ApplicationArea Variance [ZBA approved: September 21 2016]
General Information
Tax Parcel ID Number: ____________________
Zoning District: ____________________
Detailed Description of Project [include current & proposed use]:
Current Use: _________________________________________________________________
Proposed Use: ____________________________________________________________
Location of Project: _______________________________________________________________
Applicant Name: Mailing Address
Home Phone City, State, Zip
Work Phone Cell Phone
E-Mail: FAX No.
Agent’s Name: Mailing Address
Home Phone City, State, Zip
Work Phone Cell Phone
E-mail FAX No.
Owner’s Name Mailing Address
Home Phone City, State, Zip
Work Phone Cell Phone
E-mail FAX No.
Page 1
Area Variance [ZBA approved: September 21 2016]
Site Development Data
Area / Type Existing sq. ft. Proposed
Addition sq. ft.
Total sq. ft.
A. Building footprint
B. Detached Garage
C. Accessory Structure(s)
D. Paved, gravel or other hard surfaced area
E. Porches / Decks
F. Other
G. Total Non-Permeable [Add A-F]
H. Parcel Area [43,560 sq. ft. / acre]
I. Percentage of Impermeable Area of Site [I=G/H]
Setback Requirements
Area Required Existing Proposed
Front Yard [1]
Front Yard [2]
Shoreline
Side Yard [1]
Side Yard [2]
Rear Yard [1]
Rear Yard [2]
Travel Corridor
Height [maximum]
Permeability
Number of parking spaces
Page 2
(requested relief, garage closest to home)
Area Variance [ZBA approved: September 21 2016]
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): _________________________
3.Does this project require coverage under the New York State Pollutant Discharge Elimination System (SPDES) Permit
Program? __ Yes / __ No
4.Estimated project duration: Start Date: __________ 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 0.22
Commercial Moderate / Commercial
Intensive
CM / 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]
Page 3
use variance 1333-3/16/88 and 4/19//1989 one man engine
repair shop North side of Luzerne Road
Area Variance [ZBA approved: September 21 2016]
Compliance with Zoning Ordinance
Requesting relief from SECTION: ________________________________
Need relief from the requirement(s) listed below which can not be met by the project as proposed.
Buffer Zone Lot Width Other ______________________
The following questions reflect the criteria for granting this type of variance. Please complete them; use additional sheets if
needed.
1. Whether an undesirable change will be produced in the character of the neighborhood or a detriment to
nearby property will be created by the granting of this area variance?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
2.Whether the benefit sought by the applicant can be achieved by some method, feasible for the applicant
to pursue, other than an area variance?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
3.Whether the requested area variance is substantial?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
4.Whether the proposed variance will have an adverse effect or impact on the physical or environmental
conditions in the neighborhood or district?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
5.Whether the alleged difficulty was self-created?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Page 4
[Check all that apply] __Setback
The garage has electricity and no water.
Area Variance [ZBA approved: September 21 2016]
Section 179-14-030 –Application materials
Application materials and site plan drawing is to include sufficient information for the Board to review and provide a decision. The
applicant is to provide a site plan drawing(s) – a survey showing existing conditions, a proposed conditions map (see page 00 for
specific criteria) and include any other attachments that address A - D as applicable to the proposed project.
A.General Shown on Sheet #
1 Title, Name, Address of applicant & person responsible for preparation of drawing
2 Deed
3 North arrow, Tax Map ID, date prepared and scale [minimum: 1 inch = 40 feet ]
4 Boundaries of the property plotted to scale, zoning boundary
5 Principal structures, accessory structures with exterior dimensions
6 Site improvements incl. outdoor storage areas, driveways, parking areas, etc.: existing &
proposed
7 Setbacks for all structures and improvements: existing & proposed
8 Elevations and floor plans of all proposed and affected structures
B. Water & Sewer Shown on Sheet #
1 Project sewage disposal facilities, design details, construction details, flow rates, and number of
bedrooms proposed
2 Water supply [i.e. well] & septic on adjoining lots with separation distances to existing or
proposed on-site water supply and septic
3 Separation distances for proposed sewage disposal system to well and water bodies
4 Existing public or private water supply [well, lake, etc.]. Method of securing public or private
water, location, design and construction of water supply including daily water usage
5 Percolation test location and results
C. Parking / Permeable Areas Shown on Sheet #
1 Number of spaces required for project including calculations and justification: existing &
proposed
2 No. of existing parking spaces, number to be removed, number to maintain and type of surfacing
material [e.g., gravel, paved]
3 Provision for pedestrian and handicap access and parking: existing & proposed
4 Design details of ingress, egress, loading areas and cutting: existing & proposed
5 Location and character of green areas [existing and proposed], modification to green area, buffer
zone to remain undisturbed
6 Lighting, location and design of all existing and proposed outdoor lighting
D. Additional Site Development and Miscellaneous Shown on Sheet #
1 On-site & adjacent watercourses, streams, rivers, lake and wetlands
2 Utility / energy distribution system [gas, electric, solar, telephone]: existing & proposed
3 Location, design and construction details of all existing and proposed site improvements
including: drains, culverts, retaining walls, fences, fire & emergency zones and hydrants, etc.
4 Square footage of bldg. area proposed for office, manufacturing, retail sales or other commercial
activities: existing & proposed
5 Signage: Location, size, type, design and setback: existing & proposed
6 Waiver Request: provide letter with application requesting any waivers: please reference
specific items
7 Commercial / Industrial Development requires submission of Landscaping, Stormwater
Management, Grading & Lighting Plans
8 Identification of Federal, State or County permits required for the project together with a record
of application for all necessary permits
Page 5
Area Variance [ZBA approved: September 21 2016]
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 the following:
Variance ___ Site Plan ___ Subdivision ___
For Tax Map No.:________________ 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 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.) 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 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.
______________________________ _____________________________ _______________
Signature [Applicant] Print Name [Applicant] Date signed
______________________________ _____________________________ _______________
Signature [Agent] Print Name [Agent] Date signed
Page 7
12/21/1984
x 19
21 12/6/1985