Application JARRETT Engineers, PLLC Civil&Environmental Engineering
July 15,2014
Chris Hunsinger, Chairman, Queensbury Planning Board,
Steve Jackoski, Chairman, Queensbury Zoning Board of Appeals,
and Board Members
742 Bay Road
Queensbury,NY 12804
Re: Roberts Residential Development
Old West Mountain Road
JE 14-003
Dear Chairmen Hunsinger and Jackoski,plus Board Members,
Kirk Roberts plans on building a home on he lot is narrow and residenial lot that he
hampered by purchased eep slopes as
west side of Old West Mountain Road
well as by a stream that nearly splits the property into two even narrower segments.
Constructing the house at the required setbacks would not only create a steep and potentially
dangerous driveway, it would also impact the stream. Mr. Roberts has worked with our office
and the Town planning staff to try to mitigate the impacts of house construction, and as a result,
our recommendation is to site the structure closer to the road and closer to the north property
line. The recommended location is not in compliance with Town zoning requirements, which
include a 100' setback from the front property line and 75' from each side line. The proposal, as
shown on the attached variance plan, is for the house to be 37.06' from the road ROW line and
22.7' from the north property line. This location allows a driveway of approximately 8.5% grade
(as opposed to 20-25% if zoning is followed) and minimizes clearing on the lot.
House siting has attempted to preserve oad least
ands some privacy for evergreen
Mrtt.eRobert along the�rJOadewater
attempt to provide a buffer to the
will be by a NYSDOH and Town of Queensbury compliant on-site wastewater
whereas water supply is by connection to the Queensbury municipal water supply.
Stormwater management in compliance with Town residential standards has been proposed. An
eave trench along the lower side of the house will detain roof water,while two shallow vegetated
detention basins will collect runoff from the driveway. The stream will receive no runoff from
the proposed development.
Although the project is residential, we herewith request a waiver from the lighting and
landscaping plan requirements; any exterior lighting will be shielded and downcast, while
landscaping will be consistent with a woodland setting.
We look forward to discussing this project with each board; in the meantime, if you or staff have
any questions, please call our office at 792-2907,or email me at tjarrett@jarrettengineers.com.
12 East Washington Street 518-792-2907
Glens Falls,NY 12801 Fax 798-1864
Queensbury Planning Board and Zoning Board of Appeals July 15, 2014
Re: Roberts Residential Development, Old West Mountain Road
Sincerely,
JARRETT Engineers, PLLC
( 1547 7.15
04
l 154742- '00'
H. Thomas Jarrett, P.E.
Principal
End: Site Plan Documents
• Site Plan Application
• Deed
• Floor Plan
• Photographs
• Stormwater Management Report
• Drawings by Jarrett Engineers, PLLC, `Roberts Residential Development",
Revision A, dated 7/15/14 (consisting of 8 pages)
• Survey
Area Variance Documents
• Sign Variance Application
• Deeds
• Photographs
• Drawings by Jarrett Engineers, PLLC, `Roberts Residential Development",
Revision A, dated 7/15/14 (consisting of 8 pages)
• Survey
Page 2 of2
i
Site Plan Review Revised June 2009
Site Plan Review Application
REVIEW PROCESS:,
1. Required Pre-submissi{ondeadline davh Caal(518} 761 8220 fors an lappoiptment leteness to be held no
later than 1 week prior
2. Submittal of complete application: 1 original and 14 copies of the application package by monthly
deadline.
3. Determination of application for placelment on an information
for must e and
appropriate fee(s) paid for c onside
4. Incomplete applications will not be considered for placement on any agenda until all missing
information has been submitted.
5. Submittal to Warren County Planning, if applicable.
6. Planning Board meeting, generally the third &fourth Tuesday of each month. You will be advised
in writing as to which meeting to attend.
7. Following the meeting you will be provided with a copyof th the next stating
step the
Building o
decision on your application. If your application was app application was
Permit. Final drawings must be provided for the next phase of review. If your app
denied your project cannot proceed as submitted.
