3.05 3.5
TRANSIENTSNortheast Realty Development Polito&Quiuui—5-2-16
RESOLUTION APPROVING TRANSIENT MERCHANT/TRANSIENT
MERCHANT MARKET LICENSE FOR NORTHEAST REALTY
DEVELOPMENT/KEVIN QUINN/NAOMI POLITO
RESOLUTION NO.: ,2016
INTRODUCED BY:
WHO MOVED ITS ADOPTION
SECONDED BY:
WHEREAS,Northeast Realty Development/Kevin Quinn/Naomi Polito (Northeast Realty)has
submitted an application to the Queensbury Town Board for a Transient Merchant/Transient Merchant
Market License to conduct a transient merchant market from June 7h through June 11 fl,, 2016 in the
parking lot at 1650 State Route 9, Queensbury to sell assorted motorcycle and non-motorcycle
products and services in accordance with the provisions of Town Code Chapter 160, and
WHEREAS, the application is essentially identical to applications submitted by the applicant in
previous years and since the Queensbury Planning Board conducted site plan review of the prior
applications, it is not necessary to again refer the application to the Planning Board for site plan review,
NOW, THEREFORE, BE IT
RESOLVED, that in accordance with the requirements set forth in Queensbury Town Code
§160-8, the Town Board hereby grants a Transient Merchant/Transient Merchant Market License to
Northeast Realty Development/Kevin Quinn/Naomi Polito to conduct a transient merchant market in
the parking lot located at 1650 State Route 9, Queensbury, subject to the following:
1. Northeast Realty must pay all fees as required by Town Code Chapter 160;
2. Northeast Realty must submit a bond in the amount of$10,000 as required by Chapter
160;
3. Northeast Realty must submit proof of authorization to do business in New York and
authorization of agent to receive service of summons or other legal process in New York;
4. The License shall be valid only from June 7th through June l Ith, 2016 from 9:00 a.m. to
9:00 p.m. and the license shall expire immediately thereafter;
5. Northeast Realty shall advise the Town Board of any vendor changes from previous years;
6. Northeast Realty must revise its submitted plot plan to accurately depict the planned
vendor locations prior to the Town Clerk's issuance of the License;
7. Northeast Realty must provide to the Town Clerk its proof of a current/renewed
occupancy permit from the New York State Department of Transportation for parking in
the area along Route 9 prior to the Town Clerk's issuance of the License;
8. The Transient Merchant License shall not be assignable; and
9. Northeast Realty must comply with all regulations specified in Town Code §160-8;
and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs Town Code Enforcement
Personnel to rigorously enforce the terms of the Site Plan, and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs the Director of Planning,
Zoning and Code Compliance to send a certified copy of this Resolution to the Warren County Sheriff
and also contact the Warren County Sheriff to request that the Warren County Sheriffs Office enforce
off-road parking issues on Route 9 and throughout the community.
Duly adopted this 2nd day of May, 2016, by the following vote:
AYES
NOES
ABSENT :
Transient Merchant/Transient Merchant Market Revised June 2009
TOWN OF QUEENSBURY TOWN BOARD APPLICATION
TRANSIENT MERCHANT/TRANSIENT MERCHANT MARKET
Submit 15 copies to the Town Clerk along with $100 application fee plus applicable Town Clerk
fees
DATE: / 26/6
APPLICANTS NAME: /„�/�/f ter/ .� // /,� •
4&ADDRESS: f� � �
� -- r?, Fn >>itimr,
1. Federal ID#: /4'-1723657) `c' FEB 2 3 2 315 r,
1�
QUEENSBURY
2. NY State Sales Tax No.: SP CLERK'S OFFICE
/6
3. Location of Market V r 2 7 1° A 9 'y \
4. Dates&Hours of Operation: 0-0/,&720/4
5. Description of Goods,Wares, Commodities or Services to be offered for sale or to be used for the
purpose of biddin for sere ces:
i�j X , 'wilt
6. Other Information to Be Provided:
A. If application is filed by an agent,the name of the firm or person represented and written
authorization by the firm authorizing the representation.
B. Authorization of an agent to receive Service of Summons.
C. A plan or map showing the location of the proposed market in proximity to property
boundaries and any other temporary or permanent structure on the lot, the plan or map
shall also show the location of the vendors within the market the provisions for dedicated
parking vehicular access to and from the site, the zoning district in which the market is to
be located, provisions for water supply and sewage disposal.
