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Application TO W OF QUEENSBURY 742 Bay Rand, Qneepisbury, NY- 32604-5902 Septwnber 19, 2018 Cameron R_ Lewis 4 Finch Way,Apt. D Queensbury,NY 12804 Re- Single-Family Dome 11 Old West Mountain Road Tax Map No_ 295.5-1-8 Dcar fir. Lewis, I am NNTiting you with regards to my review of the above-referen"d project and to document the recent conversations between you and Laura Moore; of my office. Upon my review I find that your proposal will require an Area Variance prior to the issuance of a building permit for the project. A Variance is required as your plan offers the construction of a single-fancily home that cannot meet the minimum setback requirements for the RR-5A zoning district. Site flan Review is also required as the construction of the new home is within 50 ft. of slopes greater than 15 percent. I understand that you have prepared the necessary application materials_ As such, this letter wiII serve as the necessary denial letter for the processing of your applications. Should you have any questions or comments regarding your application, please do not hesitate to contact this office. Sincerely, Craig Brown Zoning Administrator B/sh L_', raig BrowiA2018 I,atters%Deniai Cameron Gardn r-Leivis 9.17.2018.doe " Haute of Naturnl Beatify ... A Good Place I Live " TARRETTI' Engneers, PLLC Civil&Environmental EgMeering Transmitted via email& hand delivered November 14, 2018 Stephen Traver, Chairman, Queensbury Planning Board, Harrison Freer, Chairman, Queensbury Zoning Board of Appeals, and Board Members 742 Bay Road Queensbury,NY 12804 Re: Gardner-Lewis Residential Development Old West Mountain Road JE 18-025 Dear Chairmen Traver and Freer,plus Board Members, Our clients plan on building a home on a pre-existing residential lot along the west side of Old West Mountain Road. It is the same property and the same area on the site, albeit with a new applicant, that was approved by the Planning and Zoning Boards in 2014. The lot is narrow and is hampered by steep slopes as well as by a stream that splits the property into two even narrower segments. Constructing the house at the required setbacks would not only create a steep and potentially unsafe driveway, it would also impact the stream. O ur recommendation in 2014 and again now is to locate the house closer to O 1 d West Mountain Road and closer to the north property line. The recommended location is not in compliance with Town zoning requirements, which include a 100' setback from the front property line and 75' from each side line. The proposal, as shown on the attached variance plan, is for the house to be closer to Old West Mountain Road and to the north property line, and the variances are nearly the same as approved in 2014 (slightly more setback required, ie: slightly less variance, to Old West Mtn Road). The recommended location would facilitate a short driveway, at an approximate grade of 8.5% grade, whereas situating the house in a compliant location would require a much longer driveway, and at a grade in excess of 20-25%. The house siting preserves some of the evergreen tree cover along the main road, in an attempt to provide a buffer and privacy. Wastewater management will be by a NYSDOH and Town of Queensbury compliant on-site wastewater system, whereas water supply is by connection to the Queensbury municipal water supply. Stormwater management in compliance with Town residential standards was has been proposed, and the stream will receive no direct runoff from the proposed development. The 2014 project was reviewed and approved by the Town Engineer and the technical design has changed very little. The house has a slightly different shape, and was rotated slightly from the earlier design, but the site impact is the same. The driveway has not changed, but an additional rain garden has been added to more efficiently capture runoff In 2014, an eave trench was proposed to manage runoff from the house roof, but instead of the original crushed stone trench, we have now substituted a chamber system in the trench to provide even more retention volume. Although the project is residential, we herewith request a waiver from the lighting and landscaping plan 12 East Washington Street 518-792-2907 Glens Falls, NY 12801 Queensbury Planning Board and Zoning Board of Appeals November 14, 2018 Re: Gardner-Lewis