250th
celebration are in the final planning stages,
and they should be great. The new Farmers Market
Pavilion is starting construction and should be ready
by the market opening day. The staff for the
children’s summer camp have been appointed as
well as our youth park ranger staff. The Willsboro
Golf Course has opened under town management
and seems to be off to a very successful season. The
permits are in place for our new beach at
Noblewood - I encourage all to come enjoy the
beach sometime this summer.
We will soon have a new business in town.
The new owners of the Old Adirondack chair
factory are scheduled to close on the property on
May 5th
. The new owners are Champlain Valley
Milling Company who are moving over from
Westport. They produce organic flour from grains. It
will take several weeks to transform the building to
a new facility, but they plan to hold an open house
when they have it ready. I want to welcome
Champlain Valley Milling to Willsboro, we are glad
you have come to be a part of our business
community.
The projects on the Boquet River are going
out to bid. The stream bank stabilization project and
the dam removal project are in the process of getting
final permits from the APA, DEC, and Corps of
Engineers. Funding for the dam removal is still in
question, particularly to timing of funding for work
to be done at low water flow. US Fish and Wildlife
Service and the Lake Champlain Basin Program are
working to provide that funding.
The proposed update to the town zoning
ordinance is currently under review by the
Adirondack Park Authority. The rewrite was a great
team effort of town employees, members of the
planning and zoning boards, and the public. It was
bottom to top examination and review of zoning,
practices, and considered changes that have occurred
since the 1970’s (when our current ordinance was
written), as well as the findings and conclusions
from the town’s comprehensive plan. Once the draft
is approved by the APA, we will be scheduling
public hearings on the draft prior to adoption. More
to come on that once we get feedback from the
APA.
We have two looming vital issues that are
going to affect the town critically in the short term
that everyone should be aware; wastewater
treatment plant rebuild and EMS service changes.
Sewer District: In 2013 the Town of
Willsboro Wastewater Treatment plant suffered a
series of cascading casualties that resulted in total
failure of the sewer plant. Willsboro had a Rotating
Biological Contactor (RBC) primary treatment
An outdoor lover’s dream on the banks of the
Boquet River nestled between Lake Champlain and the Adirondack Mountains.
May 2015, Volume 2, Issue 2
THE WILLIAM
GILLILAND POST
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system that had been installed over twenty years
previously. Because the plant had no redundancies,
meaning no way to isolate the system while in
operation, there was no way to conduct periodic
maintenance on the system components; it was
never taken offline. This eventually led to system
catastrophic failure beginning with the secondary
treatment clarifiers. The town proactively contracted
for immediate replacement of the clarifiers,
financing that with a $450,000 commercial bond.
While this repair was being organized the RBC,
which is responsible for the primary biological
treatment of the wastewater, catastrophically failed
and was put out of commission.
This emergency condition required the
development of a temporary fine bubble activated
sludge treatment system within the physical
infrastructure of the treatment plant. Our operator
Bob murphy, DEC, and our engineers worked
seamlessly to develop and install this system. Since
this was put online our results from effluent testing
have been better than at any time in the history of
the treatment plant. But, this system is not approved
for unlimited use by DEC, and therefore DEC is in
the process of issuing the town an order on consent
to build a new improved wastewater treatment
system to be started in 2016 and completed by 2019.
The town received a grant in 2013 to conduct
an engineering report which evaluated options for a
new treatment system. This report provided a
number of alternatives with the minimum cost
alternative starting at around $1.5 million. Add this
to the existing debt on the sewer district of
approximately $700,000 and the cost on debt service
is going to rise dramatically, very likely next year.
That would mean that total sewer costs to users
would go up to approximately $1000 per year or
higher.
In order to try to alleviate that cost increase
we are trying to secure grant funding to finance the
construction. In order to qualify for this funding we
have to show that there are a majority of users
whose median income is at or below a certain level.
