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Application & DeedSign Variance [ZBA approved November 15, 2019] General Information Tax Parcel ID Number: * ! , Zoning District: L,E Detailed Description of Project [include current & proposed use]: 57,1' set bcc. � Location of Project: (I Applicant Name: no Mailing Address - - Home Phone City, State, Zip -VII44i)h 0/)J0,_ Work Phone a Cell Phone E-Mail: FAX No. Agent's Name: G Mailing Address Home Phone Work Phone City, State, Zip Cell Phone E-mail FAX No. ,-e� Owner's Name Mailing Address Home Phone City, State, Zip VF V Work Phone �1 In d0 Cell Phone E-mail FAX No. .. Page 1 A Sign Variance [ZBA approved September 21 2016] Site Develo went Data Area / Type Existing sq. ft. Proposed Additions . ft. Total sq. ft.� A. Building footprint 8846 8846 B. Detached Garage 312 17955 312 17955 C. Accessory Structure(s) D. Paved, gravel or other hard surfaced area E. Porches / Decks F. Other G. Total Non -Permeable [Add A-F] 27113 27113 H. Parcel Area [43,560 sq. ft. / acre] 74487.6 74487.60 I. Percentage of Impermeable Area of Site [I=G/H] .363 .363 Setback Requirements Area Required Existing Proposed Front Yard [ 1 ] (,L '� ( 75 77.9 ft Carey rd Front Yard [2] Sdj Z 75 78 ft Carey Rd Shoreline Side Yard [1] 30 65 ft />3pft Side Yard [2] 30 >30ft / 36 Rear Yard [ 1 ] 30 91.9 ft Rear Yard [2] ,Z 30 95.7 ft Travel Corridor Height [maximum] Permeability 1 Number of parking spaces Page 2 Sign Variance [ZBA approved November 15, 2019] Compliance with Chapter 147 Sign Ordinance 1. A scaled drawing of the entire sign(s) and site plan drawing showing the location is to be included in the submission packet ie on building and on site. 'Please note a survey is required unless a waiver is granted. 2. This application is for a change in the (check all that apply): Number of Signs: from (currently): to (proposed): Setback for Sign Size of Sign Height of Sign Other (specify) I Sign Dimension(s) Sign Type Existing (Check) Proposed (Check) Length (ft) Width (ft) Total (Sq Ft) Height (ft) Wall Wall FreestandFb�rv rn �( /" a Freestanding Other ie panel Projecting Awning Illuminated Type: 4. Property Line Setbacks Front/ Rear Side 5. Sign Wording: k0 Gt -e,©n _ ►h la ]` y j +,a • ,r� •y` Cp Lt )-e 6. Additional information if applicable Page 3 Sign Variance [ZBA approved September 21 2016] 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 sign variance? She signs will not i rodnce a change in character to the neighborhood The sign itself is allowed by code h Pl Pr to place the sign 15' back from CaM lane would put the sign into the parking., lot. We are requesting 5'10" of relief for setback. 2. Whether the benefit sought by the applicant can be achieved by some method, feasible for the applicant to pursue, other than a sign variance? 4iggn__a_ge in needed for w8yfit1dingpurposes to place the cignfilrther back would put it in theparking Intl 3. Whether the requested sign variance is substantial? We. tin not feel that granting the 5'1()" of relief W keep the signin the as eC and off ofthe,pavement chmild be. RE -.en ae substantial as this is the only place the sign can go. _ 4. Whether the proposed variance will have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district? The sign will he unlit and will have nn impact nn the envirnnmental conditinns of the area nr naighbnrlhond 5. Whether the alleged difficulty was self-created? The difficultv could he seen as self created however Should not diminish the need for their freestanding sign to be lncaterd infront of their building in the grassy area and not in the parking lot. Additional Pro'ect Information 1. If the parcel has previous approvals, list application number(s): 113 kAnt'Pka/ Sk 5� 2. Does this project require coverage under the New York State Pollutant Discharge Elimination System (SPDES) Permit Program? _ Yes / _ No 3. Estimated project duration: Start Date End Date 4. Estimated total cost of project: Page 4 Sign Variance [ZBA approved November 15, 2019] Section 179-14-030 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 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, acbesso structures with exterior dimensions 6 1 Site improvements incl. outdoor storage areas, driveways, parking areas, etc.: existing & 7 Setbacks for all structures and improvements: existing & proposed 8 Elevations and floor plans of all proposed and affected structures B. Water & Sewer 1 Project sewage disposal facilities, design