Site Plan application w/photos & deed General Information
.,
Tax Parcel 1 D Alurn ber: „ L - I - '� (o Li 61
ZoningDistriu: CJ - 0' Pe JL In c.. + +QC-
Lot size: t . C � c\[�.�T_S rce.1
Detailed I3escription of Project [includes current&proposed use
�TGCDQLSeA `[t �- 441
Location of project: '1 '4 -k4 Ci
Applicant Name: `` Address:R LL
Home Phone '�- ell:
Work Phone ] Fax P&
E-Mail,
Agent's Name: 4 J Address: ry;, � k Le ,c a
Home Ppne elf:
Work Phone Li 0 Fax
E,mail
Owner's Name rens
Home Phone Cell
Work Phone Fax
�-tryai
2
Site Plan Review application—RLvised October 2016
Town of Queensbury Planning Office-742 Bay Road,Queensbury, NY 12804
s ) V Sl f` v L-[
Site DevcIgpment.Data
Area 1 Type Existing sq. ft. Proposed Total sq, ft.
Additions . ft. _
A- B ui[ding Cootpri nt C)
B- Detached Garage L4 I, [ , ' 0
C. Accessary Structure(s)
D. Paved, gravel or other hard surfaced area
E. Porches J Decks O ( c
R Other
- Total Nan-Permeable [Add A-9 1! � 13
� I6 -
H. Parcel Area [43,560 N. Ft.1 acre]
1- Percentage of Impermeable Area of S[te [I JH] t
Setback !fie uirements
Area required Existing Proposed
Front [I]
r
Front [2]
Shoreline ` i r
Side Ward [I � el I �,
Side Ward [21
Rear Yaj-d [1]
Rear Yard [21
Travel Corridor
Height [max] f I
Permeabi[ity +
f 6^ �
No. ofpark[ng spaces
I c ,i -1 ,i.'� 'n a r ej r-c n
Site Plan Review application-Revised October 2416
Town of Queensbury Plarming Office-742 Bay Road,Qmengbury,NY 12904
Add itxonaI Project~ Information
L Will the proposal require a Septic Variance from the Town Board of Health?
1 if the parcel has previous approvals, list application nurnber(s):
3. Does this project require coverage under the New York State Pollutant Discharge Elimination System
(SPI)ES) Permit Program ? 1D A, c-e- ; �t� 'per \,es-s 6L(-s-c
41 Estimated project duration: Start Date '+ ; I End Date ' � k
5. Estimated total cost of project: _q,0' IbDi;
f, Total area cf land disturbance for project: 0 ,'l ++-
Flour Area Ratio Worksbeet
FLOOR AREA RATIO (FAIL) -- The relationship of building size to lot size, derived by dividing the total
building floor area by the Iot size in square feet, yielding a percentage.
,Zoning District Symbol I1cor Area l atio [FAI ]
Waterfront Residential WR 0.2.2.
Corr mere ial ModerateJ Intensive CM/Cl 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 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 werior of the outside walls of a
building or structure, and when applicable, the sure total of all floor areas of the principal and accessory
buildings or structures on the project site.
A. Parcel Area t sq. fI.
B. Existing Floor Area - ;cc� kC r v, . ,,L. Sq, -ft, see above defin ition
C:. -Proposed Additional Fluor Area o sq. fl.
D. Pru p osed Total Floor Arca 00 sq. ft_
E. Total Allowable Floor Area �Arca x see above table]
*If D is larger than E. a variance or revisions to you plan may be needed. Consult with Staff.
4
Site Platt Review application—Revised October 2016
Town of Qumnsbury Planning Office-742 Bay Road,Queensbury, NY 12804
179- -080 Requirements ;dor Site Plan Approval.
The Planning Board shall not approve a Site Plan unless it first determines that such site plan meets the
folio 3ug.Standards. Please prepare responses to each of the follow ing topics:
STANDARDS
A. The proposed project furthers or is consistent with the policies arilte"lawn's Comprehensive l?tan_
B, The proposed project complies vri th all other requirements of this Chapter,including the site plan review standards as set forth in Parag�-,aph
F of this section,the dimensional,bulk and density regulations of the awning district in which it is proposed to be localod(Article 3 and
Table 1),the applicable n:quircmcnts ofalI other Articics that apply.
C. Tlne rile plan rncounq�rs padcsvi an uctivity internally and, if practicable,to and frorn the silo with peclestrian paths or sidewalk connected
to adjacent areas_
D, The site plan must conform to Chapter 136 Sewage and Sewage Disposal,Chapter 147 Stormwater Managemnmt Local Law,and other
applicable local laws.
E. The proposed use shall be in harmony with the general purposa or intent of this Chapter,specifically taking iraSa account the kruation,
character and siac of the proposed use and the description and purpose of the district in which such use is propuseel,the rack ire and intensity
of the activities to be involved in or conducted in connection with the proposed use and the nature and ruse of any increase in the burden on
supporting public sa:rkiccs and facilities which will follow the approval of the proposed use.
F. The establishment'rnWiltenawe mid operation of the proposed use will not Neale public haarrrds rrm traffic,traffic congestion or the:
lurking of veh isles andlor equi]m7ent or be otherwise detrimental to the health.safety or general welfare of persons residing or working in
the neighborhood or to the general wel fare of the town. Tral-Fw access and circulation,road intersections,road and driveway w idths and
traffic controls wild be adequate_
Off-street parking and 19oading facilities will he appropriately located and arranged and sufficient to newt traffic anticipated tU be generalexl
by the rtew uk. The cstablishnwni of vehicle links between parking areas of adjawnt pmpertirs care pmv i*0 where feasible_ This i urthem
the Town's goal ofrcducing curb cuts and reducing congestion. A twenty-foot wide connection is rcquired. ff adjamt.properties are eilber
undeveloped or previously dmlupcd without having made provision for future linkage,then a future connection must be identi Pied and
prow ided tnr in tike site plat*under review for such future 1 inkage when the time arises, The Flann ing Board may require proof that the
appticant has made cottau with adjacent property owners for purposes of coordinaling linkages with adjacent propenics.
