Site Plan Application Site P'�lan Review ppli tior>I Of, r LTi i4SBURIr"
Applioant end/or agent shall meet with Zoning Administrator to deterrmirne type of review needed
of
Pre-submission meeting with staff is required to determine gen oralrrnpleteness of application rmatedals (t
be held no later than 1 week prior to deadline submittal - Call ( 18) 761-8220 for an appointment).
Application s ubanrnittal; one (I original application package, one (1) deed and 14 copies of the application
paage with the an fee"---
� Eo2i�?
Determination of application completeness and placement on ain agenda V
i
Planning nning Board meetings are generally the gird & fourth Tuesday's of each month., You will be advised in
writing as to which misting to attend,
Following the meeting you will be provided vdtin a copy of the resol'u'tion stations the Board's decisb n on your
applicatiorr, if your application was approved, the net likely step- is a Building Permt, :If your applicatioun
was denied your project cannot proceed as submitted,
Tee: 1 00 (g to 10,000 s , 0 00 (10,001 to 0,000 s�; $500.00 ( ire DO 11 to 100.000, sf)a 1,000.00
Zoning Staff&Contact Information:
Craig i rowrwrn Director of Planning,Zoning& Code Compliance craicgb o.�ueenst;sr,ury,not
Laura Moore„ Land Use Planner lmooire@ queensbury.net
Sunny Sweet, Office Specialist (518-761-8221) su nnys@,queensbury.net
Site Plan Reviiew Revi�ed April 2016 �
Town of Quemsburry Planning office-742 Bay Road -Queensbury, r 12804•518-767-62201
Genera,l Information
Lot size:
Current Use:
Project Location: &9&�
Applicant Name Address
Home Phone Cell:
Work Phonea.
yja '—
E-Mail:
Aqenfs Narnot Sr Address.
Home Phone Cell;
` data Phone Fa.
y1fe, 3al V-is '
-irnail
� w I I �ole o
nee' Na1nrn�nat Aldess
Home Phone Cell
or P'honle . Fax
OR e
Sft Plan R,eview Rev°isW April 20,16
Town of Qui3e Asbury Planning Office-742 Bay Road-Queensbury, NY 12804,5118-761 x8220
Site Development Data
Area I Type Existing scl. ff. Proplosed Tclall g_ft,
Addition s ft.
Building footprint � 37 q,00
. Detached edl Garage
dF
C. Actassory Structure(s)
..mm � .
C04LO 4464—
D. Paved, gravel or other hard surfaced area _
E Porches /docks
F. Other
G. Total Non-Permeable [Add A-F]
H. Parcel Are [43,560 g. fit. I ae�r�ej �
I. Percentage of Impermeable Area, of Site: [l=G,/ d�] 3011010,
Setback Regmnt
� ...._
Area Regired Existing Proposed
Fruit[f
Front[ ]
Shoreline
Side afd [11
NAP CAWQE
Side Yard [2] „
Rear Yard [1
(Rear ard
Travel Corriclof
ado
Hei h 'maa
NO
IPrru�etajIit,
30, 64 ZIP
WP gp
Site Plain Review RevisedApTill 20116
Town ofQueensbury Planning Office.74Bair Road-Queenalt ury. NY 1128�104„ ,1E8a7 1i-8--220
Additional Project Information
1. Will the proposal req uJ re a Septic Variance from t�he Town, Boa rd of'Health'?
2- Ifthe parcel has proviso usapprovals, listapplication number(s):
31. Does this profectrequire coverage under the New York State Poll utantDischarge, El ift nation, System
(SPOES), Permit Program? nive� &f14PIA�6o
-rogoWr wP&4- OCCOPi
4, Est�j m ated project d u ration- Start Date_Af A End DateX&__:jF-� S-000 PK 4-?M-
5. Estimated total cost,of proJect, Ity sy,
/9
6. Total area of land di turba nice for project: Iv A
Floor Area Ratio Worksheet
FLOOR AREA RATIO (FAR) --The relationship of bulldin:gi size to, lat size!,derived by dividing the total building
floor area by the lot size in square feet, yierlIding a percentage.
—fo—nfi-n-—g I N—st r i c t Symbol Floor Area Ratio[FAR]
Waterfront Residenti'a[ 'WR 0.22
Commercial Moderate/Commerciai intensive CIS I 0.3
—ffa—In Street I MS 01.3
A- The combined area of all squiare footage, as measure from exterjorwalls, of a14 strucWres on the property, Including
all floors of the str=tures, garages, basemients and attics vOth more than five (5), feet of ceffingi height and
covered porches. Building square footage does not hiclude:Open deck, docks and that portion of covered dog
extending over 'w'ater and one storage shed of one hundred twerity (120) square feet or (less: Any additional
sheds will be includeld. (See"FLOOR AREA.RAT IV),
B.. Cornmerriall or industriall- the total area in square feet as measured from the exterior, of the outsicle walls of a
bullding or structure, and when applicablle, the sum total of all floor areas of th. e principal and accessory buildings or
structures an the pro*t site.
