Application TOWN OF QUEENSBURY
742 Bay Road, Queeplsbnry, NY. 12804-5902
January 31, 2018
William & Bonnie Thomas
11 John Glendon Road
Queensbury,N Y 121104
Re: Site Improvements
Driveway and Parking Areas
Tax Map Parcel: 289.10-1-35
Dear Mr. & Mrs. Thomas:
1 am writing you with regards to my review of the above-referenced matter and to document the
conversations between your agents at Hutchins Engineering; Little, O'Connor & Boire, P.C., and
Laura Moore of my office.
As i understand your project, your proposal includes the reconfiguration of the driveway and
parking area on your property. Upon my review I find that your proposal will require an Area
Variance and Site Flan Review should you wish to complete the project+ Specifically, Area
Variance relief is required from the minimum permeability requirements of the Waterfront
Residential; (WR) district. Site Flan Review is needed as the resulting driveway will have a slope
in excess of the 10% maximum allowable.
I understand that you may have completed and submitted the necessary application materials, as
such; this letter will serve as the necessary denial for the processing of your paperwork.
Should you have any questions or comments regarding your application, please do not hesitate to
contact this office.
Sincerely,
_ J
Craig Brown
Zoning Administrator
Blsh
LACraigSmwM18I etlem0enialThor as 131_1&doe
' House of Natural Beauty ... A Gourd Puce to Live "
LITTLE, 09CONNOR & BORIE, P.C.
NINI.;1'E 12 \A/F STN OTRF.DAME S'IREiH'I'-P.O. BOX 898
GLENS FALLS.NEW YORK 12801-0898
MICHAP.L.I.O'CONNOR 'IT:I.FPH0NF'-513 792-2113
BRIAN C,BORIS FACSIMILE-518 792-6972
FAX SFRVICE NOT ACCEPTED
NATHAN P.I•IAI,I_
,I.DAVID Ll*l"1'1-.I:. RI TIRED
ELIZABLTI I L.LI'I`I'LE,OP COUNSEL
January 16, 2018
Town of Queensbury Zoning Board of Appeals
742 Bay Road
Queensbury, New York 12804
Town of Queensbury Planning Board
742 Bay Road
Queensbury, New York 12804
Folks:
The Judkins Family Trust wishes to demolish its existing residence and construct a new
three bedroom family residence.
Associated site work includes reconstructing the driveway, partially across neighboring
parcel of Thomas to the east, installing stormwater management and a new compliant wastewater
system.
Re: Judkins Parcel
289.10-1-36,35
This parcel is the combination of the former lake side 50' wide lot and a parcel to rear
same connecting parcel to Glen Lake Road.
The lake side parcel is 50' wide and requires set back variances. The foot print of the
j proposed house is substantially the same as the home that is being demolished and existing non-
conforming setbacks and being maintained or improved except for the east side line setback.
That east line is the common boundary between the Judkins and Thomas Parcels, both of which
are subject of this application.
This project includes new stormwater management protective and specifically for the
Judkins' parcel shore line buffering, landscaping and a new wastewater system.
This project will have environmental benefits and will not change the character of the
neighborhood.
WEB SITE: www.locblaw.com
EMAIL: mjoconnor@locblaw.com
Town of Queensbury Zoning Board of Appeals
Town of Queensbury Planning Board
January 16, 2018
Page 2
Re: William & Bonnie Thomas Parcel
289.10-1-35
Site Plan Review
The Thomas parcel is involved to the extent driveway will be reconstructed to provide a better
grade with stormwater controls. Existing parking and overflow parking is proposed.
The driveway which will serve both parcels creates a 33.49% impermeable area on the
Thomas parcel; However, the impermeable on the Judkins parcel is 23.01%; Also, the driveway
now has storm water management.
Thomas will provide Judkins with a permanent non-exclusive easement to use driveway
with a shared maintenance agreement.
Yours very truly,
LITTLE,O'CONNOR& BORIE, P.C.
by: Michael 'Connor
MJOC/dma
Enclosures
Area Variance [ZBA approved: September 21 2016]
General Information
Tax Parcel ID Number: 289.10-1-36
Zoning District: WR
Detailed Description of Project[include current&proposed use]:
Current Use: Residential
Proposed Use: Residential
Location of Project: 15 Genista Drive
Applicant Name: Judkins Family Trust Mailing Address 286 Butler Pond Road
Home Phone City,State,Zip
Queensbury NY 12804
Work Phone Cell Phone
E-Mail: FAX No.