H The project shall not have an nmdue adverse impact upon the natural,scenic,acslht tio,ecological,wildlife,historic recreational or open
space resources ofthe town or the Adiroodock Park or upon the adequate p"ision orsuppnrting facilities and services made necessary by
the project, taking into account the commercial,industrial,reeidentiai, recreational or other benefits that might be derived from the project.
In making the dotermi nation hereunder,the Pla irking Bowd shat I consider those factors pertinent to the project contained in the
dcwlapmcnt considerations set forth herein under§ 179-9-080 of this Chapter,and in spa doing,the Planning Board steal i mules a net overall
evaluation of the project in relation to the development objectives and gencrah guidelines set forth in§ 179-9-080 of this Article.
] The provision for and armmgcmcmt of pedestrian traffic access and ci rculadon, walkway structures,comrol of inicrsculions with vehicular
traffic and overall pedestrian convenience shall be safe and adequate for pedestrian mowincnF. Pedestrian connections lbetween adjacent
sites shat l be provided to encourage pedestrian use.
Stormwater drainage facilities wil l prevent an increase of post development drainage flaws as cam pared to pro-development d rai nage flows_
Drainage of the site shal l recharge ground water to the extent practical_ Surface waters Flawing off-sits shall not degrade any streams or
adversely affect drainage on adjacent properties or public roads_ Fact lines shal l be in canfornance with the drainW standards of Chapter
147 of the Town Cade and the Town of Quccnsbury Subdivision Regulations where applicable.
K The;Dater supply and sewage disposal facil ilius wil l be adequate and wil l must all applicable and current requirernents set forth by
Depamnent of Health regulations lout Chapter 136 u f the Town Cale.
L„ The adequacy,type and anwLgcmcnt of trees,shrubs and other suitable plantings,landscaping and scwcniag shall e[kctively provide a
visoW andlor raise buffer brtween the applicanis and adjoining lands,including the maximum retention oroxisting vegetation and
maintenanw,iTwludi ng replacement of dead or dcecased plants. C �rD _r l ri tr4
M f=ire lanes,emergency vanes aiid fire hydrants will lie adequate and meet the needs and requirements afemergency scr Ace providers_
The design o IF structures*roadways and landscaping in areas susceptible to pond ing,flood ing andlor erasion ail l minim ixc or avoid such
impacts to the maximum extent practicable_
O. The site plan canli ms to the desip staandards,laam u*ng standurds and performance standards of 08 chapter_
Site Flan Review application—Revised October 2016
Town of ueen*ury Planning Officer7421Bay Road,Queensbury,NY 12904
U
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LAND3CAPE SCHEDULE
QTY =WTAHICAL NAME COMMON NAME SIZE REMARKS
S11k4E TRCE —
ARA 3 ACER RUBROWARhi$1iRGING' ARMSTRONG COLU MAR RED MAPLE 2 V2-3'CAL. B+B
r.2 2 GINK008I1-013A MAIDENHAIR TREE-C,INK0 2 1R-3'CAL. 6+6
AG 4 AGER G HNACA AMU R MAPLE 1 5-2`CA1_. 8*9 �
� f
EVERGPin 4 SHRU2
1GC 37 ILEX GIAE RA COMPACTA DYYARF wK6ERRY 4QLLY 1$-24' �3 CAN
JG5fi3 13 JUNIPERUS CHIREAS1$'SE.A GREEN' SEA GREEN JUNIPER 24-V SPRD- 13+13 Lu Wo
JFIP 67 JUN IPERUS HOWONTALI$PLUMOSA ANDORRA JUNIPER 15-16'$PRD. 43 CAN
CC
KL 2 KA4MIA LATIFOLIA k=N-5AIN LAUREL 30-3G B+R LL] LL'
ROHR 15 RHODODENDRON X OBTUSUM'HCFlWr=Y RED' HERSHEY RED AZALEA 18.24' H3 CAN
TOE 32 THUJA OCCIDENFA413'EMERALO' CI IERALti GREEK#ARIDOWITAE 5-6' Okla O C 0
ULCL
DECIDUOUSSHRUB CC 0
PFG 24 POTI=N TII LA FR€IT1COSA�C,= NNGER' WLDFINGER BUSH CINQUEFOIL 18.24' 93 CAN ('] - >—
$JLP f SPJREA JAPONICA'LITTLE PRINCESS' LITTLE (1)PRINGESS SPIREA 15.18' 93 CAN C) � �
z
PEREWAL {{} {fj
HHI� 34 HEMEROCALLIS'iiAPPY RVURNJ3' LIW YELLOW OAY0-Y 1 GAL. CONTANER U] y
2 I
NOTE:IF ANY DISCREPANCIES OCCUR BETVOEEN AMOUNTS SHOAW IN THE PLAN AND THE PLANT LIST,TK5 PLAN SHALL DICTATE. m OC
U] V:
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c� cx c .r :. r' ,{ �ec� ] C >�1 'Il.''ctf n•, or
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Photos from 819 State Rte 9 McDonald's Restaurant Rebuild
two
South side property proposed frees for removal and asphalt area owned and maintained by ToWn of Qu
Photos 1,2,3
tti ..
r' SSM
_ 1 I
art. Yyk:
Photo
ProposedArea for four new Maple Trees
" 5 `
Exposed root Proposed Trees to be removed rep lad
ir
f_
j
Exisiting Arborvitae showing invasive American Bamboo and height nearing
Utilities lines
Proposal to be replaced with -8 foot new plants to maintain priovacy for
neighbors
WIN
i I
179-9-050 Checklist-Application for Site Plan Review.
