006-735 Site Plan Application - SEQR 2016-10-15 Site Plan Review Application
Review Process:
Applicant and/or agent shall meet with Zoning Administrator to determine type of review needed
Pre-submission meeting with staff is required to determine general completeness of application materials (to
be held no later than 1 week prior to deadline submittal -Call (518) 761-8220 for an appointment).
Application submittal: one (1) original application package, one (1) deed and 14 copies of the application
package with the application fee*
Determination of application completeness and placement on an agenda
Planning Board meetings are generally the third & fourth Tuesday's of each month. You will be advised in
writing as to which meeting to attend.
Following the meeting you will be provided with a copy of the resolution stating the Board's decision on your
application. If your application was approved, the next likely step is a Building Permit. If your application
was denied your project cannot proceed as submitted.
*Fee: $100.00 (0 to 10,000 so; $250.00 (10,001 to 30,000 so; $500.00 (30,001 to 100,000 so; $1,000.00
(100,000+sf)
Zoning Staff & Contact Information:
Craig Brown, Director of Planning, Zoning & Code Compliance craigb@gueensbury.net
Laura Moore, Land Use Planner lmoore@gueensbu!y.net
Pam Whiting, Office Specialist (518-761-8220) pamw@queensbury.net
Site Plan Review Revised March 2014
Town of Queensbury Planning Office•742 Bay Road- Queensbury, NY 12804.518-761-8220
General Information
Renovation of existing pool area. Proposing new zero
Tax Parcel ID: 288.12-1-9.1 entry pool, children's splash pad area, warming tubs, 2
mechanical buildings,existing indoor pool building
Zoning District: RC (Recreation Commercial) addition and associated pool decks, walkways, utility,
sanitary and stormwater improvements. The existing
Lot size: 123.78 acres pool, wading pool and pool decks will be demolished
as part of the project. Mechanical/Pavilion Building#1
will be approximately 1,269 sf(2,077 sf roof area),
Current Use: Campground Mechanical/Bathroom Building #2 will be approximately
1,764 sf(2,855 sf roof area) and the existing pool
building addition will be approximately 221 sf(746 sf
Proposed Use: Campground roof area). The existing pool building facade will also
be updated to match the new mechanical buildings.
Project Location: Lake George RV Park, 74 State Route 149
Applicant Name Lake George RV Park, Inc. Address: 74 State Route 149
(Contact: Dave King) Queensbury, NY 12845
Home Phone Cell:
Work Phone (518)792-3775 Fax (518)792-5923
E-Mail:
dave@lakegeorgervpark.com
Agent's Name: CLA SITE Landscape Architecture Address: 58 Church Street, Suite 200
(Contact: Peter Loyola, RLA) Saratoga Springs, NY 12866
Home Phone Cell:
Work Phone (518)584-8661 Fax (518)584-8651
E-mail
ployola@clasite.com
Owner's Name: See Applicant Data Address
Home Phone Cell
Work Phone Fax
E-mail
Site Plan Review Revised March 2014 2
Town of Queensbury Planning Office-742 Bay Road- Queensbury,NY 12804.518-761-8220
Site Development Data
Area I Type Existing sq.ft. Proposed ----Total sq.ft.
Additions .ft.
