2001-650 3
�� Fee� Paid: / L 36
- TOWN OF QUEENSBURY
/
742 Bay Road, Queensbury, NY 12804 Approved By:
518) 761-8256 Permit' #: Cy ) 1- D
SIGN PERMIT APPLICATION
. reNED
vi..e%,„ - - -
THE FOLLOWING INFORMATION IS REQUIRED' 8 TOM
AvG 2'
1. Detailed drawing or photo of sign. E5453131
2. Plot plan of location of sign. \AN Ct�q�1DG0-D-
3. Written consent of the owner of the building or 1 anfm(v1_®1Ng_. �`"
OWNER OF PROPERTY- EN E -I W. y C1-1 ii L. Z, U/CE
ADDRESS g g OAK. "ALLEY WAY OL Ejs8u / MY I2gQ4 TEL.(5!8) 70-7073
NAME OF APPLICANT 1&14 ni ETN `i• ' Clia_I E C.• L AiKE
ADDRESS 4-2.5 B -I-R6 o&r QuEtosBUO.'I my to -A1- TEL.(5I0 7c13-s33I
BUSINESS NAME IF DIFFERENT: .__UI ET C1 I LV(
TYPE AND LOCATION
Check What Applies: Existing 0/ Permanent A/ Projecting Sign 4/
Temporary Non-conforming Existing __
Free-Standing -- Wall — New —_
Location: Tax Map Number CAI - 1 -L1-3
Address y-2. E5401 RoAs.C3 tPLSEENISE3t3RY Idy I Z OLI
Proposed Setbacks from Property Line (front) — (side)
If sign is to be illuminated, please check appropriate box: c c, JOA
PC(Arliti
i rInternal ( ) , External ( ) , Incadescent ( ) , Neon ( ) , Other ( ) a
Size of Sign: Width 3 ft. Length 2- _ ft.
Total Square Footage: — . wbf-edatj F
• Sign Copy: -- 0 /-ET (J 7�/7K-
Color and Material (��1�%� r�
To Be Used: L /a4ck - ZJoo
Signature: l-" aVx_ Rise IX2&..- C j_t_ciL___Q__
Circle One: Applicant owner con ractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON MY PROPERTY OR BUILDING.
Signature of Property Owner: ac;-? ., A.
ORIGINAL-Office Copy COPY-Applicant
General Information
Application No. (office Use Only)
Project Location: 4-Z5 3, -y /W o
Tax Map ID: 6 / _ / _ 43
Zone Classification: M,n- S
Detailed Description Of Project(include current& proposed use):
FLACE "'Ds ET Co\1TE12 1 5i&►J WHERE IT I S Cor st.1Ar.r, Wl rN OThc2 S/GA/S
AND BE 'TEA LE_ cw i3AY RoAo.
Applicant: KE vNETH W. GA/C /E G. L uscE
Address: $g QAK V&LLE/ w.&Y
QU ENCE3u2-/ N Y 12g0ci
Home Phone: (S 1 g) '710 / _ 7073
Work Phone/Fax: (51 g) 79 3-53 3 I '793- 5 20S (R x
_ Applicant's Agent:
Address:
Phone:
Work Phone/Fax:
Property Owner: -1 E N ETFI W Q /E. L. L vieE
Address: Kg OAK /,ALL Ey WAY
&)__/.. z1us 8 tz y ,t/Y /2 00 4
Phone: (5 1 g) '7(o I .70 7 3
Work Phone/Fax:
(518) 793- 5331 793 -5205 (c-Ax )
Directions to Site:
-40 MI LE Vo/'TH DF OAi '�ioAO, O&i LEFT
Sign Variance
Last Revised: 5/29/2001
,
Site Development Data
Area/Type Existing sq. ft. Proposed Total sq. ft.
Addition
sq. ft.
A. Building Footprint 1312 /37 2
B. Detached Garage
C. Accessory Structure(s) (75
D. Paved, gravel or other ��� �70
hard surfaced areas
E. Porches /Decks
2/6 0 2/0
F. Other
Total Non-Permeable ��5� � ��SZ
(Sum A through F)
Parcel Area E39 S 6 Z3 9 g
Percent Non-Permeable
(Total Non-Permeable/Parcel Z9 , 29
Area) /
Setback Requirements
Required Existing Proposed
Front (1)
Front (2)
Shoreline
Side Yard(1)
Side Yard(2)
Rear Yard (1)
Rear Yard (2)
Buffer /Travel Corridor
Height
Permeability
Sign Setback
Sign Variance
Last Revised: 5/29/2001
Compliance with Sign Ordinance: r� - /�
Section(s)that apply: �t�N 6( )( i) )
What sign(s) are you allowed to have?
wall sign(s) square feet(each)
✓ freestanding sign(s) square feet(each)
height(each)
This application is for a change in the:
Number of signs: Size of signs: Height of signs:
Setback for sign: V Other:
Elevation:
If you are proposing to install wall signs, provide a scale drawing of the facade they will be
located on,with their location shown.