Application materials and site plan shal I inolude sufficient information for the Board to review and provide a
decision, The applicant is to provide a site plan drawing and all attachrrtents that address items A- . The
applicant tray request a waiver from A-V and Es to provide reasons for waivers) requested. Please label
inforzriation to be submitted.
REQUIREMENTS _ Sheet#
A. A vicinity map drawn at the scale that shows[lie relationship of the proposal to cx-isting aantmwtit5' CaCiIitiCS tvhieh aff`cet
or serve it,such as roads,shopping areas,sdieois,etc. The map shall also show all properties,iduitify ovncrs,
subd ivisions,sheets and casemcnis with in 500 feet o r[lie prohefty. Such a sketch may be superirnpob-Qd on u United States
Geological Survey map of ihG arca.
B. The site plan shA I be drawn at a scale of forly Cast to the inch(l"=40 feet)or such other scale as the Manning hoard may
deem appropriate,on standard 24'x 36"sheets,with continuation on 3 I12."x 11"sheets as necessary for written {-
information, The information listed below shall be Jiuwn on the site plan and continuation sheers.
C. Name ortlte project,boundaries,date,north arrow,and scale of the,pion,
[ game and address o C the owner of record,developer,and seal of the engineer,archiivo or landscape architect. I f the
applicant is nat the rmvrd ownera letter ofauthoriza2ion shall be re uired from theowner. -
E, Tate local ion and use of all existing toter proposed structures within tltc property,including al I dimansions of height and
floor creat, all cxicriorcn#rances,and all anticipated future additions and altcraiionr,
F. The location of all present and proposed public and private ways,off-street park i ng areas,driveways,ouldoor starase areas,
sidcwall s-ramps,curbs,paths, landscaping,wa]Is and fences- L Dcation,type and screen ins details for all waste disposal
containers shall also be sltowrL
G. lite loo on,height,intensity and bulb type Vm4ium, inCawksc"!.,Vic.)of all external lighting fixtures. The direction of y Gk rS
i Illumination and methods to eliminate glare onto adjoining ro lies must also l<e shown in compliance with ` 17$-&-Mi1
H. The Io+aiion,height+size,inaterials and Jv6ign of a]I proposed signs-
] The location oCall present and proposrd utility sysicros including;
1. Sswageorseptic system; ,��.
2, Waicr supply system;
3, Telcphonc,cable and electrical systems;and
4. Storm drainage system i ricluding ex[sting and proposed drain lines,culverts,catch basins,headwalls,endwal Isr
hydrattls,manholcs and drainage swales.
J Plans to prevent the pollution ofcurfaw or groundwater,erosion of sail bath during and after construction,excessive runoff
and flooding of other properties,aq Hepple. A Stannwalcr Pollution Prevention Plan(S W111111)for all land development
activities(cxrluding agricultural activities)on the silt that results inland disturbance of ono acre or more- A SWPPI'shall
comply with the requirements of die DEC SPDF MS-4 Gemmal Permit and Chapler 147 ofthe Town of Quecnsbtuy
Crude. It stall be at the discretion of the inannins Roprd as to whcibcr a SWPPP or an erosion and control plan shall be
required f&r a siic plan raview project land disturbance of less ihan one acre.
I Existing and proposed topography at two-fast contour intervals,or such other emlour interval as the Planning Board shall
allow. All elevations shall refer to the nearest United States Coastal and(eodetic fiend~M"lc, I f any portion of the parcel
is with in the I40-year floodplain,the arca wi 11 be sham and base flood elevations given, Arez sbal I ba indicrated within
the proposed site and within 50 fact of rho proposed site where soil msnoval or tilling is required,showing the aplxoximate
volume in cubic yards-
I„ A lemdswpe plan shaving all existing natural lend features than may i ntlucnce the design of the proposed use such as rock
outcrops,stands of irccs,single trees eight ar more inches in diamcicr,forest mvcr and water sources and all proposed
changes to tkw'ss', FW[ums, including sides and types of plants. Waicr suurccs include ponds,lakes,vcUarids and
watercourws,aquifers, [loodplains and drainage retention greats. t"1 llllec� C_11
, Land Usa District boundaries wilhin 500 poet oftha site's perimeter shall be dra;un and identified on the silo plan,as well C
as any Overlay I}istricts that apply to the property-
6
Site Man Review application—Revised Goober 2016
Town of Queensbury Planning Office-742 Say Road, Queensbury,NY 12804
REQUIREMENTS (CONTINUED) Shed#
N. Traffic flow patterns within the site.,entranevs acid cxf ts,loading and unloading areas,as we]I as curb cuts on the site and
wilhin 100 Peet of the site_ The Planning Board may,ai its discretion,r+xlieirc a detailed traffic study for large developments or
Cur those in heavy traffic areas,which Shtrtl include; _
. The pro_ewtcd number of motor vehicle trips to-enter or 1mve the site,eAirnat*d for weekly and
annual peak hour traffic levels:
2_ The pmjected traffic flow patiern including vehicular movements at all major intersecxi ns likely
to be affected by lire propimcd use of the site;
3. The impact of this traffic on lovels of service on abutting public streets and at affected
intemecuons_ Existing and proposed weekly and annual peak hour traffic levels and road capacity
levels shall also be given
For new construction or alterations to arty structure,a table containing the following in rarmation shall be included' —
1. Estimated area of struc[ure to be used for particular purposes such as retain operation,office,
Storage,etc.;
2. Estimated maximum number of employees;
3- Maximum seating cxipaeity,where applicable;and
4. Mumber of parking spaces rxisting and required for the intended use_
p, I, Floor Plans.
