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Site Plan Application 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 Meld no later than 1 week prior to deadline submittal - Call (518) 761-5220 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 proceedas 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+so Zoning Staff&Contact Information: Craig Brown, Director of Planning,Zoning&Code Compliance craigb@queensbury.net Laura Moore, Land Use Planner Imoore@ queensbury.net Sunny Sweet, Office Specialist (518-761-8220) sunnys@queensbury.net Site Plan Review Revised April 2016 Town of Queensbury Planning office.742 Bay Road -Queensbury, NY 12804 •518-761-8220 General Information Tax Parcel ID: Zoning District: Lot size: l G Current Use: Proposed Use: Project Location: ApplicantName r: -....._ � ,L. Address: Home Phone Cell: 5-16- T-?-C. �6 Work Phone Fax E-Mail: fL,tet>S��� � lrc��. ` _ :�l n•r Agent's Name, �. � �" Address: Home Phone Cell: Work Phone Fax E-mail Owner's Name: Address Home Phone Cell Work Phone Fax E-mail Site Plan Review Revised April 2016 Town of Queensbury Planning Office.742 Bay Road-Queensbury, NY 12804.518-761-8220 Additional Project information 1. 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 New York State Pollutant Discharge Elimination System (SPDES) Permit Program? /V 4. Estimated project duration: Start Date End Date_/D— 5. Estimated total cost of project: ,1 w, ��. 6. Total area of land disturbance for project: ,rte Floor Area Ratio Worksheet � 14 FLOOR AREA RATIO(FAR)--The relationship of building size to lot size, derived by dividing the total building floor area bythe lot size in square feet, yielding a percentage. Zoning District Symbol rea Ratio[FAR] Waterfront Residential WR 0,22 Commercial Moderate/Commercial Inten CM/CI 0.3 Main Street MS 0.3 A. The co nedarea of all square footage, as measure from exterior walls-of all structures on the property, including all floors of the structures, garages, basements and attics with more than five (5) feet of ceiling height and covered porches. Building square footage does not include: Open deck, docks and that portion of covered docks extending over water and one storage shed of one hundred twenty (120) square feet or less. Any additional sheds will be included. (See"FLOOR AREA RATIO"). B. Commercial or industrial: the total area in square feet as measured from the exterior of the outside walls of a building or structure, and when applicable, the sum total of all floor areas of the principal and accessory buildings or structures on the project site. A. Parcel Area sq.ft. B. Existing Floor Area sq,ft.(see definition above) C. Proposed Additional Floor Area sq.ft. D. Proposed Total Floor sq,ft. E. Total Allo a 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 April 2016 Town of Queensbury Planning Office.742 Bay Road-Queensbury, NY 12804,518-761-8220 Site Development data Area /Type Existing sq. ft. Proposed Total sq. ft. Addition sq.ft. A. Building footprint 3G d o 2-<1 z Z23 B. Detached Garage ... C) d C. Accessory Structure(s) D. Paved, gravel or other hard surfaced area /D E. Porches/Decks ..... 0 C� F, Other G. Total Non-Permeable [AddA-F] H. Parcel Area [43,560 sq.ft. /acre] I. Percentage of Impermeable Area of Site [I=G/H] 'r ............ Area Required Existing Proposed Front[1] Front[2]m Shoreline 114 u Side Yard [1] Side Yard [2] Rear Yard [1] Rear Yard [2] Travel Corridor � �� Height[max] / M Permeability a No. of parking spaces Site Plan Review Revised April 2016 Town of Queensbury Planning Office 742 Bay Road•Queensbury, NY 12804 518-761-8220 § 179-9-080 rGM for Ailto gLan ApprovaL The Planning Board shall not approve a Site Plan unless it first determines that such site plan meets the following Standards. Please prepare responses to each of the following topics. STANDARDS B. The proposed project furthers or is consistent with the policies of the Town's Comprehensive Plan. C. 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 I is proposed to be located(Article 3 and Table I), the applicable requirements of all otherArticles 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 harmonywith the general purpose or intent ofthis 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 ofthe proposed use, F, The establishment,maintenance and operation of the proposed use will not create public hazards from traffic,traffic congestion or the parking of vehicles and/or equipment or be otherwise detrimental to the health, safety or general welfare of persons residing or working in the neighborhood or to the general welfare of the town.Traffic access and circulation,road intersections, road and driveway widths, and traffic controls will be adequate. G. Off-street parking and loading facilities will be appropriately located and arranged and sufficient to meet traffic anticipated to be generated by the new use. The establishment ofvehicle 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 contactwith adjacent property owners for purposes of coordinating linkages with adjacent properties. H, The project shall not have an undue adverse impact upon the natural,scenic,aesthetic,ecological,wildlife,historic,recreational or open space resources of the town or the Adirondack Park or upon the adequate provision