Agent's Name: Hutchins Engineering Mailing Address 169 Haviland Road,12804
Home Phone Little&O'Connor City,State,Zip 19 W.Notre Dame St,12801
Work phone Hutch:(518)745-0307 Cell Phone
L&O'C:(518)792-8728
E-mail lwdoh ie@hutchinsengineering.com FAX No. Hutch:(518)745-0308
Tjoconnor@littleoconnor.com L&O'C:(518)792-6972
Owner's Name William&Bonnie Thomas Mailing Address 11 John Clendon Rd.12804
Home Phone City,State,Zip
Work Phone Cell Phone
1�mail FAX No.
Page 1
Area Variance [ZBA approved: September 21 2016]
Site Development Data
Area/Type Existing sq.ft. Proposed Total sq.ft.
Additions .ft.
A. Building footprint
� 525 305 1 830
B. Detached Garage
0 0 0
C. Accessory Structure(s)
0 0 0
D. Paved,gravel or other hard surfaced area
2,285 0 2,285
E. Porches/Decks
0 30 30
F. Other
515 -285 230
G. Total Non-Permeable [Add A-F]
3,325 50 3,375
H. Parcel Area [43,560 sq. ft./acre] 14,668 0 14,668
I. Percentage of Impermeable Area of Site [I=G/H]
22.67% 0.34% 23.01%
Setback Requirements
Area Required Existing Proposed
Front Yard[1]
Front Yard[2]
Shoreline
50' 20' 20'
Side Yard[1]
15' 15' 10'
Side Yard[2]
15' 3.8' 7.8'
Rear Yard[1]
30' 103.5' 91.8'
Rear Yard[2]
----- -----
Travel Corridor
Height[maximum]
Permeability 75% 77.33% 76.99%
Number of parking spaces
Page 2
Area Variance [ZBAapproved: September 212016]
Additional Project 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): N/A
3. Does this project require coverage under the New York State Pollutant Discharge Elimination System(SPDES)Permit
Program? —Yes/ ✓No
4. Estimated project duration: Start Date: SPR 2018 End Date: FAL 2018
5. Estimated total cost of project: $400,000
6. Total area of land disturbance for project: 17,500
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/Commercial CM/Cl 0.3
Intensive
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.
Parcel Area 14,668 sq.ft.
Existing Floor Area 1,100 sq. ft. see above definition
Proposed Additional Floor Area 564 sq. ft.
Proposed Total Floor Area 1,664 sq.ft.
ITotal Allowable Floor Area 3,227 Area x 0.22 see above table
Page 3
Area Variance [ZBA approved: September 21 2016]
Compliance with Zoning Ordinance
Requesting relief from SECTION: 179-6-050,179-6-060
Need relief from the requirement(s)listed below which can not be met by the project as proposed.
[Check all that apply] Q Setback ❑Buffer Zone ❑Lot Width QOther DRIVE ACCESS
The following questions reflect the criteria for granting this type of variance. Please complete them; use additional sheets if
needed.
1. Whether an undesirable change will be produced in the character of the neighborhood or a detriment to
nearby property will be created by the granting of this area variance?
Therg will be no undeArahle-change to the character of the neighborhood,as an attractbve.new home wil I be
constructed at the same lake setback as the existing camp. All of the neighboring homes are situated at
approximately the same lake setback as this proposal.
2. Whether the benefit sought by the applicant can be achieved by some method, feasible for the applicant
to pursue, other than an area variance?
Given the parcel's geometiy and narrow conforming building envelope.as we11 as the site topDS by over the
conforming building envelope,there is no feasible alternative to requested area variances. Additionally,it is not
feasible to construct a new drive to access site off Glen Lake Road.
3. Whether the requested area variance is substantial?
The setback requests could be viewed as moderately substantial with respect to the amount of relief requested.