Residential Development, Old West Mt. Road requirements; any exterior lighting will be shielded and downcast, while landscaping will be consistent with a woodland setting. We look forward to discussing this project with each board; it was well received in 2014, and we hope that the current boards will concur. If there are any questions, please call our office at 518-792-2907 or email me directly at t arrett@jarrettengineers.com. Sincerely, JARRETT Engineers, PLLC ( # 2018.11.14 12:31:17 -05'00' H. Thomas Jarrett, P.E. Principal Encl: • Site Plan Review Application • Area Variance Application • I Ix17 TimberHaven Log Homes drawings (1-4) • I Ix17 Drawings by JARRETT Engineers, PLLC (1-8) entitled `Residential Development Gardner- Lewis'. Revision A dated 11-14-18 (30) Ecopy(ies)w/encl: Cameron Gardner-Lewis Mike Lewis F:IDataFile12018 Proj12018 Resi&18-025 Gardner-Lewis SPIWork Docs11802518xxxx SP+AVISrce Files118025181113 Cvr Ltr.doc peaks Log Homes Follow the path from dream to reality www.highpeaksioghomes.com 518.494-7265 Responses to site plan application—standards A) New home shall be kuilt to current stringent codes and is consistent with the policies of the town Cotlldrehensive plan. 5) New 1Dome is very modest in size and will comply with regulations of the zoning district. C) The site plan encourages pedestrian traffic.as several paths will be incorporated into landscape e dsign. Jarrett�ngineers are providing storm water management design as well as sewage disposal design. F) Single family dwelling to Dave minimal impact on existing public services. r) Project is located on minimally travelled road,parking is of street. G) Project is residential and will provide for adequate off street parking. H) Project is residential single family dwelling and will have nuni"Ial impact on landscape keeping vertu natural in design_ l) Project is located on minimally travelled road. J) Storm water management as designed kq Jarrett engineering. lU Water supplq from town,sewage disposal as designed kq Jarrett Vngineer ing. L) Currentlt)a vacant lot.[)uring construction,lot will be cleaned of dead plants and maintained in a responsihle manner. M) This is an existing road witl-i necessary requirements in place, Jarrett n ineerin . N) Storm water management as designed h3,� g g Q) The site plan conforms and is in keeping with towns comprekcnsrve plan. Town of Queensbury Site Plan Pre-Submission Conference Form 1 Section 179-9-040 1. Applicant Name: Cameron Gardner-Lewis 2, Tax Map ID 295.6-1-8 Location: 11 Old West Mt.Road 3, Zoning Classification pRR-5A 4. Reason for Review: t n"t 'SJ. 5. Zoning Section 4: 179-6-060 6. Pre-Submission Meeting Notes: Provided Outstanding; Please provide by Deed General Information complete ✓ Site Development Data Complete _—Af, Setback Requirements Complete ✓ Additional Project Information Complete ore�Cl)✓ FAR addressed ALA. Requirements for Site Plan-Standards - ✓ Checklist items addressed l� Environmental Form completed VA- Signature Page completed [Vl Dn toot Q-)k-QC U Lh G c[ 'rCL 5 r c q I 4%o �o t % �ccl, tT} eyG� f..c9c.� cevLcS �t°cl��e-cif fn ct �4� t`� (�JlC�c> P !/l�r�l t �� r PM P r bcC. t 5 c 4 ry n rf S'' 'ZcJvl9 CX� cr� CQJC r a Staff Representative: Date: Applicant/Agent: 8 Plan Review application--Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 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: �r,,►,r TM�-, ) .ks51 r 1/r—.r11_& '__.&t.,.,1 f Designates: �hn e l L e-w i S As agent regarding: �1 Variance Site Plan Subdivision For Tax Map No.: Section Block Lot Deed Referen : Book Page Date OWNER SIGNATURE: DATE: Z 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,etc.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 hislher/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 RESPONSIBILITIES: 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 die 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 shall 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 wilt 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 Itwe may be required to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy I have r9ad and agree to the above. Si afore[Applicant] Print Name[Applicant] Date signed Signature[Agent] Print Name [Agent] Date signed 9 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 Short Environmental Assessment Form Part I -• Project Information Instructions for Completing Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part). 