2_ Elevatiorts at a scale of onc-quarter inch equals one Foot(I!4"= I foot)for all exterior facades of[he proposed s[ructurc(s) `
cm(Vor alteralions to or expansions ofexisting facades,showing design fcaiurcs and indicating the typo and calor of materials e
to be used_
Soi l logs,water supply veel l wW percolation test results,and storm water nmffealculatiom as needed to deFmnine and -f 4�,
mitigate project Impact,;- �, }
Pians ror disposal of construction and demolition waste,either on-site or at arca appruvcd disposal facility,
S. I}laal-5 ror snow removal,ineludirig location(s)of on-site snow storage. _rt
T. An Environmental Assessment Farm C EAF)as required by the SUQRAFegtLlaWns,with Part I e=pleAed by the Appl ioant
shall be submitted as P24 ofthe application. If the proposed project requires a special use permit and on FAF has been
i0
submitted in conjunction with a special use permit application,n diplia e EAF isnot re uired for The site lpli�tion. `
fz-
U. If an application is for a parcel or parcels on which more than one use is proprsnd,iha apps imint may hubmit a single
application for all such arses,provided the proposed uge_e are accurately delineated on a Site plan dra%m paarsuont Io the
requirements set forth above. The Planning Board may grant the app]ication with respect to some proposed uses and nol
others. For purposes of reviewing an application(and for S EARA compliance)all proposed uses ort a single parcel or on
contiguous parcels shall be owisidewd logcthcr.
V. A brief narrative statement on how the project proposed for review runliers or is consistent%with[he visiona goals and policies
in the Town's Comprehensive Plan_
7
Site Plan review application—Revised October 2016
Town of Queensbury Planning Bay Road,Qu=nsbury,NY 12804
Town of uensbury Site Plan Pre-Submission Conference Form 1 Section 179-9-040
1. Applicant Name:
2. Tax 'Map ID ``� b � ,�`t Location:
3. Zoning Classification
4. Reason for Review:
5. Zoning Section#. - I
G. Pres ubmission Meeting Notes: Provided Outstanding; Please provide by
Deed ti
General fnfon-nation complete ,
Site Development Data Complete
Setback Req utremcnts Complete
Additional Projekt information Complete t
FAR addressed
Requirements for Site Plan-Standards
Checklist items addressed
Environmental form completW
Signature Page completed
koo
4 4 tf\ 4 , [.ck. 'y k} c� 14/-1
J-1 li L 444 L-'J #i [ V) 1 ly({+11,ll r
Staff Representative-
Applicant I Agent:
epresentative:ApplicantIAgent: � J � Date:
9
Sire Plan Review application—Revised October 2016
Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804
Town of Queensbury Site PIan Pre-Submission Conference Form / Section 179-9-040
1. ApplieanTName-_ � �{ t I
2. Tox Alap W �Q —1-9 H Location: � Ck
3. Uning Classification
4. Reason for Review- 11ff �r��� "A Av.. �C clscc-
5. Zoning Settion #: '(a()-
6-
-6- Pre-Submission Mi' eiing Notes: Proy epi Outstaading; Please provide by
Deed
Geneml Information complete
Site Development Data Complete
Setback Reguiminents Complete
Additional Project information Complete ,
FAR addressed
Requirements for Site Plan-Standards
CherAlist items addressed
Environmental Farm complewd
Signature Page completed
C
rx
Staff Representative'. cJ f L l r, k��c
Applicant!Agent: Date:
S
Site Plan Review application—Revised Octoba 2016
Towil of ueensbury Plarinfn6Office-742 Bay Road,Queensbury,NY 12904
Signature Page
This page includes the i.) Authorization to Act as Agent Farm: 2.) ) ngineering Fee Disclosure; 3.) Authorization for Site Visits; 4.)
Other Permit Responsibilities; 5.)Official Meeting Disclosure and 6.)Agreement to provide documentation required,
OWNER'S AGEhTP FORM:
Com tete the fopowin if the OWNER of the roe is not the same as the applicant 'k"'(
P JS' property�]'' PP �. �.�
Owner: e. rpt
Designates: r?_t -t� Ajd '
As agent regarding, 'Variance Site Plan Subdivision
For Tax Map No., Section Block Lot
Deed Refe _hook Page Date
OV4'I�ERSIG NATURE: � — BATE;
APPLICANT'S AGENT FQRm,
Complete the following if the APPL CANT is zlnable to attend the me ting or wishes to be represented by another party;
Owner: L
Designates: c:�:� •
As agent regarding= Valiance Site Plant Subdivision
For Tax Map No.: Section Block Lot
Deed Ref Book i Page Date
O NEliSIGNATURE: DATE,
2.1 ENGINEERING FEE DISCLOSUIR Appli+:aliuns may ba rcfeaed to the Town consulting engineer far review of septic design, slorm
drainage, etc as larmincd by the Zoning or Planning Department. Fccs for onginccring fcvicw services will be charged directly to the applicant.
Fees for engineering review will not exceed S 1,1300 withW notification to tho appTicani.
3. AUTHORIZATION FOR SITF,VISITS: By signing this page and submitting tate application tnaierials attached hemiN the Owner.Applicant,
and his/her/their agern(s) hereby aulhorinc the Zoning Board or Planning Board and To" Staff to enter the subject properties for the purpose Of
rauicwing the application subrnitted-
4.1 OTHER PERP41I RFS PONSIBILITIES: Other permits may bo"uimd fiber construction or alteration activity subsequent to appmval by rho
"Zoning Board or Planning Guard. It is the app]icares responsibility to obtain any add itional perrnits.
