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Site Plan application & deed TOWN OF QUEBNSBURY Site Plan Review Application Review Process: 1, Required Pre-submission meeting with staff to determine general completeness to be held 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 applications 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 (hard copy & electronic): Please submit 1 original& 14 copies of the completed application package to include; • Completed Application pages 2-9, signed &dated • Pre-Submission Meeting Notes: signed by staff • Copy of Deed • Checklist& Plot Plan • Environmental Assessment Form 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 era!2bCa)mueensbury.nnet Laura Moore, Land Use Planner lnnoore a,gueensbury.net Sunny Sweet, Office Specialist—Planning sunnnys(i�,gueennsbury.net (518) 761-8220 Visit our website at www.queensbury.net for further information and foams 1 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbuty,NY 12804 General Information Tax Parcel ID Number: 308,16-1-3 Zoning District: CLI Lot size: 8.60 ACRES Detailed Description of Project [includes current&proposed use]: EXISTING USE:RESTAURANT PROPOSED USE:RESTAURANT WITI SELF STORAGE FACILITY IN Location of project: 398 CORINTH ROAD Applicant Name: Address: P.O. Box 752 TNT CORINTH ROAD LLC, LAKE GEORGE NY, 12845 Horne Phone Cell: TOM: (518)307-3638 Work Phone Fax E-Mail: Agent's Name: Address: 411 UNION ST. ABD ENGINEERS SCHENECTADY NY. 12305 Horne Phone Cell: Wort(Phone Fax (518)370-0315 (518) 377-0379 E-mail TOM@ABDENG.COM Owner's Name TNT CORINTH ROAD LLC. Address P.O. Box 752 LAKE GEORGE NY, 12845 Home Phone Cell TOM: (518)307-3638 Worl(Phone Fax E-mail 2 Site Plan Review application--Revised October 2016 Town of Queerisbury Planning Office-742 Bay Road,Queensbuly,NY 12804 Site Development Data Area/Type Existing sq_.ft. Proposed Total sq. ft. Addition sq. ft. A. Building footprint 2618 46 140 48,758 (EX. RESTAURANT (NEW STORAGE UNITS) B, Detached Garage C. Accessory Straeture(s) D. Paved, gravel or other hard surfaced area 24,341' 79,654 103,995 E. Porches/Docks F. Other G. Total Non-Permeable [Add A-F] 26,959 125,794 152,753 H. Parcel Area [43,560 sq. ft,/acre] 8.6 8.6 8.6 I. Percentage of Impermeable Area of Site [I=G/H] 7 2% 33.6% 40.8% Setback Requirements Area Required Existing Proposed RESTAURANT SELF STORAGE FACILITY Front[1] 50, 24' 257' Front[2] Shoreline Side Yard[1](WEST) 30' 30' Side Yard [2](EAST) 50' 52' Rear Yard[1] 30' 902' Rear Yard [2] Travel Corridor Height[max] 60' 25' +/- 15, Permeability 35% 92.8% 59.2% No, of parking spaces RESTAURANT: 25 RESTAURANT: 32 RESTAURANT: 50 SELF STORAGE: 48 SELF STORAGE: 0 SELF STORAGE: 62 3 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbury,NY 12804 Additional Prolect 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-SOIL EROSION 4. Estimated project duration: Start Date 9/18 End Date 12/20 5. Estimated total cost of project: TO BE DETERMINED 6. Total area of land disturbance for project: 5.59 AC Floor Area Ratio Worksheet N/A 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 CM/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 pleasured 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 s . ft. B. Existing Floor Area sq, ft. [see above definition] C. Proposed Additional Floor Area s . ft. D. Proposed Total Floor Area s . ft. E. Total Allowable Floor Area (Area x ) [see above table] I f 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 NARRITIVE Corinth Road U-Store It 2 TNT Corinth Road LLC,the owner and applicant is proposing to construct self storage units on the land behind the closed PAPA'S Diner. It is the intention to keep the diner intact, anticipating that it will be reopened.The storage units will be set at the rear of the parking area, to allow code compliant parking for the diner.The self storage project will consist of 46,000 sf of lease space in 12 buildings. It is anticipated that the build out of the project will