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Site Plan application including deed ..1 General Information' Tax Parcel ID Number: q, Zoning District: eons r -� cam+ ,Tian! res ,�e_n+ 1 q Lot size: Detailed Description of Project [includes current&proposed use]: A1 �o u0_ aats �`�_ � o�k s�� qua e_ Location.ofproject: -8 into LwOL r L kz Geo e Ivy Applicant Name- Address:1 - ) /� ee,-, aISC ���f !on La L-rr �e L7 or N a� s Home Phone Cell: Work Phone Fax Sim 1U0 E-Mail: f I f e e n a �S C S IJ,66 Agent's Name: Address: Home Phone Cell: Work Phone Fax E-mail Owner's Name Address SCAMC, QS ULO Horne Phone Cell Work Phone Fax E-mail 2 Site Plan Review application---Revised October 2416 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY I2804 Site Development Data Area/Type Existing sq. ft. Proposed Total sq. ft. Additions . ft. A. Building footprint 713 B. Detached Garage lab C. Accessory Structure(s) D. Paved, gravel or other hard surfaced area E. Porches/Decks F. Other G. Total Non-Permeable [Add A-F] as � H. Parcel Area [43,560 sq. ft.l acre] I. Percentage of Impermeable Area of Site [I=GIH] 3 i'1Glv�eS .Pecr�e����pc�,v o_( avec, ►,�, rwl �rsgcy e d- grr,ss�`rlc�rte� Setback Requirements Area Required fisting Front[1] Front[2] Shoreline Side Yard [1] 5 ttmagz� ] z Side Yard [2] / Rear Yard [1] Rear Yard [2] Travel Corridor Height [max] Permeability No.of parking spaces 3 Site Plan Review application--Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 Additional Pro'ect Information 1. Will the proposal require a Septic Variance from the Town Board of Health? Np 2. If the parcel has previous approvals, list application number(s): AV—pni. 1 Q V Lia4 P q V ?w 3. Does this project require coverage under the New York State Pollutant Discharge Elimination System (SPDES) Permit Program ? 4. Estimated project duration: Start Date 1 End Date .3 5. Estimated total cost of project: ~_a �-- 6. Total area of land disturbance for project: —Aj,,,,�C 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 CMI CI '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 5 7 ' sq. ft. B. Existing Floor Area 7 sq. ft.. see above definition C. Proposed Additional Floor Area c sq. ft. D. Proposed Total Floor Area sq. ft. E. Total AIlowable Floor Area (Area x [see above table] *If D is larger than E:a variance or revisions to your plan maybe needed. Consult with Staff. 4 Site Plan Review application Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 § 179--9080 Re uirements for Site Plan App royal. The Planning Board shall not approve a Site PIan 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 Comprehensive Plan. � e.s B. The proposed project complies with all other requirements of this Chapter,including the site plan review standards as set forth in Paragraph F of this section,the dimensional,bulk and density regulations of the zoning district in which 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 co nected to adjacent areas. �J J'A D. The site plan must conform to Chapter 136 Sewage and Sewage Disposal,Chapter 147 Stormwater Management Local Law,and othr applicable local laws. es 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. C s F. The establishment,maintenance and operation of the proposed use will not create public hazards from traffic,traffic congestion or he 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, Q G. Off-street parking and 19oading facilities will be appropriately located and arranged and sufficient to meet traffic anticipated to be denerated 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 Iinkage,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 e applicant has made contact with adjacent property owners for purposes of coordinating Iinkages with adjacent properties. N 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. 01 1 X. 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. A 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 b Department of Health regulations and Chapter 136 of the Town Code. e s L. The adequacy,type and arrangement of trees,shrubs and other suitable plantings,landscaping and screening shall effectively provi e 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. Fire lanes,emergency zones and fire hydrants will be adequate and meet the needs and requirements of emergency service provide s. ES N. The design of structures,roadways and landscaping in areas susceptible to ponding,flooding and/or erosion will minimize or avoid slich impacts to the maximum extent practicable. p. 