details, construction details, flow rates, and number of bedrooms pr2posed 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 1 Number of spaces required for project including calculations and justification: existing & 2 No. of existing parking spaces, number to be removed, number to maintain and type of surfacing material re. ., gravel,paved] 3 Provision for pedestrian and handicap access and parking: existing & proposed 4 Design details of in ess, egress, loading areas and cutting: existing & pTRosed 5 Location and character of green areas [existing and proposed], modification to green area, buffer zone to remain undisturbed 6 Lighting, location and desigii of all existing and proposed outdoor lightina D. Additional Site Development and Miscellaneous 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 Signa e: Location, size, type, design and setback: existin & 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 & LightingLightirIg Plans 8 Identification of Federal, State or County permits required for the project together with a record of application for all necessary hermits Shown on Sheet # 30 Shown on Sheet # Shown on Sheet # N I, - Shown on, Sheet # Page 5 Sign Variance [ZBA approved September 21 2016] Pre -Submission Conference Form / Section 179-9-040 1. Applicant Name: AJ Signs/ HHHN 27 Carey Road 2. Tax Map ID 308.16-2-2.2 Location: 27 Carey Road 3. Zoning Classification CLI 1.10 4. Reason for Review: Applicant proposes one free standing of 8 sf setback of 9.2 ft 5. Zoning Section #: 140 6. Pre -Submission Meeting Notes: Provided Outstanding; Please provide by Deed X General Information complete Site Development Data Complete _ Setback Requirements Complete X Additional Project Information Complete - FAR addressed _ _ Compliance with Zoning Ordinance Checklist items addressed X_ Environmental Form completed ques ton yes Signature Page completed The applicant proposes to add a free standing sign for Hudson Headwaters complex at 27 Carey Road. The project includes 1 free standing signs of 8 sf and is to be 9.2 ft from the property line where a 15 ft setback is required. Relief requested for free standing sign setback. reviewed: sign variance application, survey with sign notations, sign details Items to be updated 1) Page 1 detailed description of project will need to be completed 2) Page 2 required setbacks are 75 ft for front yard and 30 ft for Side and Rear - please enter the following setbacks per the survey on the site data sheet Building 1 Front 7q-9 ft ft Carey Road, Side 1 65ft, Side 2 greater than 30. ft, Rear 91.9 ft Building 2 Front 7-8-0 ft Carey Road, Rear 131.9 ft Side 1 greater than 30 ft, Side 2 36.1 ft Rear 95.7 ft 3) Page 4 other applications SP10-2020 office and warehouse SP38-2020 modification 4) Survey will need to be stamped and full size 24X36 I EAF question 2 change to yes and it should say Queensbury Zoning Board. ()) Convert all measurements from inches to square feet Staff Representative: Laura Moore via email 7/16/2024 Applicant / Agent: Kristen AJ signs 05/13/2024 Date: 07/16/2024 Page 6 Sign Variance [ZBA approved November 1 S, 20191 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: BookPage , Date ' OWNER SIGNATU_i/�~ _ _..... DATE: % 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: VarianceSite Plan For Tax Map No.: IOWNER SIGNATURE: as Agent regarding the following: Subdivision Deed Reference: Book Page _ Date DATE: 2.1 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. 1i 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. 4.1 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. 5.1. 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. 6.1 AGREEMENT TO PROVIDE DOCUMENTATION REOUIRED: 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 Uwe 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 ee t e above. Signature ppllcant] Wri�tpplicant] �"I Date signed Signature [Agent] Print Name [Agent] Date signed Page 7 Short Environmental Assessment Form Part 1- Project Information Instructions for Comoletine 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: HHHN signage Project Location (describe, and attach a location map): 27 Carey Rd Brief Description of Proposed Action: Installation of a directional sign. Name of Applicant or Sponsor: Telephone: 518-399-9291 E-Mail: Kristen@ajsigns.com AJ Signs Address: 842 Saratoga rd City/PO: State: Zip Code: 112027 Burnt Hills NY 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 El 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 government Agency? NO YES If Yes, list agency(s) name and permit or approval: ❑ 3. a. Total acreage of the site of the proposed action? 