A Raroel ATu gar, 2;Z,y pqj,ft,
B. Bdstinignbair Area —sq,ft, seedifinffion above),
C Ropom,Additioind HoorArea, a- sq.ft.,
D. Proposed Total Noor Area 4-—7-0co sq.ft.
E Tota[Allowable Floor Area d (Area xj..0(see above tel l
If D, is larger than E, a variance or revisions to your plan may be needed. Please
consult w/Staff.
Site,Plan Review ReviseclApid 2016
TGwn of Queensbiury Paniniing Office-742 Bay Road-Queensbury, INY 112804°548-761-82201
§ '179-9- ' Requirements for She ElanA
pproval. The PanninBoard shall not appiove a Site Ran unless it
first determines that such site plan meets I t1lowing Star;tdards. Pleapn9sponses to each of the Wowing
toples.
..........
STANDARDS
The proposed project furthers,or is consistent wfth the proll6er of the Tom's Comprehensive Plan,
YJ 0S,
The proposed project compliesWith all other requirements ofthis Chapter,including the Mite plain review standardly as set forth in Paragraph F
of IhiI siectiQn,, the dimensi
sonal,bulk,,and!density feQUlations of the zoning district in whicb I Is pro osedl to be locat rEC116 3 angi Table 1).
the applicablis requirementof alll other oAqtjcJa5 that applyw PA?tg?.-Rq
OVW
C. The she plan encourages padartrian,adivity h4arriallyard', if pTacticaVe, to and from he sle Mh pedestr�an,paAhs or s,idewaliks,itNe,?rd tM N
adjacent areas,
0. The, site plan Must Con fbrm to Chapter 136 Sewage and Sewage Disposal, Chapter 147' tonmw+rater Management Local Law,.and other
appl6cable beall law8. ysr
E. the proposed use shell be il harmi the gien�ral pmrpose of intent ofibis Chapter,specifically taking intoaccount the:bcat;on.character
and siiza of the proposed use and the description ar4 purpose of the district iniwhith such use is proposed.,the:nature a nd blansliq of the
activillas tin bo,involvimil h or Cond"itod h winner ion with the proposed use and the nature and Tate of any increase In the buirdan art
suppcdingpLiiblieserwims.ar,bdlfaciiibior,whiphi wiNfollibw the approval ofthe proposed use. AS E
F. The establishment.maIndenance and operation of the proposed use will not create public hazards from iraffic Itaffic coingastion or l�he parkjInq
of vehicles andVor equipment or be o1hierwise detrimental to thea health,safety of general welfare of persons residing or woNng lI
neighborhood or IQ the general welfare of the lawn.Traffir access,and ckeulatiorr,road Intersections, road and drivoway,width,,s,and'JT9ffC
G Off-street parkjn�and loadiinig facilities will be appropriately located and arrainged and sufficient to meet trafflL anticipated to be generated 1;y
this now use- The oetabfiahmant of vehicle links between parking sTeas of adjacent pmperfieis are prcMded where feasblle- This furthers the
Town's goal al reducing Curb CuU.and MduciI congesliI A twenty-foot*Ide Gonnilection is required. ff adI pfoperiles are either
undavalopad or pitsviously dewalopad without having made provision fear future finkagel, then a fuiture conineefion must be klarAlriadl and
provided For iin the site plarli underreview for such future linkaQe when the tJme allses. The Planning Board may require proof that this
owners fof pruirposes ofcoclrdiinatinQlinkages with adjacent Properties.
.14. nio project shall Twit have an undua adverse Impact uponi the nalural,aoeniu,aesthetic,ecologiI wildlife,historic,recreationar or opan spaco
raSOLITOes of the town or The Adirondark Park or upon the adequate provision of supporting facilifies and services made necessary by the
project,,taking Into account this commarejaR,industrial,nasidenal,reoreallonal or other beneffts that might be derived from the,pincII&O Im
Trialkiag the,dolarminatipirl hereurdfefo,the Planning Board shall consider those factors pertinent to,the project contained in the,development
considerablans M forth,hiar6n,under 4 17��-91-080 of this Chapter,and in so d1bring,,the planning Board shall",ke a net overall evaluation,Ot
the:project Infelallon,to the dovaloprrant objedlives and general guidleifirre5 set Forth in§179,-9-080 of fts Article. Nip
1, The provision for and arrangement of pedI traffic a=ess and deculatibin,walkway structuras,control of IntarseQtipm,with vehiculartraffic
and overall pedestriani convenlence shall be safe and adequale for pedestrian moviamerit Pedealliannoninactions betweein adjacent sites
she III be pmvidedw encourage ped'e6trian use.