That is why the town has distributed income surveys
to the sewer district and held public information
sessions on this. We need a response rate of at least
75%, thus far it has been below 25%. The data
collected is completely confidential and no town
employees will be looking at it. The figures are
collated by an organization in Elizabethtown called
HAPEC. I would ask one last time for help in
getting this accomplished so we don’t have such a
dramatic rise in sewer rates.
EMS Services: The ambulance service for
Willsboro and Essex is in jeopardy. They are on the
verge of not being able to answer ambulance calls
because of manning to fill out a 24/7 duty roster of
EMTs and ambulance drivers. In short, we are on
the verge of not being able to provide emergency
medical services on a timely basis when urgently
needed. The volunteers in the EMS service from
Willsboro and Essex have been working for a
number of years to establish a non-profit corporation
that would operate the EMS service for both towns.
Currently each town’s EMS service is held by the
respective Fire Districts.
By New York State law Fire Districts are
prohibited from charging health insurance
companies for ambulance services. If the EMS
service is moved out from under the Fire District
then the services provided can be billed. This would
allow for additional revenue for the EMS squad to
hire professional EMT personnel to cover gaps in
duty manning.
The newly formed EMS corporation is
asking each Town Board for a resolution of support
for this effort. If it occurs the support and costs of
the EMS service would transfer to the two towns on
a proportional basis to total assessable value of each
town. This would roughly mean that Willsboro
would pick up at least 2/3 of the costs. Since billing
of health insurance companies has not begun, the
total cost would be carried the Willsboro and Essex
town general funds. This will mean a tax increase in
excess of the 2% tax cap next year. Costs would
increase in the following years because new
ambulances, defibrillators, and hiring of
professional EMT personnel would soon follow.
One alternative to this is formation of an
ambulance district that would eventually be merged
with an ambulance district in Essex to make a new
two town ambulance district. This would be a new
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taxing district entity that would collect revenue to
operate the EMS service for the town(s). If this was
enacted by the town board it would be subject to
permissive referendum. An ambulance district can
bill insurance and can set taxing levels at different
rates within the district, and separate from the
general fund taxing rate.
On both issues, sewer and EMS, please let
me know your thoughts, opinions, and ideas. It is
vital that for both these issues we get the solutions
right.
Thanks you for the opportunity to serve,
Shaun
Town Clerk’s Corner
Bridget Brown
Happy Spring!
Taxes are coming to an end. The last day to pay
taxes at the town hall is April 30, 2015. All taxes
received after that date must go out to the Essex
County Treasurers office. We are now able to accept
credit card payments at the town hall and online.
There is a fee which you will be asked to confirm
prior to continuing. If you have any questions about
the credit cards please let me know. We will be
holding a rabies clinic on May 28th at the Willsboro
highway garage from 6pm-7pm. As always, if you
have any questions please don’t hesitate to contact
me. You can reach me at 518 963 8933 Monday
through Friday from 9am-4pm.
Code Enforcement Office
Doug Rock
If something is worth doing, it is worth being done
up to minimum codes. Building permits are required
for projects that need to conform to Zoning or to the
New York State Uniform Fire Prevention and
Building Code. This includes the erection,
construction, enlargement, alteration, improvement,
relocation, removal or demolition of any building or
structure. It also includes the installation of heating
equipment. All work, permitted or not, is required to
conform to the most restrictive minimum codes that
apply. Codes are so important because they provide
a minimum standard for work to conform to. This
takes into account many things that would be
impossible to calculate for every job we do. Factors
such as wind, weather, seismic, snow loads, live
loads and many others are taken into account in
prescriptive codes for just about every different
thing to be built or installed. As a Code Officer, I
ensure your plans are consistent with the codes,
and/or have been properly engineered by a New
York State Licensed professional. As a Building
Inspector I ensure that the work is done according to
plan and with proper workmanship. Upon successful
completion of your project, I issue certificates of
occupancy, completion of conformance for the
various different types of projects. Penalties for
disregarding codes and building permits can be
severe, and the court and legal process of
enforcement is usually more difficult than
permitting and conformance. There have already
been 16 new building projects started this year. In
addition there are subdivisions, special use permits
and zoning variances, all in various stages of
completion. I am always very happy to provide
these services for all projects, no matter how big or
small.
