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Site Plan Application & narrative 169 Haviland Road Queensbury, NY 12804 Hutchins Engineering Phone: (518)745-0307 Fax: (518)745-0308 November 15, 2017 Town of Queensbury Planning Board & Zoning Board of Appeals 742 Bay Road Queensbury NY 12804 Re: Site Plan Modification - Queensbury Square, LLC 909 State Rt. 9 - Monty's Discount Wine & Liquor New 42'x130' Building Tax Map ID: 296.17-1-38 Dear Chairmen Traver and Jackoski & Board Members: This office along with Tim Shuler, Esq. represents Queensbury Square, LLC, managing member Monty Liu with respect to the construction of a new 42'x130' Morton Building with 6 retail units over the rear portion of the parcel which contains Monty's Discount Wine & Liquors. As you may recall in 2010, Area Variances and Site Plan Approval was received from the boards for the conversion of the previous Flower Drum Song into the Monty's Discount Wine & Liquors business. For this project, Area Variance relief is being sought for the front setback along Weeks Road, to allow the rear of the new building to be situated 32-ft from the northerly property line. Situating the building in this location will allow the storefronts to face south towards Wal Mart, with the parking also on the southside, inline with the parking/drive aisle that serves the liquor store. The building can be placed in a compliant location, with the parking on the northside, however this would create an undesirable appearance for the building and poor visibility for the businesses by having the rear of the building facing the large Wal Mart complex. In addition, a permeability variance would need to be granted, given the extra drive aisles that would be needed to construct the parking on the north side. Enlosed please find 15 sets of submission packages for each of the boards. We respectfully request that this item be placed upon the agendas of the boards at the December meetings. Please contact me if you have any questions or if you require additional information. Best Regards, Lucas W. Dobie, P.E. Enclosures Cc: Monty Liu Tim Shuler, Esq - MFC, LLP TOWN OF QUEENSBURY Site Plan Review Application Review Process: 1. Required Pre-submission meeting with staff to determine general completeness to be Feld no later than 1. week prior to deadline day, Call (518) 761-8265 or(518) 761-8220 for an appointment. 2. Submittal of complete application: 1 original and 14 copies of the application package by monthly deadline. 3. Determination of application completeness. All necessary information must be provided and appropriate fee(s)paid for consideration for placement on an agenda for that month. 4. Incomplete apjglicationgs will not be considered for placement on any agenda until all missing information has been.submitted. 5. Submittal to Warren County Planning, if applicable. 6. Planning Board meeting, generally the third & fourth Tuesday of each month. You will be advised in writing as to which meeting to attend. 7. Following the meeting you will be provided with a copy of the resolution stating the Board's decision on your application. If your application was approved, the next likely step is a Building Permit. Final drawings must be provided for the next phase of review. If your application was denied, your project cannot proceed as submitted. DOCUMENTATION REQUIREMENTS Lhard copy & electronic Please submit 1 ori final& 14 colgies of the completed application package to include: • Completed A lication pages 2-9, signed&dated • Pre-Submission Meeting Notes: signed by staff +� Cooy of Deed • Checklist& Plot Plan. • Environmental Assessment Foran for any non-residential project • Fee: $100 (0 — 10,000 sq. ft.); $250 (10,001 — 30,000 sq. ft.); $500 (30,001 -100,000 sq. ft.); $1,000 (100,000+ sq. ft.) Staff& Contact Information: Craig Brown,Zoning Administrator crai bAueensbu .net Laura Moore, Land Use Planner lmoor ueensbuy.net Sunny Sweet, Office Specialist—Planning sunn s r ueensbu .net (518) 761-8220 Visit our website at XMw,.gueensbuEy.net for further information and forms 1 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 General Information Tax Parcel ID Number: 296.17-1-38 Zoning District: HC-INT Lot size: 1.42 acres Detailed Description of Project[includes current&proposed use]: Construct anew 42'x 130'six-unit retail building with associated parkin ,li hting,landscapin ,and stormwater,existing ..... Monty's Discount Wine&Liquor Store operations to remain;new project is on vacant rear portion of the site. Location of project: 909 State Route 9 Applicant Name: Queensbury Square LLC Address: 909 State Route 9 Queensbury NY 12804 Home Phone Cell: (518)361-1853 ._W Work Phone Fax E-Mail: liumonty@gmail.com Agent's Name: Address: 169 Haviland Road Hutchins Engineering& Queensbury NY 12804 Home Phone Cell: Tim Shuler,Esq.