J,, Slorm.water drainage fRrAI v4II prevent an Increase of posi development drainage flows,as empared to pta-d4velopment dirainiage flows
Drainage ol'thesife shall reoharge ground waiter to the extentlipraclicat.
rit
a, a
a ,
'Pad's
pa"
r
ni
p
n
h
a
w' 's
m ofl' rl
a
',s
I degrade
I
b
a
p
a
re
L
a
Tin
q. ... pro"'O'et
or 2"ap"e
do l,111,1 y by a.,
gI
adversely affact drainage on adfaicenf properfie"s Or publiG TI Facilitlessh,all be rinconfofmance%mvith the dfainage standards of Chapter
147of th a Town Code and The Tqwni of Queensbury Subdivision RegiUlationswhiere applicable.
on rec�
X The watar supply,and aewagie disposal facilities Wil beade Uate and WH meet aR applicable and current requ 43 merftsat forth by Daporlmant
of Health regulations and Chapter 136 of the Tom Code, id
IL The adequaGy, type and arrangement of trees, shTubs and other suftable plandng . {"d ..Ng� erects ening
shad
re m
visual andtor noise buffer between the applicants and adjoining laiinds, Inducing lho ma)�inurn retention of Oxisfing vegelaiiorl and
maint.ananca, incl'uding replacement of dead or deceased plants,
M, Fire lanes.emergency zones,,and fire,,hydrants wMI be adequate and meet the needs amd requirements of emergency ice p,
N. The design of s1ruclures, roadways and landscaping h areas susceptible to ponding, oding andfor erosion wilm hirritze or ave such
Impacts IQ the maximum extent practilcable.
011p ge:
0. The site plan,conforms io file desigin standards,landscaping standards and perfprmanice alandards of thia chapter,
........... YAW' '
Sita Plan,Review Revised April:20,16
Town of'Queensbury Planning OffiCe,742 Bay Road,QuieenrOury.NY 12804,51$-761-13220
19-9450, Reffcaiti on for Site Plan Review
Absent any waiver or waivers, an application for Sfte Plan Review shull include the following:
REQUIREMENTS Sheet#
A I A vil me p drawn at the scale that shol the reiationshilpof the proposal to existing community Facilities which afilal or serve iii?,
such as reads, shopping areas, schiniols, atc- -rhal map shall a[W Shew all properties,, idienfify owners, sulladmisions. streets, and
easements wiithfn i5iX)feel of 1he properly.Such a sketch may be suipieritinposed on,a United States C~eoli survey map of the
area.
The ii plan shall be draym sit a 9 Ile of forty feet to the inch (1"�40 fl or such other scala as,this Planning Board may deem
appropr&ate.lonstandarx!24°"x Wsheetsilwilhcontinuaflonun 8)t2"x 1 Vsheets as,necessary for writtain information.'rho itFolmniatiori,
listed below shaH be shown on the site plan and continuation sheets-
............
Name of the project,,boundahes,dale, incirth wrmv, and scale of ths,plan. 6 IYF UAW dro&w—dWAM ra I MOM ww's
D Name and address of the ower of record,developer,and seal of Iflmarb&l archdacii;,or farad pia architect, I the epplicant is not
the record omer,a eltar of aulhorizalion shall,be required ftem,the cwner
E The location and use of all as sting and proposed struiduresl within the property, including ell dimensions,of height and floor areal, aill
extel ontrances, and elf anticipated future addilionsvindl alterations,.
F The location ofaill pril and proposed pvbljr and private ways, off-street pairking areas, drillieways, outdoor storage,areas,
sidewailks,ramipl;s.curb,,s.paghs.iandl:scaping,waNs,,andfence,s. Location.type,and screening details far all wasis disposa[mmie inli
shall also be shol
ted
G Theknatilon. WgK h0lensi and bub lype,(sodiumi, hcandescarl etc.)of al emli [lighting fixtures. The direction of illuninalian
arid methods to,of nnglare onto adidini propern
rties moi,also ba shaman irif compliawill,nce §1,79-�6-020� \A/
F-H1 The localioli%height,uize,materials,and desn of,all proposed signis.
11113..