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 § 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, S — r subdivisions,streets and easements within 500 feet of the property. Such a sketch may be superimposed on a United States Geolo ical Survey map of the 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 8112"x 11"sheets as necessary for written 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. D. Name and address of the owner of record,developer,and seal of the engineer,architect or landscape architect. If the applicant is 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 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 containers shall also be shown. G. The location,height,intensity and bulb type(sodium,incandescent,ctc.)of all external lighting fixtures. The direction of illumination and methods to eliminate glare onto adjoining properties must also be shown in compliance with§ 179-6-020. Ch C--c .. -H. The location,height,size,materials and design of all proposed signs. nn -- IColL GGl �. The location of all present and proposed utility systems including: m e c• 1. Sewage or septic system; C)ekwlq 2. Water supply system; 3. Telephone,cable and electrical systems;and 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 PIan(SWPPP)for all land development activities(excluding agricultural activities)on the site that results in land disturbance of one acre or more. A SWPPP shall comply with the requirements of the DEC SPDES MS-4 General Permit and Chapter 147 of the Town of Queensbury Code. It shall be at the discretion of the Planning Board as to whether a SWPPP or an erosion and control plan shall be required for a site plan review project land disturbance of less than 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 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. j, 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 watercourses,aquifers,floodplains and drainage retention areas. Nj 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. 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; 2. The projected traffic flow pattern including vehicular movements at all major intersections likely to be affected by the proposed use of the site; 3. The impact of this traffic on levels of service on abutting public streets and at affected intersections. Existing and proposed weekly and annual peak hour traffic levels and road capacity levels shall also be given. 0. For new construction or alterations to any structure,a table containing the following information shall be included: I. Estimated area of structure to be used for particular purposes such as retain operation,office, Storage,etc.; 2. Estimated maximum number of employees; 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(114"=1 foot)for all exterior facades of the proposed structure(s) and/or alterations to or expansions of existing facades,showing design features and indicating the type and color of materials to be used. 1 Q. Soil logs,water supply well and percolation test results,and storm water runoff calculations as needed to determine and 1 mitigate project impacts. J A R. Plans for disposal of construction and demolition waste,either on-site or at an approved disposal facility. ti S. Plans for snow removal,including location(s)of on-site snow storage. 0 T. An Environmental Assessment Form("EAF")as required by the SEQRA regulations,with Part I 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. J. 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 contiguous parcels shall be considered together. Q 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. P s� Gcs f'larl »'!n �Irifi� I�nl > Jtl I h� que.enS er pi J /' l l � r b rl 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 1 Section 179-9-040 1. Applicant Name:_0z ��f"T H a I'S E_ _ 2. Tax Map ID a3q j a G Ca Location: r� Loci- c Gei,,-,,- IJ` 1a84.5 3. Zoning Classification C/L� 4. Reason for Review: _� c. 5. Zoning Section#: P t.r"�i �` l7 �/ /v-07 n MGC? 17C.q 6. Pre-Submission Meeting Notes: Provided Outstanding; Please provide by Deed General Information complete _L.z Site Development Data Complete Setback Requirements Complete Additional Project Information Complete FAR addressed Requirements for Site Plan-Standards Checklist items addressed. Environmental Form completed Signature Page completed f PP-f- I c` ii �S n-e I Z doc Dee C ctwaeur,� CIL- C2 f OE On I Sire D� C �I [1 �... � �GSS f�G:c �1✓tG� �Yl�?�rr►'t�y�(�✓r ._ Staff Representative: �Qurc, A4W(� Applicant 1 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: Variance Site Plan Subdivision For Tax Map No.: Section Block Lot Deed Reference: Book Page Date OWNER SIGNATURE: DATE: APPLICANT'S AGENT FORM: Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party: Owner: Designates: As agent regarding: Variance Site Plan Subdivision For Tax Map No.: Section . Block Lot Deed Reference: Book Page Date OWNER SIGNATURE: DATE: 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 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]_OFFICIAL MEETING MINUTES DISCLOSURE: 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: 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 and agree to he above. ]1 J Signature [Applic nt] Print Name [Applicant] ate signed Signature [Agent] Print Natne [Agent] 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 Instructions for Completing 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 I 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 fo+ C+ J, Y-0 Name of Action or Project: Project Location(descri6 ,and attach a location map): !"rd �o Lulue- LXo G2tY- ,, II rz� CA,-LL) Brief DDeescript'i n of Proposed Action: .