DOCUMENTATION REQUIREMENTS:
Please submit 1 original & 14 copies of the completed application package to include:
• Completed Application: pages 1-11 completed, signed & dated
• Pre-Submission Meeting Notes: signed by staff
• Copy of Deed
• New: Checklist & Plot Plan
• Fee 0 - 10,000 sf = $100
10,001- 30,000 sf = $250
30,001- 100,000 sf= $500
100,000 + sf = $1000
ZONING STAFF & CONTACT INFORMATION:
Craig Brown, Zoning Administrator craigb(a�gueensburv.net
Keith Oborne, Land Use Planner keitho(c_queensbury.net
Pam Whiting, Office Specialist 518-761-8220 pamw(c�gueensburv.net
Visit our website at www.queensburv.net for further information and forms
Town of Queensbury Planning Office. 742 Bay Road •Queensbury, NY 12804 518-761-8220 1
A
Site Plan Review Revised June 2009
General Information
Tax Parcel ID Number: 295.6-1-8
Zoning District: RR-5A
Detailed Description of Project [include current&proposed use]:
Single family residence
Location of project:
11 Old West Mountain Road, Queensbury
Applicant Name: Address: PO Box 920
Kirk Roberts
Home Phone Glens Falls,NY 12801
Cell:
Work Phone 222-1522
Fax
E-Mail:
cashroberts2001 @yahoo.com
Agent's Name: Jarrett Engineers, PLLC Address:
12 E. Washington St.
Home Phone Glens Falls, NY 12801
Cell:
Work Phone Fax
518-792-2907 518-798-1864
E-mail
tjarrett@jarrettengineers.com
Owner's Name Address
Home Phone Cell
Work Phone Fax
E-mail
Town of Queensbury Planning Office• 742 Bay Road • Queensbury, NY 12804 •518-761-8220
2
Site Plan Review Revised June 2009
Site Development Data
Area /Type Existing sq. ft. Proposed Total sq. ft.
Addition sq.
ft.
A. Building footprint 0 1500 1500
B. Detached Garage o 0 0
C. Accessory Structure(s) 0 0 0
D. Paved, gravel or other hard surfaced area 3193 1397 1397
E. Porches/ Decks 0 0 0
F. Other 0 99 99
G. Total Non-Permeable [Add A-F] 3193 2996 2996
H. Parcel Area [43,560 sq. ft. /acre] 5.87 5.87 5.87
I. Percentage of Impermeable Area of Site [I=G/H]
0.22% 0.8% 0.8%
Setback Requirements
Area Required Existing Proposed
Front [1] 100' 37.1 *
Front [2] N/A N/A N/A
Shoreline N/A N/A N/A
Side Yard [1] 75' — 22'
Side Yard [2] 75, — 130.8'
Rear Yard [1] 100' — 1225'
Rear Yard [2] N/A N/A N/A
Travel Corridor N/A N/A N/A
Height [max] 40' — 25'
Permeability 75% 99.78% 99.2%
No. of parking spaces N/A N/A N/A
*To imputed property line. 61'to property line which is center of Old West Mountain Road
Town of Queensbury Planning Office. 742 Bay Road . Queensbury, NY 12804• 518-761-8220 3
Site Plan Review Revised June 2009
Additional Project Information
1. Will the proposal require a Septic Variance from the Town Board of Health? No
2. If the parcel has previous approvals, list application number(s): N/A
3. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention
Program? No
4. Estimated project duration: Start Date Fall 2014 End Date Spring 2015
5. Estimated total cost of project: $300,000.00
6. Total area of land disturbance for project: 0.3 Acres
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 CM 0.3
Commercial Intensive 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]
Town of Queensbury Planning Office- 742 Bay Road •Queensbury, NY 12804 • 518-761-8220
4
SEE ATTACHED Site Plan Review Revised June 2009
§ 179-9-080 Requirements for Site Plan Approval. The Planning Board shall not approve a Site Plan
unless it first determines that such site plan meets the following Standards. Please prepare responses to each of
the following topics.