"rho locaflon of all present and proposal ulility systems including:
I- Sawageorslapljonsyrtann�
2, Water sijpply syslem;
3. ephlone,cable,and e0edrica]systenri%and
4. Storm drainage system Includbg existing and intoposad drain lines,culwarts,catch baairis,headwella.lar4walts. hydrants,, v/
manholes,and drainiagieswailes,
J Plains to prevent the polUllon of surface or groundwater, alrorldi tail bol during andI after cQnistrudion,, excessiverunill and
flooding of othar properties. as,appltd te. A Storm stair Poilirtion Prevention Plan (SWl for alt Il adl develldpanad it adiiirl
(excluding aQdGURUrali aictilli'lliag) on the sli VNiall. results In(land disluigbancia of 11-acraor more, A $VUPPP shall comply with the
raqui,m,mant8 df the DEC SIRDE$ Mi G�laneral Permit andl apter 147 of the Town Of QUeansbuiy Code. ftsKafl he at the
discretion of Via Ptanning Board astowhethera,AWP PPor an erosen and control plan shalt betaquitad for as site plain rowlaw project VV
land disturbance of less than,race.
Existing end proposed top ograrhy at two-foot conlour hieryals,or such other contour bilwVal as lho Flanning Board shall alli AM
e4evalloris shall refer to the neall Unii0dMates Qoastaj arid Qeedefic Eiench Maria, If any ploftni of the parcel i§within the, 10110-
year floodpla in,the area will beshown,and base flood[elevations given.Ageas al be'indicated within the propulead sitis and wiV�li
50 feet of the proposed slid wfiers soil ramolillaillorfailing b required,ahowing the approximateviolume,in cutJoyardi
LA landscape Wen showing all existing nalurall brid features,that may hflueri the clorign of the gliopbsed use-.Urh as ruck,outrropai,
stands of trees.singla Imas ai or mom inichel In,diarnel fbim5q,power. crud water sources. and ail proposed changiesta these
features including sizes and types of planits,Water sources hiclude ponds,,lalkes,,walands,and wattacourses,aiquifers,ftoodlpiain8l, V/
and drainage retention areas.
Mi Land Use,Dis1fict bounqlaries within 500 feet of the 9W5 perimeter shall be drawn and dainfified on the site plan.as Wall as any
Overlays Districts that apply to Me propiarty.
50e Plan RevilawRavised April 2016
Town of Queenisbury Plannen Office-742 Bay Road-Queensbury,NY 12804-518-761-8l220
Rr--01JI1R5M�i CONTINUED
..............................................................
N Traffic flow peheii withiin the site„entrances and exits.and loading and Unloading areas,as wall as curb cuts an the sile and within
100 fiml of the sli 'nie Pianining i may,at its discmliori, require a detaiAad traffic study for brile developments or for those In
heavy treftio areas,which shall hchidle;
1. 'The projected number of inotor vehidia trit,s to enter or leave the sile,estimated for weekly,and:annual peak hour traflic
levals;;
2. The pn&erted Iraffm flow pattern indUding vehicular movements at all ii Wersecii likely to be alfarted by the
i use of the site-,
3. The impact of this traffic on levots of sarvice on abuti public streets end at affected iritersections. F;;xistinq and proposed
weekly and annual peak,hour traffic levels and road capacity levelsshaill also,be given.
0 For rjgXZ22strutfion or alterations to arty stmctuim.atabieconitEiininqihefoll' Ingin(formalion shall bahncludeds
1. Estimatiod area d Mr=lure to be used for particUli limorposes such as retaill operafion,office,storage, etc.;
2. Estimated imaximum number of omplcyais8�
3- Maximum seating ralipaGity.where applicable;and
4. Number of parlding spa mss,axisting and Matluirsid for the intended use,
1. Floor Plans,
2, Elevations at a scale oforei-ciLraner inch,equals one foot (11w4" 1 fqQQ for pM eerior facades of the proposed strudure(s) an for
alterations 10 Or expansiWis of existing facades,5boOng design features and indicating the"anid cdbir of materials to be used.
Q it bigs,watRT supply wall and PeTcoaffon test resulls.,and storm runoff calciflations,,as neadod!to datermina and mitigata,pm iect
inpacits.
Rains for disposal of=s1ri and demolillort yvaste, either on-site or at an approved disposaR faclKy. AILL—
S P11i for snow removal,including ipoation(s)Qfion�site snow steerage,
T IAn Environmental Assessment Form CEAF),as required by thele St-ORA,reguillabonr,with Part 1 ecomplaltod by the Applicant 5hai b
rubri as part of the Bppi If the proposed project requiires,a special use, permit and an EAF has been. submitted Fn
conjunrAion with a special use permit applbation,a dupIlcale,EAF is snot requlmd for the site plan,applicabori
U If an applicabon t For a i or i on vuhiQh more then one use is proposed. the applicant may,submit a s"ngite appoficationt 10
all such uses; provided the proposed uses are: accuiralei delineated on a site plan drawn pursuant to the Maquireni sat fWJh
above. The planning Board may grant the appliraflorw Mth, respect to sune proposed usisp anal not p1hers, FW Purposes of rayieviving
an applqallion (arid for ',SF-QRS compliance) all proposed uses on a sing4o par el or on coriNUOUS percale shall be incnisidered
together,
V A brief narralivai stalamaint tm how the project proposed.fur revieve tArthers or is consistent with the vision,goats and poillcies in tha
Town's Comprehensive Plain..
