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Application 8/20/02 Site Plan Review General Information Application No. (Office Use Only) Project Location: zfA Iz e Y ZAP Tax Map ID: O ZO - Zone Classification: 49A - Compliance with Zoning Ordinance Section: Detailed Description of Project: (include current& proposed use): Goa �r w �f C�Gib Sr W4✓e ho✓ e awl c15SOGto" S,ku vk— Modification to existing Site Plan, Yes: No: (if so,indicate Site Plan No. & approval date) Square Footage of proposed structure: lO-cvo Sr- Applicant: �1a. sk t Zv�c Address: q 3 S i c a' 1�uwC� Home Phone: e�LSo- 774- 4l Q Work Phone/Fax: 7 74- -33I`i Applicant's Agent: ��ce nc{•n mac'' ►s �� Address: 144 d l- 'cf ZA4 u �4j u r1 'r•b 12S d T Home Phone: 74!g= 4400 Work Phone/Fax: `7Rz -15stt Property Owner: Cccr N Kea( Es.k (e`T v cJ Address: Cca e jA - Succerscr __� C�-T✓ns�ez Home Phone: Work Phone/Fax: Directions to Site: 7 8/20/02 Site Plan Review Site Development Data Area/Type Existing sq. ft. Proposed Addition Total sq. ft. sq. ft. A. Building Footprint /40 jogo B. Detached Garage O C. Accessory Structure(s) 0 0 0 D. Paved, gravel or other hard surfaced areas l 79 15, 6714 E. Porches/Decks O v F. Other G o � Total Non-Permeable Sum A through F) d Z5 (v z5 Parcel Area 3 14.G 73 146 73 14G Percent Non-Permeable ? 9 Total Non-Permeable Parcel,Area To 3 5 e !n 5= I Setback Requirements Required Existing Proposed Front(1) So z 0 Front (2) — Shoreline — Side Yard(1) �( S,D Side Yard(2) 3s.o Rear Yard(1) Rear Yard(2) Buffer/ Travel Corridor — Height 4(D { Permeability .30 _ Sign Setback No. of Parking Spaces y s v S 8 8/20/02 Site Plan Review Checklist—please prepare a map depicting existing and proposed conditions. Failure to complete the following checklist or include all required information may result in a determination of incompleteness and a delay in the rocessin of your application PR NA WR GENERAL A. Title,name, address of applicant&person responsible for preparation of drawing B. North arrow,Tax Map ID, date prepared and scale(minimum 1 in. =40 ft.) C. Boundaries of the property plotted to scale,zoning boundary D. Location of principal structures, accessory structures with exterior dimensions E. Location of site improvements incl. outdoor storage areas, driveways (existing & proposed) parking areas, etc. F. Setbacks for all structures and improvements G. Elevations of proposed structures WATER& SEWER A. Location of on-site sewage disposal facilities, design details, construction details, flow rates, and r number of bedrooms proposed B. Location of water supply(i.e., well) and septic on adjoining lots with separation distances to existing or proposed on-site water supply and septic C. Separation distances for proposed sewage disposal system to well and waterbodies D. Location and description of 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 E. Percolation test location and results • PARKING/PERMEABLE AREAS / A.Number of spaces required for project including calculations and justification B. Number of existing parking spaces, number to be removed,number to maintain and type of surfacing material(e.g., gravel,paved) r C.Provision for pedestrian and handicap access and parking D.Location and design details of ingress, egress, loading areas and cutting _ E. Location and character of green areas (existing and proposed),modification to green area,buffer zone to remain undisturbed F. Lighting,location and design of all existing or proposed outdoor lighting ADDITIONAL SITE DEVELOPMENT AND MISCELLANEOUS A. Location of on-site&adjacent watercourses, streams,rivers,lake and wetlands B. Location of proposed&existing: utility/energy distribution systems(gas,electric, solar,telephone) C. Location, design and construction of all existing and proposed site improvements including: drains, culverts,retaining walls, fences, fire &emergency zones and hydrants D. Location and amount/portion of building area proposed for office, manufacturing, retail sales or other commercial activities E. Signage: Location, size,type, design and setback F. Waiver Request: provide letter with application requesting any waivers G. Commercial / Industrial Development requires submission of a Landscaping Plan, Stormwater Management Plan,Grading Plan and a ighting Plan H.The Bd. may request other