take 2 years, depending on leasing demand.An open storage area in the rear with a stone surface will be constructed to accommodate RV and other vehicle storage, as allowed by the zoning.There will not be an office at this facility, and thus there will be no water or sewer provided. Signage will direct customers to the applicants other self storage facility,just to the west of this on Corinth Road, which does have a manned office to accommodate customers needs. Daily maintenance will be performed by the maintenance group at the other facility.The project will be fully fenced,with security systems, including video cameras.Those cameras will be monitored at the other facility, as well as thru web monitoring. Lighting will be low level on the buildings, shining between the units.The back side of the units facing both east and west will not have doors or access.The building themselves will serve as the fence,thus eliminating long stretches of fencing. As part of the project there will be removal of some of the gravel parking lot that is now in the buffer area. The type C buffer will be provided 50' in width, in which there will be no improvements.The existing trees in that buffer will remain,with removal only along the edge of the building to allow for the improvements to be built. In the area where the buffer is now open lawn, trees will be added in conformance with buffer requirements.There are encroachments from the residential neighbors onto this property,some being significant. Agreements will be offered to those residents to allow the encroachments to remain. Clearing of the site to the rear will occur under this project, as once the units are constructed it would not be appropriate to have logging trucks running between the buildings. One access road between the units is designed at 28' to allow for fire access and accommodate the future development of the remainder of the property. A fire turn around, in accordance with the fire code, will be constructed. Parking will be provided alongside the units. Parking is not needed out front, as there will not be an office.Stormwater will be handled thru infiltration, with the soil being excellent sand.There will be no offsite flow and the post development flow will be contained onsite for up to the 100 year storm. As there is more than 1 acre of disturbance a SWPPP will be filed for soil erosion control only.The site will be stabilized so that there will never be more than 5 acres of exposed soil.The plans specify the construction and stabilization of the infiltration basins prior to the buildings being finished, so that siltation is controlled. Stabilization of the cleared areas is also specified to take place as the clearing proceeds.Traffic generated by the self storage units is minimal,with the other facility owned by the applicant seeing normally less than 10 cars per day. ITE predictions for the peak AM and PM hours of the adjacent street are approximately 7 vehicle trips in the AM and 12 vehicle trips in the PM for this facility based on the proposed lease area. § 179-9-080 Reguirements for Site Plan Approval. The Planing Board shall not approve a Site Plan unless it first determines that such site plan meets the following Staadards. Please prepare responses to each of the following topics. FSTANDARDS The proposed project furthers or is consistent with the policies of the Town's Comprehensive Plan, 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 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 hi 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 establishmorit,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 19oadhng 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,taldng 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, 1, 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. Fire 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. S Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury,NY 12804 Standards A. The project is conforming to