5.) OFFICIAL MEFTtNG MINUTES DISCLOSURLe- It is the pmctioe of the Community DMI10pmcnt Department to have a fcsignated
stenographer tape record tha pmcoedings of mcctings resulting from application, and minutes transcribed from those tapes consiitutc:s the official
record ofa]I proceedings_
EI4 ENT TO PROVIDE DOCUMF N-TATION REQUIRE : 1,the undersigned,have lhoroughly read and understand the instructions
for submission And agrec to the submission requiremems, I acicnowkdgc no construction activities shall be commenced prior to issuarwe or valid
permit I certify that the apptication,plans and m4Voftiog reawrials arc a true and compicle watementldescription of the existing conditiom and the
work propo&W, orad that all work will be performed in acwrdanoe with the approved plans acrd in conformance with local naning regulations, I
acknowledge the¢prior to occupying the facilities proposed,I or my agents,will obtain a ocrtifiaatc of occupancy as neecssary. I also understand[liar
JI/we may be required to provide an ars built survey by a licensed land surveyor of all newly oonstructed facilities prior to issufflw of ccrflricate of
occupancy
—1-h a head gree to the above:T w
41-C 4C
Signatu Applicant] PrintName [Applicant) Date signed
Signature [Agent] Print Name [Agent] Date signed
9
Site Plan Review application-Revised October 2016
Town of Queensbury Planni rig Office-742 Bay Road,Queensbury, NY 12804
ignswre Page
T#us P139M"uties the 1.)1t111wz6j10ra W Act ss Apni Fow,3,}Ergineering Foe Discknvre, J4 AmKori:Arbn tai STIR
VkellR; X1.1 Olhor Pa nk FieS §bltllles; 5.) Waal Tftalhp fii utsufa and s.1 Agreamortt to pfouloe d=t¢npnldl.�an
required.
i]w.pi 3WSAarrffaw.
r,ompla[e Cho rollowPrg ti Iha OWNER of Ihg prop$FW is r10k lh+e iame 8s int!appftwl
oaalgnls w ?k,bnrzld`&USA.LLc 7 Rujiter ni;w .LLC
As 22ent reps rding, lfeda'roe x Sbe Plan SubdM51an
For Tim Map Na.- � —L—MCA .Lot
DeadRefoorrva, 37$2 Bosh 2$1.,P"pa 3009 pale
APPUcAtaf'S Ac2NT Fa
Oafvlata ilte Tdipuing 1f tho AQ pUCANT Is wmND to altwd Me r weling or wishes la be repmwrde lei anuT er pa Tty
oftbr.
Dasippams-. Mt by i ineurlpg,LLU
At Netlt rogwdir4, _VarboDe-&_SQe Flw---. _Gijtd4idn
For Tax Map No-- ELM SecOon I--Qk�ck de L,rat
omw Rbleww _j=BOOfc gaga UQ0--Dwe
APPUCANT'31UKATURE DATE
F.} RWINEEP= AppfiMMWW(ray ba ra'MA[o ltw icwn r,tGrag mer gwurAew of jsag6a cLojpr&
slorn,daub qe, aIG oA srr ad eY Fta ZahkV Gr Pkmru Dupwhron[, 70m kw arg1ralwW MAOw sorrleex wa too rtmruod
OveDy to the m3kw1 r-&w k q mein,'■rx nal exated$5.430 w OaA rpUJ�an M Iha ePP&%wL
Sr) AUIM jIZATKM FQR 9i'r1P VI SR9L By d7ahey It&pegir ani!VVbf tlf1%j thel VpolkAUW M&tA dab 4 >#hvn'ifa,Iho OwYwr,
Applicenl, orad hlaft t r mgeral{s}hmW euzrAw me ZwkV 9orrd av Promift Owd and Tuft Steil tv ania the sulk
pmgjgus far to purpose ai fflvkw a;;VM.BMpcLLlon ab mflu+d
442WRe1QtMrrA=p lMUTles, Qtwr pumi[a may+ba r$qutred iar misimel;on ar a ormian ocllvxy GvEm nt to appuvd
by A�w ry7 Board prPlanrng Booed- n is trw tpolwws taapo to opwa any Itodl�cnal"rmhu,
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asov aplmt is [ted 1h&prwNdrsp oI r lmt kNs rtvutiiraQ lrc,T+appTr�t2c+t,and minutes L•ane�rlexad trorn lfrsr.�mpea ro16+:
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COMPlale 1110 f olfowing if tha AP PLICANT is wablo to allend the maPtlag Gr witha3s to ha repres2nleG by another panty
Ownar;
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APPIMANTSI NATUPIEL DATE _
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4.1 OTH5Ft PMMrr RE813Qh'Si61L173124 Omar Swrnn may be+u4tlireV i x cajtstnuctton of altoraCarr oclift sttsaquent To N:PMV4
by the ZOM9 Abend or Pffamft E�oagL III,rs the appmcar�t'af faspar s 1q w olwmin any additional pumrfta.