A. Building footprint 21 Existing Buildings N/A N/A
61,969 sf
B. Detached Garage N/A N/A
C. Accessory Structure(s) (Roof Area) 9,899 5,678 15,577
D. Paved, gravel or other hard surfaced area 26,193 13,330 39,523
E. Porches/Decks 812 - 812
F. Other(i.e. boathouse, sundeck, etc.)
G.Total Non-Permeable [Add A-9 36,904 19,008 55,912
H. Parcel Area [43,560 sq. ft./acre] 3.320 - 3.320
Project Area Only (Total: 123.78 Acres)
1. Percentage of Impermeable Area of Site [I=G/H] 26% 39%
Setback Requirements
Area Required Existing Proposed
Front[1] 30' N/A 135'
Front[2]
Shoreline
75' N/A N/A
Side Yard [1]
20' N/A 827'
Side Yard [2]
Rear Yard [1] 20' N/A 664'
Rear Yard [2]
Travel Corridor
75' N/A 135'
Height[max] 35' N/A *See Below
Permeability 30% 64% 52%
No. of parking spaces N/A N/A N/A
*Mechanical Building#11: 34'-3" Mechanical Building #2: 32'-8" - Pool Building Addition: 19'-2"
Site Plan Review Revised March 2014 3
Town of Queensbury Planning Office-742 Bay Road-Queensbury,NY 12804.518-761-8220
/1-INdditional Project Information
1. Will the proposal require Septic Variance from the Town Board of Health? No
2' If the parcel has previousapprovals, list application DUDlh8r(s): 58-2014Maintenance Building
8. ��� this NYS DECOt r8QVinB CQV8n3�8 under DEC �t�rrO��i 26-2013 ~
[] DD Program?
No, See attached letter from DEC.
4. Estimated project dUradioD: Start Date Fall 2016 End Date Spring 2018
5. Estimated total cost ofproject: TBD
R. Total area of land disturbance for project: 1.4 Aonan
Floor Area Ratio Worksheet
FLOOR AREA RATIO (FAR) – The relationship ofbuilding size to lot size, derived by dividing the total building
floor area bythe lot size insquare feet, yielding a percentage.
Zonin-g—District Symbol Floor Area Ratio [FAR]
Waterfront Residential WR N/A 0.22
Commercial Moderate/Commercial Intensive CM /Cl N/A 0.3
Main Street MS N/A 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
' 'podion 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 RAT|Q'^).
B. Commercial or industrial: the total area in aquona 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
mnthe project site.
B. Ex,isting Floor Area N/A sq. ft. [see above definition]
C. Proposed Additional Floor Area N/A sq. ft.
D. Proposed Total Floor Area N/A sq. ft.
E. Total Allowable Floor Area N/A (Area x—) [see above table]
If D is larger than E' a variance or revisions to your plan may be needed. Please consult
w/Staff.
Site Plan Review Revised March 2O14
Town ofQueensbury Planning OfDoe.742Bay Road- Queonsbury, NY 12804- 51D-781-822D 4
§ 179-9-080 Requirements for Site Plan Ap"r val. 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 Com prehensive Plan.
Yes, Cam iDground ipermitted in zonin2 district,
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. Yes
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. Yes. Sidewalks, stairways and accessible ramp are provided.
D. The site plan must conform to Chapter 136 Sewage and Sewage Disposal, Chapter 147 Stormwater Management Local Law, and other
applicable local laws. Yes, see sewage design &: stormwater summary.
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. Meets all zoning requirements.
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. Internal to Site - No increased traffic, employees or guests.
New pool area only for the use of 1park 2uests.
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 adjacentroperty owners for purposes of coordinating linkages with adjacent properties.
curb cuts. No new connections with adjacent ]2ro]2ertie
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. Development
within existin2 East Side Pool area,
1. 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 beprovided to encourage pedestrian use.Circulation internal to site, no pedestrian connections
are proposed to adjacent sites.
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.See Stormwater Summary.
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. Yes
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.Site is currently screened, additional
planting is being i2rovided, see 21antin2 Plan,
M. Fire lanes,emergency zones,and fire hydrants wille adequate and me�jhe needs and requirements of emergency service providers.
Pmergency ve icles have adequate access to site.
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. Area is not susceptible to ponding/erosion.
O. The site plan conforms to the design standards,landscaping standards and performance standards of this chapter. Ye s
Site Plan Review Revised March 2014 5
Town of Queensbury Planning Office-742 Bay Road-Queensbury, NY 12804.618-761-8220
§ 179-9-050 Application for Site Plan Review
Absent any waiver or waivers, an application for Site Plan Review shall include the following:
REQUIREMENTS 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 Cover
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 deem L100 -
appropriate,on standard 24"x 36'sheets,with continuation on 81/2"x 11"sheets as necessary for written information. The information
listed below shall be shown on the site plan and continuation sheets. L101
C Name of the project,boundaries,date,north arrow,and scale of the plan. L100
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 Cover
E The location and use of all existing and proposed structures within the property,including all dimensions of height and floor area,all 1_100 -
exterior entrances,and all anticipated future additions and alterations. L101
F The location of all present and proposed public and private ways, off-street parking areas, driveways, outdoor storage areas, L100 -
sidewalks,ramps,curbs,paths,landscaping,walls,and fences. Location,type,and screening details for all waste disposal containers
shall also be shown. L101
G The location,height,intensity,and bulb type.(sodlum,incandescent,etc.)of all external lighting fixtures. The direction of illumination L400
and methods to eliminate glare onto adjoining properties must also be shown in compliance with§179-6-020.