Zoning, thus it is consistent with the Comprehensive Plan B. The project conforms to the area requirements of the zone C. This site plan is not designed for pedestrian access, as it is not appropriate for self storage. D. The facility will not have water or sewer service. E. The facility fits well in the zone, having minimal use and maintaining a strong tree buffer along the residential side. F.There is almost no traffic generated with a self storage use, and an existing driveway is being used to access the self storage area. G. As the parcel adjoins a residential use, it is not appropriate to plan for a connection between the commercial and residential uses. Due to the security requirements, a connection to the adjoining commercial use property is not appropriate. H. There will not be any adverse impacts on open space.This project is in an area where commercial development has been planned.The zoning provide for buffers from the residential development.As the surrounding area is developed, this development will not be effecting Town resources or any open space design. I.This site is not designed for pedestrian traffic, per C above. J. The site is permeable sand. There is no discharge offsite, and thus pre and post flows remain unchanged. K.The site will not have water or sewer services. L.The existing trees will remain along the residential homes and open areas will receive additional plantings. As the project sits significantly back from the road,there is no impact on the road, and the restaurant has established lawn along the road.. M. The project has been designed with fire access, including a code compliant drive width and turn around design. N. The site is high and dry and not subject to flooding. O. The site plan does conform to the design standards. § 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, subdivisions,streets and easements within 500 feet of the property. Such a sketch may be superimposed on a United States Geological Survey map of the area, 13, 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 I I"sheets as necessary for written v) information. The information listed below shall be shown on the site plan and continuation sheets. L 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,etc,)of all external lighting fixtures, The direction of illumination and methods to eliminate glare onto adjoining properties must also be shown in compliance with§ 179-6-020. H. The location,height,size,materials and design of all proposed signs, he+- T 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 I 4. Storm drainage system including existing and proposed drain lines,culverts,catch basins,headwalls,endwalis, hydrants,manholes and drainage swales, J. Plans to prevent tine pollution of surface or groundwater,erosion of soil both during and after construction,excessive runoff and Flooding of other properties,as applicable. A Stonriwater Pollution Prevention Plan(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 tine 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. 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 C' watercourses,aquifers,floodplains and drainage retention areas, M, 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; I, The projected number of motor vehicle trips to enter or leave the site,estimated for weekly and annual peals 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 peals 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; 3, Maximum seating capacity,where applicable;and 4. Number of parking spaces existing and required for the intended use. P, I, Floor Plans. 