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1ht aMr'al mord of all FwvadngL
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Sfgrtaiuro[Agent] larfrrf NamD[Agertl] Date signod
Sits Plan R4�vP3w Revised( wdk Z01 d
Tam us Qu"n jt wry F wnrdnq QIrler 742 gay Rood•Quet rmt]ury,NY i 2ac4-!51&-7o-mD
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]�K: 3782 VG: 292 05127!2009 DEED CN,]MERCIAL Image: 7 of 9 OZ. —J
v
WARREN COUNTY
PAlNELA J-VOGEL OQCUNENT� 00003700
COUNTY CLE%OL U mF z 37"m pAGE: X 41
Lake Goorge, MY 12845
1ratrumen#Number: ZQ09-0004 74
Aa
Recorded On: May 2T,2009 Daud Ccmmargiat
Fart*5: FREEBERN DDUG LAS K
TO
FREE13ERN ROBERT K BIllablo Pages., 3
Recorded By: SART LETT PONTIFF STEWART&RHODES PC Num Of Pagos: d
Comment:
;'Exam[nod and Charged as Follows:
Coed Cornmerdal 56.50 Onar Page 5.0D r(P-5P17Cohn rroralal 795,00
TP-534 5.00
Rmtord[ng Cha:g■: 2W50
C*naldesarion
Amount Auvaml RS*m#
TrangfvTex EM0 Ae5lmo. D TT1W Boob 0.0�
UFi�SgURY Loon' R.40 S $ alAddlGOnal 0,�0
AdaLorial 0,4g Tramsfgr E50.00
To Charge= MILO
R9CORM
Cont9 tlwkr, l�fiCe
Flag 2700? OWIP
Pamela J. Yalel
%prea COLML9 Clulc
#"TH15 PAGE IS 12A RT OFT H E.INSTRUMENT
I hereby certify that tha within and foregoing was recorded in the Clark`s Office For: WARREN COUNTY, NY
File Inform Mion: Ftecard and€teturn'TO:
Documani Number: 2009-0003700 BARTLETT PONTIFF STEWART&RHODE$PC
Receipt Number, 119446 PO BOX 2168
Reaarda�DaWTImr}. May 27, 209 01:44,35P ONE WASHINGTON STREET
Book-Vr,f/'g: Bk-RP VI4782 Pg-291 GLENS FALLS NY 12801
Ca$b!ar!StaGan; s Molar ! Cash Station 1
fBE: 3782 FG: 291 05/27/2409 D=1 COMM-RC IAL lavage: 2 of 4
DOCUMENT-4: 00003700
VOLUME:= 3752 PAGE: 292
'3 WARRAnAN
cp THIS INDENTURE made tba day of 2009 between DOUGLAS H.
� D FREE=BERN, 1100 Oakridge Parkway #142, Lakeland, Florida 33811, and GEOFFRE`f D.
FREEBERN. P.O. Box 81.94, Lakeland Florida 33802, parties of the first part, ar[d ROBERT iC_
FREEBERN, P,0. Box 495, Nlanchastar,Vl rmont 05254, party of the secOnd part,
WITNES S ETH. partes of the first part,inconsidere ion of One Dollar{$1.00}lawful
money cf the United States arid other gonad and valuable consideration paid by tate party of the
sew nd part, do hereby grant and retease unto the party of the second part, the[r successors and
asst' ns forave r, all their right title and Interest in;
ALL THAT TRACT, FIECEoRPARCEL 0FiAN1)situateon#heOlensF=alls-
Lake George Road, Town of Queensbury, Warren County, Nev,r York, more
particulady bounded and described in ScheduleA attached hereto and made
; a part hereof.
BElN G the same prernises described in a Trustee's Deed from Robert K. Freebem
as surviving Trustee under Artlele Third of the Last VVN and Testament of Kenneth
1; H_ Freebern, deceased April 16, 1975, to Robert K. Freebern, Michael D. Freebem
} and Wlll[am F. Freebem, partial of the second park, and Douglas K Freebam snot
"°� aoffrey D. Freebern, parries of tha third park, dated July 02 and recorded in
� the Warren County Clerk's Of�Ge ofl Augrlst 7, 20021n Liber i 279 of Deeds at Fags
v loom
r Together witty al[ right, title and interest, if any. of the parties of the first part [n and to any
strae#s and roads abutting the Oove-descdbed premises, to the cented!rne therevF.
Together with the appurtenances and all the estate wind rights oi;#hi�-parties of the first part
in and to sa-td premises.
To have and to hold the premises herein granted unto the party of the second part, their
succe�*urs and assigns forever.
Ano[ sa[d parties otthe iilrst part covenaritas tato s,
t
HFC: 3782 FG: 231 05127/2QD9 DEED CRCTAL 7 age: 3 of 4
DOCUMENTO 00003700
VOLUME C 37E2 PAGE: 293
First, that the party of the sscond part shell quietly enjoy the said prernisas;
Second, that said parties of the first part will forever warrant U-�e title to said promises.
Subject to the trust fund provislens of Section Thirteen of.the Lien Law.
IN WITNESS WHEREOF, the parties of the first part have duly executed this deed.
- ouglas H. Freebern
GeuffrO reeb rn
STATE OF FLORIDA
as:
OUNTY OF r"N
On the day oftee_ In the year 2099 bafore me,the undsrsigrtied,
personally appeared Douglas H.'Freebem, personally known too me or proved to me on the basis
of satlsfactory evidence to be the ind fvidus I whose name is subm[bed to the vedh in Instru Mont a ad
ackno ledgtd to that he executad tha same to his capacity, and that by h1s signature on the
instrument, the hid ividual, or Lite person upon behalf of which the indGvidual acted, executed the
insfTumat t J.0
rocas MPM
-Notary R
STATE OF FLORIDA �
COUNTY OF
On the day of �l in the year 2000 before me,the unders]gned,
personally appeared Geoffrey D. Freebera, personally kncwnto me or proved to me an the basis
ofsattsfactoryevidence-tobethe IndMdualwhose name issubscrt ritothe within Instrumerit and
acknoAMedged to roe that he executed the same in his capacity, and that by his signature on the
instrument, the individual, of the person upon behalf Cr which the individual acted, laxecuted the
' fr<strument.
0TrWYl1$Mrs=OP RM M
iCM� Lane
W
Oam�amiln�D�S�A ,� #a ubllo
29733E TsxpCrrs: F.B. 05,
Sanded Thra 04w&B-ft C0.,hc.