........ .......
Site Plan Review lie evise:d April 216
Ti of Queensbury Manning Office-742 Bay Road Ouieensbury,NY 12,904-518-761-922G
P)tr, ubn1isSiOn Conference Fore 1Section 179-9-0 40
1", Applicant Nerve C.
2. Tax Mop
3. Zoning0assification
4. Ruson for Review:
S. Zoning Section ft: ON 0
6. Pre- nbm, i cion Meeting Dotes. ProvidedOutstanding; Please rovideby.
D"d
General irli"i6,miati n complete
Site Development Data Complete,
Setback Requirements Complete,
Additional Project Information Complete
FAR addressed
heo i.1st items add=sed
EnvironmentW Form completed
iaturrecompleted
w
kei'li
M
m
t r
eC.
,h
�+
L
t ffpresentatov ; 1—"rt- r—t
p heart/ gent:
Date. .
Sft�Plot,Re-view Revised October2016
Town oi`Queensbury Plann.irug OfTice. 742 Bay Ra „Queensbury,NY 12804
61720,
Appendix
Part 1,-Project Information. The applicant or project Sponsor is rosponsible for the completion of Part I. Response
bocorncpart of'the application for approval or funding,are suulbjcot to pub].icreview,,and may be subject to further veriflQation
ornplete Part 1 based on information currently rmvai table. if additional research or investigation nurounld be needed Lo Fully
respond toany itzrn„please answer asthorough lyaspossi>l5iebut_sedonCuurrcntin:for.Mr ation.
Cutrnplctc all.ittrns in Part I. You nuay also provide ammy a ddRionaul in Forrnation which you believe twill be needed by or useful
to the Bead agency;attach additional pales as nocemary to srpplenment any itern.
Part 'l,-ProjWt and.� ponsorin,fornati.aonn
ig
Name.ofActionorProject;
dt Ir
Project Conation (de;scrible,and attach a location map).,
Wl&escription of"F mr�ru: S— ° 1
Brief
Name of Applicant orSponsor; W,ephone:
MOMW& &MMR, l
Address:
L"atyr"I G: state°m ;yup Code:
RAMMPAL1 "'
;.rocs the propuased action only 'involve the legislative adoptiaan of a plan,local hear,,ordinance;, NF Y
tVuiatnurud tta iu,e
rule, or ramgnnlation?
If Yes, attach a narrative description ofthe into nt of$o pfrsptugod action and the environmental resources ffiat
may be�affected in the municipality and pimcced to fart 2. If 110,wntinuc to quacs ion 2.
"Does the proposed action require a perms it approval OrRinding fromn any other governmentalAgency? NO YES
Iff cs,Hstagency(s)namneamidpermitor.approval:
3A-Toltol t reago of time site of the proposed action uaum s
b.°'ro-tal.acreage to physically disturbed? � cres
e.Total acreage ,project site and any con4gwus propertics;"l owned
or comtralled by the appliewnt or project sponsor?
4.Check all land'uses that occur,on,adjoining mid near dre proposed +tion.
o Urban o Rural(t10'n- gtiCLltumre) 0,11M col mmierci;al of Residential (%Obl rrb 'i)
o Forest o Agriculture oAquatic o 0,01ur(spccul" );
&4'Parkland
Page, 1. of,
5, Isthe proposcd actian, YES NIA
a-A permitted use wndtr the zoning rqgu tations? Sz;�
b-Consistent with the adopt comprehensive plan?
6. Is:the proposed action consistant with the predominant dimacter o Cthe existing Wilt or natural �YES,
landscape?
-VUL9
7. Is the site offfie proposed action lovaled in,ordoes itadioin,'a state listed Critical En��vlromnenl I A7P
If Yes, identify: NI/
$, a,Will tbv proposed actionresult in a substantial increase in traffiio above prownt lzwh?' NO, YES
b,Are public transportation service(s)available at or near,ffie site ofthe Proposed actkn?
o�Art any pedestrian accommodations or bicycle routes avai[able on 07 near,site of the proposed action?
9.Does the proposed, action meet or excecd lhc state energy code requirements? NO -YEIS
Ifthe proposed,act�ion will exceed requirements,describe design RotuTes and technologies.
