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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

codes@willex.com.

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 parks@willex.com 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

Email

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

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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 @ parks@willex.com