2
SIC: 3782 PG: 291 05127/2005 DUD COMHERCIAT. Image: 4 of 4
r
+ DocL4nENT4 OCIC103760
VOLUMEM X782 PAGE= 294
BEGINNING at a point in the northerly side of Aviation 110a(1,
which point is 300 feet, meas-ured on .a course of N 85 degrees 30
minutes W €nom an iron pipe set at tete intersection:, of said Aviation
Roan with the Glens Palls-LAke George State 'Highway and which point
likewise ma-tks the most westerly corner of. premiSes Heretofore con-
veyed by the Foxt Amherst Realty Co. , Ina.'r to the Tidia Water xssoc-
iated Oil Company by deed dated October 15, 1954, recoxded in Warren
County Clark' s Office on the same day in Lamar 337 of Creeds at Page
3 7 r and ranning thence from such point of beginning along the aorth-
arly side of said Aviation Rbad on the same cOUrse of N= 85 ' degrees
30 minutes W a distance of J.97.27 feet to .a Pq'— far a sorrier which'
also marks the utast westerly korner of premises her etofOre conveyed
to the Voxt Amherst. l�eELIty Co. , Ino. , by 14ormari-W. Dobart by d6ed
dated. May 30 , 1958, recorded- in the Warrens County Clerk, 5 Office
71Aly 2r- 1553, it- Liber 323 of Ddeda. a� :page x.32; running thence N
3 degrees -44 ,minutes Br a distance cf' -261-. 27 feat to a, pont 3.n the
westerly side of the-. Glens Valls- rLkke George State Bighwayu !thich+
mark.is -tie most rkortberly corner- of premi.Ses heretofore aonveyed. to'
the .r'ort erst Realty Co. , Ina'. , by Norman W. Dohart as afor-esaaxd, '
r+, nrLi xg thence along the westerly side of said Clens ftlla-Lake Gearg�
State Hi4h a oz1'7 a, course' of S 50; degxpes 16 minutes E a distance -o2
. 152. 86 feet to a' point for- a cozener; which point also marks the mpst
northerly .corner of rremises heretcfare conveyed by the:- Eort: Amherst
Realty Company to Tine 'water Assoujat e' d- C'il Company as =afe-orssaid;
X'Unrning the'nee S 37. degrees 25 minutet- .W along the narthwestr boundary
of said preonisea' e€ Tide Mater Associated Cil, Company' a distance of
..46.11 feet to the- poi pt -Oz pIaca of beginning lying intheno;'therl.y
side of Av:.atj_on Road as aforesaid.
?ZCORO&RETURN
Bartlett;PonUg, Stewart&Rhfdn.RC,
RA. Box2168,Oris washingtaa street
Glum Fags,New York 728u1
[
- I
SCEMULE A
Signature Page (LCAT 1)
This page fnoludas The 1.) Authorization to Act as Agent Form: 2.) Engineering Fee Dls(.,Gosure; 3.)Authorization for Site
Vislls; 4.) Other Permit Responsibifitles; 5.) Official Mealing Disclosure and 5.) Agreement to pmvlde rfocurnardafieri
regulfed.
OWN�Ft%AGENT F0.11m;
Cornpl. a Me faltowtng If the OWN of the property is not the same ss tlt9 appEicant
Owner: McDonald's USA. LLC
Designates: Bahle Eng!n0enng, LLC
As apenk regarding: Variance_ Site Man . Subdlvlsion
Fur Tax Map No.: R%).n Sactfon j_81cc;s .48-- Lot
Deed Reference: 378, Book Page 3LqtQL 0aLte
#OWNER SIGNATURE,
APpucAN'r's Aazt4T FoRm.
Complete the iol!owing if the APPLICANT is unable to at#end the meeting-or wishes to he represented her anc€her party
oviner. McDonald's USA. LLC
Designates-, Poh_ter Engllnearing. LLC .
As agent regarding: -Variance X Sike Plan Subdivision
For Tax Map No,: 102.0 Seotlort f Block A8 tot
Deed Reference: Boots 291 Page 319 q9 Data
APP L.ICANT SIG NATLRR-. DATE:
2.} g1LGjKMEAJhLG FEE qsoLQsjjR . ApAl oalions may be relarmd to the Town cansulling englnQar for revlaw of septic dastgn,
storm dr$Irtcaa, sb as detarmined by the Zorang or Planning Department. Feas for ongineefing reulew sarvlcas wi.l be obargad
dirartly to the appIcarlt, fees 14r a ngf nearing ra*aw w7I nuk Exceed S 1,00 mlboul n Gtillcation to the applicant.
3.) Al THDRIZAl1 1 FOR SITE 1f1SITS: By signing this page and stibmil;H5 Ut2 epp5caflon matedals atlWwd hereln,the Owner,
Applrcarit, and ftislherAheir�agenl(s) hereby authcffze rhe Zoning BcerU or Planning Board anti Tavvn ;3Wf to enter The subw,
plupariles for IN)purpose of miewing ltreappuaftn sub7rr11ted.
4.) .OTHE) �>ws��nrr$E3A CfSlBlLt IES- Other pamatts may bg rgCtuired for constrwcrClo r orelteration r{CliIty subsequent to approval
by tha Zsning$card or Kenning R4ard. It ks the epplivanes responsibHlty to ahlain anv additlmtet permits.
5,} QFFICrAL-rr rti LO LORE; f[is the pmckirls of the Community Devefopmanf Deparlm a nt to have a dastgnatecf
stoncgrapher tape recwd the p=eadrnga qt meat3rigs msultfng Irern Oppifoalionr,and rrdnvl s transcnbed from tho8e tap ss tonslitutes
1h 4 oftlo I record of al grcceadings.