10- Will LM Proposed action connect to an existing pub]ic/privale water supply? No YES
If Yes,does the existing system have c2pachy W provide service? ONO 0 YES
If No, describe method,far providing potable m%ter;
I L Will the proposed action connect to existing wastewater utilities" No
If Yes, does tete txj.,Aing system have capacity to provide sery ire'? NO 0 YF S AX
IfNo,idesorjb,method forprovidingwastewatertrj2:,3tmen.t,
12. a.Does the site contain a.struoture that is listed on either the State orNadonal Register of Historic NO YES
Places?
h.Is the piqwsed actiout tocased in an archcological sensitive area?
13.&Does any portion eat;the site ofthe propusod action,or lands ad�oining the:prope;e—da—ition,—contain NO
iveflands or other waterbodies regatated by a F"lml,state or local ageriqy?'
Would ffieproposed action physically alter,or eneroach into,any exisl�g werland or walerbody7
If Yes, identify the"efland or waterbody and extent of 010.rations in square feet err acres:
1a4Identify the ..............
-typical habitat types that oocar an,or are likely to be
found on 1he project site. Check Baa that apply:
0 911melifte offorest 0 AgriculluraVprasslands
Wo land 0 Urban
15.Does the site of the pmposcd action contain any species of aninial,at associated halritats, NO YES
lry the State or Federal: govemineift as fltreatorted or endangerud?
1fa site located in the 100y ear flood plain? NO YES
17.still thplmoposed action create strirni water dischargc.,either Roan point onion-point saurces? NO YES'
a,Will stormiw4tordis�chargesfiowtoadjlacentpi°o,.Pertieqr2' 41 NO 0 YES
b. W111,storm water discharges be Ji1r(-1c1P.N1 to otablished conveyance systems(run. ffaajid starin drainsy?
IfY,es,briefly describe-.. 0 NO 0 YES
Daae,2 of 4
CPP� VIOIX 1-07--
Iq r#g awd 15P
F
j=A00&f
18.Docs the:proposed action inalude construction orothcr activitics that resullt:in the irnpoundmcntof YE
water or other I lquids(C,.g.retention pond,waste lagoon,darn)?
If Ycs,explain.purpose and Size;
X
191,11as the site od Uic proposed action or an adjoihing property been the location ofan aotivz or clowd NO YES
Solid waste management facility?
If Yes,describe:�
20-Has the site,of the:proposed action or an adjoining pnapeily been die sulalca of remediatiGn. (ongoing or NO YES
completed)for hazardous waste?
If Yes,describe:
I AFFIRM TFIATTFIE,INF'()RMATION PROVIDED COVE IS'MUP AND ACCU.Rjk'rE TO THE BEST 0f^,MY
KN0WLZT)GZ
ApplicanUsponsor na=. Da$e:
Signaftue,
Part 2-Impact Assessment. Ilia Lead Agency is responsible for the completion of Part 2..Answer all of the folly wing
questionsin Part I using die:h1brinatioii contained in Part I and othermiaterials submitted by the prod curt sponsaror
odienvise available to the reviewar. When answering the questions the review or should boguidod by the concclpt Havc my
res,"nses been reasonable considering,die scale and context ofthe proposed action?"
'No,or Modcrate
S.Mall to large
impact impact
May may
octur O,CCU;.r
Wil I the proposed "tiort vreae a Inateri All confilict with an adopted land use plan or zoning,
:regulat-lons'!
2, Wil 1, ft pm posed action result in a chwhge in die use or Intensity of use of Ian.d?
3. Will die proposed action impair the character or quality offfic existing coramuniky?
4. Wil I the proposed action have an impact on the environmental characteristics that caused the
estabitiMunent of a CAtical Environmental Area(CEA)?
5.. Will tlie proposed,action result in an adverse change:in the existing Level of traffic or
affect existing infrastructurc fliT inam transit, biking orwalkway?
6. Will the proposed actioncause wi increase in ffie use of energy and it fails to illoorporate
reasonably ovaiMle:ewr8y wwwrvatiori or reoewob I&eiiergy opportu0ieq?
7, Will IlKe pa posed action finpact existing'
a.pubilic I private water supplies?
4-Public I private wastewater treatment utilities'?
8. Willi the pmposed acti(m impair Me 0iaracter oTqiiality ref important historic,ardmeallogical,
aTC11MCCAUral OT ft5thefiC T'OSOUNCS?
9, Will,the proposed action result in an advr,:rscohangc to nuturul rewwus(o,g,weflaad.%
Nvaterbodies, grinin.dWater,air quality, flora and fauna)?
Page 3 of 4
No..or Maderate
small to large
impact irnpac;t
may may
occur OCCLLr'
10. 'Wil I tlif-proposed action result in an increase in the potential for aroslon,floodingordrainsk90
problems?
I I-Willi the proposed actioncreate a hard toonvi"oomental resources or human health?
