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Site Plan Application - 29 Jan 2016 Larry Brown RUCINSKI ALL ARCHITECTURE Ronald Richard Rucinski Ethan Peter Hall 134 Dix Avenue Glens Falls NY 12801 Voice 5,18 741 0268 Fax 518 741 0274 Email ephall@nyeap.rr.com Project Narrative — Roof structure over existing Part Storage Racking — Jerry Brown Auto Parts — 26 Lower Warren St The proposed project is a new roof and gable end wall siding installation on an existing part storage racking structure within the existing salvage yard. The enclosure of the existing part storage rack will provide protection of salvaged auto parts from the elements and allow for,storage of certain interior auto parts that require additional protection from the rain and snow. There is no additional lighting or hard surfacing proposed with this project and all existing facilities will remain as, the currently exist. This project has already started construction and work was suspended upon notification that the project required site plan review. Y:Uerry Brown Auto PartsTart Storage ShedftpeTworkTroject Narrative.doe .................... ............. ------------------ Site Plea Review Revised June 20019 General: [ for tl n Tax Parcel ICS umber: 303-19-1-49 Zoning District: H1 — Heavy Industrial Detailed Description of Project [include current& proposed use]: Installation of a roof system above an existing part storage rack. Location of project -M-Lower WarreaStrept Applicant Name: Larry Brown Address: 26 Lower Warren Street Queensbury IVY 128014 Home Phone dell: 518-361-2428 WOrk Phone 518-298-8141 x115 Fax 518-798-0431 E- 'ail: larry@jbap.com jhap.com Agent's a : Ethan R. Hall--Rucinski Hall Address: 134 Dix Ave Architecture Glens Falls IVY 12801 Home Phone Cell. 518-260-2888 Work Phone 518-741-0268 Fax 518-741-6274 E-mail ephall nycap.rr.com Owner's Name Same as Applicant Address Horde Phone Cell Work Phone ex E-mail Town of Quueensbrury Planning Office- 742 Bay Road . Queensbury, NY 12804. 518-751-8220 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 22,100 SF 4,924 SF 27,024 SF B. Detached Garage C. Accessory Structure(s) D. Paved, gravel or other hard surfaced area 546,612 SF 546,612 SF E. Porches/ Decks F. Other G. Total Non-Permeable [Add A-F] 568,712 SF 573,636 SF H. Parcel Area [43,560 sq. ft. / acre] 606,223 SF 606,223 SF I. Percentage of Impermeable Area of Site [I=G/H] 93.81% 94.62% Setback Requirements Area Required Existing Proposed Front [1] 100'-0" 85'-2" 85'-2" Front [2] NA NA NA Shoreline NA NA NA Side Yard [1] 50'-0" 172'-7" 172'-7" Side Yard [2] 50'-0" 58'-6" 58'-6" Rear Yard [1] 50'-0" 597.9' 597.9' Rear Yard [2] NA NA NA Travel Corridor NA NA NA Height [max] 60'-0" 18'-0" +\- 24'-0" Permeability 30.0% 19.63% 19.09% No. of parking spaces Town of Queensbury Planning Office- 742 Bay Road • Queensbury, NY 12804 • 518-761-8220 3 Site Plan Review Revised June 2.009 Addifignal ProiegiInformation .. 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)" See Attached Parcel History S. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Programi? No 4. Estimated project duration: Start Bate 7/2015 End Date 5/2016 5. Estimated total cost of project: $25,000 6. Total area of land disturbance for project: _4,924 SF FlooLA&ra 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 heighi 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 q. ft. [see above definition] Proposed Additional Floor kr—ea sq. ft. 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 Parcel 303.19-1-49 Lower Warren Street Jerry Brown Auto Parts, QgMpkWEjnalied entries Finalized BP 946-20 Storage Building (issue 5/15/89) 1/17/1991 BP 946-20 Warehouse 7,000 sq. ft. (issue 101/18/94) 9/29/1995 BP 2004-44 Interior Alterations 1,800 sq, ft, 3/l/2004 BP 2006-652 Addition 7,500 sq. ft. 11/2/2007 BP 2010-012 Storage Shed 900 sq. ft. (SP 59-09) 2/28/2011 BP 2011-431 Comm. Storage Bldg. 1,440 sq. ft. 5/19/2013 In Review Entries Date Listed UV 40-1992 Expansion of 120' x 60' nonconforming use 4/22/1992 accessory building SP 19-1992 Stockade Fence on west side of business 6/16/1992 SP 16-2002 1, 50 sq. ft. Addition to office space 4/1/2002 SP 54-2005 7,500 sq. ft. Storage Building 9/22/2005 SP 59,-2009 900 sq. ft. Storage Building 11/20/2009 SP 63-2010 900 sq. ft. Storage Building (withdrew SP-63 9/21/2010 2010 & AV 54-2010) AV 54-2010 900 sq. ft. Storage Bldg. setback relief 10/20/10 SP 48-2011 1,440 sq. ft. Storage Bldg, 6/20/2011 AV 50-2011 Comm. Parts Bldg. setback relief 10/21/2011 SP 41-2012 (w/parcels -58 & 48) same as AV 34-12 below 6/21/2012 AV 34-2012 Storage Bldg. w/-50, 51 & 58 — 120' x 200' 7/25/2012 w/ramp connecting to dismantling bldg. TB Res. 359-2013 Mod. of Junkyard license w/-48,50,51 & 58 10/21/2013 Site Plan Review Revised June 2009 179_9. The Plannin 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 flan. 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 intemally 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 143 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. l . 