If you are proposing more than two (2) signs, the following information must be provided for
each sign(please use additional sheets if necessary):
Sign Number: 1 • Size: Length 3 x Width 2 =
Total Sq. Ft.
Existing: Height ft. (for freestand'
Proposed: Depth in./ft. (project' g
Wall: Distance from property line: — '+ f .
51j—
Freestanding Wording:
Illuminated _
Projecting
Design of Sign: Scale 1" = inches/feet
Sign Variance
Last Revised: 5/29/2UU 1
The following questions reflect the criteria for granting this type of variance.
Please complete them, using additional sheets if needed.
1. How would you benefit from the granting of this Sign Variance? I RosPECTI LIE
CUSTor"I E...S CAI SEE Arlo READ "Sr-1ALL' }-IANJGIrdG
WHILE "Dr21 rrJG P si- pFFrCE. .
2. What effect would this variance have on the character of the neighborhood and the
health,safety,and welfare of the community? L.oc. r i 0.0 o I^ S is A/ /5
/ WSIS~r r &i,iw o rye? NS On/ .CAA% . Si&'I /s SMALL
An10 NEAT. No kttowN EFFEr-T O'i H EA LTH, SA FETJ AiLlt7
lAiELFAi2E OF THE Carr MUNITY,
3. Are there feasible alternatives to this variance? klo I Wow LD L I,<E To k EJ
MALL .ANIL) AJ€AT 144-IILE ISE,NGG d.c3LE.. -TO REAo 51G1.1
Rao r i i3.s`/ -RoA ED.
4. Is the amount of relief substantial relief relative to the Ordinance? a �r.S
LIGM WOOLo 3C 2t�?v/,e� Tv /3E . I3 DTo.
W& Ade 3 E-4/' '2'4 , -T ,Se .4,"9J' AT 4S'
/T i✓Err 8e-42-84A" F2ooy
5. Will the variance have an adverse effect or impact on the physical or environmental
conditions in the neighborhood or district? kk,
Sign Variance
Last Revised: 5/29/2001
Checklist
Please prepare a map depicting existing and proposed conditions. Failure to complete the following checklist
or include all the required information on your plot plan will result in a determination of incompleteness and
a delay in the processing of your application.
Check/Initial The Applicable Box Address Each Item
Provided Not Applicable Waiver L GENERAL
Requested(1)
A. Title, name, address of applicant and person responsible for
preparation of drawing.
- B. North arrow,Tax Map-1D;date prepared and scale(minimum
6tWL l in.=40ft.).
1 C. Boundaries of the property plotted to scale,zoning boundary.
D. Location of principal structures and accessory structures with
exterior dimensions.
E. Location of site improvements including outdoor storage
areas,driveways(existing and proposed),parking areas,etc.
F. Setbacks for all structures and improvements.
IL WATER&SEWER
A. Location of on-site sewage disposal facilities, design details.
-construction details. flow rates, and number of bedrooms -
«L served
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.
(tun_ E. Percolation test location and results.
III. PARKING/PERMEABLE AREAS
A. Number of spaces required for project including
• calculation/justification
B. Number of existing parking spaces, number to be removed,
number to remain,and type of surfacing material(e.g.,gravel,
• paved).
C. .Provision for pedestrian and handicap access and parking.
V l— D. Location and design details of ingress, egress, loading areas.
and curbing.
Sign Variance
Last Revised: 5/29/2U01
Provided Not Applicable Waiver Address Each Item
Requested(1)
E. Location and character of green areas(existing and proposed).
modification to green areas. buffer zone to remain
Kta— undisturbed
F. Lighting: location and design of all existing or proposed
outdoor lighting.
IV. ADDITIONAL SITE DEVELOPMENT&
MISCELLANEOUS
� � A. Location of on-site and adjacent watercourses: streams,
rivers,lakes.wetlands.
ii B. Location of proposed and existing: utility/energy distribution
16 systems(gas,electric.solar,telephone).