Please feel free to contact me at 963-7411 or
Department of Parks and Recreation –
Justin Drinkwine
Hello Everyone
It has been a very busy time here in the park and
recreation office. We had a great turn out for the
Pancake Breakfast with the Easter Bunny. We had
approximately 50 kids show up to collect Easter
Eggs. This was made a success from the generous
donations from Reber Valley Snack Shack, Maple
Brook Farms, and Ben Weaver Farm. Also I have to
thank Tracie Gay, Carrie Pierson, Todd Pierson,
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Zach Pierson, Rylee Pierson, Darrian Sweatt, and
Cheryl Vanderpool, who helped me out with the
cooking and the hiding of the Easter Eggs.
I have been very busy working and planning some
different events for the summer. One event that I am
planning is a town wide barbeque at Florence
Hathaway Park. This would be an event where the
whole town could come together and play
horseshoes, washers, volleyball, tennis, and bring
children around the youth trail that we have in back
of the tennis courts.
Another event that I have been actively planning is
the 4th
of July Celebration. This will celebrate the
250th
anniversary of Willsboro. We have a good line
up for the parade with several floats, old cars,
horses, and fire trucks of course. There are rumors
that the Willsboro Fire Department Indians may
make a return for the 250th
anniversary. After the
parade we plan on having food and carnival games
at the Paine Soccer Fields. We hope that you can all
make it and have a great fun filled family day. If
you would like to participate in any way please be
sure to contact me at the town hall.
Another major project that I have been working on
is the Willsboro Golf Course. The course is coming
along great thanks to the dedicated employees. If
you are ever on the course and you happen to see
them, please make sure to give your feedback about
the course’s conditions. I have been working closely
with different radio stations in order to promote
more utilization of the golf course. If you have not
enjoyed the 9 holes of Adirondack heaven then
make sure you come down and play.
If you have any thing that you would like to see
happen in the town for events please contact me. My
contact information is [email protected] or call me
at 963-8933 Monday-Friday 9am-4pm.
Department of Public Works
Travis Crowningshield, Highway Superintendent
This was a winter like no other I have seen. The
long cold season took frost into the ground to depths
we have not witnessed before. We had many water
main breaks and leaks that between snow storms,
kept the entire DPW crew busy night and day.
Finally this has come to an end and we can
concentrate on getting ready for summer road repair
and maintenance.
We’re building the farmers market pavilion
now. Our DPW crew are very talented group and we
doing all the construction ourselves. This should
make a fantastic market venue and can be used
throughout the year for many public uses. We also
put the dock back in at the public boat launch so that
boaters and anglers can get a jump on the season
when it warms up.
We are planning for road repair and
blacktopping for this summer. The State has given
us some additional money this year for road repair
to account for the harder winter, so we believe we
can get a head start on the much needed work on
many town roads.
Don’t forget that May 16 is Chip day at the
Willsboro-Essex transfer station. Yard wood cutting
and logs up to 6” diameter will be accepted there for
chipping. So if you need to get rid of cuttings and
branches bring them on the 16th
.
We will soon be into the roadside mowing
season. Over the last few months our ditches and
roadsides have accumulated unsightly trash and
litter. Bottles, cans and other objects are a hazard to
our road mowing crews. I want to thank Camp
Poko-Macready and many town volunteers who
took time to clean up the roadsides of trash and
debris lately. It makes the town look better and
makes working on the roadsides safer.