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 Name of Action or Project: Project Location(describe,and attach a location map): r �s1� P r Brief Description of Proposed Action: Name of Applicant or Sponsor: Telephone: S, 71 Address: City/PO: State: Zip Code: 1.Does the proposed action only involve the legislative adoption of a plan,local law, ordinance, 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; 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? S acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) [:]Industrial ❑Commercial y! Residential(suburban) ❑Forest ❑Agriculture El Aquatic [:]Other(specify): ❑Parkland Page 1 of 3 NO YES NIA 5. is the proposed action, 'L ❑ a. A permitted use under the zoning regulations? El❑ X ❑ b.Consistent with the adopted comprehensive plan? NO YES 6. 1s the proposed action consistent with the predominant character of the existing built or natural ❑ `` landscape? YES 7. 1s the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO If Yes,identify: No YES 8. a.Will the proposed action result in a substantial increase in traffic above present levels? X- it of the proposed action? ❑ available at or near the site ro ❑ P P b.Are public transportation service(s) ❑ ❑ c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? NO YES 9.Does the proposed action meet or exceed the state energy code requirements? El ❑ 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 No,describe method for providing potable water: NO YES 11.Will the proposed action connect to existing wastewater utilities? ❑ ❑ If No,describe method for providing wastewater treatment: NO YES 12, a.Does the site contain a structure that is listed on either the State or National Register of Historic ❑ ❑ Places? ❑ rcheological sensitive area? b.is the proposed action located in an a X 13.a.Does any portion of the site of the proposed action,or lands adjoining She 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 ❑AgriculturaVgrassland& ❑Early mid-successional ❑ Wetland El Urban ❑Suburban p YE5 15.Does the site of the proposed action contain any species of animal,or associated habitats, listed IY�` UES by the State or Federal government as threatened or endangered?1b.Is the project site located in the 100 year flood plain? NO 17.Will the proposed action create storm water discharge,either from point or non-point sources? No YES If Yes, 0 NO ❑YES a.Will storm water discharges flow to adjacent properties? b.Will storm water discharges be directed to established conveyance systems(runoff Oand©rm drains)? If Yes,briefly describe: Page 2 of 3 I S.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other Iiquids(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: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE REST OF MY KNOWLEDGE _ r , Applicant/sponsor ie: /f ' "' Date: `f „ i Signature: i PRINT FORM Page 3 of 3 WARRANTY DEED DELIVERY DATE: November/ ), 2018 GRANTOR: JOSEPH WOODWARD I 1 Old West Mountain Road Queensbury,New York 12804 GRANTEE: CAMERON R. GARDNER-LEWIS JESSIE E. GARNER-LEWIS 4 Finch Way,Apt. D Queensbury,New York 12804 as tenants by the entirety THIS WARRANTY DEED made between Grantor and Grantee on the deed stated above WITNESS THAT GRANTOR in consideration of ......................................... One Dollar($1.00) ........................................ lawful money of the United States and other good and valuable consideration paid by Grantee, DOES HEREBY GRANT AND RELEASE UNTO GRANTEE and their heirs, successors and assigns forever all that property located at: 11 Old West Mountain Road Town of Queensbury County of Warren State of New York Tax Map No. 295.6-1-8 (THE PROPERTY IS DESCRIBED MORE FULLY IN SCHEDULE"A"ATTACHED) BEING the same premises described in an Deed from Kirk Roberts and Susan Fuller- Bombard dated May 12, 2017 and recorded in the Warren County Clerk's Office on June 9, 2017 in Book 5570, at Page 301.. THIS GRANT IS MADE: TOGETHER with the appurtenances and all the estate rights of the Grantor in and to said premises. TO HAVE AND TO HOLD the premises herein granted by this Warranty Deed unto the Grantee and their heirs, successors and assigns forever. Title No.: W785S81 SCHEDULE A ALL THAT CERTAIN PIECE OR PARCEL OF LAND situate, lying and being in the Town of