The driveway access request is not substantial,as the parcel is presently accessed from Genista Drive and the
reconstructed road will also allow access from Genista Drive.
4. Whether the proposed variance will have an adverse effect or impact on the physical or environmental
conditions in the neighborhood or district?
There will be no adverse effects to the physical or environmental conditions in the neighborhood. A new
conforming wastewaters stem will be installed along with stormwater management,and the new drive will
provide much improved access and parking for the easterly neighbor.
5. Whether the alleged difficulty was self-created?
Given theparcel's geometry and topography,the difficulty is not self-created. There is no feasible way to
undertake the project without the requested area variances.
Page 4
Area Variance [ZBA approved: September 21 2016]
Section 179-14-030—Application materials
Application materials and site plan drawing is to include sufficient information for the Board to review and provide a decision. The
applicant is to provide a site plan drawing(s)—a survey showing existing conditions,a proposed conditions map(see page 00 for
specific criteria)and include any other attachments that address A-D as applicable to the proposed project.
A. General Shown on Sheet#
I Title,Name,Address of applicant&person responsible for 2reparation of drawing ALL
2 Deed ATTACHED
3 North arrow,Tax Map ID,date prc2ared and scale minimum: 1 inch=40 feet ALL
4 Boundaries of the property plotted to scale,zoning boundary Sl
5 Principal structures,accessory structures with exterior dimensions Si,S4
6 Site improvements incl. outdoor storage areas, driveways,parking areas, etc.: existing&
proposed
S1,S4
7 Setbacks for all structures and im rovements: existing&proposed ALL
8 Elevations and floor plans of all proposed and affected structures Al,A2
B. Water& Sewer Shown on Sheet#
1 Project sewage disposal facilities, design details,construction details, flow rates, and number of
bedrooms proposed
S4
2 Water supply[i.e.well] &septic on adjoining lots with separation distances to existing or
proposed on-site water supply and septic
S4
3 Separation distances for 2roposed sewage disposal system to well and water bodies S4
4 Existing public or private water supply[well,lake, etc.]. Method of securing public or private
water, location,designand construction of water supply includingdailywater usage
S4
5 Percolation test location and results TBD
C. Parkin /Permeable Areas Shown on Sheet#
1 Number of spaces required for project including calculations and justification: existing& S4,S5
proposed
2 No. of existing parking spaces,number to be removed,number to maintain and type of surfacing
material e. ., avel,paved] S3,S4
3 Provision for pedestrian and handicap access and parking: existing&proposed S3,S4
4 Design details of in ess,a ess, loading areas and cutting: existing&proposed S3,S4
5 Location and character of green areas [existing and proposed],modification to green area,buffer
S3,54
zone to remain undisturbed
6 Lighting, location and design of all existing and proposed outdoor lighting BLDG MOUNTED
D. Additional Site Development and Miscellaneous Shown on Sheet#
1 On-site&adjacent watercourses, streams rivers,lake and wetlands S1
2 Utility/eneray distributions stem as, electric,solar,telephone]: existing& ro osed Si,S5
3 Location, design and construction details of all existing and proposed site improvements
including: drains,culverts,retainingwalls,fences, fire&emergency zones and hydrants,etc. Si,S4,S5
4 Square footage of bldg. area proposed for office,manufacturing,retail sales or other commercial
activities: existing&proposed
RESIDENTIAL
5 Signage: Location, size,type, design and setback: existing&proposed RESIDENTIAL
6 Waiver Request: provide letter with application requesting any waivers: please reference
f
specific items NONE
7 Commercial/Industrial Development requires submission of Landscaping, Stormwater
RESIDENTIAL
Management, Grading&Lighting Plans
8 Identification of Federal, State or County permits required for the project together with a record
of application for all necessarypermits NONE
Page 5
ItCl� =��0 we C"\)c-ck'u It A�J
Area Variance izaa approved: SaptemW 2120161
,Z -jj� , � �r t\ caa -,( ()Q�� 6(G �A LAJ1`kl.s FzWIX ln4 $i
Pre-Submission Conference Form/Section 179-9-040
1. Applicant Name: ludunklins Family Trust
.2—pgq.ro- 1— G97-
t.
2.