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 bark 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§ 139-9-0180 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, shrutas 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. Fire lanes, emergency zones and fire hydrants will be adequate and meet the needs and requirements of emergencyservice providers, f�. 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. 0. The site plan conforms to the design standards,landscaping standards and performance standards of this chapter. Town of Queensbury Planning Office- 742 Bays Road • Queensbury, NY 12804. 515-761-8220 RUCINSKI HALL ARCHITECTURE Ronald Richard Rucinski Ethan Peter all 1134 Dix Avenue Glens Falls NY 12801 Voice 518 741 0268 Fax 518741 0274 Email!, ephall@nycap.rr.com Response to A-0 Standards — Roof structure over existing Part Storage Racking — Jerry Brown: Auto Parts — 26 Lower Warren St The following are responses to questions A t�hru 0 of the site plan review standards. A. The project is a roof over an existing part storage rack located in the HI zone and is therefore consistent with the Town's Comprehensive Plan B. The facility has been designed in accordance with all requirements set forth in Chapter 179- 9-080 and no variances are being sought. C. There are no pedestrian activities associated with this project. D. The existing site sewage disposal will not be effected by the project. E. The proposed structure is an allowed use in the Hl zone. F The proposed project is simply a roof over an existing structure so no additional traffic will be generated. G. All parking is existing and no new traffic will be generated by the proposed project. H. The proposed project is construction of a roof over an existing part storage rack inside the facility and cannot be seen from outside the premises. I. No pedestrian activities will be generated by the project, J. The new roof is above current hard surface so no new hard surfaces are being proposed, the existing stormwater management system will be unchanged by the proposed project. K. The proposed structure will not have any impact on either the sanitary or water facilities. L. All public area have been landscaped as parts of previous projects. This current project takes place completely inside the existing storage yard and will not have any impact on views so no landscaping is proposed. M, All vehicular traffic on site is existing and will not be effected by this project. N. All areas have been designed to avoid ponding or flooding and take place on existing hard surfaces. 0. All areas in this portion are existing and there will be no changes with this project. Y:\Jerry Brown Auto PartsTart storage ShedTaperworkaesponse to A-0 standards.doc Site Flan. Review Revised June 2009 Application for site plan approval shall be made to the Planning Board using forms supplied by the Beard. Application materials and the site plan shall include sufficient information for the Board to make its findings under§ 179-9-070 and 179-941817 below. In determining the content of the site plan and supporting documentation,the p'lann'ing 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: to REQUIREMENTS, on Shoo A A vicinity map drawn at the scale that shows the relationship of the proposal to existing community facilities which affect or C-1&C-2 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 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 -1 &C_ deem appropriate, on standard 24"x 36"sheets, with continuation on 8'/2"x 11"sheets as necessary for written information. The information listed!below shall be shown on the site plan and continuation sheets. G lame of the project,boundahes,date,north arrow„and scala of the plan. ALL D Name and address of the owner of record,developer,and seal of the engineer,architect,or landscape architect. If the ALL applicant is not the record owner,a letter of authorization shall be required from the owner E The location and use of all existing and:,proposed structures within the property, including all dimensions of height and floor ALL area,all exterior entrances"and all anticipated future additions and alterations. The location of all present and proposed public and private ways, off-street parking areas, driveways, outdoor storage areas, C-1& -2 sidewalks, ramps, curbs, paths, landscaping, walls, and fences, Location, type, and screening details for all waste disposal containers shall also be shown. The location, height, intensity, and bulb type Qsodiurn, incandescent, etc.) of all external lighting fixtures. The direction of NA and methods to eliminate glare onto adjoining properties must also be shown in compliance with§179-6-020. H1 The location,height,size,materials,and design of all proposed signs, NA I The location of all present and proposed utility systems including: A 1. sewage or septic system; 2. Water supply system; 3, Telephone„cable,and electrical systems, and 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, -1 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 SW"VPPP shall comply with the requirements of the CLEC SPCES IVIS-4 General Permit and Chapter 147 of the Town of Queensbury Code. It shall be at the discretion of the Planning Board as to whether a S'W'PPP or an