elements as considered necessary. I. Identify any Federal, State or County permits required for the project. J. Please submit record of application for approval status of all necessary permits required from Federal, State and Coun officials. Legend: PR—Provided; NA—Not Applicable; WR—Waiver Requested TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY. 12804-5902 Town of Queensbury Planning Board Waiver Request I hereby request that the Planning Board grant me a waiver from the requirement for the submission of the following plans. a Stormwater Management Plan o Grading Plan ❑ Lighting Plan o Landscaping Plan ❑ Sketch Plan approval ( Subdivision ) I acknowledge that these plans are required and I seek such waivers) knowingly and for the following reasons: 1 0 n e- Z�-i ue s w r Applicant Date L:\Crcgg\Templates\WaiverReq8602.doc �v 8/20/02 Site Plan Review tat1.41111961—Text 12 PROJECT I.D.NUMBER 617.20 SEOR Appendix C Stale Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART 1—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) i. APPL CANT/SPONSOR 2. PROJECT ME ra't ✓IG ��( .c LIoyse 0. PROJECT LOCATION: I 1 I I Municipality �B✓eJ�✓r County wev/Qk 4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,sto.,or provide map) 6. IS PROPOSED ACTION: ew ❑Expansion ❑Modificationlatteratlon S. DESCRIBE PROJECT BRIEFLY: . t.�e�.J VJc✓2vW4J.4 7. AMOUNT OF LAND AFFECTED: Initial) "e- .acres Ultimately ' & acres S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ❑No If No,describe briefly 9. WHAT IS PRESENT LAND BE IN VICINITY OF PROJECT? ❑Residential dustri.l ❑Commercial ❑Agriculture ❑PswFo.vttopen space ❑OIMr Deecdbe: dvsHo �cv� 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAQ? ❑Yea ;77o If yes,list a9ancyls)and permivapprovala 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ / Yes Silo If yes,list agency name and permiUapprov.l 12. AS A RESULTOF P OPOSED ACTION WILL EXISTING PERNIMAPPROVAL REQUIRE MODIFICATION? ❑Yea o I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApplIcantisponeor name T er' Date: 3 l If the action Is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 I� 8/20/02 Site Plan Review • PART II—ENVIRONMENTAL ASSESSMENT(To be Completed by Agency) A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR PART 617.4? If yes,coordinate the review process and use the FULL EAR ❑Yea ONO B. WtLL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 8 NYCRR,PART 817.6? If No,a negative declaration may be superseded by another involved agency. ❑Yes ONO C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,If legible) Cl. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic Panama. aclid waste production or disposal, potential for erosion,drainage or flooding problems?Explain briefly: C2. Aesthetic agricultural.archaeological,historic,w other natural or cultural resources;or community or neighborhood character?Explain briefly: GM. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered speclea?Explain briefly. C4. A community's existing plane or goals as offlelelly adopted,or a change in use or Intensity of use of land or other natural resources?Explain briefly C5. Growth,subsequent development,or related activities likely tube Induced by the proposed action?Explain briefly- CO. Long term,short term,cumulative,or other affects not identified In C1-05?Explain briefly. - C7. Other Impacts(Including changes in use of either quantity or type of energy)?Explain briefly. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF CEA? ❑yes ONO E IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yu ❑No If Yea,explain briefly PART III—DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTION& For each adverse effect Identified above,determine whether It Is substantial,large,important orothemise significant. Each effect should be assessed in Connection with Its(a) setting (i.e. urban a rural$(b) probability of mounting;(c)duration;(d) Irreversibility;(a)geographic scope;and M magnitude.If net:eseary,add attachments or reference supporting materials.Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been Identified and adequately addressed.If question D of Part 11 was checked yes,the determination and significance must evaluate the potential Impact of the proposed action on the environmental characteristics of the CEA - ❑ Check this box If you have identified one or more potentially large or significant adverse Impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. ❑ 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 AND provide on attachments as necessary,the reasons supporting this determination; Name of e Agency Print or Type Name of it.w.,.bl.Ofitke,.n L..d AgmcY Title Of Res,couble officer Signature of loeslponmble Otflcar m Lead Agency sparer M wrtnt rom,esponn e o mar Date 2 8/20/02 Site Plan Review Signature Page This Page includes the Authorization to Act as Agent Form, Engineering Fee Disclosure, Other Permit Responsibilities and Agreement to provide documentation required. Complete the following if the OWNER of the property is not the same as the applicant Owner's Agent Form Owner: 4!�-o o le C,,- ✓ �i«u sc- 14� '�cslea Designates: As agent regarding Variance_Site Plan Subdivision 8• For Tax Map No.:&o L o Section I Block —3 Lot Deed Reference: _Book Page _Date SIGNATURE: (Owner) (Date) Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party: Applicant's Agent Form ^ Owner: /���oo kn �¢ T_ �c �• c Designates: e- As agent regarding: Variance KSite Plan _Subdivision For Tax Map No.: 5bS.Zo Section _/Block ,�_Lot SIGNATURE: i (Owner) (Date) Eneineerine 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. Please Note: 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. Official Meetine Minutes Disclosure: It is the practice of the Community Development Dept. to have a designated stenographer tape record the proceedings of meetings resulting from application, and that minutes transcribed from those tapes constitute the official record of all proceedings. If there is a discrepancy between such record and the handwritten minutes taken by the designated stenographer, the handwritten minutes shall be deemed the official record. I, the undersigned, have thoroughly read and understand the instructions for submission, agree to the submission requirements and completed the checklist. i SIGNATURE OF APPLICANT: Date B Pi c 5 SIGNATURE OF AGENT: d Date E i5 d N Site Plan Inspection Report Form � IL Name: Abmast, Inc. Location: Carey Road, Queensbury, NY 12804 Site Plan No.: 43-2003 Area Variance No.: Building Permit No. (if any): Date: July 1, 2004 Dear Abmast, Inc.: During a site plan inspection of your project, the following deficiencies were discovered: 1) "DO NOT ENTER" signs missing at Carey Road exit. 2) "DO NOT ENTER" signs missing at Carey Road entrance. 3) Missing "HANDICAP" parking sign at designated HC parking space. 4) Dumpster not surrounded by enclosure. 5) Drywall not found at southwest detention basin (if installed, was not observable due to 100% sediment coverage). 6) Drywall at northeast detention basin 95% covered by sediment (needs to be maintained as needed). 7) Grass areas surrounding drywells are not completely stable (some grass growing). Areas need to be better stabilized to prevent sediment from flowing into drywells and covering catch basin grates. Until areas are stable, hay bale dams need to be installed around catch basin grates and grates need to be wrapped with filter fabric (see detail "J" on sheet SP-5). It is my expectation that these items will be addressed by July 9, 2004. Please contact this office to propose an acceptable schedule for developing the site as approved. Sincerely yours, Bruce Frank Code Compliance Officer 518-761-8226 brucef@queensbury.net on7 FILE Site Plan Inspection Report Form Name: Abmast, Inc. Location: Carey Road, Queensbury, NY 12804 Site Plan No.: 43-2003 Area Variance No.: Building Permit No. (if any): Date: July 29, 2004 Dear Abmast, Inc.: During a site plan inspection of your project, the following deficiencies were discovered: 1) All deficiencies corrected; site now developed as approved; good to issue CO. Sincerely yours, d2" Bruce Frank Code Compliance Officer 518-761-8226 brucef@queensbury.net 5tandinq 5eam Metal 1/ 2'' on 12'' 51 ope Walk boor Canopq (fqp,) L/71/ 11 1 1 L I I I I I I i Loadinq bock boors _ Fin. Grade R 4-0" 0'-0" F rout �ndwal I N evation Fave R 21'-0" Walk boor Canopq Corrugate Metal 50inq FILE // �/ ❑/ Fin, Floor R 0'-0" /in. Grade FI, -0'"6" 60'-0" Sidewall � ovation VMA5T WAF�NOU5� 125 'x80' �igl�t �levations 5cal e, I/8"-1'-0" bate;Au 13,2003 V &H construction,Inc. rJraw�rq No.. 0�,�1,01