141 acres b. Total acreage to be physically disturbed? 0 acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? 1.71 acres 4. Check all land uses that occur on, are adjoining or near the proposed action: 5. ❑ Urban ❑ Rural (non -agriculture) ❑ Industrial m Commercial ❑ Residential (suburban) ❑ Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify): ❑ Parkjand Page 1 of 3 9- 5. Is the proposed action, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A ❑ ❑ ❑ ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? NO YES ❑ ❑ 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? If Yes, identify: NO YES Z ❑ 8. a. Will the proposed action result in a substantial increase in traffic above present levels? b. Are public transportation services available at or near the site of the proposed action? c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed action? NO YES ❑ ❑ ❑ ❑ ® ❑ 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features and technologies: NO YES ❑✓ ❑ 10. Will the proposed action connect to an existing public/private water supply? 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 project site contain, or is it substantially contiguous to, a building, archaeological site, or district which is listed on the National or State Register of Historic Places, or that has been determined by the Commissioner of the NYS Office of Parks, Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b. Is the project site, or any portion of it, located in or adjacent to an area designated as sensitive for archaeological sites on the NY State Historic Preservation Office (SHPO) archaeological site inventory? NO YES ❑ ❑✓ ❑ 13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain 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: NO YES ❑✓ ❑ ❑ Page 2 of 3 7 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 ❑ Early mid -successional ❑ Wetland ❑ Urban m Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered? NO YES ❑ ❑ 16. Is the project site located in the 100-year flood plan? 17. Will the proposed action create storm water discharge, either from point or non -point sources? If Yes, a. Will storm water discharges flow to adjacent properties? b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: NO YES ❑✓ ❑ NO YES ❑✓ ❑ ❑ ❑ ❑✓ ❑✓ 18. Does the proposed action include construction or other activities that would result in the impoundment of water or other liquids (e.g., retention pond, waste lagoon, dam)? If Yes, explain the purpose and size of the impoundment: NO YES ❑ ❑ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe: NO YES 20.Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste? If Yes, describe: NO YES I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE2-11 / Applicant/sponsor/name: , 1� Date: Signature: Title: PRINT FORM Page 3 of 3 /0 EAF Mapper Summary Report Friday, May 10, 2024 4:02 PM Disclaimer: The EAF Mapper is a screening tool intended to assist project sponsors and reviewing agencies in preparing an environmental assessment form (EAF). Not all questions asked in the EAF are answered by the EAF Mapper. Additional information on any EAF question can be obtained by consulting the EAF Workbooks. Although 308.16-2-2.3 the EAF Mapper provides the most up-to-date digital data available to DEC, you may also need to contact local or other data sources in order to obtain data not provided by the Mapper. Digital data is not a substitute for agency determinations. 1'•_u,d 9, t�Jb- 34'9.13 -2 3 1.2 �tKingstcn bonlp 308.16-2-4.1 Queen sbury TUO un ko 308.16-2-2.2 r' .1" I'- " ripar tsr ` n on .4 eurrar� i + Albany A SaVt s E r HERE G rr ii LSGS Irtzrrra; Ih!