of supporting facilities and services made necessary by the project,taking into account the commercial,industrial,residential,recreational or other benefits that might be derived from the project In making the determination hereunder,the Planning Board shall consider those factors pertinent to the project contained in the development considerations set forth herein under§179-9-080 of this chapter,and in so doing,the Planning Board shall make a net overall evaluation of the project inrelation to the development objectives and general guidelines set forth in§179-9-080 of this Article. I. The provision for and arrangement of pedestrian traffic access and circulation,walkway structures,control of intersections with vehicular traffic and overall pedestrian convenience shall be safe and adequate for pedestrian movement Pedestrian connections between adjacent sites shall be provided to encourage pede5trian use. J, Stormwater drainage facilities will prevent an increase of post development drainage flows as compared to pre-development drainage flows. Drainage of the site shall recharge ground water to the extent practical. Surface waters flowing off-site shall not degrade any streams or adversely affect drainage on adjacent properties or public roads.Facilities shall be inconformance with the drainage standards of Chapter 147ofthe Town Code and the Town of dueensbury Subdivision Regulations where applicable,. K„ The water supply and sewage disposal facilities wall be adequate and will meet all applicable and current requirements set forth by Department of Health regulations and Chapter 136 of the Town Code. L The adequacy„ type and arrangement of trees, shrubs and other suitable plantings, landscaping and screening shall effectively provide a visual andlor 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. Fie 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 ofthis chapter, Site Plan Review Revised April 2016 Town of Queensbury Planning Office-742 Bay Road Queensbury, NY 12804,518-761-8220 § 179-9-0506pglication for Site la Review Absent any waiver or waivers, an application for Site Plan Review shall include the following: REQUIREMENTS -- - -... .. ... ::..�.:�.. . .��_. �. : ..— ..._.. ..�.. ... — TS Sheet# A A vicinity map drawn at the scale that shows the relationship of the proposal to existing community facilities which affect or serve it, such as roads, shopping areas, schools, etc. The map shall also show all properties, identify owners, subdivisions, streets, and easements within 500 feet of the property.Such a sketch may be superimposed on a United States Geological Survey map of the S• 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 appropriate,on standard 24"x 36'sheets,with continuation on 8)12"x 11"sheets as necessary forwritten information, The information listed below shall be shown on the site plan and continuation sheets. —Z C Name of the project,boundaries,date, north arrow,and scale of the plan, D Name and address of the owner of record,developer,and seal of the engineer,architect,or landscape architect F the applicant is not the record owner, a letter of authorization shall be required from the owner F The location and use of all existing and proposed structures within the property, including all dimensions of height and floor area, all exterior entrances, and all anticipated future additions and alterations. S P The location of all present and proposed public and private ways, off-street parking areas, driveways, outdoor storage areas, sidewalks,ramps,curbs,paths,landscaping,walls,and fences. Location,type,and screening details for all waste disposal containers shall also be shown, S– CT The bcation, height, intensity, and bulb type(sodium, incandescent, etc,)of all external lighting fixtures The direction of illumination and methods to eliminate glare onto adjoining properties must also be shown in compliance with§179-6-020. H The location,height,size,materials,and design of all proposed signs, I The location of all present and proposed utility systems including: 1. Sewage or septic system; 2. Water supply system; 3. Telephone,cable,and electrical systems; and S-Z 4. Storm drainage system including existing and proposed drain lines,culverts,catch basins,headwalls,endwalls, hydrants, manholes,and drainage swales. J Plans to prevent the pollution of surface or groundwater, erosion of soil both during and after construction, excessive runoff,and flooding of other properties, as applicable. A Stormwater Pollution Prevention Plan (SWPPP) for all land development activities (excluding agricultural activities) on the site that results in land disturbance of 1-acre or more. A SWPPP shall comply with the requirements of the DEC SPDES MS-4 General Permit and Chapter 147 of the Town of Queensbury Code. It shall be at the discretion of the Planning Board as to whether a SWPPP or an erosion and control plan shall be required for a site plan review project land disturbance of less than 1-acre. K Existing and proposed topography at two-foot contour Intervals,or such other contour interval as the Planning Board shall allow. All elevations shall refer to the nearest United States Coastal and Geodetic Bench Mark. If any portion of the parcel is within the 100- year floodplain,the area