Signature of Applicant Date: _____„94�
Signature of Agent: Date: _413024
Town of Queensbury Planning Office-742 Bay Road•Queensbury,NY 12804.518-761-8220 1
Site Plan Review Revised June 2009
General Information
Tax Parcel ID: a277 -/-,.J 3 Mjr/ _/
Zoning District: k-44
Current Use: /? / SzP,55, Sorv/c- ,5 ?b4alay5
Proposed Use:
of
project: /4�/ ‘54216' �� 9
Applicant Name Address:
,(1644 ga 9113 ./251-y
Home Phone Cell:
5/S.xl/. y8
Work Phone Fax
5/3. 118 tWe
E Mail:
Agent's Name: Address:
41/.3.3 65h
Home Phone
X18. 77/.37 Cell:
Work Phone
5/8.668.0 Fax
E-mail
Owner's Name: iva 2six2 �,�J/ av Address f ` !,
Home Phone / Cell 7CJT G
Work Phone Fax
452Be.0 513.4/2T Q6a7
E-mail
Town of Queensbury Planning Office.742 Bay Road Queensbury,NY 12804•518-761-8220 2
Site Plan Review Revised June 2009
Site Development Data
Area/Type Existing sq.ft. Proposed Total sq.ft.
A. Building footprint Addition sq.ft.
B. Detached Garage
C. Accessory Structure(s)
D. Paved,gravel or other hard surfaced area
E. Porches I Decks
F. Other
G. Total Non-Permeable [Add A-F]
H. Parcel Area [43,560 sq.ft.I acre]
I. Percentage of Impermeable Area of Site [l=G/H] •
Setback Requirements
Area Required Existing Proposed
Front[1]
Front[2]
/ 2 -751 /DO 75
Shoreline
Side Yard[1] -
Side Yard[2]
Rear Yard[1]
Rear Yard[2]
ISO�—//D /86 �—//O
Travel Corridor
Height[max]
Permeability
No.of parking spaces
Town of Queensbury Planning Office-742 Bay Road-Queensbury,NY 12804.518-761-8220 3
Site Plan Review Revised June 2009
Additional Project Information
1. Will the proposal require a Septic Variance from the Town Board of Health?
2. If the parcel has previous approvals, list application number(s): /977 iYS
3. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Program?
4. Estimated project duration: Start Date 4/7/4 End Date //& •
5. Estimated total cost of project
6. Total area of land disturbance for project
Floor Area Ratio Worksheet
FLOOR AREA RATIO(FAR)--The relationship of building size to lot size, derived by dividing the total building
floor area by the lot size in square feet, yielding a percentage.
Zoning District Symbol Floor Area Ratio[FAR]
Waterfront Residential WR 022
Commercial Moderate CM 0.3
Commercial Intensive CI 0.3
A. The combined area of all square footage,as measure from exterior walls of all structures on the property,including all
floors of the structures, garages, basements and attics with more than five (5) feet of ceiling height and covered
porches. Building square footage does not include: Open deck, docks and that portion of covered docks extending
over water and one storage shed of one hundred twenty (120) square feet or less. Any additional sheds will be
included. (See'FLOOR AREA RATIO").
B. Commercial or industrial:the total area in square feet as measured from the exterior of the outside walls of a building
or structure,and when applicable,the sum total of all floor areas of the principal and accessory buildings or structures
on the project site.
Parcel Area Sq.ft.
Existing Floor Area sq.ft.[see above definition]
Proposed Additional Floor Area sq.ft
•
Proposed Total Floor Area sq.ft
Total Allowable Floor Area (Area x )[see above table]
Town of Queensbury Planning Office-742 Bay Road•Queensbury,NY 12804.518-761-8220 4
Site Plan Review Revised June 2009
§179-9-050 Application for Site Plan Review
Application for site plan approval shall be made to the Planning Board using forms supplied by the Board.Application materials and the
site plan shall include sufficient information for the Board to make its findings under§179-9-070 and 179-9-080 below. In determining
the content of the site plan and supporting documentation,the Planning Board may waive certain requirements if the Planning Board
deems such requirements or information unnecessary for the type of project proposed. Any such waiver shall be made in writing,and
shall contain statements of the reasons why the waived information requirements are not necessary for an informed review under the
circumstances. The Planning Board may grant such waivers on its own initiative or at the written request of an applicant.Such request
shall set forth the specific requirements that are requested to be waived and the reasons for the requested waiver. Absent any waiver
or waivers,an application for Site Plan Review shall include the following:
Shown
REQUIREMENTS on Sheet
A A vicinity map drawn at the scale that shows the relationship of the proposal to existing community facilities which affect or serve fl,
such as roads,shopping areas,schools,etc. The map shall also show all properties,identify owners,subdivisions,streets, and
easements within 500 feet of the property. Such a sketch may be superimposed on a United States Geological Survey map of the
area
B The site plan shall be drawn at a scale of forty feet to the inch(1"=40 feet)or such other scale as the Planning Board may deem
appropriate, on standard 24"x 36" sheets, with continuation on 834"x 11"sheets as necessary for written information. The V
information listed below shall be shown on the site plan and continuation sheets.
