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1-Site Plan App TOWN OF QUEENSBURY Site, plan review Application Review Pro 1. Required Pro-submission meeting with staff to determine general completeness to be held no later tban 1 week prior tar deadline day. Call(518)761-8265 or(518)761-8220 for an appointment. 2. Submittal of complete application: I original and 14 copies of tile application package by monthly deadline. 3. Determination of application completeness. All necessary information must be provided and appropriate fec(s)paid for consideration for placement on an agenda for that month. 4. Incoto rW a HC ations will not be considleredl for lacement on an a uda until all dnissin ianforanation bas 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 copy of the resolution stating the Board's decision on your application. if your application was approved,the next likely step is a Building hermit. Final drawings must be provided for the next phase of review. If your application was denied,your prospect cannot proceed as submitted. DOCUMENTATION REQUIREMENTS hard copy & electronic Please submit 1 ari incl fisc 14 copies of the completed application package to include: • Coanmeted A1!P-1icafion pages 2-9,signed&dated • Pre-Subrnission Meeting Notes: signed by staff • Copy of Deed • Checklist&Plot Plan • Environmental Assessment Form for any non-residential project • Feec $100(0— 10,000 sq.ft.); $250 (10,(101 —30,000 sq. ft,); $500(30,001 -1.00,000 sq. ft.); $1,000 (100,000+ sq. ft.) Staff& Contact Information. Craig Brown, Zoning Administrator Laura Moore, Land Use Planner -_.__..r ...,..r. .-...._..__..... .. .... ..___._ Sunny Sweet,Office Specialist Planning W (S 18) 761-8220 Visit our website tat ...._ ...,...,. _ . . ,m. 'ti for further information and forms Site Plan Review application—Revised October 2016 Town of Queensbury Planning 03ffice-742 Bay Road,Queensbury,NY 12804-518-761-8220 General Information Tax Parcel ID: Zoning District: � PCd .z ["C., Lot size: Ac Current Use: . Proposed Use: . tri�r I e on4 C;ctc, , Tcc t., - Project Location: S 1A C Applicant Name Address: Home Phone Celli Work Phone a Fax L[ E-Mail: Agent's Name: A21 � Address: Home Phare Cell: "� 1�)9 {��� 93 Work Phone Fax 1 (7 E-mail owner's Name: K-1 Addr ss dome Phone Cell Work Phone Fax E-mail Site Dian Review Revised October 2016 Town of Queensbufy Planning Office.742 gay Road-Queensbury, NY 12804.5'68-76'6-8220 2 Dew lopmeni D alp, r,�<.� 1 t+ l�r�x t:xistaaifg f1 it. : 6�r( �osetl l`f) ill t3lrilciilrt; $r5a5ttariall i 50,, 339 50 910 $°; $.."•w°,rt t(Itrcl I ,«Ir<rx.lfr 0' t 0 I l (' lt( d) 0 - I ,.pr�rt(l or.ctl1C:r lwrf9 :,trrrzIcd+ra rrft:�r 7C 361 0 76,361 x q (DocJ ,Im��c�1.t�C� T)UC��� ){ 586 —339 2,VI O 0 l i; B r?; ti l!•'.5rr $'rafrr4r:r;rk)$t livid A 1719 ?"1, 599 0 127, 599 y `��' t'°�°�r).,r$. it 1 f�r:rfag 135 835 ; 0 s 3''5,035 ) I$ i afc`i'I t+,f'�rcr ' (3 ,12 ac I l""sllra:r,t�lC�cr fl'f Irt�lr�r'rrrti>�rt5lr� ",rra� of',,itc: {l�.a��sl l'J 93 97 ; ! 0 93 .9% � ,.�t tk�::t+. l< l':C''C_1t alt�,4�wlt•.a l_ Area f° t.ctliie,c l=:xi ;tn } iq Hol 50 . No l I of it()i N/A /A N/A�l 9 N Sl'lorolinr' �/ N//A q f `allifa °r°21Cf$ 1-il �„),Q..�. ltr9_S7, `31.m of 50{s 40-81 .,25 .51 (So .lfaaCingi Cock) min ;�txatt �d. r !, 24 .6�_r ! No Change I .�0 r NO change R l\F;r11-YI1Ct l 1251 5 .551 kc or `s' rrcil N/A ll N/A $ i 1 r.�}/(�1 r cit I icif7r N/A i r:it.1lrl�trt,�>:fl l 1El ZU 0 NNochiral e I k f r.rtt7�o lbilil N l I ] by . . N/A ✓� � N/A I No of I>r.#u, �l>lr r,la ar:^r, 4 NIA i N/ rlr1, i�/:IlI 1�� lig: i.trtf r.lalr al 5111+� C r�+r�ri t'�a lead::c!fr��tir')°�r"e,;nna f)tht:6t• /��"t�ry'a���t1•C)�.r,ry",,I:Iurt�,C.fY 4�',a9r°,1 .r,9 Y,•rt,a-Q,s�:��f Additional Project Information I Will the proposal require a Septic Variance from the Town Board of Health? 2. If the parcel has previous approvals, list application number(s). 3. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Program? �J G — 4. Estimated project duration: Strt Date End Date 5. Estimated total cost of project: IWI 6, 6. Total area of land disturbance for project: 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] F Waterfront Residential WR 0.22 lipe Commercial Moderate Commercial Intensive CM 0 CI 0.3 Main Street MS 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 stied 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. B. Existina Floor Area sq. ft. [see above definition] Floor Area x- sq. ft. -5-.—Pr—oposed Total Floor Area 0""."1 1 so. ft. E. Total Allowable Floor Area (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 2014 4 Town of Queensbury Planning Office,742 Bay Road-Queensbury, NY 12804- 518-761-8220 179-9-080 Requirements for Site flan Ap,proval,. 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 ofthis 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 19oading 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 timc 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 tactors 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. l The provision for and arrangement of pedestrian tragic 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. �. g g g g post development drainage flows as compared to pre-development drainage flows. Stormwater drainage facilities will revert an increase of ost Drainage of the site shall recharge round 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 mcet all applicable and current requirements set forth by Department of Health regulations and Chapter 136 of the Town.Code. 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. 0. The site plan conforms to the design standards,landscaping standards and performance standards of this chapter. Site Plan Review Revised October 2016 Town of Quecnsbury Planning Office*742 Bay[load,Queensbury,NY 12804-518-761-8220 5 l79-9-08¢Requirements for Site Plan Approval Responses tothe Standards STANDARDS A. The proposed exterior renovation is consistent with the policies of the Town's Comprehensive Plan. B. As the project is limited to an exterior renovation with much of the existing site and building footprint remaining intact,we feel the project complies with the applicable requirements of this Chapter C. The existing site and associated parking has limited change and will function asitcurrently does relative to internal pedestrian activity.Quaker Road is not a pedestrian corridor and therefore there are noexisting pedestrian paths orsidewalks toadjacent areas. D. The project does not have any impact on sewage or sewage disposal.Stormwater strategy and impervious areas will remain as is. See letter attached to this application from Jarrett Engineering. E. The use of the building does not change with this project and will remain a retail plaza. There is mosignificant construction that will change the size oflocation ofthe building. F. As the use of the building will not change, and the parking,traffic and circulation will not be affected,wefeel weare not creating any public hazards. G. There is no off-street parking and the loading facilities will remain on the east side of the building which is the prime location for that function. Future linkage to adjacent properties has not been established aa |tseems unnecessary. H. As simply an exterior renovation,the project should have no adverse impact on the natural, scenic,aesthetic, ecological, wildlife, historic, recreational, or open space resources of the Town orAdirondack Park. |. Existing parking lot and pedestrian movement will remain unchanged as part of this project. J. 5tormvvaterstrategy and impervious areas will remain as is.See letter attached tothis application from Jarrett Engineering. K. The water supply and sewage disposal facilities are not affected by this project. L The existing trees and landscaping along Quaker Road are to remain,in place.The project will call for new landscaping beds along the face ufthe building that comply with Town standards. M. Existing fire lanes, emergency zones and hydrants will remain unchanged as part of this project. N. The design of structures and landscaping