w!II be shown,and base flood elevations g'nren.Areas shall be indicated within the proposed site and within 50 feet of the proposed site where soil removal or filling s 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, stands of trees,single trees eight or more inches In diameter, forest cover, and water sources, and all proposed changes to these IS 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 dentified on the site plan,as well as any Overlay Districts that apply to the property, S Site Plan Review Revised April 2016 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 100 feet of the site, The Planning Board may,at its discretion, require a detailed traffic study for targe developments or for those h heavy traffic areas,which shall include: 1. The projected number of motor vehicle trips to enter or leave the site,estimated for weekly and annual peak hour traffic levels; C• �� 2. The projected traffic flow pattern including vehicular movements at all major intersections likely to be affected by the proposed use of the site; 3. The impact of this traffic on levels of service on abutting public streets and at affected intersections. Existing and proposed weekly and annual peak hour traffic levels and road capacity levels shall also be given. 0 For new construction or alterations to any structure,a table containing the following information shall be included:. 1. Estimated area of structure to be used for particular purposes such as retail operation, office, storage, etc.; 2. Estimated maximum number of employees; S^ 3. Maximum seating capacity,where applicable;and 4. Number of parking spaces existing and required for the intended use. p 1. Floor Plans. 2. Elevations at a scale of one-quarter inch equals one foot (1/4"=1 foot)for all exterior facades of the proposed structure(s) and/or alterations to or expansions of existing facades, showing design features and indicating the type and color of materials to be used. Q Soil logs,water supply well and percolation test results,and storm runoff calculations,as needed to determine and mitigate project impacts R Plans for disposal of construction and demolition waste, either on-site or at an approved disposal facility. S Plans for snow removal,including location(s)of on-site snow storage, T An Environmental Assessment Form("EAF"),as required by the SEQRA regulations,with Part 1 completed by the Applicant shall be submitted as part of the application. If the proposed project requires a special use permit and an EAF has been submitted in conjunction with a special use permit application,a duplicate EAF is not required for the site plan application_ U I If an application a 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 reaped to some proposed uses and not others For purposes of reviewing an application (and for SEQRA compliance) all proposed uses on a single parcel or on contiguous parcels shall be considered P T together, V A brief narrative 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 April 2016 Town of Queensbury Planning Office-742 Bay Road-Queensbury,NY 12804•518-761-8220 Pre-Submission Conference Form [179-4-040] 1. Tax Map ID 2. Zoning Classification 3. Table of Allowed Uses . : �� "���.�.r„„ �� »� � �" '�°�_ subjectto Site Plan Review 4. Ordinance Section# (� s. Pre-Submission Meeting Notes; Outstanding Items To BeAd Wssed I f 114( Deed —No General Information complete Yes No Site Development Data Complete No Setback Requirements Complete No Additional Project Information Complete � No Y I..r o FAR Worksheet complete r r r , Y N Standards addressed Yes Checklist items addressed No Environmental Form completed Y No.,,. Signature Page completed Yes eo) " ; M .v . + 3( .P M. . �'.. a°�.. .��� C /.,y 'A2pligg_nJ mu st orovide.-offiggwi h Notice f Intent i :SWPPP AgceptangLa Form. Q EQ Iett r O§yiag pqrrnit number: Notice of Termination (NOT) Staff Representative: LGy ( � Applicant /Agent: Date: Site Plan Review Revised April 2016 Town of Queensbury Planning Office.742 Bay Road-Queensbury, NY 12804.518-761-8220 61720 Appendix B Short Environmental Assessment Form lmguctiuns XIM19" Part 1- Project Information, The applicant or project sponsor is responsible for the completion of Pan 1. 11esponses become part ofthe application for approval or funding,are subject to public review,and may be subject to ftirther verification . Complete Part I based on information currently available. If additional research or investigation would benceded to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part I. 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 1-Project and Sponsor Information Name of Action or Project: 7 Project Location(describe, and attach a location map): Brief Description of Proposed Action: Name of Applicant or Sponsor: Telephone: Address: City/PO: State: Zip Code. 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 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: X ]KJ 4j(= 3.a.Total acreage of c site of the proposed action? 7— b.Total acreage to be physically disturbed? eZ_acres c.Total acreage(project site and any contiguous properties) owned or controlled by the applicant or project sponsor? 6� acrcs 4.Check all land uses that occur on,adjoining and near the proposed action. o Urban o Rural(non-agriculture) kMdustrial ACCommercial o Residential(suburban) oForest o Agriculture o Aquatic o Other Opecify): 0 Parkland ........