C Name of the project,boundaries,date,north arrow,and scale of the plan. t✓
D Name and address of the owner of record,developer,and seal of the engineer,architect,or landscape architect. If the applicant is
not the record owner,a letter of authorization shall be required from the owner it
E The location and use of all existing and proposed structures within the property,including all dimensions of height and floor area,all v
exterior entrances,and all anticipated future additions and alterations.
•
F The location of all present and proposed public and private ways, off-street parking areas, driveways, outdoor storage areas, /
sidewalks, ramps, curbs, paths, landscaping, walls, and fences. Location, type, and screening details for all waste disposal I!
containers shall also be shown.
G The location,height,intensity,and bulb type(sodium,incandescent,etc.)of all external lighting fixtures. The direction of illumination
and methods to eliminate glare onto adjoining properties must also be shown in compliance with§179-6-020.
H The location,height,size,materials,and design of all proposed signs.
The location of all present and proposed utility systems including:
1. Sewage or septic system;
2. Water supply system;
3. Telephone.cable,and electrical systems; and
4. Storm drainage system including existing and proposed drain lines,culverts,catch basins,headwalls,endwalls,hydrants, //ik
manholes,and drainage swales.
sl Plans to prevent the pollution of surface or groundwater,erosion of soil both during and after construction,excessive runoff,and
flooding of other properties,as applicable. A Stonnwater Pollution Prevention Plan(SWPPP)for all land development activities
(excluding agricultural activities)on the site that results in land disturbance of 1-acre or more. A SWPPP shall comply with the
requirements of the DEC SPDES MS-4 General Permit and Chapter 147 of the Town of Queensbury Code. It shall be at the �/�
discretion of the Planning Board as to whether a SWPPP or an erosion and control plan shall be required for a site plan review project
land disturbance of less than 1-acre.
K Existing and proposed topography at two-foot contour intervals,or such other contour interval as the Planning Board shall allow. All
elevations shall refer to the nearest United States Coastal and Geodetic Bench Mark. If any portion of the parcel iss within the 100- /
year floodplain,the area will be shown,and base flood elevations given. Areas shall be indicated within the proposed site and within Q
50 feet of the proposed site where soil removal or flung is required,showing the approximate volume in cubic yards.
L A landscape plan showing all existing natural land features that may influence the design of the proposed use such as rock outcrops,
stands of trees,single trees eight or more inches in diameter,forest cover,and water sources,and afl proposed changes to these /2/a features including sizes and types of plants. Water sources include ponds,lakes,wetlands and watercourses,aquifers,floodplalns,
and drainage retention areas.
M Land Use District boundaries within 500 feet of the site's perimeter shall be drawn and identified on the site plan,as well as any
Overlay Districts that apply to the property.
Town of Queensbury Planning Office-742 Bay Road'Queensbury,NY 12804-518-761-8220 6
Site Plan Review Revised June 2009
N Traffic flow patterns within the site,entrances and exits,and loading and unloading areas,as well as curb cuts on the site and within
100 feet of the site. The Planning Board may.at its dscretion,require a detailed traffic study for large developments or for those in
heavy traffic areas,which shall include:
1. The projected number of motor vehicle trips to enter or leave the site,estimated for weekly and annual peak hour traffic
levels;
2. The projected traffic flow pattern including vehicular movements at all major intersections likely to be affected by the
proposed use of the site;
3. The impact of this traffic on levels of service on abutting public streets and at affected intersections. Existing and proposed
weekly and annual peak hour traffic levels and road capacity levels shall also be given.
O For new construction or alterations to any structure,a table containing the following information shall be included:
1. Estimated area of structure to be used for particular purposes such as retail operation,office,storage,etc.;
2. Estimated maximum number of employees; /2/1a,
3. Maximum seating capacity,where applicable;and
4. Number of parking spaces existing and required for the intended use.
P 1. Floor Plans.