Queensbury, Warren County, N.Y., more particularly bounded and described as follows: BEGINNING at a point in the westerly bounds of lot 73 of the Queensbury Patent distant 405.81 feet at a bearing of South 06 degrees, 12 minutes and 30 seconds West, measuring along the said boundary line, from an iron pipe set in a stone pile found at the northwesterly corner of;the said lot 73, running from thence South 83 degrees and 59 minutes East, 1406.08 feet to a point for a corner in the center of Old West Mountain Road; running from thence South 47 degrees and 12 minutes West in the center of the said road, 82.15 feet; thence running South 49 degrees, 32 minutes and 30 seconds West, still along the center of the said road, 30.10 feet; thence running South 48 degrees, 27 minutes and 3'0 seconds West, still in the center of the said road, 55.57 feet, thence running South;41 degrees and 46 minutes West, still in the center of the sad road, 50.00 feet; thence running South 29 degrees and 48 minutes West, still in the center of the said road, 41A7 feet; thence running North 83 degrees and 59 minutes West, 1248.64 feet to a point in the westerly bounds of the said lot 73; thence running North 06 degrees, 12 minutes and 30 seconds East along the westerly bounds of the said lot 73, 202.91 feet to the point and place of beginning. AND THE GRANTOR COVENANTS as follows: FIRST,that Grantee shall QUIETLY ENJOY said premises; SECOND,that Grantor will forever WARRANT the title to said premises; THIRD, that this conveyance is made subject to the trust fund provisions of section 13 of the lien law. If there are more than one Grantor or Grantee,the words"Grantor"and"Grantee" used in this deed includes them. IN WITNESS WHEREOF,the Grantor has executed this Warranty Deed on the date stated above. *JOSEPWO RD STATE OF NEW YORK ) COUNTY OF WARREN )ss.: On the/2 tday of November, 2018, before me,the undersigned, a Notary Public in and for said State, personally appeared JOSEPH WOODWARD, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whos name is subscribed to the within instrument and acknowledged to me that he executed the s e in his capacity, and that by his signature on the instrument,':the individual, or the person upopf bAalf of ich he individual acted, executed the instrument. V,INOARY L -PuArrc y Area Variance [ZBA approved: September 21 2016] p / General Information Tax Parcel ID Number: Z / c5•b ! "� Zoning District: Detailed Description of Project [include current& proposed use]: Current Use: �/�}-C illT Proposed Use: Af Ly /467]51,6&W Location of Project: Ol-6 �)�S /Y)4yn!7-M/J IC Applicant Name: n_lneWoa z Mailing Address F Q Home Phone City,State,Zip Work Phone CeII Phone 61S- 79/- 7031 E-Mail: FAX No. Agent's Name: // Mailing Address �1h rr�/r LCC�lS 6-Z �r- oX �tr� Home Phone City,State,,Zip �18-y9y� �zcs Work Phone Cell Phone 619—fbo- 33z 7 E-mail MiK6:—/_ ros P, AH9Y FAX No. �} S GeC,/To lY7 ES• �o/✓1 Owner's Name �// ' Mailing Address �lDSEPN 000lur>�� SD/� l�o�sTRr�L U/�G G�� Home Phone City, State,Zip ,eFFNs,�o,� Nc Work Phone Cell Phone E-mail FAX No. Page 1 Area Variance [ZBAapproved: September212016] Site Development Data Area/Type Existing sq.ft. Proposed Total sq.ft. Additions .ft. A. Building footprint 0 1392 1392 B. Detached Garage 0 0 0 C. Accessory Structure(s) 0 0 0 D. Paved,gravel or other hard surfaced area -1390 1472 82 xisting Driveway Removed Includes Driveway in RO E. Porches/Decks 0 192 192 F. Other Retaining Walls 0 144 144 G. Total Non-Permeable [Add A-F] -1390 3195 1805 H. Parcel Area [43,560 sq.ft./acre] 261,468 0 261,468 (Excludes Old West Mountain Road) 1. Percentage of Impermeable Area of Site [I=G/H] -0.5% 1.2% 0.7% Setback Requirements Area Required Existing Proposed Front Yard [1] 100' 0 37.6 Front Yard [2] N/A 0 N/A Shoreline N/A 0 N/A Side Yard [1] 75' 0 22.7' Side Yard [2] 75' 0 >75' Rear Yard [1] 100' 0 >100' Rear Yard [2] N/A 0 N/A Travel Corridor N/A 0 N/A Height [maximum] 40' 0 34' Permeability 75% 99.5% 99.3% Number of parking spaces N/A N/A N/A Page 2 Area Variance(ZOA approved: Septe iLber21 2016] Pre-Submission Conference Form 1 Section 179-9-040 1. Applicant Name: Cameron Gardner-Lewis 2. Tax Map ID i 295.6-1-8 Location: f 3. Zoning Classification RR-5A 4. Reason for Review: 5. Zoning Section#: 179-3-040 6. Pre-Submission Meeting Notes: Provided Outstanding; Please provide