C. Location.design-and construction of all existing and proposed
VA-VA-A- site improvements including: drains.culverts,retaining walls,
fences.fire&emergency zones and hydrants.
D. Location and amount/portion of building area proposed for
V1.L7.. office, manufacturing, retail sales. or other commercial
activities.
KttYL E. Signage: location,size,type,design and setbacks.
ADDITIONAL REQUIREMENTS
1) ** Waiver Request—Provide a letter to the Zoning Board and/or Planning Board requesting the waivers indicated
on the checklist.
2) Commercial Development Activities will require submission of a Landscaping Plan,Stormwater Management Plan
and a Grading Plan.
3) Other elements integral to the proposed development as considered necessary by the reviewing board
4) Identify any Federal.State or County permits required for the project's schedule.
5) Please submit record of application for approval status of all necessary permits from Federal, State and County
officials.
6) Other Fees may apply—Engineering Fees,Recreation Fees
For Office Use Only-
Reviewed by
Application fee received
Original and 14 copies of Application and Plot Plan submitted
Required Signatures
Other:
Sign Variance
Last Revised: 5/29/2001
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: (Print Owner Name)
Designates: (Print Applicant/Agent Name)
As agent regarding: Variance Site Plan Subdivision
For Tax Map No.: Section Block 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
Applicant: (Print Applicant Name)
Designates: (Print Agent Name)
As agent regarding: Variance Site Plan Subdivision
For Tax Map No.: Section Block Lot
SIGNATURE: (Applicant) Date
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
Please Note: Other permits may be required for construction or alteration activity subsequent to approval by
the Zoning Board and/or Planning Board. It is the applicant's responsibility to obtain any additional permits.
Official Meeting Minutes Disclosure: It is the practice of Community Development Department 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.
C/61fL2?'peso3ignatulte:`^
app&i'cane6 agent oignatcvte: bate
Sign Variance.
Last Revised: 5/29/2UU 1
14-16-4(11/96)—Text 12
• PROJECT I.D.NUMBER 817.20 SEAR
• Appendix C
Stabs Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
1. APPLICANT/SPONSOR 2. PROJECT NAME
KaaETH w. Cy&zn C. LuKE 171 a? LOV-T-
3. PROJECT LOCATION:
Municipality QUEE4S6uR'/ County 212E1.1
4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map)
4L25 gay O
5. IS PROPOSED ACTION:
111
/New 0 Expansion 0 Modification/alteration •
6. DESCRIBE PROJECT BRIEFLY:
RoViDE F1 OFESSIonIAL OFFICE ,5PACL—' >c+�' WEIGHT Cp uNSEL/nIG
SERVICE oR OTFIE2. Fla or S IotAA, . OFFICE SPAc[. P 1iIL ,BY c'7R-S
7. AMOUNT OF LAND AFFECTED: O/39 g SC,I FT
Initially acres Ultimately acres
8. WILL,-P�/PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
ItJYes ❑No If No,describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
❑Residential 0 Industrial L50 Commercial 0 Agriculture ❑Park/Forest/Open space 0 Other
Describe:
10. DOES ACTION INVOLVE A PERMIT APPROVAL.OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL,
STATE OR LOCAL)?
❑Yea giNo If yes,list agency(s)and permit/approvals
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
❑Yes i3 No If yea,list agency name and permit/approval
12. AS A RESULT OF PROPOSEDACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
❑Yes IJ No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant/sponsor name: �FVnIETH I •C'V/SE Date:
Signature: E)1/72,aw4,<S�-""`r
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
Sign Variance
Last Revised: 5/29/2001
•
•
• PART II—ENVIRONMENTAL ASSESSMENT(To be completed by Agency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR PART 617.4? If yes,coordinate the review process and use the FULL EAF.
❑Yes tit No
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No.a negative•declaration
may be supersed�ed y another involved agency.
❑Yes LJ No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,If legible)
Ct. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal,
potential for erosion,drainage or flooding problems?Explain briefly:.
C2 Aesthetic agricultural.archaeological,historic.or other natural or.cultural resources;or community or neighborhood character?Explain briefly:
Qs. Vegetation or fauna,fish,shellfish or wildlife-species,significant habitats,or threatened or endangered species?Explain briefly: •
C4. A community's existing plans or goals as officially adopted,or a change in use or intensity o1 use of land or other natural resources?Explain briefly
CS. Growth,subsequent development,or related activities likely to-be Induced by the proposes action?Explain briefly.