erosion and control plan shall be required for a site plan review project land disturbance of less than 1-acre. Existing and proposed topography at two-foot contour intervals, or such other contour interval as the Planning Board shall A allow. All elevations shall refer to the nearest United States Coastal and Geodetic Bench Mark. If any portion of the parcel is 11 within the 106-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,showing the approximate volume in cubic yards. L A landscape plan showing all existing natural land features that may influence the design of the proposed use such as rock NA 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 watercourses, aquifers,floodplains,and drainage retention areas. Town of Queensbury Planning Office- 742 Bay Road - Queensbury, ICY 12804 - 518-761-8220 6 Site Plan Review Revised June 2009 M Land Use District boundaries within 500 feet of the site's perimeter shall be drawn and identified on the site plan, as well as C-1&C-2— any Overlay Distdcts 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 C-1 & C-2 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: I The projected number of motor vehicle trips to enter or leave the site, estimated for weekly and annual peak hour traffic levels; 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: C-1 &C-2 1. Estimated area of structure to be used for particular purposes such as retail operation,office,storage,etc.; 2. Estimated maximum number of employees; 3. Maximum seating capacity,where applicable;and 4. Number of parking spaces existing and required for the intended use. P 1. Floor Plans. A-1 2. Elevations at a scale of one-quarter inch equals one foot(1/4"= 1 foot)for all exterior facades of the proposed structure($) and/or alterations to or expansions of existing facades, showing design features and indicating the type and color of materials to be used, Soil lags, water supply well and percolation test results, and storm runoff calculations, as needed to determine and mitigate NA project impacts,Plans for disposal of cons#ruction and!demolition waste,either on-site or at an approved disposal:facility. NA S Plans for snow removal,including location(s)of on-site snow storage. C-1&C-2 An Environmental Assessment Form ("EAF"), as required by the SEQRA regulations, with Part I completed by the Applicant - YES shall be submitted as part of the application. If the proposed project requires a special use permit and an EAF has been 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 NA 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 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 YES in the Town's Comprehensive Plan. Town of Queensbury Planning Office- 742 Bay Road - Queensbury, NY 12804 518-761-8220 ................. ...... ......... Site Plan Review Revised June 2009 . Tax Map ILS 303.19-1-49 2. Zoning Classification til-- Heavy Industrial 3. Reason forReview: . Zoning Section#: . Pre-Submission Meeting Notes;Outstanding Items To Be Addressed Include: Deed Yes IVa General Information complete 'Yes No Site Development Data Complete Yes No Setback Requirements Complete Yes No Additional Project Information Complete Yes No FAR Worksheet complete Yes No Standards addressed Yes No Checklist items addressed Yes No Environmental Farm completed Yes No Signature Page completed Yes No Staff Representative: Applicant/Agent: Gate: Town of Queensbury Planning Office- 742 Bay Road - Queensbury, IVY 12804 - 518-761-8220 Short Environmental Assessment Form Part I -Project Information Instructions for Completin 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 I 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 I -Project and Sponsor Information Name of Action or Project: Jerry Brown Auto Parts Project Location(describe,and attach a location map): 26 Lower Warren Street Brief Description of Proposed Action: A new roof is being installed above an,existing part storage rack within an existing auto salvage yard operation Name of Applicant or Sponsor: Telephone: 518-798-8141 Larry Brown E-Mail: larry@jbap.com Address: 26 Lower Warren Street City/PO: Queen,sbury State: Zip Code: New York 12804 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a pen-nit,approval or funding from any other governmental Agency? _-K-0 If Yes,list agency(s)name and permit or approval: 3.a. Total acreage of the site of the proposed action? 1 acres b. Total acreage to be physically disturbed? Q.10 acres c.Total acreage(project site and any contiguous properties)owned — or controlled by the applicant or project sponsor? 21.35 acres 4. Check all land uses that occur on,adjoining and near the proposed action. [:]Urban ®'rural (non-agriculture) R]Industrial [3Commercial El Residential(suburban) Oforest ElAgriculture 0 Aquatic ElOther(specify): E]Parkland Page I of 3 ............. 