Tax Map ID Location: jGenILane
3. Zoning Classification WR
4. Reason for Review: IOCILC1 �[/►
I Zoning Section M Oq--�-Uy.O 17q-&- 3e I
6. Pre-Submission Meeting Notes: r Pr wit P�k Outstanding; Please provide by
Deed ✓
General Information complete
Site Development Data Complete
Setback Requirements Complete
Additional Project Information Complete
FAR addressed
Compliance with Zoning Ordinance
Checklist items addressed
Environmental Form completed
Signature Page completed AN
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C.
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Ccs Ct C�
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U�el `� -- �S Cir l� S c r
Staff Representative: �L .[�-
once �a
Applicant/Agent: Date:
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Area Variance [ZBAapproved: September 2120161
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 the following:
Variance Site Plan Subdivision
For Tax Map No.: 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: Judkins Family Trust
Designates: Hutchins Eng.&Little&O'Connor as Agent regarding the following:
Variance ✓ Site Plan ✓ Subdivision
For Tax Map No.:226.15-1-36 Deed>�e-Aerercce: 600k4978 Page287 Date 5/8/14
OWNER SIGNATURES / �' .k DATE: r I
2.1_ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic
design, storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be
charged directly to the applicant. Fees for engineering review will not exceed$ 1,000 without notification to the applicant.
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 RESPONSIBILITIES: 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_1 OFFICIAL_MEETING MINUTES DIS!gLOSURE: 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.
6. AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: 1,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 [/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 {
r I have read and agree t e abov
Signatur n Print Name[Applicant] Date signed
` Lucas W.Dobie,P.E. / �4.��
Signature[Agent Print Name[Agent] Dated
Page 7
Area.Variance [ZBA approved: September 21 2016]
i
General Information
Tax Parcel ID Number: 289.10-1-35
Zoning District: WR
Detailed Description of Project[include current&proposed use]:
Current Use: Residential
Proposed Use: Residential
Location of Project: 9 Genista Drive
Applicant Name: William&Bonnie Thomas Mailing Address 11 John Clendon Rd.
Home Phone City, State,Zip
Queensbury NY 12804
Work Phone Cell Phone
E-Mail: FAX No.
Agent's Name: Hutchins Engineering Mailing Address 169 Haviland Road,12804
Home Phone Little&O'Connor City, State,Zip 19 W.Notre Dame St,12801
Work Phone Hutch:(518)745-0307 Cell Phone
L&0'C:(518)792-8728
E-mail lwdob ieC@hutchinsengineering.com FAX No. Hutch:(518)745-0308
mjoco nor@littleoconnor.com _ L&0'C: 518)_(518)792-6972
Owner's Name Mailing Address
(same as applicant)
Home Phone City, State,Zip
Work Phone Cell Phone
E-mail FAX No. l
Page 1
Area.Variance [ZBAapproved: September 21 2016]
Site Development Data
Area/Type Existing sq.ft. Proposed Total sq.ft.
Addition sq.ft.
A. Building footprint
595 l 0 595
B. Detached Garage 0 0 0
C. Accessory Structure(s) 0 0 0
D. Paved,gravel or other hard surfaced area
2,160 875 3,035
E. Porches/Decks
0 30 30
F. Other
0 0 0
G. Total Non-Permeable [Add A-F]
2,755 875 3,630
H. Parcel Area [43,560 sq.ft./acre] 10,645 0 10,645
I. Percentage of Impermeable Area of Site [I=G/H]
25.880/0 8.22% 34.10%
Setback Reqqilrements
Required Existing Prop d
Front Yard[1]
Front Yard[2]
Shoreline
Side Yard[1]
Side Yard[2]
Rear Yard[1]
Rear Yard[2]
Travel Corridor
Height[maximum]
Permeability
Number of parking s es
/Z
Page 2
Area Variance [ZBAapproved: September 212016]
Additional Project 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): N/A
3. Does this project require coverage under the New York State Pollutant Discharge Elimination System(SPDES)Permit
Program? _Yes/ ✓No
4. Estimated project duration: Start Date: SPR 2018 End Date: FAL 2018
5. Estimated total cost of project:
6. Total area of land disturbance for project:
Floor Area Ratio Worksheet
FLOO\ARO� RATIO (FAR) -- The relationship of building size to lot size, derived by dividing the total bui lig floor
area bsquare feet,yielding a percentage.
