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