in areas susceptible to poncling will be avoided. O. We feel that the site plan conforms with the design, landscaping and performance standards of this Chapter. §179-9-050 Application foo-Site Plan Review Application materials and the site plan shall include sufficient information for the Board to review and provide a decision. The applicant is to provide a site plan drawing and a]I attachments that address items AN, The applicant can request a waiver from AN and is to provide reasons for waiver(s) requested. Please label information to be submitted, REQUIREMENTS Sheet 11 A. A vicinity map drawn at the scale that shows the relationShiporthe proposal to existingeom"ainity 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 casements within 500 feet of the property. Such a sketch may be superimposed on a United States Geological Survey inap of the area. B, The site plan shall be drawn at a scale of forty feet to the inch(I"--40 feet)or such other scale as the Planning Board muy decor appropriate,on standard 24"x 36"sheets,with continuation on 8 1/2 N I I"sheets as necessary for written information. The information listed below shall be shown on the site ,hin and continuation sheets. C, Narric or the pro�lect,boundaries,date,north arrow,and scale of the plan. '41 ob D, Name and address of the owner of record,developer,and seal of the engineer,architect or landscape architect. Ifthe -911 Fes n licant is not the record owner,a letter ofauthorization shall be required front the owner. The location and use of all existing and proposed structures within the property,including alt dinneusions of height and floor area,all exterior entrances,and all anticipated future additions and alterations, Awc- F. The location of all prcqcmit 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. G. The location,height,intensity and bulb type(sodium,incandes xnt,etc.)of all external lighting fixtures. The direction of illumination and methods to'eliminate are onto a12 Lnunop—rLITS-1-liust also be shown in compliance with§ 179-6-020, The location,height,size,materials and design of nII proposed signs. A I. 'rhe 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 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 so rfince or groundwater,erosion of soil both during and offer construction,excessive runoff and flooding of other properties,as applicable. A Stormwater Pollution Prevention Ilion(SWPPP)for all land development activities(excluding agricultural activities)on the site that results in land disturbance of one acre or more. A SWPPP shall comply with the requircrocnis of the DEC SPIDES MS-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 SWPPP or an erosion and control plan shall be required fora site plan review project land disturbance of less than one acre. K. Existing and proposed topography at two-loot 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. Ifanyportion offlieparcel is within the 100-year floodplain,the arca 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 fitling is required,showing the approximate volume in cubic yards. A landscape plan showing all existing natural land features than may influence the design ofthe proposed use such as rock- outcrops,stands of trees,single trees eight or more inches in dimneter,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 A too watercourses,aquifers,floodplains and drainage retention areas. MI Land Use District boundaries within 500 feet of the site's porhucter shall be drawn and identified on(lie site plan,as well (2 J as any Overlay Districts that apply to the property. Site Plan Review Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804-518-761-8220 6 REQUIREMENTS (CONTINUED) Sheet# N. Traffic flow patterns within the site,entrances and exits,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: I. The projected number of motor vehicle trips to enter or leave the site,estirrinted for weekly and annaid peak hour traffic levels-, 2. The projected traffic flow pattern including vehicular inlovernews at Lill