Department of Planning
Ashley Ryan Blanchard
To date we have been working on, or assisting with,
the following priority projects:
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1. SAVE the Adsit Cabin – This cabin is no
ordinary cabin. It is one of the oldest structures,
still standing in its original location, in the
United States which aptly qualifies it for its
Historic National Register designation. The
Town has been aware of its deteriorating state
and urgent need of repairs. Over the past few
years grant opportunities have been sought, but
were unfortunately unsuccessful. This year the
Town was awarded approximately $10,000 from
the NYS DEC Smart Growth program for
repairs and renovations. Additionally, the
County DOT has agreed to remedy the road
drainage issue that has caused some degradation
to the property. Although progress has been
made to secure funds to help in the renovation
efforts, this is not enough to complete the
project. We, with the help of the Willsboro
Heritage Society, are asking that the public
consider donating to this crucial endeavor. The
Adsit Cabin is a keystone for Willsboro, the
region, the State, and the nation. If you would
like to contribute to this effort please send
donations to:
Town of Willsboro/
Willsboro Heritage Society
5 Farrell Road
Willsboro, NY 12996
Subject: Adsit Cabin Renovation
If you should have any questions, feel free to
call Ashley Blanchard or Supervisor Gillilland at
518-963-8668. The Smart Growth grant proposal
can be viewed at the Town Hall M-F 9am to
4pm.
2. Broadband Utility Installation
After receiving just fewer than 100 surveys from
residents we have tabulated the data which can
be seen on the last pages of this newsletter.
3. Willsboro Sewer District #1 – Treatment Plant
Upgrade & Collection System Tie-In
The Town is completing a CDBG ($600,000
requested) application for funding for the sewer
district that will be submitted if we receive
enough completed income surveys. A USDA
application will also be submitted – requesting
$750,000 in grant funding.
The Town is held two public informational
meetings which discussed the costs to upgrade
the new system and its impacts on the existing
sewer rates, how not completing the survey will
affect funding which in turn will negatively
impact the existing sewer rates (which are
already above the NYS EFC target service
charge, and the reasons behind the necessary
upgrade.
I encourage you to get your questions and
concerns answered. In the pages below you
will find general questions and answers that
have been asked regarding completion of the
survey. A copy of the NYS CDBG survey is
attached to this newsletter. It can be sent
directly to HAPEC at the following address:
HAPEC
Attn: Aran Voss-Hutchins
103 Hand Avenue
Elizabethtown, NY 12932
4. Willsboro Dam Removal Project
Unofficially, funding has been allotted to the
Town for the removal of the Willsboro Dam. If
made official the project will take place mid to
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late summer dependent upon weather and river
conditions.
5. Tourism Opportunity Establishment – Gateway
Trail (Gateway Park to Noblewood Park)
The Town has received grants from the NYS
DEC Smart Growth program, the Lake
Champlain Basin Program, and the Essex
County Creating Healthy Places program to
establish the Gateway Trail that will begin at the
Gateway Park and end at Noblewood.
Discussions with the corresponding landowners
have already begun and the project will begin
mid-summer with assistance from the Nature
Conservancy and Champlain Area Trails. The
Gateway trail work will involve – trail clearing,
installation of interpretive signage, the
construction of a fishing access platform,
placement of an erosion control system at the
municipal boat launch, and further work on
establishing easements and agreements with the
corresponding property owners. If you would
like to assist the Town by volunteering for trail
clearing, please contact Ashley Blanchard or
Justin Drinkwine at 518-963-8668. The farmer’s
market pavilion construction is set to begin next
week. Funding for the project was provided from
the NYS Department of Agriculture and
Markets, with match donations from NYCO
Minerals (wollastonite) and the Stefanik Family
(roofing plywood).
6. Community Garden – The Florence Hathaway
Park Community Garden has only 4 plots left for
purchase ($15.00 each)! The plots will be
fertilized and prepped into mound forms,
roughly 3’ x 10’ (larger if space permits).