Zoning District Symbol Floor Area Ratio [FAR]
Waterfront Residential WR 0.22
Commercial Moderate/Commerc' 1 CM/CI 0.3
Intensive
A. The combined area of all square footage, easure from exterior walls of a structures on the property,including all
floors of the structures, garages, basements d attics with more than c (5) feet of ceiling height and covered
porches. Building square footage does not inc e: Open deck, doe nd that portion of covered docks extending
over water and one storage shed of one hundre enty (120) s re feet or less. Any additional sheds will be
included. (See"FLOOR AREA RATIO").
B. Commercial or industrial: the total area in square feet as 1n red from the exterior of the outside walls of a building
or structure,and when applicable,the sum total of all floor rc, of the principal and accessory buildings or structures
on the project site.
Parcel Area sq. ft.
Existing Floor Area sq. ft. [see abo definition
Proposed Additional Floor Area sq. ft.
Pro osed Total Floor Area sq. ft.
Total Allowable Floor Are Area x 0.22 see above table
l
s
f
Page 3
Area Variance [ZBA approved: September 21 2016]
Compliance with Zoning Ordinance
Requesting relief from SECTION: 179-6-050,179-6-060
Need relief from the requirement(s)listed below which can not be met by the project as proposed.
[Check all that apply] ❑Setback ❑ Buffer Zone ❑Lot Width 7Other DRIVE ACCESS
The following questions reflect the criteria for granting this type of variance. Please complete them; use additional sheets if
lneeded.
! 1. Whether an undesirable change will be produced in the character of the neighborhood or a detriment to
nearby property will be created by the granting of this area variance?
There will be no undesirable change to the character of the neighborhood as the driveway construction is part of a
larger project on the neighboring project that will improve the character of the neighborhood.
2. Whether the benefit sought by the applicant can be achieved by some method, feasible for the applicant
to pursue, other than an area variance?
Due to the constricting geometry of the neighboring parcel,there is no feasible alternative to the requested area
variance.
3. Whether the requested area variance is substantial?
The requested variance is not substantial as driveway access from Genista Drive will not change.
4. Whether the proposed variance will have an adverse effect or impact on the physical or environmental
conditions in the neighborhood or district?
There will be no adverse effect or impact on the physical or environmental conditions in the neighborhood.
' S. Whether the alleged difficulty was self-created?
1 Due to the constricting geometry of the neighboring parcel,the difficulty is not self-created.
i
Page 4
Area Variance [ZBA approved: September 21 2016]
Section 179-14-030—Application materials
Application materials and site plan drawing is to include sufficient information for the Board to review and provide a decision. The
applicant is to provide a site plan drawing(s)—a survey showing existing conditions,a proposed conditions map(see page 00 for
specific criteria)and include any other attachments that address A-D as applicable to the proposed project.