2. Elevations at a scale of one-quarter inch equals one foot(1/4"=1 foot)for all exterior facades of the proposed structure(s)and/or //n
alterations to or expansions of existing facades,showing design features and indicating the type and color of materials to be used. (/(,
Q Soil logs,water supply well and percolation test results,and storm runoff calculations,as needed to determine and mitigate project /
impacts.
R Plans for disposal of construction and demolition waste,either on-site or at an approved disposal facility.
1‘g.
S Plans for snow removal,including location(s)of on-site snow storage. ,2/
T An Environmental Assessment Form('EAP),as required by the SEQRA regulations,with Part 1 completed by the Applicant shall be
submitted as part of the application. If the proposed project requires a special use permit and an EAF has been submitted in /
conjunction with a special use permit application,a duplicate EAF is not required for the site plan application._ V
U If an application is for a parcel or parcels on which more than one use is proposed,the applicant may submit a single application for
all such uses provided the proposed uses are accurately delineated on a site plan drawn pursuant to the requirements set forth
above. The Planning Board may grant the application with respect to some proposed uses and not others. For purposes of
reviewing an application (and for SEQRA compliance) all proposed uses on a single parcel or on contiguous parcels shall be
considered together.
V A brief narrative statement on how the project proposed for review furthers or is consistent with the vision,goals and policies in the
Town's Comprehensive Plan.
Town of Queensbury Planning Office-742 Bay Road-Queensbury,NY 12804.518-761-8220 7
Site Plan Review Revised June 2009
Pre-Submission Conference Form 1179-4-0401
1. Tax Map ID
2. Zoning Classification
3. Code Reference for Review:
4. Ordinance Reference#:
5. Pre-Submission Meeting Notes;Outstanding Items To Be Addressed Include:
Deed Yes No
General Information complete Yes No
Site Development Data Complete Yes No
Setback Requirements Complete Yes No
Additional Project Information Complete Yes No
*Coverage under DEC SWPPP Program Yes No
FAR Worksheet complete Yes No
Standards addressed Yes No
Checklist Items addressed Yes No
Environmental Form completed Yes No
Signature Page completed Yes No
*Applicant must provide office with Notice of Intent(NOD:SWPPP Acceptance Form.DEC letter issuing permit number.
Notice of Termination(NOT)
Staff Representative:
Applicant/Agent
Date:
Town of Queensbury Planning Office-742 Bay Road•Queensbury.NY 12804.518-761-8220 8
617.20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part l-Project Information. The applicant or project sponsor is responsible for the completion of Part I. Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully
respond to any item,please answer as thoroughly as possible based on current information.
Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful
to the lead agency;attach additional pages as necessary to supplement any item.
Part I-Project and Sponsor Information
& / A2 LIrr/oa err.
Name of Action or Project:
Project Location(describe,and attach a location map):
,Pa)e9, &Jec41A'y/ash
Brief Description of Proposed Action:
/en3ceraxy eaeobarexp7l,/G'
fees/
Name of Applicant or Sponsor: Telephone: 5e r� ^.�
a//.9 E-Mail: Vv �-(.J W
Address:
PD &x 9D417
City/PO: j State: Zip Code:
1.Does the propos action only inv a the legislative adoption of a plan,local law,ordingince, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that
may be affected in the municipality and proceed to Part 2. If no,continue to question 2.
2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES
If Yes,list agency(s)name and permit or approval:
l X
3.a.Total acreage of the site of the proposed action? /• acres
b.Total acreage to be physically disturbed? acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? acres
4. Check all land uses that occur on,adjoining and near the proposed action.
o Urban 0 Rural(non-agriculture) ❑Industrial ik.ommercial 0 Residential(suburban)
o Forest ❑Agriculture ❑Aquatic ❑Other(specify):
❑Parkland
Page 1 of 4
5. Is the proposed action, NO Y?
a.A permitted use under the zoning regulations? �'
b.Consistent with the adopted comprehensive plan? ✓
6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape?
1/.
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify:
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES
b.Are public transportation service(s)available at or near the site of the proposed action?
c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? /
9.Does the proposed action meet or exceed the state energy code requirements? NO YES
If the proposed action will exceed requirements,describe design features and technologies:
10. Will the proposed action connect to an existing public/private water supply? NO YES
If Yes,does the existing system have capacity to provide service? ❑NO❑YES
If No,describe method for providing potable water:
11.Will the proposed action connect to existing wastewater utilities? NO YES
If Yes,does the existing system have capacity to provide service? ❑NO❑YES
If No,describe method for providing'wastewater treatment:
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places?