Interested individuals can fill out the attached
form and return it to the Town Hall with
payment. The gardens will be prepped no later
than May 25th
, 2015, after which garden plot
owners can do their plantings. A pumpkin and
sunflower patch will also be planted this year. If
you have any questions call Ashley Blanchard or
Justin Drinkwine at 518-963-8668
7. RV Campground – The Town is looking into the
notion of developing an RV campground within
the Town. We are seeking funds from the NYS
CFA grant programs for a feasibility study.
8. Local Government Efficiency – The Towns of
Willsboro and Essex are looking into grant funds
through the Department of State for a feasibility
study to be done regarding shared services
efforts. Being a primary goal of the state to
combine services, this has the potential to save
both communities a significant amount of
money.
To stay up-to-date on projects going on in the Town
visit: www.townofwillsboro.com.
COMMUNITY * GARDEN * NOTICE
2015 GARDEN PLOTS
ARE AVAILABLE FOR PURCHASE!
PLEASE CALL THE TOWN HALL FOR MORE
INFORMATION 518-963-8668.
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GET YOUR PARK SEASON PASS NOW! VISIT
THE TOWN HALL FOR MORE INFORMATION.
WILLSBORO BROADBAND SURVEY
RESULTS - A full Report can be
viewed at the Town Hall or online
at www.townofwillsboro.com
Question #3 – Do you currently have internet
service?
93 of the respondents indicated that they did indeed
have internet service in their homes or businesses.
Question #4 – If yes, who is your provider?
An overwhelminging majority of respondenets
stated that Willex (Cable Communications) was
their service provider (61 individuals). Satellite
internet was the next most commonly utilized
service, followed by the “other category” which
comprised of wireless internet provider CV Wireless
and cell based Verizon. Dial Up and general cell-
phone hotspots were the least commonly used with
reasonings being the additional inadequacies of the
exisitng cell coverage.
Question # 5 – If you do not utilize the internet,
please explain why.
Only a small portion of respondents indicated that
they did not use the internet as can be seen in the
chart below. Of those that responded, the majority
selected other stating such things as “too
expensive”, and that “the current service is too
slow”.
Question #6 – Is the internet speed adequate for
your current usage pattern?
The majority of individuals that submitted a survey
responded that they are not satisfied with the
internet speed as it corresponds to their useage
patterns.
0
100
Internet
Question #3
Yes
No
0
20
40
60
80
Provider
Question #4
Cell Hotspot
Willex
Dial-Up
Other
Satellite
0
2
4
No Internet - Why
Question #5
N/A
Price
None
Other
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Question #7 – If not adequate, would you purchase
faster service if it was available?
Correspondingly, individuals indicated that they
would indeed purchase faster internet service if it
was made available. Many indicated their concerns
about affordability, as well as the importance of
high-speed internet for new and exisitng businesses
within the community.
Question #8 – Do you have any school age children
using the internet at home?
Most respondents noted that they do not have school
age children within your home with some indicated
that they do have visiting school age children. 22
respondents indicated that they did have children in
their home that are attending school or college.
Question #9 – If you have internet service OR were
able to get it at your home, what do you you/would
you use it for?
Uses varied, ranging from personal use of email,
web services, and connecting with family and
friends, to business related telecommuting, banking,
and education.
A full report can be viewed at the Town Hall or
online at www.townofwillsboro.com
(Supervisor’s Page)
0
50
100
Adequate Speed
Question #6
Yes
No
0
100
Purchase FasterService if Available
Question #7
Yes
No
0
50
100
School AgeChildren
Question #8
Yes
No
0
10
20
30
40
50
60
70
80
Types of Use
Question #9
Telephone
Web Search
Telecommuting
Banking
Connecting
Shopping
Education
Home Biz
Entertain.
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TOWN OF WILLSBORO – SEWER DISTRICT SURVEY
– COMMON QUESTIONS/CONCERNS & ANSWERS
The Town of Willsboro faces a sewer system
crisis. The town has aging infrastructure that was
constructed in 1994 to 1995.