major intersections likely to be affected by the proposed use of the site; 3. The impact of tbis,traffic or,levels of service oil 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 StrLiCtiffC,a table containing the following information shall be included: I. Estimated area of'structure to be used for particular purposes such as retain operation,office, Storage,etc,; AJVV 2, Estimated maximum number of employees; 3. Maxitnum scaring capacity,where applicable;and 4. Number of parking spaces existing and required for the intended use. p. 1. Floor 2. Elevations at a scale of'one-quarter inch equals one fbot(1/4"—,I foot)for all exterior facades of the proposed structure(s) andfor alterations to or expansions of existing facades,showitagdesign features and indicating the type and color of materials to be used. 0 Q._ Soil logs,water supply well and percolation'test results,and slorno water runoff calculations as needed to determine and mitigate project impacts. R. Plans for disposal of construction and demolition waste,either on-site or at an approved disposal facility, A Plans for snow removal,including IOCV16011(S)Of 011-Silc snow storage, H I A T, Art Environmental Assessment Form("EAP)as required by the SEQRA regulations,with Par(I completed by the Applicant shall be submitted as pail of the application. If the proposed project requires a special use permit and an EAF has been submined in conjunction with a special use permit appliention,a duplicate EAF is not required for the site plan application, 1r f U, If an application is for a parcel or parcels on which inore,than one use is proposed,the applicant may submit 4 single application for all such uses,provided the proposed uses are accurately delineated oil 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 orreviewing an application(and for SEQRA compliance)all proposed uses on it single parcel or on contiguous parcels shall be considered together. V A briefriarralive statement on how the project proposed for review furthers or is consistent with the vision,goals and policies in the Town's Comprehensive Plan, Site Plan Review Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804-518-761-9220 7 Pre-Submission Conference Form / Section 179-9-040 1. Applicant Marne: - () / 2. Tax Map ID q� 'I Location: Cf 3. Zoning Classification 4. Reason for Review: d �,e Lt)&e 5. Zoning Section 4: L 6. Pre-Submission Meeting Notes: Provided Outstanding; Please provide by Deed General Information complete Site Development Data Complete Setback Requirements Complete Additional Project Information Complete V11 FAR addressed Compliance with Zoning Ordinance Checklist items addressed Envil'OrInental Form completed Signature Page completed A /I nc -IV,:, C"'. (C /1A c K --t C, oux V-,ki IC-4. r -q e S,,, A v I-,qc LAC "k C- 'C ' T�rlly'3' k_>A-e o C.; V-s C T-0 TE)1-�, C C, C^ C k- ..A -C l an C Staff Representative: L G � Q, Applicant/Agent: Date: ZA -6�� :site Plan Review Reviscti October 2016 i,own of Queensbury Phannin Office-742 Bay Road,QueensbLiry,NY 12804-518-761-8220 8 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 anent 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 t)e represented by another party Owner: Designates: As anent regarding: 'Variance Site Plan Subdivision For Tax Map No.: Section Bloch Lot Deed Reference: Book Page Date APPLICANT SIGNATURE: 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$ 1,000 without notification to the applicant. 3.) AUTHORIZATION FOR StTE VISITS: By signing this page and submitting the application materials attached herein, the Owner, Applicant, and histherltheir 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,) OTHERPERMIT RE PONSIBILITIES: Other permits may be required for construction or alteration activity subsequent to approval by the Zoning Board or Planning Board, It isthe applicant's responsibility to obtain any additional permits. 