by Deed General Information complete Site Development Data Complete Setback Requirements Complete Additional Project Information Complete FAR addressed Compliance with Zoning Ordinance Checklist items addressed Environmental Form completed Signature Page completed __149arc G cvl G r14 t� f 'dac� 40 `'T c G9tt-l'in r e- r-p- Staff Representative: cJ Date Applicant 1 Agent: Page 6 Area Variance [ZBAapproved: 5eptembcr212016] 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. OWNF,R's AGENT FoRm, Complete the following if the OWNER of the property is not the same as the applicant: Owner: Designates: as Agent regarding the following: Variance_ Site Plan Subdivision For Tax Map No.: Deed Reference: Book Page Date OWNER SIGNATURE:- Y DATE: 0 9/1 612 0 1 8 ArPLICANT'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 the following: Variance_ Site Plan Subdivision For Tax Map No.: 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, etc. 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 RESPONSIBILITIES: 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. OFFICIA.L 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: 1,the undersigned,have thoroughly read and understand the instructions for submission and agree to the submission requirements, I acknowledge no construction activities shall 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 I/we may be required to provide an.as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy I have read and agree to the above. Cameron Gardner-Lewis Jessie Gardner-Lewis 09/16/2018 Signature[Applicant] Print Name[Applicant] Date signed Signature[Agent] Print Name[Agent] Date signed Page 7 Short Environmental Assessment Form Part I -Project Information Instruct-ions for Compietin� Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. 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 1 -Project and Sponsor Information Name of Action or Project: � C9 p7b�4c'! l4No �Css1� �,q�a v F,e - Zr w IS Project location(describe,and attach a location map): 11 G 4dE07- 7-411J XCI Brief Description of Proposed Action: �U/Go �EGt) ��Od � SINGLE �fj-NIIG y A5?,0 64 C L5_ Name of Applicant or Sponsor: Telephone: 72 Ls �ICl�EZ !`• t�FGJ1S &Mail:/''l EG�wls Address: � l�'�Ptq,�'S �a N1esS City/PD: — w4 Stater zip Code: +� 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, Vy /zg// administrative rule,or regulation? NO YES 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? If Yes,list agency(s)name and permit or approval: NO YES n VSJ ❑ 3.a.Total acreage of the site of the proposed action? b.Total acreage to be physically disturbed? _acres c.Total acreage(project site and any contiguous properties)owned acres or controlled by the applicant or project sponsor9 rj.6 acres 4. ChecE<all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Cotmmereial ,Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other s ❑Parkland (specify): Page 1 of 3 5. Is the proposed action, NO YES NIA a.A permitted use under the zoning regulations? HIJ 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? ❑ El 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? 21 ❑ 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 excce�ed requirements,describe design features and technologies: AV VIf r___0 GbtV eX1FTE 015M-5P /nl ❑ oD lN,S dzit aIV 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ,Sf7�1'1 G' 5 yJ7Z:'- '1 ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? © ❑ b.Is the proposed action located in an archeological sensitive area? 13.a.Does any 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 ❑i;arly mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed N0 4YES by the State or Federal government as threatened or endangered? ®16.Is the project site located in the 100 year flood plain? ND 17.Will the proposed action create storm water discharge,either from point or non-point sources? O YES If Yes, a.Will storm water discharges flow to adjacent properties? NO DYES ❑ b.Will storm water discharges be directed to established conveyance systems runoff and storm drains)? If Yes,briefly describe: �} JNO YES /'Fie �Nt�rinfE�ie Page 2 of 3 IS.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.I]as 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: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor n / "/1 L/���L LC d 1-3 Date: Signature: PRINT FORM Page 3 of 3 Agency Use Only 11f applicable] Project: Date: Short Environmental Assessment Form Part 2-Impact Assessment Part 2 is to be completed by the Lead Agency. 