STANDARDS
A. The proposed project furthers or is consistent with the policies of the Town's Comprehensive Plan.
B. The proposed project complies with all other requirements of this Chapter, including the site plan review standards as set forth in
Paragraph F of this section,the dimensional, bulk, and density regulations of the zoning district in which it is proposed to be located
(Article 3 and Table 1),the applicable requirements of all other Articles that apply.
C. The site plan encourages pedestrian activity internally and, if practicable, to and from the site with pedestrian paths or sidewalks
connected to adjacent areas.
D. The site plan must conform to Chapter 136 Sewage and Sewage Disposal, Chapter 147 Stormwater Management Local Law, and
other applicable local laws.
E. the proposed use shall be in harmony with the general purpose or intent of this Chapter,specifically taking into account the location,
character and size of the proposed use and the description and purpose of the district in which such use is proposed,the nature and
intensity of the activities to be involved in or conducted in connection with the proposed use and the nature and rate of any increase in
the burden on supporting public services and facilities which will follow the approval of the proposed use.
F. The establishment,maintenance and operation of the proposed use will not create public hazards from traffic,traffic congestion or the
parking of vehicles and/or equipment or be otherwise detrimental to the health, safety or general welfare of persons residing or
working in the neighborhood or to the general welfare of the town. Traffic access and circulation, road intersections, road and
driveway widths,and traffic controls will be adequate.
G. Off-street parking and loading facilities will be appropriately located and arranged and sufficient to meet traffic anticipated to be
generated by the new use. The establishment of vehicle links between parking areas of adjacent properties are provided where
feasible. This furthers the Town's goal of reducing curb cuts and reducing congestion.A twenty-foot wide connection is required. If
adjacent properties are either undeveloped or previously developed without having made provision for future linkage, then a future
connection must be identified and provided for in the site plan under review for such future linkage when the time arises. The
Planning Board may require proof that the applicant has made contact with adjacent property owners for purposes of coordinating
linkages with adjacent properties.
H. The project shall not have an undue adverse impact upon the natural, scenic, aesthetic, ecological,wildlife, historic, recreational or
open space resources of the town or the Adirondack Park or upon the adequate provision of supporting facilities and services made
necessary by the project,taking into account the commercial,industrial,residential,recreational or other benefits that might be derived
from the project. In making the determination hereunder, the Planning Board shall consider those factors pertinent to the project
contained in the development considerations set forth herein under§ 179-9-080 of this chapter, and in so doing,the Planning Board
shall make a net overall evaluation of the project in relation to the development objectives and general guidelines set forth in§179-9-
080 of this Article.
I. The provision for and arrangement of pedestrian traffic access and circulation, walkway structures, control of intersections with
vehicular traffic and overall pedestrian convenience shall be safe and adequate for pedestrian movement. Pedestrian connections
between adjacent sites shall be provided to encourage pedestrian use.
J. Stormwater drainage facilities will prevent an increase of post development drainage flows as compared to pre-development drainage
flows. Drainage of the site shall recharge ground water to the extent practical. Surface waters flowing off-site shall not degrade any
streams or adversely affect drainage on adjacent properties or public roads. Facilities shall be in conformance with the drainage
standards of Chapter 147 of the Town Code and the Town of Queensbury Subdivision Regulations where applicable.
K. The water supply and sewage disposal facilities will be adequate and will meet all applicable and current requirements set forth by
Department of Health regulations and Chapter 136 of the Town Code.
L. The adequacy, type and arrangement of trees, shrubs and other suitable plantings, landscaping and screening shall effectively
provide a visual and/or noise buffer between the applicants and adjoining lands, including the maximum retention of existing
vegetation and maintenance,including replacement of dead or deceased plants.
M. Fire lanes, emergency zones and fire hydrants will be adequate and meet the needs and requirements of emergency service
providers.
N. The design of structures, roadways and landscaping in areas susceptible to ponding,flooding and/or erosion will minimize or avoid
such impacts to the maximum extent practicable.