}_ I o dock a+above 6, Name oO_U �Applicant oyr�Sponsor: Telephone:s" /�.'7 _ � Or JJ fp_e- 1 ' I's _ E-Mail: e e + S b co Address:_ Ere, �, C' /PO: State: Zip Code: a �(4 S 1.Does the proposed action o ly 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: Lai C ' ' El v �r an oar .1 ear e t;�, 3.a.Total acreage of the si of the proposed ction? (i I acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban �R Rural (non-agriculture) ❑Industrial ❑Commercial oResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkl and Page I of 3 5. Is the proposed action, NO YES NIA a. A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? ❑ D 6. Is the proposed action consistent with the predominant character of the existing built or natural NO AYES landscape? ❑ 7, is the site of the proposed action located in,or dos it adjoin,a state listed Critical Environmental Area? NO S If Yes,identify: S. 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? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO S If the proposed action will exceed requirements,describe design features and technologies: _ip�d) 10. Will the proposed action connect to an existing public/private water supply? NO ES If No,describe method for providing potable water: S o L� roa� �ac! I, 11.Will the proposed action connect to existing wastewater utilities? NO ES, If No,describe method for providing wastewater treatment: { fprl 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? Elb.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 I'Forest ❑Agricultural/grasslands El Early mid-successional ❑ Wetland ❑Urban ❑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? Z ❑ 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? O YES If Yes, a.Will storm water discharges flow to adjacent properties? �NO ❑YES , ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: �NO [:]YES 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 purpose and size: � ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: � 0 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AF FIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURA E T THE BEST OF MY KNOWLEDGE r Applicant/ pgnsor arae: c� Date: �l Signature 1 PRINT FORM Page 3 of 3 F Agency Use Only [1f 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 bden reasonable considering the scale and context of the proposed action?" ' V 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? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the El 11establishment of Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: 11 ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g., wetlands, waterbodies,groundwater,air quality, flora and fauna)? ❑ ❑ 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage 11 Elproblems? 11. Will the proposed action create a hazard to environmental resources or human health? ❑ ❑ PRINT FORM Paget of 2 Agency Use Only[If applicable] 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. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT FORM Page 2 of 2 Queensbury Planning Board RE: Colleen M. Halse. Class A Marina Chapter 179.Zoning 179-10-040 Requirements for site plan approval. A. The proposed project is consistent with town policy The project is consistent with the Towns Comprehensive Plan in that it authorizes by Special use Permit the use of docking by vessel owners that are not owners of the property, providing seasonal access to the recreational opportunities of Lake George for other members of the public. No physical changes are proposed by this application so the visual and aesthetic impacts are non-existent. B. The proposed project is in compliance with requirements of all articles that apply. C. There is pedestrian walkways leading to the docks and to my home for restrooms.The vessels are small therefore do not have bathroom facilities. I do provide access to the restrooms. D. There is no sewage disposal on this site. Boats do not need pump out facilities. Bathrooms available at home. E. There is not a change in dock size. Nothing has changed in regard to the area around the docks. The docks are at the end of the bay and so do not infringe on other neighbors or their use of the lake.There are other class A marinas and private docks in the vicinity. F. There is adequate parking for all on the property. It is a quiet area with little traffic and no hazard to local traffic. Each vessel owner is instructed that they may only park one vehicle on the property. G. The parking area has appropriate setbacks from adjacent properties. Each vessel owner is only allowed to park one vehicle on the property. H. The project has been designed to maintain the existing structures and aesthetics. No new buildings or impermeable surfacing is proposed. No impact of any kind is expected. 