5.) OFFICIAL MEETING MINUTES DISCLOSURE: It isthe 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: I,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 material's 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 inconformance 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 agri to the above. r� . .... _Signature[,Aplicant] � Print Name(Applicant] [Date signed 4Sigature[ gent] Print Name [Agent] Date signed Site Plan Review Revised October 2016 Towyn of Queensbury Planning Office, 742 Bay Road -Queensbury, NY 12804•518-761-8220 9 Short Environmental Assessment Forin Part I - ProjectInformation Instructions for Completing Part.I -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. fartI -Project and Sponsor Information CN Name of Action or Project: Project Location(describe,and attach a location map): Brief Description of Proposed Action: xx V, Name of Applicant or Sponsor: Telephone: y%c t) I, Mail- "VI Address: Cit /P state: State: Zip Code: C 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? 'intent of the proposed action and the environmental resources that r-4 If Yes,attach a narrative description of the int IV I may be affected in the municipality and proceed to Part 1 if no,continue to question 2. 2,. Does=the proposed action require a permit,approval or funding from any other governmental Agency??I N;O YES name an if Yes,list agency(s) nam:eand permit or approval: 14 —�he pro—posed acuo acres. 'c� tio 2 3.a.Total acreage of b.Total acreage to be physically disturbed? C, acres c.Total acreage(project site and any contiguous properties)owned or controlled by the-applicant or project sponsor? i, acres 4. Check all land uses that occur on,adjoining and near the proposed ction. ❑Urban ORural (non-agriculture) EjIndustrial M ornmercial, ]Residential(suburban) ❑Forest ClAgriculture El Aquatic E30ther(specify): ElParkland Page 1 of 3 naa 5. l the Iposcd atc[it)it, Nty 'l, NIA It,A purnutted also onder tlae vooane,aeg„ulatioaas? R6 0 b,('otasistuarut with Ilia tadralatcd cutnlarehensive galas"? Ca. Iantlse cp posed.action Consistent with die predonainant chillm"ter of the.existing Inlilt or naltual NO VES_ vF-71 , Is the site of,tile propwwd autioaa located ill,oa does it adjoisa,a slate hsical C 11(j tl I:avnoanaental At oil'? NO '1'I S ll'`'cs,ideaahl'y _ 1 � h 8. aa,Will the proposer)action icsnll in it strh'Amitial Incrcilsc in traffic above present levels,? I ! F1 la.Ace public transportation scrviee(s)available at or near the site ol'the proposal taction? 0— �nI�I C.fhraa aany pedestrian tanccrturaanihatiorts or Iricyele routes available t'ara or aaetn•Sita-sail"lira l 1�raa aursu�d aae6innY 1 Does the proposed teliora meet or exceed Ileo state�uncagy Crack requirements?? � � � � NO VES' ly the proposed action will exceed requirements,describe design ieaatnres and technologim 10, Will the proposal taction connect to ora existing pablic/privatc w11tur Supply? NO Yl,8 If' No,describe method liar Ialcwiding;pOtable%voter: _ _ _ . . J S 57 axfastlrah t�ugdural:# Coveruna' €�xa�tUoae lo�arlin aler�2y,do0s 1101 Jffoel f_ t 1.will tlae p€oposed action connect to existing;wastewater ulilatics"? NO VES 11' No,describe method lot,providing;avastetvalcr treatment: _ ("ovoainf)existincg tnaadinrg clock (loas notaffect oxislincl huilrlirayp ---- 12. it.Does the site contain ra strncttuc that is lasted on ctlherihe Stato of Natiomil Rcg,istca of l listodcNO ItV�I'�tlS Places? I M r 1 h,is the proposed action located in ata al-clicologiaal sensitive arca? Lt.a. Doesally portion optiau site of the proposed action,or lands adaonmag,tilt Inolsowd autiora,eoW ain NO Vf_`?.. wulhands ol.other wMeriaodies regulated by it li,dural,stal0 or laical ag;cnay? ®_ h.Would the proposed aactiora physically alter,or cocroach into,any existing;wetland or%vatcrbodY? LYJ II,Yes,i(IcIitif)'lila wet iruad ot,rvaterbody aaaatl extent of It[to)atioaas iia sa)u.are l"eel or ares. __.. Id, leloil tify the(ypte11 al 11111)itill types ilttal aaecua ml,m itre libel to be lirund oil the p oolcut site. Check all 111aat apply: ©Shoralina D Forest EJA rrcufituaal7�rrssl;ancls (�il:;trlyanarl-sucuassiurtaal ❑ Wetland Urban ubnr°ban I S. Does the site 11 a-HIIie 11 prol)os cd action ca'ail I any spuciCs til"anaimill,or associated llilbiblts,listed N(.7a ATS by tine 4iaUe or federal p;,ovcrmuent las threatened or cnclaangelvd? tta, Is the project site located in tine 100 year flood plitill 1 7.Will file proposed action Create stoma rt<aterdkell,aag,e,either I'ioaal plaint oa.mora-point soarrea:a? NO '1'I: a.Wilt stcarraa ra��ater discharpges flow to adi scent properkies? �hRC) Q1"1;S Mi la.Will stor•na rt atcl.diselaangos be directed to established conveyance systems(auooft"llid storm dwins)? If'Yes,briclly dcsctabc: ZNU EIYFS Page 2 of 3 18, Coes the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g, retention pond,waste lagoon,darn)? If Yes,explain purpose and size:_ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: E 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YI;S completed)for hazardous waste? If Yes,describe: _ — El Q E AF ERM TFIAT TIIF INFORMATION PROVIDED ABOVE IS T'RUE+;AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor nan „tom_ 1 ' N Date: — Signature:_ ._ PRINT FORM Page 3 of 3 Agency Use Only 111'applicable) Project: Short En vironniental Assessment Form Part 2 - Impact Assessment fart 2 is to be completed by the Lead Agency. Answer all Of the fallowing 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")-lave my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occul, occur 1. Will the proposed action create a material conflict with all adopted land use plan or zoning regulations? D 2. Will the proposed action result in a change in the use or intensity of use of land? El r--1 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)? El D 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? El El 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? El 7. Will the proposed action impact existing: a.public/private water supplies? El D b.public/private wastewater treatment utilities? El D 8, Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 1:1 El 9. Will the proposed action result in an adverse change to natural resOUrces(e.g., wetlands, waterbodies,groundwater, air quality,flora and fauna)? E-1 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage problems? D El 11, Will the proposed action create a hazard to environmental resources or human health? PRINT FORM Pagel oft Agency Use Only[If applicable] Project, Date; Short Environmental Assessment Form Part 3 Determination of Significance For every question in Pail 2 that was answered"moderate to large impact may occur",or if there is a need to explain why 1 particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Pail 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact Should be assessed considering its setting, probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short- term, long-term and cumulative impacts, Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT FORM Page 2 of 2 1-,-".AF Mapper St.tt1ftt"Csary Report Wednesday,R'Itt[ltrst 12,2015 8:50 AM Disclalmor:� Tho 1 f hktrpr+a r I +e a a uaninel raatr Inns u6e+a1 Cn a ;"aal I I� ba lk nrroli'mm awl d tra to rnr(EAl) I lo! a�s qruo shun In preparing 1 1 cahinIbo l -rare'narr€,arkeaa �l w vwcrc I by 1110 FAV Mapper.>'lrtcrilional Buermruicrrr cdrr nay LAI I a, I �a tic+oa an ran ho rare^+Inert by coo uirhig 1ho VAV worKtsnolt . Allhotjo r 1 t the 1x11 r1 alq'Mr rxov(10$rho uu+ n np4t+dale rlra�itrrl d rla waokarr to Orr you miry also rneccl a+a conj act 1,wil or other dal r snurm gar order �i to obt"rtn 6*1 not raaovided try Ole,Plarrp r)'ptai drrinr h 11o4 to —. I e bs,9atrat5 for nrare jr y rleteainullOtIOAS, lls47r,,1.1-I...4 I li a . i IDi1trJ:, t�1�ir1r(:rl M k lr ua r=fll artasaa, °,lrr ll�'3C'tl:r�tll"y. l ZOO: r To c itlra jrdr . '�•'t=.a � t a a r r Fz xrri 1ps,lr:•.I,'ar rrr r1r7ara� rr'it4.� rru: rr^ rr rr3troil rsrll},rlr> a.a tae tr!n y ri r All+A141 .