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?" 1Vo,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. Wil1 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, ❑ :E1 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)? ❑ ❑ 10. Will the proposed action result in an increase in the potential for erosion,flooding or drai problems? nage ❑ t 1. Will the proposed action create a hazard to environmental resources or human health? PRINT FORM Pagel of2 Agency Use Only[If applicable] Project- Date: Short EnWronmental Assessment Farm Part 3 Determination of Significance 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. 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) PRfNT FORM Paget oft ® TOWN OF QUEENSBURY ® Zoning Board of Appeals-Record of Resolution 742 Bay Road,Queensbury,NY. 12804-5902 Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518)761-8238 Steven Jackoski,Chairman Roy Urrico, Secretary Town of Queensbury Planning Board TO: Kirk Roberts PROJECT FOR: Kirk Roberts PO Box 920 11 Old West Mountain Road RESOLUTION TO APPROVE SITE PLAN 62-2012 KIRK ROBERTS Glens Falls.NY 12801 ZBA Meeting Date:Wed.,August 20,2014 Tax Map ID 295.6-1-8/Property Address: 11 Old West Mountain Road A site plan application has been made to the Queensbury Planning Board for the following: RESOLUTION TO:Approve Area Variance No.57-2014,Kirk Roberts,Tax Map No.295.6.1-8 Applicant proposes construction of a 1,500 sq.ft.single family dwelling with disturbance for septic, The Zoning Board of Appeals of the Town of Queensbury has received an application from Kirk Roberts driveway,and stonnwater management. Pursuant to Chapter 179-6-060 of the Zoning Ordinance for a variance from Sectlon(s):179-3-040 of the Zoning Code of The Town of Queensbury.Applicant any construction within 50 feet of slopes greater than 15%shall be subject to Planning Board proposes construction of a 1,500 sq.8.single-family dwelling and associated site work.Relief requested review and approval. from minimum side and front yard setback requirements for the RR-5A zoning district. SEQR Type II; SEQR Type II-no further review required; PB made a recommendation to the ZBA on 8-19-14;the ZBA approved the variance requests on 8- A public hearing was advertised and held on Wed.,August 20,2014; 20-14; Upon review of the application materials,information supplied during the public hearing,and upon consideration of the criteria specified in Section 179-14-080(A)of the Queensbury Town Code and A public hearing was advertised and held on 7-15-14,8-19-14&tabled to 9-16-14; Chapter 267 of NYS Town Law and after discussion and deliberation,we find as follows: This application is supported with all documentation,public comment,and application material in the file of record; 1. Will an undesirable change be produced in the character of the neighborhood or will a detriment to the nearby properties be created by The granting of the requested area variance?1 believe MOTION TO APPROVE SITE PLAN NO.62-2012 KIRK ROBERTS,Introduced by Donald minor Impacts to the neighborhood would be anticipated. Krebs who moved for its adoption,seconded by David Deeb: 2. Can the benefit sough}by the applicant be achieved by some method,feasible for the applicant This is per the resolution prepared by Staff. to pursue,other than an area variance?Feasible alternatives are limited because of the topographical constraints of the property. 1) Pursuant to relevant sections of the Town of Queensbury Zoning Code-Chapter 179-9-080,the Planning Board has determined that this proposal satisfies the requirements as stated in the 3. Is the requested area variance substantial?The relief may be considered moderate;not really Z substantial. Zoning Code; 4. Will the proposed area variance have an adverse impact on the physical or environmental 2) Waiver requests granted: landscaping&lighting plans conditions in the neighborhood or district?Minor Impacts to the physical and environmental conditions of the neighborhood are anticipated. 