1. The path to the dock is well established and safe. J. I am not changing anything that would affect storm water drainage. K. There is not a need for pump out.The size of the boats do not have pump out requirements. Even in the future the size of the vessels maintained at the dock will not have pump out facilities. L. There is not or will there be changes to the landscape. It is lawn and tress and with stay that way. M. Emergency access is provided by virtue of public highways adjacent to the site. Each vessel owner is instructed to where the local fire department is located. N. I am not changing the structure of the landscape. I only want to rent two dock spaces. 0. The project conforms to design standards, landscaping standards and performance standards. This has been approved in the past by the Queensbury town board Site Plan AV-2013 Chapter 179.Zoning Article 10,Special Use Permits 179-10-060. General Criteria A. I am not seeking to change anything that wasn't already been in existence and has already been approved by the Queensbury zoning board, dock, parking,structure. B. The proposed use is a valuable and important resource provided within a waterfront residential zone. Studies have shown that seasonal dock renters are more responsible and skilled operators obtaining access to the lake by short term boat renters. It is a beneficial resource to residents of the town who can not afford direct lakefront property ownership but wish to have the opportunity to have a boat on Lake George.The renters add to the local economy by using the services of full service marinas in the area.There is a need for dock space on the lake, boat dealers are constantly seeking legitimate dock spaces for their customers.Tis application will not impede or discourage future growth plans for the area. C. There is easy access with convenient and safe access to their boats. Bathroom accessibility is available to the renters and pump out is not necessary. D. There are two large garbage cans available to the renters,for garbage and recyclables.The garbage receptacles are located next to the front,or road side of the garage. E. I am not doing anything to change the environment of natural features of the area.There will be not changes and no expansion to structures or impermeable surfacing. F. The dock is well maintained and there is space for vessels.This added income will assist in paying taxes. I am the sole proprietor and reaching retirement. Specific Standards for Special Use Permit Per Section 179-10-070(F): Class A Marina Lake George Park Commission 6 NYCRR Part 646 General Requirements: RE Class A Marina 1. No sale of Marine products or services. 2. No sale, lease, rental or charter of vessels 3. No boat launch operation. 4. No offering of rides, instruction or water-based recreation for a fee. 5. No quick launch facility 6. Proposed berthing of 2 vessels plus my own vessel. Room for 3 vessels total Lake George Park Commission 6 NYCRR Part 646-1.2(b)Class A Marina Specific Requirements: 1. Restroom access provided at the home. 2.There are 4 parking areas total. One provided for each vessel (2). 3. No storage of trailers permitted. 4. No fuel sales/no bulk storage tanks. 5. Not applicable. No fuel sales. 6. Garbage and recycling containers located in the front of the garage(road side)emptied weekly by garbage service pickup. 7. No pump out facility available.There is access to one at Harris Bay Yacht Club. .2 mile away This is not necessary because the boats do not have pump out facilities. 8. No boat cleaning shall be permitted on site. 9. No PWC rentals permitted on site. BK: 4455 PG: 5 03/26/2012 DEED Image: 1 of 4 WARREN COUNTY PAMELA J. VOELDOOLIMENT� 000022?0 COUNTY CLE LUME: 4455 PAGE: 5 Lake George, NY 12845 sozoyzoaoozzso Volm-4455 Pg-5 Instrument Number: 2012-00002290 As Recorded On: March 26,2012 Deed Parties: HALSE COLLEEN M To HALSE COLLEEN M Billable Pages: 3 Recorded By: IANNIELLO ANDERSON SCIOCCHETTI &REILLY Num Of Pages: 4 Comment: **Examined and Charged as Follows: ** Deed 55.00 Cover Page 5.00 RP-5217 Resid/Agric 125.00 TP-584 5.00 Recording Charge: 190.00 Consideration Amount Amount RS#!CS# Transfer Tax 0.00 0.00 TT 1516 Basic 0.00 QUEENSBURY Local 0.00 Special Additional 0.00 Additional 0.00 Transfer Q.00 Tax Charge: 0.00 RECORDED Counts Clerks Office Mar 26r2012 01:55P Pamela J. Vogel Warren Counts Clerk **THIS PAGE IS