The existing processing system is no longer in
conformance with the Department of
Environmental Conservation’s waste-water
treatment plant standards, of which the Town
was recently issued a NYS DEC Consent Order.
Willsboro needs help as it faces a $1.7 million
project to bring the system to compliance. The
Town is attempting to gain State and Federal
funding to prevent the increase in user rates by
roughly $279.00/year/user, putting undue
hardship on district residents.
I vote down any tax rate and budget increase!
The Town is required to meet the NYS DEC
requirements. The Town Board must operate within
the law and protect the health, safety, and welfare of
the community residents and environment.
Furthermore, if the waste-water treatment plant
should fail, it would result in an extensive and costly
remediation as well as fines issued by the State for
having not complied. The increase in your sewer bill
will be a result of not obtaining grant funding,
possibly due to lack of surveys.
I don’t understand this survey – why do I have to
fill this out?
A survey is the mechanism for determining the
sewer district median household income. We need
this information in order to apply for grant funding
to implement the project described above.
How can I become involved, what can I do to
help?
The Town has arranged for a third part to conduct an
income survey. This survey will assist the Town to
apply for grants that will help to control project
costs and resulting increases in user rates. If you
want to help, please send the Town a letter of
support for the proposed waste-water treatment
system project.
Are surveys reviewed by the Town of Willsboro,
other local government agencies or the IRS?
The survey answers are entered into a spreadsheet
for calculations by one staff member. Your address
is given a number to track that you have or have not
responded. Your surveys will be placed in a locked
file called “confidential” as required by the State
grant program.
I am a seasonal resident and therefore I do not
count.
We need to know how many seasonal residents are
in the sewer district. Some grant funding programs
will disregard seasonal incomes and some will not,
depending on how many are within the district. If a
seasonal resident does not fill out the survey, we
will determine the household as vacant in our results
(no penalty).
What if I never fill out this survey?
If the surveys are not returned, the Town will not be
able to apply for grant funding. Therefore, the sewer
district will have to afford the entire $1.5M project
(210 users). If a certain percentage, of survey
responses, is not met, grant money and hardship
qualification is unobtainable. If you want to help the
Town lower your future cost of the waste-water
treatment plant system upgrades, please return a
completed survey.
What if I am a landlord of a multi or one unit
rental property?
Please do not fill out the survey if you are a
landlord. The renter(s) must complete the survey.
I do not want to fill this out because it is invading
my privacy.
The only person reviewing the completed survey is a
staff member at the Essex County HAPEC Office.
Names are irrelevant for our data and will never be
reproduced or discussed. Only the number
corresponding to your address will be required to
keep track of who has or has not filled out the
survey.
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I do not feel comfortable putting my information
in writing but am willing to answer the question
via phone.
Please call Aaron Voss-Hutchins, Essex County
HAPEC at 518-873-6888 to provide your answers
via phone.
CELEBRATING 250 PROUD YEARS WITH A SERIES OF
COMMUNITY EVENTS ALL SUMMER LONG – CHECK OUT THE
FULL EVENT LISTING AT: WWW.TOWNOFWILLSBORO.COM
EVENT HIGHLIGHTS: June 8:
WCS Colonial Parade & Picnic (10AM)
June 20:
Founder's Day Golf Tournament
(‘T’ Times 8AM, 12PM – 4 Person Teams)
July 4:
-Downtown Parade & (11AM)
Activities at the Soccer Field
-Sunset Boat Parade @ Willsboro Bay
July 11
Battle of the Boquet Race Day (8AM)
See Registration form at end of newsletter.
Aug 1
-Founder's Day Ball/Dance at the Noblewood Lodge
(6PM)
-Essex Days @ Downtown Essex, NY
Sept
Willsboro Farm Tours
Community Garden Plot Purchase/
Registration Form
Fee Requirements
o The Adopt-A-Row owner will pay a
fee of $_15.00_ to help cover the
expenses of garden preparation and
maintenance.