-MFC,LLP Work Phone Fax (518)745-0307 (518)745-0308 E-mail LWDobie@hutchinsengineering. om Owner's Name Address Home Phone Cell Work Phone �� Fax ..... ......... E-mail 2 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 Site Development Data Area/Type Existing sq. ft. Proposed Total sq. ft. Additions . ft. A. Building footprint 7,000 5,460 12,460 B. Detached Garage 0 0 10 C. Accessory Structure(s) 0 0 0 D. Paved, gravel or other hard surfaced area 19,900 9,310 29,210 E. Porches/Decks 1,600 0 1,600 F. Other 0 0 0 G. Total Non-Permeable [Add A-F] 28,500 14,470 43,270 H. Parcel Area [43,560 sq. ft./acre] 61,873 0 61,873 I. Percentage of Impermeable Area of Site [I=G/H] 46.1% 23.8% 69.9% Set,back Requirements Area Required Existing Proposed Front[1] Route 9 75'(Tray.Corridor) 27.62' 201 6 (Prop.Bldg) Front[2] 50, 1.97' 35.00' Weeks Road (Existing Bldg to Remain) (Proposed Bldg-A/V Req'd) Shoreline Side Yard [1] Side Yard [2] Rear Yard [1] 25' 225.14' 44.7' West Rear Yard [2] South 25' 64.99" 76.3' Travel Corridor Height [max] 40' 25' 25'+/- Permeability 5'+/- Permeability 30% 53.9% 30.1% No. of parking spaces 27 24(A/V recv'd for Liq.Store 27(for new bldg) 3 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 Additional Pro"et:Information 1. Will the proposal require a Septic Variance from the Town Board of Health? No 2. If the parcel has previous approvals, list application number(s): AV 59-2010/SP 8-2015/SP 70-2010 3. Does this project require coverage under the New York State Pollutant Discharge Elimination System (SPDES) Permit Program ? No_ 4. Estimated project duration: Start Date Spring 2018 End Date Summer'18 5. Estimated total cost of project: $5001000 6. Total area of land disturbance for project:.. 32,000 SF Floor Area Ratio Worksheet FLOOR AREA RATIO (FAR) -- The relationship of building size to lot size, derived by dividing the total building floor area by the lot size in square feet, yielding a percentage. Zoning District Symbol Floor Area Ratio [FAR] Waterfront Residential WR 0,22 Commercial Moderate/Intensive I 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 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 61,873 sq. ft. B. Existing Floor Area 8600 sq. ft.. see above definition y C. Proposed Additional Floor Area 5460 sq, ft. D. Proposed Total Floor Area 14,060 sq. ft. E. Total Allowable Floor Area 18,562 Area x 0.3 see above table *If D is larger than E. a variance or revisions to your plan may be needed. Consult with Staff. 4 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 § 179-9-080 Reguirements for Site Plan AppLoyal. The Planning Board shall not approve a Site Plan unless it first determines that such site plan meets the following Standards. Please prepare responses to each of the following topics: STANDARDS A. The proposed project furthers or is consistent with the policies of the Town's Comprchensive Plan. B The proposed project complies with all other requirements of this Chapter,including the site plan review standards asset forth in Paragraph F of this section,the dimensional,bulk and density regulations of the zoning district in which it is proposed to be located(Article 3 and Table 1),the applicable requirements of all other Articles that apply. C. The site plan encourages pedestrian activity internally and,if practicable,to and from the site with pedestrian paths or sidewalks connected to adjacent areas. D The site plan must conform to Chapter 136 Sewage and Sewage Disposal,Chapter 147 Stormwater Management Local Law,and other applicable local laws. E. The proposed use shall be in harmony with the general purpose or intent of this Chapter,specifically taking into account the location, character and size of the proposed use and the description and purpose of the district in which such use is proposed,the nature and intensity of the activities to be involved in or conducted in connection with the proposed use and the nature and rate of any increase in the burden on supporting public services and facilities which will follow the approval of the proposed use. F The establishment,maintenance and operation of the proposed use will not create public hazards from traffic,traffic congestion or the parking of vehicles and/or equipment or be otherwise detrimental to the health,safety or general welfare of persons residing or working in the neighborhood or to the general welfare of the town. Traffic access and circulation,road intersections,road and driveway widths and traffic controls will be adequate. G. Off-street parking and 19oading facilities will be appropriately located and arranged and sufficient to meet traffic anticipated to be generated by the new use. The establishment of vehicle links between parking areas of adjacent properties are provided where feasible. This furthers the Town's goal of reducing curb cuts and reducing congestion. A twenty-foot wide connection is required. If adjacent properties are either undeveloped or previously developed without having made provision for future linkage,then a future connection must be identified and provided for in the site plan under review for such future linkage when the time arises. The Planning Board may require proof that the applicant has made contact with adjacent property owners for purposes of coordinating linkages with adjacent properties. H. The project shall not have an undue adverse impact upon the natural,scenic,aesthetic,ecological,wildlife,historic,recreational or open space resources of the town or the Adirondack Park or upon the adequate provision of supporting facilities and services made necessary by the project,taking into account the commercial,industrial,residential,recreational or other benefits that might be derived from the project. In making the determination hereunder,the Planning Board shall consider those factors pertinent to the project contained in the development considerations set forth herein under§ 179-9-080 of this Chapter,and in so doing,the Planning Board shall make a net overall evaluation of the project in relation to the development objectives and general guidelines set forth in§ 179-9-080 of this Article. 