2, Elevations at a scale of one-quarter inch equals one foot(1/4"=I foot)for all exterior facades of the proposed structure(s) i e.6 C and/or alterations to or expansions of existing facades,showing design features and indicating the type and color of materials U 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, R, Plans for disposal of construction and demolition waste,either on-site or at an approved disposal facility. G5 i S, Plans for snow removal,including location(s)of on-site snow storage, . ,7 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 f submitted in conjunction with a special use permit application,a duplicate EAF is not required for the site plan application, b+ U, If an application is for a parcel or parcels on which more than one use is proposed,the applicant may subunit 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, -1. 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, 7 Site Plan Review application—Revised October 2016 Town of Queensbury Planning Office-742 Bay Road,Queensbttry,NY 12804 Town of Queensbury Site Plan Pre-Submission Conference Form / Section 179-9-040 1. Applicant Name: 7 A// 2. Tax Map ID ?,C �' �� Location: Ge CCU l`t ✓1'� I� 3. Zoning Classification 4. Reason for Review: Ale Lo 5e W S ex „ d ,r !(V � C� I P� Cpt/ C�`�' ( 5. Zoning Section#: Rta54rtt cir` 6. Pre-Submission Meeting Notes: Provided Outstanding; Please provide by Deed V General Information complete r` Site Development Data Complete Setback Requirements Complete Additional Project Information Complete �/- 0A FAR addressed Requirements for Site Plan-Standards Checklist items addressed Environmental Form completed -IO Signature Page completed tf C t�1 a 5 ' � � �'� CeC9 cx.Cs 67cll(,f cCI+U t�a nc'O— S,SA ctG a r-y-) 4 cal S cx 4')'rdJVrM �e t Staff Representative: U LC ��C Applicant/Agent: �i Date: 1 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 FORA: 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 t ttend ilie meeting or wishes to be represented by another party: Owner: tlj`j (.e)V'�� �c�1( Designates: cm ezk,5 1 LL-e r - As agent regarding: ariance Site Plan Subdivision For Tax Map No.: �, ection Block '-3 Lot Deed Reference: Book Page Date OWNER SIGNATURE: DATE: 1 2.) ENGINEERING FEE DISCLOSURE: Applications may be referred to the Toni 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 connnenced 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 the above. Signature [Applicant] Print Name [Applicant Date signed 5 i e [Agent] rint Name [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 1 -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 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: ya Project Location(describe,and attach a location map): Brief Description of Proposed Action: �( , Name of Applicant or Sponsor: �J Telephone:y l 0 7 'rm 'J 6z Y r vJ1A ��.Q �L E-Mail: Address: V e> 0,k —7 C City/PO: State: Zip Code: L,.,.. &e-c Ny t-Z_:e�49 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: �+t �� ——plo, 3.a. Total acreage of the site of the proposed action? 910 acres b. Total acreage to be physically disturbed? Ci acres c. Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? o o acres 4. Check all land uses that occur on,adjoining and near the proposed action. M Urban ❑Rural(non-agriculture) [—]Industrial X Commercial [,Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic El Other(specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ Pq ❑ b. Consistent with the adopted comprehensive plan? ❑ 0 ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: F&—/] ❑ 8, a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ® ❑ b.Are public transportation service(s)available at or near the site of the proposed action? � ❑ 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 YES If the proposed action will exceed requirements,describe design features and technologies: 10, Will the proposed action connect to an existing public/private water supply? N/A 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: (d 1 ❑ ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 7 ❑ b.Is the proposed action located in an archeological sensitive area? F6—/] ❑ 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? Fv_1 [I- b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? rl;�q ❑ 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 mud-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 