5, Is the proposed action, N/A a.A permitted use under the zoning regulations? YES 0— b.Consistent with the adopted comprehensive plan? El- 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? F 1 0 I—Vi 7. Is :he site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of theproposed action? El 21 : c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? _a 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: El R1 M Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: =1 There is no Plumbing involved with the project Lin El I I,Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment. There is no plumbing involved with the project 21 El 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? b.Is the proposed action located in an archeological sensitive area? 13. a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain E NO YES wetlands or other waterbodies regulated by a federal,state or local agency? 21 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: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: El Shoreline El Forest E3 Agricultural/grasslands Early mid-successional [3 Wetland OUrban 0 Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? LVJ' 16.Is the project site located in the 100 year flood plain? NO YES :RUFT 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a. Will storm water discharges flow to adjacent properties? NO [:]YES b, Will storm water discharges be directed to established conveyance systemsoff and storm drains)? If Yes,briefly describe: 'ENO EDYES Page 2 of 3: S.Does the proposed action include construction or other activities that result in the impoundment of NO YES grater or other liquids(e.g.retention pond,waste lagoon,darn)? If Yes,explain purpose and size: Z El 19. Has the site of the proposed action or an adjoining property been the location of an active or closed O D'E'S solid waste management facility? 1f Yes,describe: 20.Has the site of the proposed action or an adjoining property been,the subject of remediation(ongoing or NO 'YE completed)for hazardous waste? 1f Yes,describe: I AFFIRM THAT THE E FO 'T'ION PROVIDED A-BOVE IS TRUE AND ACCURATE TO THE EST OF MY KNOWLEDGE DGE Applicant/sponsor name: Ethan P.Hall-Architect'tAgent for the Applicant Date: January 12,2016 Signature: PRINT „J, Page 3 cif" F Mapper Summary Report Tuesday, January 1 , 2016 9:26 A 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 the EAF Mapper provides the most up-to-date digital data available to gl DEC,you may also need to contact local or other data sources in order s to obtain data not provided by the Mapper.digital data is not a r substitute for agency determinations r mG J �,N h�ry a iii (j �r , r Toft i aedbavrd D" rm stlola d i �j a r�pfi art a SaLrces f"w`4 �ttr r it S y Yr r B �apTtl�a Es tai oa�tFil i f t rtt �ttt�rkft� y 'ON , Lornd ,U�GS leta-a map incre m nt p p , y c m Sr- g g), ei v ej m 461'At f rint ranap, iTh r ieno ,i"R aprryindia, p n 1�� p altaw ,�, 1 i„Fr ami td n�rt p,NRC N, ih .f 5,an'd the I p s r fMMuru$y Tl. i l Part 1 /Question 7 [Critical Environmental No Area], Part 1 /Question 12a [National Register of No Historic Places] Part 1 /Question 12b [Archeological Sites] Yes Part 1 /Question 13a [Wetlands or Other Yes Digital mapping information on Racal and federal wetlands and Regulated Waterbodies] wraterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 /Question 1 [Threatened or No Endangered Animal] Part 1 /Question 1 [100 Year Flood Plain) Digital mapping data are not available or are incomplete. Refer to EAF Workbook. Part 1 /Question 20 [Remediation Site] Yes Short Environmental Assessment Fords - EAF Mapper Summary Report � Site Plan Review Revised June 2009 Signature Page This page includes the 1.)Authorization to Act as Agent Form: 2.) Engineering Fee Disclosure; 3.)Authorization for Site Visits; 4.) Other Permit Responsibilities; 6.) Official Meeting Disclosure and 6.) Agreement to provide documentation required. OWNER's AGENT FORM: Complete the following if the OWNER of the property is not the same as the applicant Owner: Designates: As agent regarding: Variance Site Plan Subdivision For Tax Map No.: 303.19 Section :L Block 49 Lot Deed Reference: 63.9 Book 80,1 Page 6/5/81 Date OWNER SIGNATURE: DATE: APPLICANT's AGENT FORM: Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party: Owner: Larry Brown Designates: Rucinski-Hall Architecture As agent regarding: —Variance V Site Plan Subdivision For Tax Map No.: 303-19 Section 1—Block 49 Lot Deed Reference: 639 Book 801 Page 0/5/9.1 Date OWNER SIGNATURE: DATE: 2'.1 ENGINIEERINrp FEE niRgL_0SURE. Applications may be referred to the Town consulting engineer for review of septic design, storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be charged directly to the applicant. Fees for engineering review will not exceed$ 1,000 without notification to the applicant. 3.) AUTHORIZATIf)lel MR 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.) OTHER PERMIT RESPONSLBILITIES- Other permits may be required for construction or alteration activity subsequent to approvalby the Zoning Board or Planning Board, It is the applicants responsibility to obtain any additional permits, 5.10FIFICIAL 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.)-AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: 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 I/we 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 agree to the above. 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