�. J+rurlal,�°r, e llrnrkar rl 5cue�c pta r I r+C G�Ccrnr� r3 a� N , a,r a1 �pa11 ttin ay, rEl}t rr ,rl l' t trl a PdC+1 t ra ,,ra rar i 11:11 Fa e a [nr a rHK rkl,ht rft8f2is 'l al NI1,f'kII Jir rrsl�rsat r. r i I rPnrlrr r 1 ant lna8r�ar �r?a�.e i, e- itY�., ti'itrJ t Il k ntY � tr 5y� r+ rlFtt r°a. r I f } Inkul i MF31 k:acl C.a,anu Part 1 J Q1lestion I [Crilical EnvironlxnentM No Areal hart 1 1 Question 11a [National Register of No Historic;Places] I'rart 1 /Question `tlta [Archeologicot Sites] Yes Dart 1 /0110stion 13a[Wratirands or Other Yes-Digital mapping information on local and federal Wetlands and Roflailated Waterhodies] wale rtaoclies is 1<11olwn to be incomplete,Refer to,EAF Workbook. RHI-1 '1 1 tl<astiora 15 p't'lreatened or No F rndcanya,red Aniin al] f'1ar1 1 1 C211estion 143[100 Year Flood Blain] Digital mapping data are not available or are incomplete. Refor to EAF Workbook. POO 1 P Question 143[R mediation Situ] Yes Short Environmental Assessment Form - EAF Mapper Stlrnmary Deport r [hi3 CS Zs N 3'.X_.12.12€l t l THXD INDENTURE, salla September 16„ 1993, among (, GEORGE I. DaYCNUK, having an address at 2000 South Ocean Boulevard, Whitehall Bouth, Apt. 101, Boca Baton, Florida 33433 ("t)ranter.el r ,a Party of the first part,,, and fi ONI.ST UOYCRUK and NAN1A BOMIUK, as Tonanto in common, oath having an address at 35 Orchard Drive, Quoenabury, NY 1.3004, (collectively hereinafter referrod to as "'Grantae"ll), a C, Portico of the second part. t:3 VITNEDSET11, that Grantor, In consideration. of Ton Dollars and other valuable conaidoration, the receipt and sufficioncy of which is hereby acknowledged, does hereby grant 1%1rat release unto Grantao and the heirs, executors, adminintratora, legal rapresontotivea, aucce"sora and assigns of GrnntaQ forever, ;r I ALL that certain plot, piece or parcel of land, with T' the buildinga anti improvements thereon erected, M situate, lying and being in the 'gown of Queensbury, .« the County of Warrcrn and the, state of New York, ` boing more particularly described in Exhibit A i attached hereto and made a part hereof, r TOGETHER with all right, tltla and Interest, if any, of Grantor in and to any streets and roads abutting � the abovo described premises to the center lines thQroof, r; TOGETHER with the appurton4ncc9 bawd ail the eetato �{P and rights of Grantor In and to said preaalses, •� TO 11AVC AND TO HOLD the premises herein granted unto i GrAnteea and the heirs, executors, adAnlatrators, legal ` rslrrlsontatives, aucces:;ore Intl assiryrra of Grantees forever. Grhator covenants that Grantor is acizod of cold premises in foo,nimplo, and has (good right to convey the same) that Grantee shall clulotly enjoy said presises; that "aid preiniaoa are free from eneumb"Mms, emeis as set forth her"111; that Grantor will execcrto or procure any further i 8 l �ci,. nacasoary aa$wranco of the titlo OC said prenja0a; and that Grantor will forever warrant the title, Of Said prormlsoij. Law, cov Grantor, in compliance with Section 13 of the Lion Onanta that Gruntor will raceive the conaldoration for this convayanco And will hol(I Consideration an the right to racajVd ouch a trust fund to be bl)pll4jd first for PurPOOO Of Paying the coot of the the iMPrOvomont before using ally part or the total Of the 041no for any OtIlar purpoaa, IN ffXTNZqo qHgAtor Grantor has duly Oxocutod thio dOOd On the data firot aboya vrittort. EORGE STATE: OF NEW YORK COUNTY OF ) 'l' 16 r On the day, of September, Personally come GEORGE r. BOyCHUK, 1992, before p)a tO nO known to ba the individual doscribod in and who executed tl'Q fOvOqolrlq good, and he duly Acknowledged that he oxectIted GajqA&.