Gardener Volunteer Obligations
o Adopt-A-Row owner agrees to
volunteer __2___ hours/bi-weekly
toward the community gardening
efforts.
Name ____________________________________
Address___________________________________
____________________________________
Phone ___________________________________
Signature__________________________________
Date ____/____/_____
Payment Type:
____ Cash ____ Check ____ Money Order
Garden Plot Guidelines will be sent to you upon
receipt of your registration form and fee as well
as a schedule for garden prep, clean up, and
other organized events. Plantings and weeding
can be done at one’s leisure per the parameters
of the above volunteer hours and guidelines.
For more information regarding a payment plan
contact the Town Hall at 518-963-8668.
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WILLSBORO SEWER DISTRICT
HOUSEHOLD CHARACTERISTICS SURVEY
FOR STATE (CDBG) GRANT PURPOSES
PROJECT YEAR 2015
Please answer all questions completely and
accurately.
The information gathered from this survey will be
used to support the Town of Willsboro in its efforts
to obtain federal and state money for the purposes of
sewer district improvements. All information that
you supply in this survey will remain strictly
confidential. Rental properties must indicate the
income of the renters.
1. Type of dwelling unit (check one)
______ one family ______ two family ______
three family or more, how many housing units total
in the building
2. Do you own or rent your residence? ______ own
______ rent
3. How many persons, including yourself, live in the
household (over the age of 18)?
______ number of occupants
4. How many residents living in your household are
age 62 or older?
______ number of residents age 62 or older
5. How many residents in your household are
handicapped?
______ number of residents handicapped
6. How many residents in your household are in
each of the following categories?
______ White
______ Black/African American
______ Asian
______ American Indian/Alaskan Native
______ Native Hawaiian/Other Pacific Islander
______ American Indian/Alaskan Native and
White ______ Asian and White
______ Black/African American and White
______American Indian/Alaskan Native &
Black/African American
______ Hispanic
______ Other Multi Racial
______ Female
______ Male
8. What is the adjusted gross annual household
income? Household income is the total income of all
money earners in the household. The figure to be
reported should include all earned and unearned
income, social security, unemployment
compensation, retirement and public assistance.
Total Annual Household Income:
$ ______________________
**Sewer District Resident Service Address:
_________________________________
To protect the privacy of this information, please
put the survey form in a stamped envelope and
place it in the nearest mail box. Please include
your service address so that your survey can be
accounted for adequately at the HAPEC office.
Thank you for your cooperation.
Please mail this form to:
HAPEC
Attn: Aran Voss-Hutchins
103 Hand Avenue
Elizabethtown, NY 12932
12 | P a g e
REGISTRATION FORM
VISIT: WWW.BOQUETBATTLERACE.WEEBLY.COM
___ Individual Trail 5K ($10.00)
___ Team Trail 5K ($20.00)
___ Individual Kayak 2 Mile ($15.00)
___ Team Kayak 2 Mile ($25.00)
___ Individual Duatholon ($20.00)
___ Team Duatholon ($40.00)
*Teams will consist of no more than 2 people. Children under
16 are Free, however their participation is at the discretion of
the parent or guardian.
*Course includes a moderate trail run and 2 mile upstream
kayak.
First Name: ___________________________
Last Name: ___________________________
Gender: ___ Male
___ Female
Date of Birth: ___/___/_____
Email Address: _______________@__________
Day Phone: (_____) ______ - _________
Address:
Country: __________________________
Mailing: __________________________
City: _____________________________
State: ____________________________
Zip: ______________________
Emergency Contact Name:
_____________________________________
Emergency Contact Phone:
_____________________________________
How did you hear about this event?