1/
b.Is the proposed action located in an archeological sensitive area?
13.a.Does any y portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES
wetlands or other waterbodies regulated by a federal,state or local agency?
b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody?
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:
14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply:
❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional
❑ Wetland ❑Urban ❑Suburban
15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES
by the State or Federal government as threatened or endangered? /'
16.Is the project site located in the 100 year flood plain? NO YES
17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES
If Yes,
a.Will storm water discharges flow to adjacent properties? ❑NO❑YES
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
If Yes,briefly describe: ❑NO❑YES
Page 2 of 4
18.Does the proposed action include construction or other activities that result in the impoundment of NO YES
water or other liquids(e.g.retention pond,waste lagoon,dam)?
If Yes,explain purpose and size:
19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES
solid waste management facility?
If Yes,describe:
20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES
completed)for hazardous waste?
If Yes,describe: V
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor name: ell/ al/16 Date: ,�/ �/lp
Signature:
Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following
questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or
otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my
responses been reasonable considering the scale and context of the proposed action?"
No,or Moderate
small to large
impact impact
may may
occur occur
1. Will the proposed action create a material conflict with an adopted land use plan or zoning
regulations?
2. Will the proposed action result in a change in the use or intensity of use of land?
3. Will the proposed action impair the character or quality of the existing community?
4. Will the proposed action have an impact on the environmental characteristics that caused the
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or
affect existing infrastructure for mass transit,biking or walkway?
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing:
a.public/private water supplies?
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological,
architectural or aesthetic resources?
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands,
waterbodies,groundwater,air quality,flora and fauna)?
• Page 3 of 4
No,or Moderate
small to large
impact impact
may may
occur occur
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage
problems?
11. Will the proposed action create a hazard to environmental resources or human health?
Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every
question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular
element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.
Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and
cumulative impacts.
to Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action will not result in any significant adverse environmental impacts.
Name of Lead Agency Date
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
Page 4 of 4
Site Plan Review Revised June 2009
Signature Page
This page includes the 1.)Authorization to Act as Agent Form: 2.) Engineering Fee Disclosure; 3.)Authorization for Site
Visits; 4.) Other Permit Responsibilities; 5.) Official Meeting Disclosure and 6.) Agreement to provide documentation
required.
OWNER'S AGENT FORM:
Complete the following if the OWNER of the property is not the same as the applicant
Owner
Designates:
As agent regarding: Variance Site Plan Subdivision
For Tax Map No.: Section Block Lot
Deed Reference: Book Page Date
OWNER SIGNATURE: DATE:
APPLICANT'S AGENT FORM:
Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party:
Owner.
Designates:
As agent regarding: Variance Site Plan Subdivision
For Tax Map No.: Section Block Lot
Deed Reference: Book Page Date
OWNER SIGNATURE: DATE:
2.) ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design,
storm drainage, eta as determined by the Zoning or Planning Department Fees for engineering review services will be charged
directly to the applicant. Fees for engineering review will not exceed$1,000 without notification to the applicant
3.) AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein,the Owner,
Applicant, and his/her/their agent(s) hereby authorize the Zoning Board or Planning Board and Town Staff to enter the subject
properties for the purpose of reviewing the application submitted.
4.) OTHER PERMIT RESPONSIBIUTIES: Other permits may be required for construction or alteration activity subsequent to approval
by the Zoning Board or Planning Board. It is the applicant's responsibility to obtain any additional permits.
5.) OFFICIAL MEETING MINUTES DISCLOSURE: It is the practice of the Community Development Department to have a designated
stenographer tape record the proceedings of meetings resulting from application,and minutes transcribed from those tapes constitutes
the official record of all proceedings.
6.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I, the undersigned, have thoroughly read and understand the
instructions for submission and agree to the submission requirements, I acknowledge no construction activities shalt be commenced
prior to issuance of a valid permit. I certify that the application, plans and supporting materials are a true and complete
statement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the
approved plans and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed,I or my
agents,will obtain a certificate of occupancy as necessary. I also understand that Uwe may be required to provide an as-built survey b
a licensed land surveyor of all y Y
y newly constructed fatalities prior to issuance of a certificate of occupancy
pa cY
I ha - read and .- -to the abo -
46 )64 g)lafi -- [Applicant] Prin ! nI t _•. -
/ �rU'l//IDU C/ D to t d
•''I='1-e[Agent] Print Name[Agent] Date gned
Town of Queensbury Planning Office-742 Bay Road•Queensbury,NY 12804.518-781-8220 11
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