H The location,height,size,materials,and design of all proposed signs. ADE Pool Drawings
The location of all present and proposed utility systems including: L100 -
1. Sewage or septic system; L101
2. Water supply system; &
3. Telephone,cable,and electrical systems, and L200 -
4. Storm drainage system including existing and proposed drain lines, culverts,catch basins,headwalls, endwalls,hydrants, L201&
manholes,and drainage swales. L400
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 L200 -
requirements of the DEC SPDES MS-4 General Permit and Chapter 147 of the Town of Queensbury Code. It shall be at the L201
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- L200 -
year floodplain,the area will be shown,and base flood elevations given. Areas shall be indicated within the proposed site and within L201
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 Outcrops, L300
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.
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 any Cover
Overlay Districts that apply to the property.
Site Plan Review Revised March 2014 6
Town of Queensbury Planning Office-742 Bay Road-Queensbury, NY 12804.518-761-8220
`
REQUIREMENTS CONTINUED Sheet
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 Waiver,
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: Traffic
1, The projected number of motor vehicle trips to enter or leave the site, estimated for weekly and annual peak hour traffic along
levels; Route
2. The projected traffic flow pattern including vehicular movements at all major intersections likely to be affected by the 149
proposed use of the site; will not
3. The impact of this traffic on levels of service on abutting public streets and at affected intersections. Existing and proposed increase,
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.; Waiver, 14ot
2. Estimated maximum number of employees; proposir g
3. Maximum seating capacity,where applicable;and new ng.
4. Number of parking spaces existing and required for the intended use.
P 1. Floor Plans. ARCH
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)and/or
alterations to or expansions of existing facades,showing design features and indicating the type and color of materials to be used. DWGS
0 Soil logs,water supply well and percolation test results,and storm runoff calculations,as needed to determine and mitigate project L-201
impacts. L-704
R Plans for disposal of construction and demolition waste,either on-site or at an approved disposal facility. L-200
S Plans for snow removal,including location(s)of on-site snow storage. L-100
T An Environmental Assessment Form("EAF),as required by the SEQRA regulations,with Part I 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 submitted in EAF
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 others. For purposes of reviewing N/A
an application (and for SEQRA compliance) all proposed uses on a single parcel or on contiguous parcels shall be considered
V A brief narrative statement on how the project proposed for review furthers or is consistent with the vision,goals and policies in the Attache
Town's Comprehensive Plan.
Site Plan RmxkawRevised March 2O14
7
Town ofQueensbury Planning Office-742Bay Road 'Queensbury, NY 12804'510'761'8220
Pre-Submission Conference Form [179-4-0401
1. Tax Map ID 288.12-1-9.1
2. Zoning Classification RC (Recreational Commercial)
3. Table of Allowed Uses East End Pool Improvements with Is subject to Site Plan Review
4. OAccessory Buildings.
Ordinance Section#
5. Pre-Submission Meeting Notes;Outstanding Items To Be Addressed Include:
Deed L,/Yes No
General Information complete. V7Yes No
Site Development Data Complete c- ' Yes No
Setback Requirements Complete Yes No
Additional Project Information Complete Yes No
*Coveraoe under DEC SWPPP Pro grarn 'ke be-4V Yes No'Dif:-C- rc
FAR Worksheet complete A,)AYes No
Standards addressed ✓ Yes No
Checklist items addressed Yes No
Environmental Form completed Yes No
Signature Page completed Yes --�/-'No
F
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Rpt L),/1+ tA
nev-\( C-1 11A ftcx�, L. te Ve I' a -C _U V-e r U9 P-07—
A10'04 C%C4 A. 16.) QIC-0^e>kO t-4G t on'6% (/Lf t4-t tl-tC)
Cc
*Applicant must provide office with Notice of Intent(NO]): SWPPP Acceptance Form. DEC letter Issuing permit number,•
Notice of Termin ton N
a 1onN
Staff Representative:
Applicant Agent.