___active.com
___Facebook
___Family/Friend
___Internet/Website _________________
___Past Participant
___Print Marketing
T-Shirt Size (If Registered by 6/15/2015)
___Small
___Medium
___Large
WAIVER: I know that participating in a strenuous athletic event of this type is a
hazardous activity. I certify that I have no physical, medical, nor
mental condition which would interfere with my participation in the
Battle of the Boquet Trail Run & Kayak Race, and that I have trained
adequately for this off road trail and boat race. I fully understand that
I, or the person I am responsible for, will be subjected to potentially
harsh environmental conditions, including but not limited to, extreme
temperatures, unpredictable weather conditions, hiking trails,
unimproved trails, uneven terrain, rocks, cliffs, roots, trees, stream
crossings, wild animals, limited access to immediate medical
assistance, as well as any other conditions that man or mother nature
may provide. I understand that there is a risk of sustaining serious
bodily injury, permanent disability, or even death that might result not
only from my own action, inaction, or negligence but the actions, in
actions, or negligence of others, the rules of the race, or the conditions
of the premises. Further, I acknowledge there may be other risks not
known nor reasonably foreseeable at this time. I assume all the
forgoing risks and accept personal responsibility for the damages
following such injury, permanent disability, or death. Knowing these
facts and in consideration of the acceptance of my event entry, I or the
person I am responsible for, and my/his/her assigns hereby waive,
covenant not to sue, indemnify RELEASE AND DISCHARGE the
Town of Willsboro, the Nature Conservancy, Lee's Vision, LLC, the
Willsboro Health & Fitness Group, and Lorilee Sheehan (property
owner), its race director(s), organizers, event staff, volunteers,
sponsors, and property owners and their officers, directors,
employees, agents, other participants, and any other persons or
organizations involved in this event from and against any and all
claims, liabilities, losses, damages, costs, and expenses arising from
or in any way related to my participation in this event or the
participation of the person I am responsible for. I certify that I, or the
person that I am responsible for, is of sound body and mind and truly
capable of participating in this event. I agree to comply with the rules
concerning this Event and agree to go only in those areas authorized
by the Event organizers. I understand that, in addition to the above, I,
or the person I am responsible for, will be responsible for any cost of
emergency service that is required during this event. I also understand
that my competition number is not transferable.
Participant Signature: ____________________________________
Date: ___/ ___/ _____
Please return this form to the Willsboro Town Hall Parks
& Recreation Department – 5 Farrell Rd, Willsboro, NY
13 | P a g e
Founder’s Day Golf Tournament
Preliminary Registration Form
(An official form will be sent to you upon receipt of
this form)
Name:_____________________________________
Phone:___________________
Address:___________________________________
___________________________
___ I cannot attend.
Enclosed please find my donation in the amount of
$_________
___ I can attend. See my details below
Please complete one or more of the following:
_____ Golfers @ $65 per golfer (includes cart)
$___________
_____ 2 golfers plus 1 hole sponsorship @ $200
$___________
_____ Hole Sponsorship - No golf @ $100
$___________
_____ Cart Sponsorship - $500 $______
_____ 250th
Tournament Sponsorship - $2500.00
$___________
For hole sponsors, please list your name as you
would like it to appear on our advertising. Please
return by June 5, 2015. NAME FOR SIGNAGE:
__________________________________________
______________________
Golfer # 1
Name: __________________________
Handicap*_______
Golfer # 2
Name: __________________________
Handicap* _______
Golfer # 3
Name: __________________________
Handicap*_______
Golfer # 4
Name: __________________________
Handicap*_______
*All players need to provide an official handicap.
Teams will compete in flights to be determined by
the handicap of the player with the lowest handicap.
PLAYER’S FORMS MUST BE MAILED TO
REACH US NO LATER THAN June 13, 2015
Please make your check payable to:
Town of Willsboro
And return with this form to:
Willsboro 250th
Golf Tournament
5 Farrell Road, P.O. Box 370,
Willsboro, NY 12996.
For further information, call Justin 518-963-8933 or
email: Justin @ [email protected]