O. The site plan conforms to the design standards,landscaping standards and performance standards of this chapter.
Town of Queensbury Planning Office-742 Bay Road • Queensbury, NY 12804 • 518-761-8220 5
Roberts Site Plan Application July 2014
§179-9-080 "Requirements for Site Plan Approval. The Planning Board shall not
approve a Site Plan unless it first determines that such site plan meets the following
Standards. Please prepare responses to each of the following topics."
The proposed project fulfills the required standards in the following ways:
Standards
A. The proposed project furthers or is consistent with the policies of the Town's
Comprehensive Plan.
Proposal: the site plan proposed is for a single family residence, which is in
accordance with the Town's objectives for this area of Queensbury.
B. The proposed project complies with all other requirements of this Chapter,
including the site plan review standards as set forth in Paragraph F of this
section, the dimensional, bulk, and density regulations of the zoning district in
which it is proposed to be located (Article 3 and Table 1), the applicable
requirements of all other Articles that apply.
Proposal: All components of this site design are in compliance with Town
standards with the exception of the front setback and north side setbacks;
those variances are warranted by the pre-existing configuration of this lot
which does not readily support development at the required lot dimensions.
C. The site plan encourages pedestrian activity internally and, if practicable, to
and from the site with pedestrian paths or sidewalks connected to adjacent
areas.
Proposal:N/A
D. The site plan must conform to Chapter 136 Sewer and Sewage Disposal,
Chapter 147 Stormwater Management Local Lay, and other applicable local
laws.
Proposal: This lot will be provided with an on-site wastewater disposal
system meeting Town and State standards, and a stormwater management
system meeting Town standards for residential development (NYSDEC
stormwater standards do not apply)
E. The proposed use shall be in harmony with the general purpose or intent of
this Chapter, specifically taking into account the location, character and size
of the proposed use and the description and purpose of the district in which
such use is proposed, the nature and intensity of the activities to be involved
in or conducted in connection with the proposed use and the nature and rate
Roberts Site Plan Application July 2014
of any increase in the burden on supporting public services and facilities
which will follow the approval of the proposed use.
Proposal: Single family residential development along Old West Mtn Road is
in keeping with the neighborhood,and with Town objectives.
F. The establishment, maintenance and operation of the proposed use will not
create public hazards from traffic, traffic congestion or the parking of vehicles
and/or equipment or be otherwise detrimental to the health, safety or general
welfare of persons residing or working in the neighborhood or to the general
welfare of the town. Traffic access and circulation, road intersections, road
and driveway widths, and traffic controls will be adequate.
Proposal: No objectionable impacts are expected as a result of this new single
family residence.
G. Off-street parking and loading facilities will be appropriately located and
arranged and sufficient to meet traffic anticipated to be generated by the new
use. The establishment of vehicle links between parking areas of adjacent
properties are provided where feasible. This furthers the Town's goal of
reducing curb cuts and reducing congestion. A twenty foot wide connection is
required. If adjacent properties area either undeveloped or previously
developed without having made provision for future linking, then a future
connection must be identified and provided for in the site plan under review
for such future linking when the time arises. The Planning Board may require
proof that the applicant has made contact with adjacent property owners for
purposes of coordinating linkages with adjacent properties.
Proposal:N/A
H. The project shall not have an undue adverse impact upon the natural, scenic,
aesthetic, ecological, wildlife, historic, recreational or open space resources
of the town or the Adirondack Park or upon the adequate provision of
supporting facilities and service made necessary by the project, taking into
account the commercial, industrial, residential, recreational or other benefits
that might be derived from the project. In making the determination
hereunder, the Planning Board shall consider those factors pertinent to the
project contained in the development considerations set forth herein under §
179-9-080 of this chapter, and in so doing, the Planning Board shall made a
net overall evaluation of the project in relation to the development objectives
and general guidelines set forth in§179-9-080 of this Article.
Proposal: This project involves one single family residence in a zone
earmarked for this type of development; the project is expected to create no
more impact than any other single family house in a suburban/rural area.
