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Application
New Business Area Variance No. Review in the month of May 2011 NSB Hos itali LLC d/b/a Rodewav Inn 1449 State Route 9 TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 518-761-8201 Apri118, 2011 ARab (Sam) Bhatti 547 Aviation Road Queensbury, NY 12804 Re: NSB Hospitality, LLC d/b/ Rodeway Inn Building Additions /Decks Tax Map Parcel 288=1-56 Dear Mr. Bhatti: I am writing you with regards to the above-referenced project and to document the recent conversations between your agent; Gary Hughes and Keith Oborne of my office regarding the same, As I understand your Proposal, You wish to construct additions to the office building to include office space, storage and a sign tower as well as additions to one of the motel buildings to include decks, stairs and landing areas. I have reviewed your plans and find tLat Area Variances will be needed for your project ~ P~~ SPecificallY, Yom P work does not meet the minimum property line setbacks of the commercial Intensive; (Cn zone. Further, as the bw'Idings in question are already in violation of the current setback requirements, relief is needed for the expansion of anon-conforming structure. Additionally, Site Plan Review is necessary for yrour proposed changes, Please note our established submittal deadlines when preparing your application materials. Sincerely, Town of Queensbury Craig Brown Zoning Administrator CB/sh Cc: Gary Hughes L:VC1aig &o~vn12011 I.etlas~Deoisl glatfi _ Rodeway Ion 4 I8_i l.doc "HOME OF NATURAL BEAUTY ... A GOOD PLACE TO LIVE° SETTLED 1763 de~~: ~~ .~ ~ . ~~; Area Variance evised June General Information ~~~ °~~ ~ ~~ ~~~ -~ ~- q 1.: _ ~ 'f? Tax Parcel ID Number: 2 28 -! - 56 ~- Zoning District: CI Detailed Description of Project [includes current & Proposed use]: Apra : To PJLDC~ -#-I ~oae~Y OFFtGE Q 229 sF To l,.oa~~ ~<029 SF STa~.gCer mv~1a., Lot3BY $4 SF StCW tcwE:12 4 164 SF ~.C, '2a-ti, 8a 5- C~op7 TOTAL c.. = ~ 5']' S F To FOOT (?.t RR 07J G 1~,0 U u D~ ! k ~ 6 5F T6T/k~t. 2 5T o (Q 1 ~S i_ocation of project: t 5@!1 FT, Sour'K ©F (ZT °~ ~ RT 14~ 1NTEtZS~r1A~J D}~ ~/g5T SIDE of ~ouTE~ q ~:.. ._.~ _.- M ': ,~;:- ~Y v .:' ...._.... _ .. 1 Town of Queensbury • Zoning.office • 7,q2 gay Road • Queensbury, NY 12804 + 518-761-8238 Area Variance Revised June .+ ,~. a ~~ ~A-ST. Front [1 j ~._ ~ Front [2] ,~ A Shoreline -~Io~rN Side Yard [1j ~sd v r ~ Side Yard [2j >>;i/ES7 Rear Yard [1] ' ~ :' Rear Yard [2J `~~ Travel Corridor `~ Height [maxj ~,_ ,. . " ~ Permeability ,~ , o. of parking spaces ~=. ~~. . ~. s_... rt. Site Development Data 75 N~A~ ~l~ 2d 30 25 2 ,S ~~. . 40 3 a ~1 30 31 N~A ~~~ lS l6 Z~ 20 2Q. S 2"i,5 3q 3~ N/!~ N ~~4 12 !6 6~ ~.6 ..'-~ ~' 24,.x" 25.G~ 3y Town. of Queenstnrry • Zoning Office • 742. Bay Road • Queensbury. NY 12804.518-761-8238 ~ 2 , '~:A~nnlTlo~.s Ov~~ 7 Setback Requirements ~ "p~~ ~~~~ '~'~ `` 'Pre-Submission Conference Form f179-4-0401 ~_.~~ 1. Tax Map ID 2 ~ 8 - ~ _ 2: Zoning Classification C Z 3. Reason for Review: y~r 12 (~Kl ~ 5 jo ~,~,~ 1-tT Area Variance Revised JunE < 4. Zoning Section #: --5. Pre-Submission Meeting Notes; Outstandin g Items To Be Addres ed Include: r~'~ - ~ ~. ~ Deed General Information complete --~ Yew No ~~ ~'' Site Development Data Complete s Yes No Setback Requirements Complete Yes No Additional Project Information Complete FAR addressed Yes No Compliance with Zoning Ordinance Yes Yes No No Checklist items addressed Yes No Environmental Form completed Signature Pa e com l t d Yes No . g p e e Yes No .. ~ - ~SI~N~itf~= ~,~4Gy t::~ ~ :~= yam. ~L~vG~9-TiOiU ~~iC~_pv~ :.'s; ~'<. ,~ .: y._< . x:Staff Representative: 6cant / !°-PP Agent: !'"'~ Date: rte. Town of Queensbury • Zoning Office.. 