3) The limits of clearing will constitute a no-cut buffer zone,orange construction fencing shall be installed around these areas and field verified by Community Development staff; 5. Is the alleged difficulty self-created?Yes 4) If required,the applicant must submit a copy of the following to the Town: a) The project NOI(Notice of Intent)for coverage under the current"NYSDEC SPDES General Permit from Construction Activity"prior to the start of any site work. b) The project NOT(Notice of Termination)upon completion of the project; 5) The applicant must maintain on their project site,for review by staff: Page 1 of 2 a) The approved final plans that have been stamped by the Town Zoning Administrator.These plans must include the project SWPPP(Storm Water Pollution Prevention Plan)when such a Approval of the application means that the applicant can now apply for a Building Permit unless plan was prepared and approved; b) The project NOI and proof of coverage under the current NYSDEC SPDES General Permit, your lands are Adirondack Park Jurisdictional or other approvals are necessary(such as review by the Queensbury Planning Board.) or an individual SPDES permit issued for the project. 6) Final approved plans,in compliance with the Site Plan,must be submitted to the Community Zoning Board of Appeals-Record of Resolution Development Department before any further review by the Zoning Administrator or Building Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518)761-8238 and Codes personnel. 7) The applicant must meet with Staff after approval and prior to issuance of Building Permit ZBA Decision Resolution(continued) and/or the beginning of any site work. ZBA Meeting Date:Wed.,August 20,2014 Area Variance Application No.57-2014,Kirk Roberts 8) Subsequent issuance of further permits,including building permits is dependent on compliance with this and all other conditions of this resolution Based on the above findings I make a MOTION TO APPROVE Area Variance No.57-2014,Kirk Roberts, 9) d Introduced by Mr.Kuhl,who moved for its adoption,seconded by Mr-McCabe. provided prior plans to certify that the site plan is developed according[o the approved plans to be THIS D RAW I N G INCLUDED provded r IOI to issuance of the certificate of occupancy. As per the resolution prepared by staff with the following: Duly adopted this 16a'day of September,2014,by the following vote: A. The variance approval is valid for one(1)year from the date of approval;you may request an extension of approval before The one(1)year time frame expires; AYES:Mr.Deeb,Mr.Schonewolf,Mr.Ferone,Mr.Krebs,Mr.Traver,Mr.Hunsinger F 0 R REFERENCE 0 N LY B. Final approved plans in compliance with an approved variance must be submitted To the NOES:NONE Community Development Department before any further review by the Zoning Administrator or Building&Codes personnel; ABSENT:Mr.Magowan C. Subsequent issuance of further permits,including building permits are dependent on receipt of these final plans; Cc:Jarrett Engineers D. Upon approval of the application;review and approval of final plans by the Community Development Department The applicant can apply fora building permit unless the proposed ISSUED F 0 R CONSTRUCTION project requires review,approval,or permit from the Town Planning Board and/or the Adirondack Park Agency,Lake George Park Commission or other State agency or department. Duly adopted this 20rh day of August,2014.by the following vote: AYES: Mr.Garand,Mr.Henkel,Mr.Urico,Mr.Freer,Mr.Kuhl,Mr.McCabe,Mr.Jackooki 09-22-14 © TOWN OF QUEENSBURY ZBA&PLANNING BOARD OF APPROVALS NOES:none ZBA&PLANNING BOARD RESOLUTIONS 08-18-14 TOWN OF QUEENSBURYTDE COMMENTS NO REVISIONS THIS SHEET) Steven Jackoski,Chairman 07-15-14 A 0 SUBMITTED TO THE TOWN OF QUEENSBURY Queensbury Zoning Board of Appeals PLANNING AND ZONING SJ/sh DATE REV# ISSUED/REVISIONS cc:Jarrett Engineers,PLLC as�a�jNT�S,oNwoRK�w( out �wRr N�o 5O�(,��O151oN arooK�0�YD0 PNOTa��s� SISS,reoOR OFNEwY0 TOWN OF QUEENSBURY APPROVALS AP1 0 o s✓q9 9� ROBERTS RESIDENTIAL DEVELOPMENT Page 2of2 o w 11 OLD WEST MOUNTAIN ROAD QUEENSBURY,NEW YORK Approval of the application means that the applicant can now apply for a Building Permit unless �FES ( JARRETT Engineers, PLLC your lands are Adirondack Park Jurisdictional or other approvals are necessary(such as review Civil %Environmental Engineering by the Queensbury Planning Board.) H.THOMAS JARRETT P.E.#57509 12 EAST WASHINGTON STREET GLENS FALLS,N.Y. COPYRIGHT©2014 PHONE:(518)792-2907 a��ESEA� EAEo,A�E JUNE 2014 PRO#14-003 SHEET:2 OF 9 BASESHEET'.22.94 PLOTTED/REVISED'.11/14/18 12'.00 PM