Date:
Site Plan Review Revised March 2014
Town of Queensbury Planning Office-742 Bay Road-Queensbury,NY 12884.518 781-8220 8
617.20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
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:
Lake George RV Park - East End Pool Improvements
Project Location(describe,and attach a location map):
74 State Route 149 Queensbury, NY 12845
Brief Description of Proposed Action:
Renovation of existing pool area. Proposing new zero entry pool, children's splash pad area,warming tubs, 2
mechanical buildings,existing indoor pool building addition and associated pool decks,walkways, utility,
sanitary and stormwater improvements. The existing pool,wading pool and pool decks will be demolished as
part of the project. Mechanical/Pavilion Building#1 will be approximately 1,269 sf(2,077 sf roof area),
Mechanical/Bathroom Building#2 will be approximately 1,764 sf. (2,855 sf roof area)and the pool building
addition will be approximately 221 sf(746 sf roof area). The existing pool building facade will also be updated
to match the mechanical buildings.
Name of Applicant or Sponsor: Telephone: 792-3775
Dave King, Lake George RV Park, Inc. E-Mail:
Address:
74 State Route 149 Queensbury, NY 12845
City/PO: State: Zip Code:
Queensbury I NY 12845
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 X
may 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 governmental Agency? NO YES
If Yes,list agency(s)name and permit or approval:
NYS DOH&Warren County Building Department X
3.a.Total acreage of the site of the proposed action? 123.78 acres
b.Total acreage to be physically disturbed? 1.40 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 123.78 acres
4. Check all land uses that occur on,adjoining and near the proposed action.
®Urban 0 Rural(non-agriculture) El Industrial XCommercial )Q Residential(suburban)
CK Forest ❑Agriculture ❑Aquatic ❑Other(specify):
13 Parkland
Page 1 of 4
18.Does the proposed action include construction or other activities that result in the impoundment of -WO YES
water or other liquids(e.g.retention pond,waste lagoon,dam)?
If Yes,explain purpose and size:
X
19.Has the site of the proposed action or an adjoining property been the location of an active or closed P40— YES
solid waste management facility?
If Yes,describe:
X
20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or '--FqO YES
completed)for hazardous waste?
If Yes,describe:
X
I AFFIRM THAT THE INFORMATION PROVEDED,ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor naPeter Lo o1a Date: 10/15/16
Signature:
Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following
questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or
otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my
responses been reasonable considering the scale and context of the proposed action?"
No,or Moderate
small to large
impact impact
may may
occur occur
I. Will the proposed action create a material conflict with an adopted land use plan or zoning
regulations?
2. Will the proposed action result in a change in the use or intensity of use of land?
3. Will the proposed action impair the character or quality of the existing community?
4. Will the proposed action have an impact on the environmental characteristics that caused the
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or
affect existing infrastructure for mass transit,biking or walkway?
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing:
a.public/private water supplies?
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological,
architectural or aesthetic resources?
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands,
waterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
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; 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: Variance Site Plan Subdivision
For Tax Map No.: Section Block Lot
Deed Reference: Book 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: Lake George RV Park(Dave King)
Designates: CLA SITE Landscape Architecture(Peter Loyola, RLA)
As agent regarding: Variance X Site Plan Subdivision
For Tax Map No.: 288.12 Section 1 Block 9.1 Lot
Deed Reference: 4198 Book 186 Page 2/6/11 Date and 3391-91 10/3/07
APPLICANT SIGNATURE: DATE: 10/15/16
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$1,000 without notification to the applicant.
3.) 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.) 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.) 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.) 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. t 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 agree to the above.
Dave King 10/15/16
Sig ,:1 ti Ap . r nt] Print Name[Applicant] Date signed
Peter Loyola 10/15/16
Signatu a[Ag� Print Name[Agent] signed
9 ] Date
Site Plan Review Revised March 2014
Town of Queensbury Planning Office-742 Bay Road•Queensbury,NY 12804.518-761-8220