742 Bay Road • Queensbury~ NY 12804.51&761-8238 6 WARREN COUNTYpocUME:NT~ 40QQ2363 PAMELA J. VOG~~IUME= 422[li PAGE= 296 COUNTY CLERK ~~ ~ Lake George, NY 12845 E, zolt ~ Volm-4220 Pg-296 Instrument Number: 2011- 00002363 As Recorded On: March 21, 2011 Deed Commercial or Vacant Parties: TARIQ MOHAMMAD To NSB HOSPITALITY LLC Billable Pages: 2 Recorded By: STANCLIFT LUDEMANN 8r MCMORRIS Num Of Pages: 3 Comment: "* Examined and Charged as Follows: ** Geed Commercial or Vacant 50.00 Cover Page 5.00 RP-5217 Commercial 250.00 TP•564 Recording Charge: Transfer Tax QUEENSBURY Tax Charge 0.00 0.00 Special Additional 0.00 Transfer RECORDED County Clerks Office Mar 71,3011 04-;iP Parela J. Vosel Marren Cotmty Clerk 0.00 6,000.00 ** 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: 2011- 00002363 MATT LUDEMANN Receipt Number: 204620 PO BOX 2844 Recorded Date/Time: March 21, 2011 02:41:43P GLENS FALLS NY 12801 Book-VoI/Pg: Bk-RP VI-4220 Pg-296 Cashier /Station: s slater 1 Cash Station 1 5.00 310.00 Consideration Amount Amount RS#/CS# 6,000.00 1,500,000.00 TT 1468 Basic Local Additional 6,000.00 ~4('' DpCUMEMT~ 04002363 VOLUME: 4220 PAGE: 297 ~~~ WARRANTY DEED WITH LIEN COVENANT C~~~" ~ ~~ v~ THIS INDENTURE, made the 17`s day of March, Two Thousand Eleven, + ~ BETWEEN MOHAMMAD TARIQ, having an address at 1449 State Route 9, Lake George, New York 12845, /~i party of the first part, and -~ - NSB HOSPITALITY LLC, a New York State limited liability company, ~G having offices at 547 Aviation Road, Queensbury, New York 12804, U C ~ party of the second part, ;~7~ ! WITNESSETH, that the party of the first part, in consideration of One and 00!100 Dollars / ($1.00) lawful money of the United States and other good and valuable consideration paid by the party of the second part, does hereby grant and release unto the party of the second part, his heirs and assigns forever, ALL THAT CERTAIN PARCEL OF LAND, situate in the Town of Queensbury, Warren County, New York, located on the westerly side of New York U. S. Route 9, in said town, and which parcel is bounded and described as follows: BEGINNING at a point in the westerly bounds of New York U.S. Route 9 at the northeasterly corner of lands now or formerly of Hol-Car Enterprises, Inc., being also the southeasterly corner of lands now or formerly of Jessie and Mabel S. McKee; running thence from the place of beginning, S 33 degrees 15' 21" W along the westerly line of New York U.S. Route 9, for a distance of 150 feet; thence S 68 degrees 30' 39" W for a distance of 309.14 feet; thence N 33 degrees 15' 21" E, parallel to the westerly bounds of New York U.S. Route 9, for a distance of 150 feet; thence S 68 degrees 29' E, and along the southerly line of said lands now or formerly of McKee, for a distance of 63.11 feet to an angle point therein; thence S 68 degrees 08' E for a distance of 84.01 feet to another angle point in said southerly line; thence S 68 degrees 43 E, along said southerly line, for a distance of 162.02 feet to the place of beginning, and containing 1.04 acres. Said parcel being more modernly described as follows: ALL THAT CERTAIN PARCEL OF LAND situate, lying and being in the Town of Queensbury, County of Warren, State of New York, more particularly described as follows: BEGINNING at the southeast corner of lands now or formerly of Basketville of Lake George, Inc. [675/729] being the northeast corner of the parcel being conveyed herein; Said point being on the westerly side of the New York State Route 9 proceeding thence the following three courses along the western boundary of New York State Route 9; South 29 degrees 45 minutes 15 seconds West 59.78 feet; thence North 59 degrees 26 minutes OS seconds West 5.90 feet; thence South 29 degrees 00 minutes 35 seconds West through a New York State right of way marker 90.67 feet to a corner; thence proceeding North 71 degrees O1 minutes 00 seconds West 300.95 feet to a capped iron rod for a corner; thence North 30 degrees 45 minutes 00 