--- .............. . .......................... Page 1 of 4 5. Is the proposed action, NO YES NIA a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? X 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental ronmental Area? NO YES If Yes,identify: �.. 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? x c.Are any pedestrian accommodations or bicyclees available on or near site of the proposed action? x _...._. 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: x 10. Will the proposed action connect to an existing public/private water supply? NO YES If Yes,does the existing system have capacity to provide service? O NO X YES If No, describe method for providing potable water: _ 11.Will the proposed action connect to existing wastewater utilities? NO YES If Yes, does the existing system have capacity to provide service? O NO 1<YES x IfNo,describe method forproviding wastewater treatment: I2. a.Does the site contain a structure that is listed on either the State orNational Register of Historic NO YES Places? b.Is the proposed action located in an archeological sensitive area? 13.a.Does anportion of the site of proposed ..._ ..­ y p p posed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? x b.Would the proposed action physically anter,or encroach into,any existing wetland or waterbody? If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identaly the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: 0 Shoreline 36orest 0 Agricultural/grasslands 0 Early mid-successional 41—Wetland -B,Vhban 0 Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats, listed _ NO YES by the State or Federal government as threatened or endangered? X 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ONO 0 YES K b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? IfYes brieflydescribe: ONO O O YES X _.. ... ................ _.. Page 2 of 18.Does the...wro sed action ....__ ._... ...�.._...... �,W include construction or other activities that result in the impoundment of N P PoO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? 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: 20.Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or NO YES completed)for hazardous waste? If Yes,describe: ........... I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponso amt Date: 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 ofthe proposed action?" n. �w�..— __...--------_ ------ No, ... _No,or Moderate small to large impact impact may may occur occur L 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 I 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 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11.Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element ofthe proposed action may or will notresult in asignificant 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. Part 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. o 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. o 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) Page 4 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: '"" Z Designates: As agent regarding: Variance >e—Site Plan Subdivision For Tax Map No.: Sebe 7,a Block / Lot 2 a Deed Reference: BookSe: _S-Z Page d Date /e- /. e-N . APPLICANT SIGNATURE: DATE - 7 2.) N INEE IN - FEE Dl CLOSURE: 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 RESE SIBILITIE'S: 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 ofalli 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. r certify that the application, plans and supporting materials are a true and complete statement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the approved plans and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents, will obtain a certificate of occupancy as necessary. I also understand that Itwe 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 h dead and agr to the above. Signature[Appiidaftt, Print Name [Applicant] Date signed 7 Signature[Agent] rint Name [Agent] Date signed Site Plan Review Revised April 2016 Town of Queensbury Planning Office 742 Bay Road Queensbury, NY 12804 •518-761-8220 WARREN COUNTY—STATE OF NEW YORK `n b * ., D °, "a PAMELA J.VOGEL, COUNTY CLERK 1340 STATE ROUTE 9, LAKE GEORGE, NEW YORK 12845 COUNTY CLERK'S RECORDING PAGE ***THIS PAGE IS PART OF THE DOCUMENT-DO NOT DETACH*** Recor ing: Cover Page 5.00 Recording Fee 35.00 Cultural Ed 14.25 Records Management - Coun 1,00 Records Management - Stat 4, 75 TP584 5.00 BOOK/PAGE: 5055 / 34 RP5217 - County 9.00 INSTRUMENT #: 2014-6510 RP5217 All others - State 241.00 Receipt#: 2014346865 Sub Total : 315.00 Clerk: LB Rec Date: 10/15/2014 12 :26:28 PM Transfer Tax Doc Grp: RP Transfer Tax - State 0.00 Descrip: DEED _ c Num Pgs: 4 Sub Total : 0.00 Red Frm: HODGSON RUSS LLP Partyl: T7 UPSTATE PROPERTIES LLC Total : 315.00 Party2: T] UPSTATE PROPERTIES LLC **** NOTICE: THIS IS NOT A BILL **** Town: QUEENSBURY ** Transfer Tax * * * Transfer Tax #: 557 Transfer Tax Consideration: 0.00 Total : 0.00 WAR,\TING*** I hereby certify that the within and foregoing was recorded in the Warren County Clerk's Office, Record and Return To: State of New York. This sheet constitutes the