Roberts Site Plan Application July 2014
The provisions for and arrangement of pedestrian traffic access and
circulation, walkway structures, control of intersections with vehicular traffic
and overall pedestrian convenience shall be safe and adequate for pedestrian
movement. Pedestrian connections between adjacent sites shall e provided to
encourage pedestrian use.
Proposal:N/A
J. Stormwater drainage facilities will prevent an increase of post development
drainage flows as compared to pre-development drainage flows. Drainage of
the site shall recharge ground water to the extent practical. Surface waters
flowing off-site shall not degrade any streams or adversely affect drainage on
adjacent properties or public roads. Facilities shall be in conformance with
the drainage standards of Chapter 147 of the Town Code and the Town of
Queensbury Subdivision Regulations where applicable.
Proposal: Stormwater management in accordance with Town standards has
been provided. Further, although the watercourse through the property is not
jurisdictional,the site design attempts to protect that watercourse.
K. The water supply and sewage disposal facilities will be adequate and will
meet all applicable and current requirements set forth by Department of
Health Regulations and Chapter 136 of the Town Code.
Proposal: Wastewater management is to be by a Town and State compliant
on-site wastewater treatment/disposal system; water supply is by connection
to the Town of Queensbury municipal system.
L. The adequacy, type and arrangement of trees, shrubs and other suitable
plantings, landscaping and screening shall effectively provide a visual and/or
noise buffer between the applicants and adjoining lands, including the
maximum retention of existing vegetation and maintenance, including
replacement of dead or deceased plants.
Proposal: A tree buffer is to be maintained along the front of the site, between
the proposed house and road, to better protect the site and to provide privacy
for the occupants of the house. Likewise,a buffer is proposed along the north
property line, and in general, site disturbance will be minimized where
possible.
M. Fire lanes, emergency zones and fire hydrants will be adequate and meet the
needs and requirements of emergency service providers.
Proposal: Emergency service to this development will be best facilitated by
the proposed site design, wherein the house is closer to the Town Road and
the driveway is less steep and shorter. If the variances are not granted, the
Roberts Site Plan Application July 2014
house will be located further upslope and would need to be accessed by a
longer and much steeper driveway.
N. The design of structures, roadways and landscaping in areas susceptible to
ponding,flooding and/or erosion will minimize or avoid such impacts to the
maximum extent practicable.
Proposal: The existing watercourse on the property will be protected, and all
new development will detain runoff on the property up to the 25 year pre-
development storm event rates.
0. The site plan conforms to the design standards, landscaping standards and
performance standards in this chapter.
Proposal: All standards except front and side setbacks are being met.
§ 179-9-050 Application for Site Plan Review Site Plan Review Revised June 2009
Application for site plan approval shall be made to the Planning Board using forms supplied by the Board. Application materials
and the site plan shall include sufficient information for the Board to make its findings under§ 179-9-070 and 179-9-080 below.
In determining the content of the site plan and supporting documentation, the Planning Board may waive certain requirements if
the Planning Board deems such requirements or information unnecessary for the type of project proposed. Any such waiver
shall be made in writing, and shall contain statements of the reasons why the waived information requirements are not
necessary for an informed review under the circumstances. The Planning Board may grant such waivers on its own initiative or
at the written request of an applicant. Such request shall set forth the specific requirements that are requested to be waived and
the reasons for the requested waiver. Absent any waiver or waivers, an application for Site Plan Review shall include the
following:
REQUIREMENTS Shown
on Sheet
A A vicinity map drawn at the scale that shows the relationship of the proposal to existing community facilities which affect or
serve it, such as roads,shopping areas, schools,etc. The map shall also show all properties, identify owners, subdivisions,
streets, and easements within 500 feet of the property. Such a sketch may be superimposed on a United States Geological 1
Survey map of the area.
B The site plan shall be drawn at a scale of forty feet to the inch(1"=40 feet)or such other scale as the Planning Board may appropriate,on standard 24"x 36"sheets,with continuation on 8 'x 11"sheets as necessary for written information.