13.] AQT•JKMENT TO PR12VIDE DQCUME: T QN E IRED; t, the undersigned. have thofqughfy read and understand the
rnstwzWDris for submissforr and agrea to lbe subm[asTorr mqurmmLsnirr,T acknoviledge no canstruatlan actiultles shall ha commenced
prier to I5suQnce of a valid perrr!11. I oerdly ftl the anplicsllon, plaris and suppcArng materlais are a true and complafe
statsrnanWescrlpiion of the existing mondlrlon$ and file wofk proposed, and that Eli work will be performed In accordance with Iha
wrovad Alerts and In corifarmanca wlln iocal zoning regulaf no. E riekijowledge that ardor to ocCWna ihD F6011tlas pro pcmed.1 or my
eguAts,well obWn a Certiticate of occupancy as nece&5ary. 1 also.uscrersland that 11vie may be regtdred to provide an as-built Survey by
EL licensed 1MJ alimUor of all navrlp vonstruoted facllb 12 s prrs}r to issuance of a certlltrgte of acouganoy
*hrW re 1 agre per rCE3nk] Print Dame [Appllcant} Date slgned
Signature [Agent) � Print Name [Agen#] Datia signed
Site Plan Revfew ReWniDd MarCh 2014
TDwn of Queens"Plannirn0 pricer 742 Say Road•Queensl}ury,NY 12844•Xl8-781-a2M
Signature Fuge
Th15 MR rncludu*thOr 7.)AtSlr do didn to P4 as ARM Form:1. Erigkleering Foe UsAwur+>;1}AuihorkaWn for Sao
Vim; 4.) CAht:r Parm' flseporlmlblfitlta; 5.) OI`lrciet MwIing DkdMM WW 0.) Aote5mant to prmide doClrwrilf3km
luqu d-
�WtIR1i'�Asr>r FaHa97
ComPNIS ft fvlk4Wklg It the OWNER of ilia pmputy is not the same ac Iho a ticum
lamer. 1k. Ir
. T,r�.. 1J
l7ee5gr D! a .LLD i WNW rtg nst! ng,LLC
As ager> regsr ft, __Veriamw JL_Elle Ffsn aubdiv�Ton
For Tis Map No,, u2zswon —t—Blwc 49 ..l.ot
Dead fieiemnce: aI Sook 2w Pw S&ML Cale
MWMR Sk lIAYtCriS: F 1DA7 : f
ArPtjcm&s AaEf r SBRa.►:
Cmplele Iha f01104V if 1ha APPUCANT W ti' la to attend the mealLng oT wtgh s W In raprpgerkled by s�nvther psTly
Ownw:
ves!Gnulas: Mnes L _ Boh r En rte ear
As sgonl Fogard r.W Varfgrte —&in Ram � __Subdkro;en
Far Man Mep Nu--. 'sQQ,�Seccorl 1 Sfocl! A9 r..o1
Deed nererenae; 37A2 5w% �1�Page 319ffij—Ow'D
APFIJ CANT SIGNATUFM DA3Er I
�'} ���F�Als,u��ey5��eils$ � �pP�*�+s iFpy bi@ f#9irod to X79 Torrh Goh9W:it1'I�RnF�r44�tw raVC�w 4r as da,41pT,
91 mm c1nanno, *14.u dolvnnkmd by We Zt171"a Pienrdng aWsowyl- teas for 071ipoe rem auk-Ba WN bo chw
draeuy io ft AP*,v,f, Fmw ror er On&o ft mvq m wDI mt wc=- S 1,0DO ialohca=l8rP iw to lh¢appWril
Appliceral, and hla9yshks9lr VOID, By f 4pin0 Crus ppp armTzwbwr la1p 6te ppp$--a n trmkeii�ada0 Ewan w,be Owmr,
ppolo�. an�Ta agerd�s} harcby maism to Ina zMwv Bwd or Flafwinp amid fed Ytwm St>ttt to entr trx auks
pcm'p41e 0 r kft ttp a4f crgv n ZWmHled.
4} c Cftr pomp may tw rpgcirad faL cmwwct w or PAwaawn er"w44aqurnt io Approval
by IMO zaft scam U}ptamiru;k3aarcf, r{ie Uig t4 tfY'8 raS�oFls�tllty to c41a n m1y mddltfonel r effnlG3
d.} • II is the pmctr"of Ine I=arrrxcaifty c4velopmank oviwamem W haws a delignahrd
ItanowophK bte MOrci 4m pracaa Inge al muoUrpa zasul"from app%sklop,wwi minulas irwurn1W f mtr}ium lopes ccmvmums
ft crIkIal wArd el M pmcoedkngs,
0. 1x8 1, lha uad&PQVaO,hw4k %wqu db rgid and VX tbrrd klwi
Grst on,For nubm�s and loom to ItF6 SLJ;rozdw regvimu*n;S,I ecta YAtWdge no=K4nw4NBIt ocmu@ar shill W COWTT9 9 d
pdw FO hm tr ck a v%fd 1ur&. t carRy fib# A* apoksftn, plwm and vL"q** cmiwt b am is lope and gpmplam
alileaeaWdaao*dM of ft e�ditp wtvd*rrs aad tha mwk prapusA aA(hof a3 workwla bo perlamled rn d=;P .nos waa,Tw
aP"BdPIBM wDdIn oodonteanee wRh kaaol x ckV ragcdrl14M, I e+eurrarrt a O+aip4njto MupftIwb qcwko IDMPoWt r or"
Aortsc va ablafn s ce9kaw ofo=pNx r as rweiuwf, I ob D uwkvdand thM Vwa maybes reW*W to M04Wa an$6r•WK VAVW by
a I wTdsd11rd st,n�Wc1411 aomlamWd taerbklosWiwlo hmnue a acart&we of ,y
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