govermnent as threatened or endangered? Kerner Blue, Frosted Elfin ❑ RI 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? NO ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: M 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: - . �e qVq Q14� sl zr—Ci 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: n ❑ 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: &w3 tee--&A r,rl, �, ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY I'NTOWLEDGE Applicant/sponsor name; Vi 4V k -ti 1 lJ Date: 1 Signature: PRINT FORM Page 3 of 3 EAF flapper Summary Report Tuesday, June 05, 2018 5:52 PM Disclaimer: The EAF Mapper is a screening tool Intended to assist project sponsors and reviewing agencies In preparing an environmental assessment form(EAF).Not all questions asked in the EAF are " µ answered by the EAF Mapper,Additional Information on any EAF question can be obtained by consulting the EAF Workbooks. Although the EAF Mapper provides the most up-to-date digital data available to DEC,you may also need to contact local or other data sources In order to obtain data not provided by the Mapper,Digital data is not a substitute for agency determinations, VoitV V. r s t 4 tG ,� t `trl v 1 Totcrr5i( { � � RUN�r i ry` f t 89 ticsi� K t� t tnt�€mr�fis(fi l 3� 11Et€T $E3 i� I t - fi t i t adt� ` f� n �il arttn4 ping g�f t=s€t � .r! r, arratri,. ' eeea €t 3rTgiJr end G €€jIfisz� c , F ;Part 1 /Question 7 [Critical Environmental No Area] 'Part 1 /Question 12a [National Register ofNo Historic Places] ...,w_...... Part 1 /Question 12b [Archeological Sites] INo 'Part 1 /Question 13a [Wetlands or Other 'No {Regulated Waterbodies] ;Part 1 /Question 15 [Threatened or =Yes 'Endangered Animal] t ,Part 1 /Question 15 [Threatened or 4Karner Blue, Frosted Elfin Endangered Animal Name] Part 1 /Question 16 [100 Year Flood Plain] Digital mapping data are not available or are incomplete. Refer to EAF , €Workbook. Part 1 /Question 20 [Remediation Site] iYes Short Environmental Assessment Form - EAF Mapper Summary Report 1 3 TIM52 lot s ANT ]RED vw a MR1.low S�xex�a�s Ruad Greex�xeld�enter,,�Tew ' 'N' CCRIN`T`H RC)AID LLC, New'York Lunxtd L ablxty Coman ,wxtli�a_ 2 acie ress of PC►Bc�x 152,Lake( e6rgv,' ;�l it�efilh that the par v the "rst' rxrtino�tsideratxaiQe Ella �� f / � one �f theMR T 1n�ted �' atesr otlr grx�d acd�aa&Ie �ortsxdea�at pcttl of the second part, �lo�es hereby grant r�ndyreleuse unta the�?���ofthe�eco�tpart>�the �'��=` j _. ��;�CT fio any ax�.d al �enfczrceabl�cQ�ve �;coac�.fioxzs,r�sf�c�r ,���ns4= r �-� - K s............................. ,y„ " r � Ig r��-u � �.� � �-- .sa � � _ `°` mac. ��`�,x�.� `r�.W��S �•=�= �� R' � c, 5�_ •�'3 � �r�„, ��' a�_��__�t � �iW�ffgK%5�� �G.�`"` r�ii '�� -ems � ��- i..tlf L Gt ARM� a HIM - d- S YS� Z wME tl7 { 1TS12 Qf caS n IE f'tlze 17ZIYUZeYftG31t he,fas^e xtSzng RYIy11a�f :same"any ath&pularo e. e urard"per"shall be construed.as xfjt reaTh d "parties" wTez�eer the se�afthys � � Uires in in: W'ft.ess here6f,the pasty o,f t�first p� �iids hereurtvv s�t'hs/hr hcnds} attt � V Wro W /L 5f b! lit the, rese ce B� ?arrlC'E'�E'y �� r E g'tJttltl 'of Waiarren R. C}n is day allay 20l 8 befoxe me the ursdersignedrsczialygpeacdCtar�es E. Seeley and Barbara d Seeley;to rn persc� lly known Ux proved tee me Qnh�baszs off v s"atzsfactvey ndence to be the div duals wh- Names are subsea edbtc ie w�thu .��# u � and they aek�imvledg to m tha1k#hey exe�utd the e'ui max capacs, d tax � �� signatures on lie�ns�.�rne�xf,the�td���duals,or the a upon.be�, of�rh�c�.�e�aa .�v�dua�s�� ��� �,� � z - �a j� /(�.r^�1 ''��]jjj'""'''��- .�r'[���(•� °�7•t�'r _ ram` _ t as �- _ wa � c-. � 3l �E�11Ileth C 35` ��j,p(3 .f� [f ¢¢,�,�'[ _ ,Y�r^ _ a .