Clerks endorsement required by Section 316 of the Real Property Law of the State of New York. HODGSON RUSS LLP 60 RAILROAD PLACE SUITE 300 Pamela J Vogel SARATOGA SPRINGS NY 12866 Warren County Clerk Record and Return to: Hodgson Russ LLP 60 Railroad Place,Suite 300 Saratoga Springs,NY 12866 BARGAIN AND SALE DEED THIS BARGAIN AND SALE DEED, made this day of October, 2014, between TJ UPSTATE PROPERTIES, LLC, a New York limited liability company having an office located at 527 Queensbury Avenue, Queensbury, New York 12804 ("Grantor") and TJ UPSTATE PROPERTIES, LLC, a New York limited liability company having an office a"- located at 527 Queensbury Avenue,Queensbury, New York 12804(the "Grantee"). WITNESSETH : That the Grantor, in consideration of One Dollar ($1.00) and other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, does hereby grant and release unto the Grantees, its successors and assigns forever, all right title and interest of the Grantor in and to the following: ALL THAT LOT OR PARCEL OF LAND, situate in the Town of Queensbury, County of Warren and State of New York, more particularly described on the attached SCHEDULE A. BEING the same premises conveyed from Adirondack Industrial Park Co., Inc. to TJ Upstate Properties, LLC by deeds dated October 2, 2003 and recorded October 9, 2003 in the Warren County Clerk's Office in Liber 1344 of Deeds at Page 259 and Liber 1344 of Deeds at Page 262; and also being a portion of the same premises conveyed from Adirondack Industrial Park Co., Inc. to TJ Upstate Properties, LLC by deed dated May 20, 2014 and recorded June 4, 2014 in the Warren County Clerk's Office as Instrument # 2014-3268, Book 4988 of Deeds at Page 319. THE intent of this deed is to combine the described parcels into one tax map parcel. SUBJECT TO all easements, covenants and restrictions of record. TOGETHER with the appurtenances and all the estate and rights of the Grantor in and to said premises. TO HAVE AND TO HOLD the premises herein granted unto the Grantees, its successors and assigns forever. AND THE GRANTOR COVENANTS that it has not done or suffered anything whereby the said premises have been encumbered in any way whatever. The Grantor covenants further that, in compliance with Section 13 of the Lien Law, the Grantor will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. THIS CONVEYANCE is made in the ordinary course of Grantor's business and does not constitute all or substantially all of the assets of the Corporation. IN WITNESS WHEREOF, the Grantor has caused this instrument to be executed and delivered as of the day and year first above written. TJ UPSTATE PROPERTI'E ' LLC By: N ie: ohn Bu s Title. es�dent . STATE OF NEW YORK ) :ss. COUNTY OF Sar(t�y a ) On the 13'�' day of October, in the year 2014, before me,the undersigned, a notary public in and for said state, personally appeared JOHN BUYASKAS, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. Notary Public DEBRA L. SCHREIBER Notary Public, State of New York Saratoga County. #01SC4964857 Commission Expires September 23, 2018 S+CHE RULE A All that certain tract, piece or parcel of land, situate in the Town of Queensbury, County of Warren, State of New York, lying along the westerly line of Queensbury Avenue and the southerly, southwesterly and westerly lines of Marcy Drive being designated as Lots 1, 8 and 9 on a map entitled, "Adirondack Industrial Park, Inc. — Subdivision Layout Plan" dated January, 1991 last revised November 20, 1991, prepared by VanDusen& Steves Land Surveyors and filed in The Warren County Clerk's Office in Cabinet Al as Map 178 and being further bounded and described as follows: Beginning at the point of intersection of the common division line of the northerly line of lands now or formerly Warren-Washington County Industrial Development Agency and the southerly line of Lot 1, with the westerly line of Queensbury Avenue, all as shown on aforesaid filed map, thence from said point of beginning along said common division line and the northerly line of lands now or formerly of Warren County, North 840 24' 06" West, 887.25 feet to a point in the easterly line of lands now or formerly of Warren County Airport, thence along said easterly line, North 120 08' 30" East, 503.28 feet to the point of intersection of said easterly line, with the southerly line of Lot 10, thence along said southerly line, South 84° 24' 06" East, 227.90 feet to a point in the westerly line of Marcy Drive, thence along said westerly, southwesterly and southerly lines of said Marcy Drive the following four (4) courses: 1.) South 05° 35' 54" West (map—South 05° 35' 54" East), 25.00 feet to a point of curvature, thence 2.) along a curve to the left, having a radius of 275.00 feet, an arc length of 431.36 feet (map - 387.97 feet) and a chord of South 39° 28' 00" East, 388.48 feet to a point, thence 3.) South 84° 24' 06" East, 299.00 feet to a point of curvature, thence 4.) along a curve to the right, having a radius of 28.00 feet, an are length of 43.97 feet and a chord of South 39° 23' 20" East, 39.59 feet to a point in the westerly line of Queensbury Avenue, thence along said westerly line, South 05° 35' 54' West, 172.62 feet to the point of beginning and containing 6.09-acres of land. 077341.00000 Business 13203673v1