C6. Long term,short term,cumulative,or other effects 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 PROJECTr HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA?
Ellit Yes No
E. IS THERE.OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
Dyes No If Yes,explain briefly
•
PART III—DETERMINATION OF SIGNIFICANCE(To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above,determine whether It Is substantial,large,important or otherwise.significant.
Each effect should be assessed in connection with its (a) setting(i.e. urban or rural); (b) probability of occurring; (c) duration;(d)
Irreversibility;(e)geographic scope;and(f)magnitude.If necessary,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 I)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. --in Check 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 Lead Agency
•
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer(II different from responsible officer)
Date
2
Sign Variance
Last Revised: 5/29/2001
y
r:
wnrv:.7.
'`• :.' WARREN COUNTY UEPART-ME:NT OF PUBLIC WOFtl�3
in t I�ut4.
i I'E1t119IT '1 ) WORK IN COUNTY IR1(-;Ii'I'-014-WAY
\, _
\,vvrn t'• A (Under Aricle 6,St•„^.lion 1.36 fiT.AL..of Highway L.aw)
i}
William Rctnlnptnn, P. •
Warreitebtu'g Of•L7,ten 3Upc'.r intender it of Publio Work
4028 Main ttree+t.
Warrensburg, N.Y. 1^9$:3 WIII.)tlm m ).,:vny, P-E.
618-781-0888 or (3 18 (323-4 1 4 1 1J�1:ntl,y Jt-tpertnt:endcntt of Pt&b1io Vlbrke •
fax 818 1323-2773
t.i tic r'.77777 7-p-,i I. ._._..-
1ns urance Policy#::1LA ,..,00:7 Q:;:.L_l . County Road/I: C. r. 7
oou --ve
Expiration pate: Permit.?I: ��l._:!__3.• __ IE zp.Date:--/- 4-5 7 /
. ;G
WHEREAS,AC Cunt- -Coati•9 c�+ /
is part of the,County Road System and
• WEIEKEAS, /eh t'I C_.Y—..I)r.7,.''_f :_r'_... whence:ttIdir^s is
—1 _y_L_�Lr .A..1J ,._�_Irs-/:i4;7.i , /,
/::;.Y_ ‘'•�' ,- A 1. y...- ,'hoar trl. ,dims:
• it
number is !79, .. 3/3 ir,lursts pei'nlisiiott to...(:.�;/..,/__!/iii= /_ h/Y.0 l " „ __-.
-- !U 2V '-(o .J.1:::/<<,r, F 4±_-61.4:4i:/,1a/.,c:'_i_ . 7 GY•,o/_fa e i1No Rea 0 Al /iJA/9 — ....
". lv/—/- 4/3_--k%=T" Si6.t) Lacs) T&7'-- --- —
4
.•li
.-.-..-
NOV,V TIHEIRE.FORE,permission is gtanten.l to the sapplic.1nt to do said work subject to tltc following conJitinns:
A(Certified Check) (flond) in the aunt of S_J)9 t •ablo to the Count•1re*su,ec of\Varian County is On File) •
(To Be deposited)at security that the highway wire restored to itt original condition where d.ist-tubed at the expense of the appbcant, as
soon as the Work bas been completed,and the said County Superintendent of Public Works Li hereby authntir ed to expend all or as much of
inch depots is may be necessary for that purpose,should tale said 9pl•licarrt ncglcct or refuse to perform the work.
SPECIAL CoN1).)1(_iNS •
X/J A)._ l> 7i.(4A16C ✓! /(/(c) T .. 7 /.irlc-1trI - _._--:. - - -...
,)
I.I
-11t consideration of granting this.pentut the undersigned accepts it subject to conditions described. . .
� can
r. CtituotySupe Ante ndento Public Works
. 1 F 9,0,41r-27
IMPORTANT N(YCICE: ( wfully read and fully comply W. i the following condi ions. .von affe in t e toots or tops of tires is
authorized bi4lthpemit,excepting thole[rennin issued for this llnpr:se.(;Dyingto tiers rep ' sw,itttcn mission. to oidthcc.iac;c to owcr
and co atiitleation lines and cables,gas mains,watcrntains,etc.,permit tee.%hall contact t owners t eof and obtain dick pet mi s a ion beim,-
• starting woxl4It is mandatory to s'otifl the person or municipality dietrib tinK gas in that area at le /1 hours in advance before discharging
"Plosives.conduct operations Safely.Prevent accidents.Ste conditions on teat-tie side of this pe
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