� fYr 3 t�`S, FFvj ,- ;�_ '`'� •s x .. .i �, k _ `1980,SM6, 9. ALL,THAT-PILCL C}R PARC�I,C3g� situate � and 1�ing m�t�he Tom of �7c7om V�afren Gouty New "ork;bounded ar�d descr�bed.jas fel.lo�vs• Cl)�-CIlT at ; A ? Lc4r0/i.AA7 � y _ - �' y�4SLs'' '-- -s k �c c a pvir�t whzch marks the northwest comar prexses MIN,'- ich pout rs inked bn uo�pm uu set in the ground,;conveyed by Ada Sue �ttko to 1cl�ael >Juv�s andMananne Ras,hit , deed dated September 21 97 and recorded in the Wart`en County C1crk s 4cc�nepmberLL } 22, 174 Lrber 526 Deus at pale 07 afd b6"undeiand deshd as 'cows rwn�ngfrom sad iron pm set in the ground north S degrees 6 muautes,west a drstance of 50 feet to an�mn pm s t,inhegoundf smnc idhdges 49rntaci3 t r it ce of1 5�9 7 z fit to an iron pug set xn they gground for a eoxner,raxng thecce southldegre�32xm tesest Zt18.65 feet to an�rorr pxn set fit e ground for a comer°thenice south 7 degrees 49inu es w�`� distancef 158qAg feet to a point aril whichlpoint marks the nr�rth east�corner ofprses conve: ed to 7arvs b Wittko bY the abcive referred deed them n rah$5 deesZf ue� -west a chtance of 1.S9 feet mope or less to fide po�.t br place of l�eg�nr}�ng § � � �; � a a s&` AI..I.r T`I- AT PIECE C?R.I'. t:C�L�flF LAND sztate,l and beui. ii the T©wn oft ueenab Warr Coon New'York baundeo and described as ;follows N NIT— Il at an gran p�nfoundan the grtunt for a corzzer,sand poantxberng locate one n�rfhe�rl� d cif the Glens�a11s Cc�nnth Road and-wluclo marks the sutheasterly corner of the 4prenus�+e�abe thenc ia6i 85 de ees2 minutes west 119 feet alc ng the northerly conveyed heMA;rung = F n side of satct hrghwayknown as the Cxlerrs Fa11s Caznth load;to an iron pset"xn�tTae gr�d-fo drsta ce of 75'feet foam rnripr set a comer, en, e north' .. 49 nut east a � the ound no for arrrer,men-running thence rth 8 clegrs 26 sautes weft dratance of 4tl fe:t�to an uan pm set rn the ground far a corner raaranng thence north 7 degrees ARV— MaINNIMIN mrriutes east a distance of 195 feet to an rron-pin set m the ground for a rcrnW,MO guti8e�grF # - ce 25 mtriu�eseast a drstance of 159 feel more or less to a poXnt on tt��:eas ery�hne ofth�eprses t. herera descnbed,'rtnurxg thth em sou'th?degrees 49 minutes v�Ea dsta�ce �2I feetc�xe less along the easterly'liiae of the premises here�n2 to the postalec of heg , Saad preen us 1.es{are described by a mare modem descr�ptzcn as folios' j �� � ,� . ,�.�'SAT CER.TATN PARCEL QF�� � ,being sxtua.�e ttheTow�o�f t �nsbury� � �. Y Gouty�f"Warren�d Stake o �Iew�'�"ork�aor+e�at�zcuiarly�desib`���as�c�llciws: ��� �.�a ,.� ��� #ltentersectton of ke noiherl bounds of Co 'nthRo�ad�wiw 'tx` ,. �X�`' boun of landsrnc� Tarr formry,of Rchard eeleyerr�Boo f �fI a ,=gam 3 thence fro said csnt cif begnnr� North x° Qf 45'► e3slong th s d no g er1 s , s '"' MW = 1,. 0(1 feet to a oB ce-no erl d westerl. aIo the bo Cornh load, l P Y towor� erly oEMzcbele Sellit% barn per� oak79 ofI ee ds apag 28 , erg � c s MKS l £Yalia4,4 Neu M PM f, Y per,$ook G79 of Deeds� 195.00 feetra anronpPe> aid }Noxtb 814 ++ causes 1}�N�rt4 v eee 11 4' 7 East altnge'easter how e5412 feety a�i' anpp Y und�xcflands zi6�vor fozmexl� -� � � �� Cava.�lari"pex ��o� 14�0 of Dew 5'30„ Eft along theatherly bond la 3 ' a��rc��pPi�adi� 77 €f ds new ormerl of Tb¢o D Nashand fold C. Nash hook 67Q of3eeds ar �.., ��� } ar „_ 121,thenceUll 52 +Iest aI 22 westerly founds aflands rw,®r fo�rmrly cfvrcalegr '� Wig. ` D at page 1 Janney and oareno per BOO, �ecls at a e 268 t{ 4e atp�age amespeBaBk 5028 of D p g : as ellon per 13c ok x170 I Beds t page 78 P rsox B 669 of feeds at page 93� Yanney percaok 28' cif deeds at§ a e 3l 1,13 rag a Pok 369 _- i { k o DeMs at pag 2d1, Baez a�e 29 '7 afl S a page p 93,. a uz ok 1J 4 a Dees at page 2�, lvermallroc8 © Dei ate a �17 � e Aux :. � LL t p_ � QC3876c�f Dew v at page 28$ p'1€�rs p+ vc� 117_lcfl�eedsat�page4'7; ugg�perQ413Oti �aiage 09 Dewitt per�oo�655 o�'�eeds�atrpage 234;and th�frst mentsonec��R�chardR, Seeleyper Book 681 cif"be ds miR a �.'�a z �ci '€` Sr& $ x-.�� �� ar ti� � t�� -_. t _f �•. � ems`""-" �. ass � � p"..�� � ���� 6�'�� F �� �T x- 2 � � � .� £- �.. � �-.>' --:` ram--• 'P` iF � a� --��3...��. .�5srsl � 's � � �s` y r�-a' } sf �a•'� ��;". stu ��,,. , Y _ -x'�n � tya 3 --.� ,`ems �♦. -