PART OF THE INSTRUMENT'* I hereby certify that the within and foregoing was recorded in the Clerk's Office For: WARREN COUNTY, NY File Information: Record and Return To: Document Number: 2012-00002290 IANNIELLO ANDERSON SCIOCCHETfI & REILLY Receipt Number: 250471 8 AIRLINE DR Recorded DatelTirne: March 26, 2012 01:55:39P SUITE 101 Book-Val/Pg: Bk-RP VI-4455 Pg-5 ALBANY NY 12205 Cashier/Station: C Latham / Cash Station 3 SK: 4455 PG: 5 03/26/2012 DEED Image: 2 of 4 DDCUMENTY 000022';x0 VOLUME: 4455 PAGE: 6 BARGAIN AND SALE DEED Q � (WITH COVENANT AGAINST GRANTOR'S ACTS) RECORD&RETURN TO: Colleen M.Halse 25 Brayton Lane Lake George,NY 12845 THIS INDENTURE,Made the day of March,Two Thousand Twelve, BETWEEN COLLEEN M.HALSE,residing at 25 Brayton Lane,Lake George,New York 12845 and BRUCE W.HALSE,residing at 544 Columbia Street Extension,Cohoes,New York 12047, parties of the first part, and COLLEEN M.HALSE,residing at 25 Brayton Lane,Lake George,New York, 12845,party of the second Pte. WITNESSETH that the party of the first part in consideration of ONE DOLLAR($1.00)lawful money of the United States,and other good and valuable consideration paid by the party of the second part,do hereby grant and release unto the party of the second part,her heirs,successors and assigns, ALL THAT PIECE OR PARCEL OF LAND, situate, lying and being in the Town of Queensbury, County of Warren and State of New York,being more particularly bounded as described in SCHEDULE A attached hereto and made a part hereof. BEING the same premises conveyed to parties of the first part, by Deed, dated March 21, 1994 and recorded in the Warren County Clerk's Office on March 24, 1994 in Liber 911 of Deeds at Page 24, SUBJECT to any covenants,conditions,restrictions,and easements of record,if any. TOGETHER with the appurtenances and all of the estate and rights of the party of the first part in and to said premises. TO HAVE AND TO HOLD the premises herein granted unto the party of the second part, her, heirs, successors and assigns forever. AND the party of the first part covenant that they have not done or suffered anything whereby the said premises have been encumbered in any way whatever. AND that,in compliance with Section 13 of the Lien Law,the grantor will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvements and will apply the same first to the payment of the cost of the improvements before using any part of the total of the same for any other purpose. BK: 4455 PG: 5 03/26/2012 DEED Image: 3 of 4 DOCUMENT-4 00002290 VOLUME: 4455 PAGE: 7 IN VVXTNESS WHEREOF,the parry of the first part have executed this deed on the day and year first above written. IN PRESENCE OF COLLEEN M.HALSE( A.A� � BRUCE W.HALSE STATE OF NEW YORK ) COUNTY OF ALBANY On this day of March,Two Thousand Twelve,before me,th dersigned,personally appeared COLLEEN M.HALSE,personally known to me or proved to o he basis of satisfactory evidence to be the individual(s)whose name(s) is/are subscribed to the wi trument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies) at by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf f ch the individual(s) acted, executed the instrument. Notary Public KELLY M. CURRQ Notary Public,State of New York Qualified in Albany County c Commission Expires Feb.22, 20 X J STATE OF NEW YORK ) Registration No.02CU5008532 COUNTY OF ALBANY )ss.: On this 19 day of March,Two Thousand Twelve,before me,the undersigned,personally appeared BRUCE W. HALSE, personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that helshe/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. Notary Pu 'c BK: 4455 PG: 5 03/26/2012 DEED Image: 4 of 4 ' e DOCUMENT* 00002290 VOLUME: 4455 PAGE- g CHED E "All ALL THAT FW,CE OR PARCEL OF LANA situate, lying and being at Assembly Foiant in the Town of Queensbury, Warren, County, New Ydik, described as follows: BEGINNING at the center of an ash tree located at located at the southwest corner-of a right-of-way now or formerly owned by Fred Brayton and running thence westerly along tba northerly boundary of the mamr highway a distance of 85 feet and running thence northerly along a stone wall built by F. Farrant Lawrence and over an iron pipe driven in the ground on the north side of an ash tree to the water line of Lake George and running thence easterly along said water line of said Lake to the northwest comer of said Fred Brayton right-of-way running thence along the westerly boundary .line of said Fred Brayton'right-of-way to the place of begi6hiung. Said premises containing one quarter of an acre be the same more or less. The course from the said southwest corner to said.Lake of the westerly boundary line of the premises herein conveyed Extends along a line running from the southwest corner of said premises to the northeasterly corner of the Hotel Sagarnore's dock on Green Island.