$ed. FRED No" MataCA*-YVA W.".CAmy 0473Z)OI Ltf Co—mm(4011ts 64th 10.It 11P 9 Notary 6 to TIN—Y lty Cotabiaaion expires.0/O"Vii- 0 AltHkAD L AOw�Amaj WIARYMAr 511 Ww m �aL u ALL THAT CERTAIN PlECZ 4R PARCEL OF LAND, oituato, dying and being is the "Town of Queenabury, Warren County, N.Y., more particularly bounded and described as foliowaz BEGINNING in the northerly bounds of quaker Road at the southeasterly corner of premises conveyed by the Town of Queenabury'to Regan and Denny Funeral Services, Inc., by deed dated November 9, 1971 recorded November 1$, 1971 in B00% Number 543 of -deeds at page 249 in the Marren County Clerk's Office running from thence North 13 degrees and 39 minutes East along the easterly bounds of the said lands of Regan ,and Denny and continuing the same-course for a total distance of 450.00 j feetz thence running South 79 degrees and 43 minutes East, 299.51 �rs feet; thence running South 13 degrees and 39 minutes West, 450.00 feet to a paint in the northerly bounds of Quaker Roads thence running North 92 degrees and 54 minutes West along the northerly bounds of Quaker Road 153.00 feet to the center of a concrete monument; thence running North 74 degrees and 22 minutes West, still along the northerly bounds of Quaker Road, 147.00 feet to the pout and places of beginning, containing 3.110 acres of land, be the sante inure or less. Bearings given in the above description refer to the magnetic meridian as of June, 1971. Subject to all covenants, conditions and easements of record. BEING the same premises conveyed to the grantor herein by The Town' of Queensbury by deed dated the 23rd day of May, 1974 and recorded in the Offices of the Clerk of the County of Warren in Liber $94 of deeds at page 945 on the 25th day of October, 1974. ..to i t:Wr91fr a�2 +' 11 to ;.4X trCma:all. � C•• :: Y: .. • CC p7 EXIMIT "A" Y , s 5, Is the proposed action, NO Y147,S N/A a. A permitted use under the zoning regulations? ❑ ( -1 b.Consistent with the adopted comprehensive plan? ff �J 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 7. Is tine 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 'M b. Are public transportation service(s)available at or near the site of the proposed action? E ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 191 1:1 a.Does the proposed action meet or exceed the state enemy code requirements? NO VE If the proposed action will exceed requirements,describe design features and technologies. rul ❑ 10. Will the proposed action connect to an existing public/privatc water supply? NO YES If No,describe method for providing potable water: t7--r1( Vii,io,i lid'of(cl i Y - i f`'1. ..�a 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment. 0-\✓l, (1)�1AeIL `a ' � ❑ Mil a C " 12, a. Does tiie site contain a structure that is listed on either the State or National Register of Historic ND 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 NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would tiie proposed action physically alter,or encroach into,any existing wetland or waterbody? El ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:. 14. Identify the typical habitat types that occur oil,or are likely to be found on the project site. Check all that apply: ❑Shoreline ®Forest ❑Agricultural/,grasslands ❑Early mid-successional Wetland El Urban Suburban 15.floes the site of the proposed action contain any species ofanimal,or associated habitats, lusted NO YES by the State or Federal government as threatened or endangered? ❑ ' 16. Is the project site located in the 100 year flood plain? NO YES TTTT 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a. W11i storm water discharges flaw to adjacent properties? NO DYES b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: F-1 NO []YES Page 2 of 3 111.Does div proposed actiota inchade cnaastruclioaa oa nY1x.r activ'rtaos ihaat resull in 111e inipoundment eat' NO ,water car other liclaaicls(e.g,retention l)olul,waste lagoon,dam)? It'Yes,explain purpose and sirc: -19.Has the Nile ofthe proposed action car an aattltainual 1aa•operty been the lucaation off-IIIActiveor closed NO YES solid waste nuuaragentent fatality? It'Yes,describe: _... .. 20.las the site of the proposal action of as adjoining property laecaa the subject of aanaediation(casagoiaag or NO 7PI Completed)for lulz as doaws ry aste? if Ves,describe: ___.__.... _..__._ _ I A FF IRNI 1'1IAl""I'll 14,1 NFORMATION PROVIDED A110V E IS TIM E AN 1)ACCURATE'1"O TlIT,BEST OF MY KNOWLEDGE Applicaanlspoatsor signature: pN �NI FIRM Page 3 of 3