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 pedestrian 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 in conformance with the drainage standards of Chapter 147 of the Town Code and the Town of Queensbury Subdivision Regulations where applicable. K. The water supply and sewage disposal facilities will be adequate and will 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 and/or noise buffer between the applicants and adjoining lands,including the maximum retention of existing vegetation and maintenance,including replacement of dead or deceased plants. M. lire lanes,emergency zones and fire Hydrants will be adequate and meet the needs and requirements of emergency service providers. N. The design of structures,roadways and landscaping in areas susceptible to ponding,flooding and/or erosion will minimize or avoid such impacts to the maximum extent practicable. 0. The site plan conforms to the design standards,landscaping standards and performance standards of this chapter. 5 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 Applicant: Queensbury Square, LLC Tax Map #296.17-1-38 179-9-080 Responses to Standards Questions A- A. This site involves an intensive commercial uses in a Commercial Intensive Zone, zoned for this types of use. B. The proposed project as presented is believed to be in compliance with applicable code parameters. C. The proposed project has been designed to allow internal pedestrian activities as necessary and applicable to this type of use. D. Stormwater management facilities are provided for the new impervious areas and the new building will be connected to a previously installed 6-inch sewer main which connects to the town's sewer infrastructure in Weeks Road. E. The proposed project has been designed to be in harmony with the general purpose or intent of this Chapter. F. The proposed project has been designed to be in compliance with principles of good site access, traffic flow, and safety and general welfare of the neighborhood. G. The proposed project has been designed with the intent to provide safe, adequate, and functional off-street parking and loading facilities. An interconnect exists to the parcel to the south, which directs traffic to a signalized traffic light at Route 9. In addition, an ingress only interconnect is proposed the adjoining parcel's parking area to the west. H. The proposed project has been designed to not impact natural, scenic, aesthetic ecological, wildlife, historic, recreational or open space resources of the Town. I. The site's parking layout is adjacent to the neighboring parcel's parking areas, thus allowing pedestrian uses between adjoining properties. J. Stormwater management facilities are provided for the new impervious parking areas. K. The proposed project has been designed to be in compliance with Chapter 136 as applicable. L. The proposed project has been designed to maintain existing vegetation to the west and new landscaping is proposed for the project site. M. The project has been designed in effort to meet the needs of emergency service providers adequately. N. The site grading and drainage provisions have been developed with the intent of avoiding flooding and ponding. O. The site has been designed with the intent of maintaining the existing vegetation and landscaping as feasible. § 179-9-050 Checklist-Application for Site Plan Review. Application materials and site plan shall include sufficient information for the Board to review and provide a decision. The applicant is to provide a site plan drawing and all attachments that address items A-V. The applicant may request a waiver from A-V and is to provide reasons for waiver(s) requested. Please label information to be submitted. REQUIREMENTS Sheet# A. A vicinity map drawn at the scale that shows the relationship of the proposal to existing community facilities which affect or serve it,such as roads,shopping areas,schools,etc. The map shall also show all properties,identify owners, S1,52 subdivisions,streets and easements within 500 feet of the property. Such a sketch may be superimposed on a United States Geoloizical Surve ma ofthe 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 1/2"x 11"sheets as necessary for written S2 information. The information listed below shall be shown on the site plan and continuation sheets. C Name of the project,boundaries,date,north arrow,and scale of the plan. ALL _..........._ D Name and address of the owner of record,developer,and seal of the engineer,architect or landscape architect. If the ALL aimlicantis not the record owner,a letter of authorization shall be required from the owner. E. The location and use of all existing and proposed structures within the property,including all dimensions of height and S1,S2 floor area,all exterior entrances,and all anticipated future additions and alterations. F 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 Sl,S2 containers shall also be shown. G The location,height,intensity and bulb type(sodium,incandescent,etc.)of all external lighting fixtures. The direction of S5 illumination and methods to eliminate glare onto adjoiningproperties must also be shown in corn liance with§ 179-6-020. H The location,height,size,materials and design of all proposed signs. Sl,S2 j. 