Dart 3-Doterm inaflon of significance. The Lead Agency is responsible for the completion of Part 3. For every
question in Part:'2 that was answered'!rnodorato to large impact may occur',or if there is a need to explain w1iy aparticul ar
clumont ofthr proposed actibn.may Or Yd.11 not result in a signi ficant adverse enviroinnental impact,pleas complete Part3
Part 3 should,in suffluitnt detail..identify the impact,,including any measures or design,clernantsthat have been included by
flic proj"t sponsor to avoid ormducc irnTmcls. Part 3 shoukia[so explain ho(w the lead agency determined thatthe impact
may orwill not be signi ficant.Eaeli potcn.fial impaet should be asscssW considering its setting,probability ofoccurring,
dUrAtk)D,imvem'ibilitY,8009,raPhicstople and magni'tudr—A Iso consfdar thopotential Forshort-term,,Iong-tonn and
cumulative irnpacts-
o Clicuk this box ifyou have dctcrm,inod,based on the in,fonnation and analysis abovet and any supporting documentation,
that the proposed, action may result in one or more potentially large or sign.ificant adverse impacts acrd arm
environmental impact staternent is rcqu ired-
0 Clieck this box i f yo u have detennim4d based,On the infonriation and analysis abovo.and uy Supporting documcniation,
that the proposed action will nut result in any significant adverse environmental finpacts-
Narrw offoat Agency Date
Print or Type Narric of Rcspansible Officer in Lead Agency Title,of Responsible Officer
Signature oflIcsponsible O,fflccr in Lead Agency Signature of'Preparer ffdiffibrent from RespoiisibleOfficer)
Page 4 of 4
DATE.- January 16, 2017
MEMO T . Town of Queensbuirly Planning Board
On Behalf Of. PrirneUnk, IN .,Applicant
RE: Application for Site Plan Review,of 643, Upper Glen Street
This brief nairrative is presented as,further explanation of the atta,chedl application.
This application seeks approval for PrimeLink, Inc. to operate an office ata43 Upper Glien Street. This
will be on a lease basis. The site, is currently the location of The Inside Edge and the leased space will be
a portion of that which is excess the The Inside Edge and Reliable Racing. The space totals 1843 square,
feet and requires no change to either the exterior or the interior of the building, to be suftable, for the
PrimeLink use.
[Please see, the attached from Greg MacConnell., President of PrimeLink for a description 'Of the
proposed use. The required fee of $100 is attached to, the, original] of this application in the form olf
check number 139900, dated January 13,, 20117, ,from PrimeLl
STANDARDS: 179-9-080
The applicant has indicated responses to this section on the page containing the standards,to the extent
possible, and the attached diagrams,, photos and other items are intended to present,further detalls.
REQUIREMENTS: 129-9-050,
"'A"—Google Earth aerial includes that information
"B" - The, required information is s;upplled on a series of 8 Y2X 11 and 8 M:X 14 attached! pages.
"C" -The project name is,"643 Upper Glen Street—Lease to, PRIMELINK"
"0" — Lease of interior space, no new construction. Owner has signed this application along with the
applicant"s,agent.
"E" - Location of alll structures,is shown on,attachments
"F` —Location of all structures requested is shown on attachments,
"G"—WAIVER is requested
"H" - Applicant wRl comply with sign ordinance and pllains to replace the existing,canopy above the dolor
with a new one with the company narne.
1,00" Pril"Y `Wjo "1""—'WIVER is requested for each
"M`—Land Use D strnct 'Braundarles are shown on attachment
"N" The traffic flow is anticipated) to he a,ppro'Ximatelly 3 to 6 vehicles per day fuer employees entering,
and lea ling , plus an, unknown number of clients, vendors, etc. Th ie clients,vendors and other,should not
exceed ars average of 2 to, per day. The traffic pattern is shown ars an attachment.
"OO' —There will the no new construction, and alterations; are expected to he limited to paining of malls.
The eases of portions of the, n•t°naiinl building are identified on the attachment. Six of the seventy seven
parking spaces will be asst a'ned to Primetink—as meted on an attachment.
"'p," The 7�'fl o,rl1an, for the a aiirn bulldli ng is providl�e�d, Th e exterior photos shows the�elevatiion, involved.
"Cr',
"ROP,
na s",,.,.,WAIVER ER re "ste'd
"T"—Time EAF is attached
't,i"—There will he no,changes to current uses of office and garage.
"V"—This project its an excellent example of the concept of'In-fill", which has been a fundamental part
of the Town's Comprehensive plan. While normally thought of in, terms of "filling. —in"' entire parcels
between existing parcels" this is utiui aticrn ofexisting space to avoid the appearance and fact of empty
space. Tout much 'empty" or "vacant" space can be, devastating to lanasiness activity in a torn-urr a n[ y.