A. General Shown on Sheet#
1 Title,Name,Address of applicant&person responsible for preparation of drawing ALL
2 Deed ATTACHED
3 North arrow,Tax Map ID,date prepared and scale minimum: 1 inch=40 feet ALL
4 Boundaries of the property plotted to scale, zoning boundary S1
5 Principal structures,accessory structures with exterior dimensions Si,S4
6 Site improvements incl. outdoor storage areas, driveways,parking areas, etc.: existing&
proposed
Sl,S4
7 Setbacks for all structures and improvements: existing&proposed ALL
8 Elevations and floor plans of all proposed and affected structures Al,A2
B. Water& Sewer Shown on Sheet#
1 Project sewage disposal facilities,design details,construction details, flow rates, and number of
bedrooms proposed
S4
2 Water supply[i.e.well] &septic on adjoining lots with separation distances to existing or
S4
proposed on-site water supply and septic
3 Separation distances for proposed sewage disposal system to well and water bodies S4
4 Existing public or private water supply[well,lake, etc.]. Method of securing public or private
water,location,desi and construction of water supply includingdailywater usage
S4
5 Percolation test location and results TBD
C. Parkin /Permeable Areas Shown on Sheet#
1 Number of spaces required for project including calculations and justification: existing&
proposed
S4,S5
2 No. of existing parking spaces,number to be removed,number to maintain and type of surfacing
S3,S4
material e, ., gravel,paved]
3 Provision for pedestrian and handicap access and parkin : existing&proposed S3,S4
4 Design details of ingress,egress,loading areas and cutting: existing&proposed S3,S4
5 Location and character of green areas [existing and proposed],modification to green area,buffer
zone to remain undisturbed S3,S4
6 Lighting, location and design of all existing and proposed outdoor li hting BLDG MOUNTED
D. Additional Site Development and Miscellaneous Shown on Sheet#
1 On-site&adjacent watercourses, streams,rivers,lake and wetlands S1
2 Utility/energy distributions stem as, electric,solar,telephone]: existing&proposed Si,S5
3 Location, design and construction details of all existing and proposed site improvements
including: drains, culverts,retainingwalls, fences, fire&emergency zones and hydrants, etc. Si,S4,S5
4 Square footage of bldg. area proposed for office,manufacturing,retail sales or other commercial
activities: existing&proposed
RESIDENTIAL
5 Signage: Location, size,type,design and setback: existing&proposed RESIDENTIAL
6 Waiver Request: provide letter with application requesting any waivers: please reference
specific items NONE
7 Commercial/Industrial Development requires submission of Landscaping, Stormwater
RESIDENTIAL
Management,Grading&Lighting Plans
8 Identification of Federal, State or County permits required for the project together with a record
of application for all necessarypermits NONE
Page 5
J7,--(WO C,\)CA kc(,�
ArVariance[ZBA approved: September 2[2016]
to kAjc-�-( PQ 1.
TF74sq
Pre-Submission Conference Form/Section 179-9-040
1. Applicant Name: Judkins Family Trust
rs ►.
2. Tag Map IDS - C �\nLocation: 15 Gena Lane
3. Zoning Classification WR
4. Reason for Review: �� f -
- �i W � � ��� �
5. Zoning Section M 17 1- Xo 3e�6e& f` e&,t cwkrct
.1-74-
Pre-Submission `� � •�d z�, e.
6. Meeting Notes. Prov�Ped Outstanding; Please provide by
Deed ✓
General Information complete
Site Development Data Complete
Setback Requirements Complete
Additional Project Information Complete
FAR addressed
Compliance with Zoning Ordinance
Checklist items addressed
Environmental Form completed
Signature Page completed J�
e
ai IOt 01,4C
-�c, 9- Vyen-
C eq Le AitAy)
r -- Aflt?7 i or Sl UQ
ro. �
Staff Representative: f z-
[ - �� G�
Applicant/Agent: �(,., Date:
VVy� '� 1 page 6
L,c•E l • �� e�(L'flQ- O. 6�-p
i
Area Variance [ZDA approved: September 21 20161
I
JThis 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: William&Bonnie Thomas
Designates: Hutchins Engineering as Agent regarding the following:
Variance ✓ Site Plan_ Subdivision_
For Tax Map No.:289.10-1-35/36 / Deed Reference: Book_ Page Date
OWNER SIGNATURE: I.tf DATE: 1/5/2018
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: as Agent regarding the following:
Variance_ Site Plan Subdivision_
1 For Tax Map No.: �" Deed Reference: Book Page Date
OWNER SIGNATURE: 1i 4� /emDATE:
2. ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic
design, storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be
charged directly to the applicant. Fees for engineering review will not exceed$ 1,000 without notification to the applicant.
3. AUTHORIZATION FOR SITE VISITS• By signing this page and submitting the application materials attached herein. the
Owner,Applicant,and his/her/their agents)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 RESPONSIBILITIES: 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•) OFFICE MEETING MINUTES DISCLOStJRE: 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.
6. AGREEMENTTO PROVIDED CUMENTATION 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. 1 certify that lite application, plans and supporting materials are a trite and complete
statetnentldescription 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 and agree to the ab%ye.
LL� William&Bonnie Thomas 1/5/2018
atur scan Print Name[Applicant] Date si ed
_ _ Lucas W.Dobie,P.E. le
-Signature[Agent] Print Name[Agent] Date signed
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