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 S2 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(S WPPP)for all land development activities(excluding agricultural activities)on the site that results in land disturbance of one acre or more. A S WPPP shall comply with the requirements of the DEC SPDES MS-4 General Permit and Chapter 147 of the Town of Queensbury S2 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 one 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 will be shown and base flood elevations given. Areas shall be indicated within S1,S2 the proposed site and within 50 feet of the proposed site where soil removal or filling is required,showing the approximate volume in cubic yards. L. A landscape plan showing all existing natural land features than 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 features,including sizes and types of plants. Water sources include ponds,lakes,wetlands and S5 watercourses,aquifers,floodplains and drainage retention areas. IVI. Land Use District boundaries within 500 feet of the site's perimeter shall be drawn and identified on the site plan,as well as any Overlay Districts that apply to the property. S1 6 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 REQUIREMENTS (CONTINUED) Sheet# N. Traffic flow patterns within the site,entrances and exits,loading and unloading areas,as well as curb cuts on the site and within 100 feet of the site. The Planning Board may,at its discretion,require a detailed traffic study for large developments or for those in heavy traffic areas,which shall include: 1. The projected number of motor vehicle trips to enter or leave the site,estimated for weekly and annual peak hour traffic levels; S1,S2 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. O. 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 retain operation,office, Storage,etc.; 2. Estimated maximum number of employees; S2 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 ARCH to be used. Q Soil logs,water supply well and percolation test results,and storm water runoff calculations as needed to determine and mitigate project impacts. SW REP. R. Plans for disposal of construction and demolition waste,either on-site or at an approved disposal facility. S2 S. Plans for snow removal,including location(s)of on-site snow storage. S2 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. APP U. If an application is for a parcel or parcels on which more than one use is proposed,the applicant may submit a single application for all such uses,provided the proposed uses are accurately delineated on a site plan drawn pursuant to the requirements set forth above. The Planning Board may grant the application with respect to some proposed uses and not others. For purposes of reviewing an application(and for SEQRA compliance)all proposed uses on a single parcel or on APP contiguous parcels shall be considered 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. COVER 7 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 Town of Queensbury Site Plan Pre-Submission Conference Form/ Section 179-9-040 1. Applicant Name: Queensbury Square LLC 2. Tax Map ID 296.17-1-38 Location: 909 State Route 9 3. Zoning Classification 1ie4NTw' .' 4. Reason for Review: L'o, � 1.� . C)n(� re 5. Zoning Section#: 6. Pre-Submission Meeting Notes: Provided Outstanding; Please provide by Deed _WW General Information complete Site Development Data Complete Setback Requirements Complete 117 Additional Project Information Complete 17 FAR addressed Requirements for Site Plan-Standards Checklist items addressed Environmental Form completed Signature Page completed c�c�� c` 6 � � CJr_O^ p (W L-1 ­1-it „.� � "� e t° `t,a 0 U) o �5 lek" f '% / .( +Z.:.) �r�, fy1c,rt.�" �.tu h �... �s c ir" It' oil V Via. r✓t� �:: � �, " .. " Staff Representative: Gw ! �- Applicant/Agent: Date: 8 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 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: a...............Variance Site Plan Subdivision For Tax Map No.: Section Block _ Lot Deed Reference: Book Page m 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: Designates: ._. Hutchins 1sn��nc+erin d'" 1"��r ESQ As agent regarding: Variance ✓ Site Plan _Subdivision For Tax Map No.: 7, ctiou 1 Block 38 Lot /" o �� —� Deed Reference: k 319 Page 5/7/15 Date OWNER SIGNATURE: �.... DATE: " 2.1 I;N+C INiyI:R1NC FINE I) t1I '. Applications may be referred to the Town consulting engineer for review of septic design, storm drainage,etc. as determined bythe'72oni 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. J. AtJT1IORI%A'1µ1 N FPR."I"I"t 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. ( °I°IIl'i.R PERMI"" a,SI'C NSIBILIT'IES: Other permits may be required for construction or alteration activity subsequent to approval by the Zoning Board or Planning Board. It is the applicant's responsibility to obtain any additional permits. 5 ( FFII" AL ME1r]tN(; MINt) ISS DISCI. JRtl';: It is the practice of the Community Development Department to have a designated stenographer tape record the proceedings of meetings resulting from application, and minutes transcribed from those tapes constitutes the official record of all proceedings. fa' AGREI*Mh."N"I"'I O PROVIDE 100)MENTATION REQUIRED: I,the undersigned,have thoroughly read and understand the instructions for submission and agree to the submission requirements,I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application,plans and supporting 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 I/we may be required to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy I have read boys. " .