The information listed below shall be shown on the site plan and continuation sheets. 2-7
C Name of the project,boundaries,date,north arrow,and scale of the plan.
1-7
D Name and address of the owner of record,developer,and seal of the engineer,architect,or landscape architect. If the
applicant is not the record owner,a letter of authorization shall be required from the owner
1-7
E The location and use of all existing and proposed structures within the property, including all dimensions of height and floor
area,all exterior entrances,and all anticipated future additions and alterations. 2-4,7
F The location of all present and proposed public and private ways, off-street parking areas,driveways, outdoor storage areas,
sidewalks, ramps,curbs, paths, landscaping, walls, and fences. Location,type, and screening details for all waste disposal
containers shall also be shown. 2-4,7
G The location, height, intensity, and bulb type (sodium, incandescent, etc.) of all external lighting fixtures. The direction of
illumination and methods to eliminate glare onto adjoining properties must also be shown in compliance with§179-6-020. N/A
H The location,height,size, materials,and design of all proposed signs.
N/A
I The location of all present and proposed utility systems including:
1. Sewage or septic system;
2. Water supply system;
3. Telephone,cable,and electrical systems; and 2-4,7
4. Storm drainage system including existing and proposed drain lines, culverts, catch basins, headwalls,
endwalls,hydrants,manholes,and drainage swales.
J Plans to prevent the pollution of surface or groundwater, erosion of soil both during and after construction, excessive runoff,
and flooding of other properties, as applicable. A Stormwater Pollution Prevention Plan(SWPPP) for all land development
activities (excluding agricultural activities) on the site that results in land disturbance of 1-acre or more. A SWPPP shall
comply with the requirements of the DEC SPDES MS-4 General Permit and Chapter 147 of the Town of Queensbury Code. It 7
shall be at the discretion of the Planning Board as to whether a SWPPP or an erosion and control plan shall be required for a
site plan review project land disturbance of less than 1-acre.
K Existing and proposed topography at two-foot contour intervals, or such other contour interval as the Planning Board shall
allow. All elevations shall refer to the nearest United States Coastal and Geodetic Bench Mark. If any portion of the parcel is
within the 100-year floodplain, the area will be shown, and base flood elevations given. Areas shall be indicated within the
proposed site and within 50 feet of the proposed site where soil removal or filling is required,showin the 1-7
in cubic yards. 9 a pproximate volume
L A landscape plan showing all existing natural land features that may influence the design of the proposed use such as rock
outcrops, stands of trees, single trees eight or more inches in diameter, forest cover, and water sources, and all proposed
changes to these features including sizes and types of plants. Water sources include ponds, lakes, wetlands and N/A
watercourses,aquifers,floodplains,and drainage retention areas.
Town of Queensbury Planning Office. 742 Bay Road Queensbury, NY 12804 • 518-761-8220
6
Site Plan Review Revised June 2009
M Land Use District boundaries within 500 feet of the sites perimeter shall be drawn and identified on the site plan,as well as
1
any Overlay Districts that apply to the property.
N
Traffic flow patterns within the site,entrances and exits,and loading and unloading areas,as well as curb cuts on the site and
within 100 feet of the site The Planning Board may,at its discretion,require a detailed traffic study for large developments or
for those in heavy traffic areas,which shall include:
1.The projected number of motor vehicle trips to enter or leave the site,estimated for weekly and annual peak hour
traffic levels; N/A
2.The projected traffic flow pattern including vehicular movements at all major intersections likely to be affected by the
proposed use of the site;
3.The impact of this traffic on levels of service on abutting public streets and at affected intersections. Existing and
proposed weekly and annual peak hour traffic levels and road capacity levels shall also be given.
0 For new construction or alterations to any structure,a table containing the following information shall be included:
1. Estimated area of structure to be used for particular purposes such as retail operation,office,storage,etc.;
2. Estimated maximum number of employees; N/A
3. Maximum seating capacity,where applicable;and
4. Number of parking spaces existing and required for the intended use.
P 1. Floor Plans.