`REtti4�t"i�e-4-114I rO , S r.rces: Esri, HERE, GaTr �i US;- 5 it}'.gvr�ta ,l7 f3 Eh1T`F P E<C t Es i Jaj�dr t;4E'1;'E3+i @F.C�r Esrr l ua , ME-i Esri Chirp fF )r g Kcrg,. Bn t'c iva Es-i l Chia I'Hcr Kong', Etirr K r: a Esri if I)tl rd'a. Pl .: `�er5tree hit et �#rl ri# rs a�I�t r, i r ; ^prrr5treettAap wcrW*i ter, am tie ulc =he 15 Llse; Calt�t�r rn`ty Uk er : i�r s fir; Esri; HERE. G rWflI' wyL'I?G-5 -,P 308.16-2-4.3 ti �iMahumh Part 1 / Question 7 [Critical Environmental No Area] Part 1 / Question 12a [National or State No Register of Historic Places or State Eligible Sites] Part 1 / Question 12b [Archeological Sites] Yes Part 1 / Question 13a [Wetlands or Other No Regulated Waterbodies] Part 1 / Question 15 [Threatened or No Endangered Animal] Part 1 / Question 16 [100 Year Flood Plain] Digital mapping data are not available or are incomplete. Refer to EAF Workbook. Part 1 / Question 20 [Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report I j 1 WARREN COUNTY — STATE OF NEW YORK PAMELA J. VOGEL, COUNTY CLERK 1340 STATE ROUTE S, '} LAKE GEORGE, NEW YORK 12845 COUNTY CLERK'S RECORDING PAGE *"THIS PAGE IS PART OF THE DOCUMENT — DO NOT DETACH*** BOOK/PAGE: 5844 / 271 INSTRUMENT #: 2018-7306 Receipt#: 2018480496 Clerk: CL Rec Date: 11/07/2018 10:21:27 AM Doc Grp: RP Descrip: DEED Num Pgs: 4 Rec'd Frm: COMMUNITY TITLE AGENCY Partyl: STOYA ROBERT Partyl: HUDSON HEADWATERS HEALTH NETWORK Town: QUEENSBURY Record and Return To: BARTLETT PONTIFF STEWART & RHODES PC ONE WASHINGTON STREET PO BOX 2168 GLENS FALLS NY 12801 Recording: Cover Page 5.00 Recording Fee 35.00 Cultural Ed 14.25 Records Management - Coun 1.00 Records Management - Stat 4.75 TP584 5.00 RP5217 - County 9.00 RP5217 All others - State 241.00 sub Total: 315.00 Transfer Tax Transfer Tax - state 1800.00 sub Total: 1800.00 Total: 2115.00 **** NOTICE: THIS IS NOT A BILL **** ***** Transfer Tax ***** Transfer Tax #: 846 Transfer Tax consideration: 450000.00 Transfer Tax - State 1800.00 Total: 1800.00 WARNING*** I hereby certify that the within and foregoing was recorded in the Warren County Clerk's Office, State of New York. This sheet constitutes the Clerks endorsement required by Section 316 of the Real Property Law of the State of New York. Pamela J. Vogel l Varren County Clerk 13 ^�acp' 0 WARRANTY DEED WITH LIEN COVENANT DATE OF DEED: November 6, 2018 GRANTOR: Robert Stoya l 27 Carey Road 0 r Queensbury, New York 12804 V GRANTEE: Hudson Headwaters Health Network l 9 Carey Road Glens Falls, New York 12801 THIS WARRANTY DEED made between Grantor and Grantee on the deed date stated above WITNESSES THAT GRANTOR in consideration of ------------------------One Dollar($1.00)----------------------------------------- lawful money of the United States and other good and valuable consideration, paid by Grantee, DOES HEREBY GRANT AND RELEASE UNTO GRANTEE and his assigns forever all that property located at: C _ 27 Carey Road Town of Queensbury c N w County of Warren z State of New York TAX MAP #: 308.16-2-2.2 o (THE PROPERTY IS DESCRIBED MORE FULLY IN SCHEDULE "A" ATTACHED) EO(D 0 THIS GRANT IS MADE: TOGETHER with the appurtenances and all the estate and rights of the Grantor in and to said premises. TO HAVE AND TO HOLD the premises granted by this Warranty Deed unto the Grantee and his assigns forever. I AND THE GRANTOR COVENANTS as follows: FIRST: That Grantee shall QUIETLY ENJOY said premises; SECOND: That Grantor will forever WARRANT the title to said premises; THIRD: That this conveyance is made subject to the trust fund provisions of section thirteen of the lien law. If there are more than one Grantor or Grantee, the words "Grantor" and "Grantee" used in this deed includes them. IN WITNESS OF THIS CONVEYANCE, Grantor has executed this WARRANTY DEED on the deed date stated above. IN PRESENCE OF l (L. S.) Robert ya STATE OF NEW YORK ) ss.. COUNTY OF WARREN ) i , On the � day of November the year 2018, before me, the undersigned, personally appeared Robert Stoya, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the individual, or the person upon behalf of which the individual ac d, executed the instrument. Bruce G. Carr Notary Public Notary public, State of New York Mrren County 01CM808919 Cott rMssbn F:ores November 1$, 2MB SCHEDULE A ALL THAT CERTAIN LOT, PIECE OR PARCEL OF LAND, situate in the Town of Queensbury, County of Warren and State of New York, shown on a map entitled Northern Distributing Subdivision, Town of Queensbury, Phase 2, made by Rist-Frost Associates, P.C., dated February, 1989, filed in the Office of the County Clerk of the County of Warren on October 3, 1989 in the Oversize Map Cabinet as Map E-3, as Lot Number 6. Subject to all covenants, easements and restrictions of record. BEING the same premises conveyed by Carole Carey & E. Joseph Britton, Successor Co - Trustees of the Carey Real Estate Trust to Robert Stoya by Warranty Deed dated November 21, 2006 and recorded in the Warren County Clerk's Office on November 30, 2006 in Book 3126 of Deeds at Page 198. R&R: Jon Lapper, Esq. Bartlett, Pontiff, Stewart & Rhodes P.C. P.O. Box 2168 Glens Falls, New York 12801 1