-. m ] [ Si at _- D to si ret Signature [ en m Print Name [Tent] Date signed 9 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 Short Environmental Assessment Form Part I -Project Information Instructions1`or Com lefin Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: Queensbury Square LLC Project Location(describe,and attach a location map): 909 State Route 9,Town of Queensbury,Warren County Brief Description of Proposed Action: Construct a new 42'x 130'six-unit retail building with associated parking,lighting,landscaping,and stormwater;existing Monty's Discount Wine&Liquor Store operations to remain;new project is on vacant rear portion of the site Name of Applicant or Sponsor: Telephone: (518)361-1853 Queensbury Square LLC E-Mail: liumonty@gmail.com Address: 6E Manor Drive City/PO: State: Zip Code: Queensbury NY 12804 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: �I ❑ Town of Queensbury 3.a.Total acreage of the site of the proposed action? 1.42 acres b.Total acreage to be physically disturbed? •7 4 0 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 1.42 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) []Industrial m Commercial ❑Residential(suburban) ❑Forest ❑Agriculture El Aquatic El Other(specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES I N/A a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? -� 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? El Z 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area?_ NO YES If Yes,identify _rrrrr ____ & 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? ❑✓ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 12 9.Does the proposed action meet or exceed the state energy code requirements? NO YES I*Ithe f�proposed action w 1 exceed requirements describe design features and technologies: p P g P__.. c p msup b. _..... _... � . ._..... ........._ ......... 10. Will the ro osed action connect to an existin ublic/ rivate water supply? NO YES If No,describe method for providing potable water: 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: mmmp ___.m .. ... ............... El Z ..._............... 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES .. Places? b.Is the proposed action located in an archeological sensitive area? ❑✓ ✓ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO _YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,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. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply„ ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban m 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? P71 E 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? W1 NO DYES ✓� b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: m NO DYES Page 2 of 3 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain ain urose and size: ...___.... — _ ................................. .................._--- ....._.......... 19.Has the site of the proposed action or an adjoining property been the location of an active or closedNO YES _.._.._.................. solid waste management facility? If Yes,describe: .........................�. • I ... .. .............�.................—..... , . 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? IfYes,describe: m. ................ ....................................................................................................... Z F-1 I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name. Date: Signature INT FORM Page 3 of 3 Agency Use Only [If applicable] Project: Date: Short Environmental Assessment Form Part 2 -Impact Assessment Part 2 is to be completed by the Lead Agency. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" .......... ............ ..........__...................._ No, or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 1:1 El ............... ........................__ _.................... ._........... ....... 2. Will the proposed action result in a change in the use or intensity of use of land? E 3. Will the proposed action impair the character or .. i ������� quality of the existing community? 4 establishment of a Critical Environmental mental Area(CEA)mental characteristics that _..... Will the proposed p at caused the � 5. Will thero osed action result in an adverse chane in the existing p p g ng level of traffic or affect existing infrastructure for mass transit,biking or walkway? El F-1 ..... ................... ...... 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: ( 1 a.public/private water supplies? �) b.public/private wastewater treatment utilities? 8. Will thepropos....__ ......... ....... ...... ....._. ed 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)? 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? El ....._._..... ........ ...................... ................................. 11 Will the proposed action create a hazard to environmental resources or human health? PRINT FORM Pagel oft Agency Use Only f 1f applicahle) Project Date: Short Environmental Assessment Form Part 3 Determination of Significance 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 of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. 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. ........ - .�....�_M that the proposed .......action may result in one or more potentially large or significant adverse impacts an Check this box if you have determined based on the information and analysis above and any supporting documentation, P p Y P Y g Sn mp d an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. ...,. __..m,. Na _m..... � me of Lead Agency Date .. . . ... . ..... Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer ature of Responsible O p (' di Si'gn p Officer in Lead Agency Signature of Preparer �f different from Responsible Officer) PRINT FORM wwww��� Page 2 of 2