2. Elevations at a scale of one-quarter inch equals one foot(1/4"=1 foot)for all exterior facades of the proposed structure(s) Included
and/or alterations to or expansions of existing facades,showing design features and indicating the type and color of materials
to be used.
Q Soil logs,water supply well and percolation test results, and storm runoff calculations, as needed to determine and mitigate Report
project impacts,
R Plans for disposal of construction and demolition waste,either on-site or at an approved disposal facility. N/A
S Plans for snow removal,including location(s)of on-site snow storage. N/A
T An Environmental Assessment Form("EAF"), as required by the SEQRA regulations,with Part 1 completed by the Applicant
shall be submitted as part of the application. If the proposed project requires a special use permit and an EAF has been Included
submitted in conjunction with a special use permit application,a duplicate EAF is not required for the site plan application.
U If an application is for a parcel or parcels on which more than one use is proposed, the applicant may submit a single
application for all such uses provided the proposed uses are accurately delineated on a site plan drawn pursuant to the
requirements set forth above. The Planning Board may grant the application with respect to some proposed uses and not N/A
others. For purposes of reviewing an application(and for SEQRA compliance) all proposed uses on a single parcel or on
contiguous parcels shall be considered together.
✓ A brief narrative statement on how the project proposed for review furthers or is consistent with the vision,goals and policies Included
in the Town's Comprehensive Plan.
Town of Queensbury Planning Office- 742 Bay Road• Queensbury, NY 12804 • 518-761-8220 7
Site Plan Review Revised June 2009
Pre-Submission Conference Form f179-4-040j
1. Tax Map ID 295.6-1-8\`
2. Zoning Classification ` 5 A
3. Reason for Review: LOCAL wk n S044 oh s%, coop°
4. Zoning Section#: ( 1 q — 0 ('CP(:)
5. Pre-Submission Meeting Notes; Outstanding Items To Be Addressed Include:
Deed Yes I/No
General Information complete Yes No
Site Development Data Complete Yes No
Setback Requirements Complete Yes No
Additional Project Information Complete Yes t/No
FAR Worksheet complete Yes No
Standards addressed 4Yes o
Checklist items addressed Yes ✓ No
Environmental Form completed es No
Signature Page completed - Yes No
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Staff Representative: d\Cl tJ ' `- '-C3V4--"
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Applicant/Agent: ' IP •
Date: (L-i(
Town of Queen,•ury Planning O∎ice- 742 Bay Road•Queensbury, NY 12804• 518-761-8220 8
signature gage
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 Kirk Roberts
Designates Jarrett Engineers, PLLC
As agent regarding X Variance X Site Plan Subdivision
For Tax Map No: 7295 • "_«ion I Block b Lot
Deed Referet3 ;' 3.21 =• k 97 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 Kirk Roberts
Designates Jarrett Engineers, PLLC
As agent regarding. X Variance X Site Ran Subdivision
For Tax Map No 295.• ok on 1 Block �— Lot
Deed Refere "'' 4 ! , .-9L Page Date
OWNER SIGNATURE - I 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 S 1,000 without notification to the applicant
3,1 AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application matenals attached herein the
Owner, Applicant, and his/herftheir 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 Zon:ng 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 Corrrmunrty Development Department to have a
designated stenographer tape record the proceedings of meetings resulting from application, and minutes transcnbed from
those tapes constitutes the official record of as proceedings
6.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED. 1, the undersigned, have thoroughly read and understand
the instructions for submsson and agree to the submission requirements, I acknowledge no construction activities shalt be
commenced prior to issuance of a valid permit I certify that the application, plans and supporting materials are a true and
complete staternentdescnption 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. also understand that liwe may be
required to provide an as-built survey by a hcensed land surveyor of all rewty constructed facilities prior to issuance of a
certificate of occupancy
I have read a • gree - he above
Kirk Roberts 06/25/2014
at Print Name (Applicant] Date signed
:. g
� //, H. Thomas Jarrett 06/25/2014
ignat it''"'t � '� Print Name [Agent] Date signed
Jarrett Engineers, PLLC