This ire-fill doesn't create any disturbance to the environment.,
t.
COMMENT:
It is important to mote. that the onily 'fled plain that includes, any of the parcel is along the stream, and
that is greater than 100 feet from the precise site of the leased area,.
uu 6 uuo uu w
uu a uuu uu uuuuu� .
Data c Fast
I 1 18 StaftRoute 9
PO. IBox 783
Champlain, New York 12'91'9-0783
January arr 16,2017
Dear Tenn of Queensbury o ninn ,Board,
PrimeLirrlr Plams to use the new location at 643 Upper Glean Street as a kcal
contact,point for business customers and private individuals who subscribe,to our
services, We will also meet members,o 'the general public here who want t
discuss PrimeLink c 'eriiru „. We will assign our sales representatives to this
location as,their primary office and will conduct traditional meetings and
teleconferences!Here. Our lccuul sea ice personnel will share:the office space. Ira
ddition, our local service vehicles and will be housed in the two garage spaces at
the site.
Sincerely,
Pe
onnell
tet: 5:18-32A.LINK P4,651
8,00-396-8146
fox, 5 1 1X43
www-Primelink'T.Corn
Signature Page
This page ilnchides the 1)Authorization to Act as Agent Form,,2) Englineerjrlq Fee Distlosure: 3.)Ajuth onz ation,for Site
Visits: 4.) Other Permit, Responsibilities. Official Meeting Disollo,sore and 6.) Agreetnent to provide doieo mentation
requiired.
OWNER'S AGENT FORM-.
Complete the following ff the OWNER of the property is,not the same as the applicant
Owner: 7-A&A
Designates:
As agent regardling: Varlance T;bi.0112.0 Subdivision
For Tax M ,. Se
ap No- d' cdon 7 c1c. Lot 09
Deed Reference: -75—o k WT-Page so#3 Data 31-11 /P46
OWNER SIGNATURE DATE'
APPLICANTS AGENT FORM!
Complete the following I the APPLICANT is unable to,atten dthie meeting or wishes to,be Irepru,sented by another party
Owner:
DeMpates: ..............
As agent regardinqVariance Site Plan Subd[vision
For Tax Map No.: Sechon Ellock Lot
Deed Reference: Book _Page Date
LA DATE�-
.ffUCANT SIGNATURE
2-) Elms gIU5gMU_ra��—SCLOSARE: Applications may be, referred' to the Town consulting engineer for review of septic design,
stormi draiinage, a1c, as determined by the Zoning or Planning Department Fees for engineering review serv6c-es, will be charged
direcIty to the applicant Fees for engineering review wiilll not exceed 5 1,0010 without notification to,the applibant.
3) AUTHORIZATION FOR SITE V15IT5, By signing this page and submitting the application materials attached herein, the Owneir,,
Applicant, and his1heritheif agenl(s), hereby authorize the Zonnq Board air Planning Board and Town Staff to enter the subject
properties for the purpose of reviewing the applicabon submidW-
4) STI lf�, '�P �RE S P 0�NS I Bl�
LITI ES: Other permits may Ike required for cc nstruction or afteration acti�vity s�ubsequienit to,approvall
by the Zoining Board or Planning Boardl. It is,the applicant's responsibility to,obtain any additional permits.
5.), OFFICIAL MEETING MINUTES DISCLOSURE- IUsthepracUce of the Community Development Departmentto hiave adiesignated
stenographer tape recof d the proceedings of meetings re5,ultilng from application, ands minutes transcribed from those tapes conslitutes,
the official record of all proceedings.
a.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I,the undersigned, have thoroughly read and understand the
instructions for suubmission and agree to the submission requirements, 11 ackncAvledge no construction activifies s,hall be w.mm",ced
prior to suanice of a valid permit. r certiM that the application, plao,is, and supporting materials, we a truile and complete
statementidesciiptlon of the existing conditions and the work proposed!, and' that all work will be performed in accordance with the
approved plains ands in,conformance with locall zoning regulafions. I acknowledge that:prior to occupying the faculities p'roposed', I or my
agents,will oblain a certificate of occupancy as necessary, 11 also,understandthat IA#e may be requiired'to,provide an as-built survey by
a licensed land surveyor of all newly constructed facIlifles, prkw to bsuance of a certificate of occ;upani;y
I have read and agree tea the above.
iigin ,[ture pplicanit] Priat Name [Applicant) Datesig ed
67
e
Sign tki n 7
Print Name [Agent) Date signed
Site Plan Review Revised April 2016
Town of QueeflsburV Manning Office- 742 Bay Road Queensbuiry, NIY 125514 -51 8-781-8220