seconds East 150 feet for a corner; thence South 70 degrees 59 minutes 20 seconds East 63.11 feet; thence South 70 degrees 38 minutes 20 seconds East 84.01 feet to a Bathey marker; thence South 71 degrees 13 minutes 20 seconds East 155.98 feet to the point and place of beginning. SUBJECT to aRight-of--Way and Easement granted to the Town of Queensbury and recorded in the Warren County Clerk's Office on October 28, 2003 in Book 1348 of Deeds at Page 121. DOCUMENT 00002363 VOLUME: 4220 PAGE. 298 TOGETHER with the appurtenances and all 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, his heirs and assigns forever, And said party of the first part covenants as follows: FIRST, that the party of the second part shall quietly enjoy the said premises; SECOND, that the said party of the first part will forever WARRANT the title to said premises. THIRD, that incompliance with Section 13 of the Lien Law, the party of the first part shall receive the consideration for this conveyance and shall hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and shall apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. IN WITNESS WHEREOF, the party of the first part has hereunto set his hand and seal the day and year first above written. IN PRESENCE OF ~~~ L.S. HAMMAD T STATE OF NEW YORK ) COUNTY OF WA On this day of March in the year 2011, before me, the undersigned, a Notary Public in a d for said state, personally appeared MOHAMMAD TARIQ, personally known to me or provided to me on the basis of 's act ry evidence to be the individual whose name is subscribed to the within instrument and a owledged to me that he executed the same in his capacity, and that by his signature on t e instnunent individual, or the person upon behalf of which the individual acted, a cuted i ru nt. (! l ~ ,. ,,_ RODNEY C. POWIS Notary Public, State of New York pu811fied In Rensselaer Courriy No.02P05078798 Commiesbn Expires June 02, 20 Q n i \~~ . Q ~ ~ , .' ~ ~ ~5~ I ':, ~,'. 'Jl r' :s. L~J ~ + Area Variance Revised June 2009 AREA VARIANCE 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 dav. Call (518) 761-8238 for appointment. 2) Submittal of complete application: 7 original & 74 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 anv agenda until all missing information has been supplied. 5) Submittal to the Warren County Planning Board, if applicable. 6) Zoning Board meeting, generally the. third and fourth Wednesday 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 plans/drawings must be provided for the next phase of review. If your application was denied your project cannot proceed as submitted. DOCUMENTATION REQUIREMENTS: (-'lease submit 1 original and 14 copies of the completed application package to include: ` Completed Application: pages 1-9 completed, signed & dated • Pre-Submission Meeting Notes: signed by staff • Denial Letter: from the Zoning Administrator • Waiver Request: any request for a waiver from the applicant regarding submission requirements. • Copy of Deed • Survey: stamped, dated & signed • Fee ZONING STAFF & CONTACT INFORMATION Craig Brown, Zoning Administrator craigb(c~gueensbury.net Keith Oborne, Land Use Planner keithoC~gueensbur Sue Hemingway, Office Specialist (518) 761-8238 Visit our website at www.gueensburv.net for further information and forms. Town of Queensbury • Zoning Office • 742 Bay Road •Queensbury, NY 12804 •518-76.1-8238 ~ Area Variance Revised June 2009 General Information Tax Parcel ID Number: 228-L -56 Zoning District: CI Detailed Description of Project [includes current & proposed use]: +4P1~ : Tn b~~G -#I LoOeY 9Ft=iG!/ Q 229 5F To Lo~rSrt ©CoZq SF STo~2~Gi: mv~ LOn~Y (~ 84 SF StCti '1"o-w~12,~ ®t64 5F 4},G 1Z,~.w, go SF C~¢n~op-f TOra~ = 557 SF To t=o0-rPfz~~trr (oU CRovND) It~6 S'F TbT,drl.. 2 SToWt~s Location of project: t Sea FT, Sourt~ of (ZT `~ ~ R7 t4q INT~SECTto-~ 01.{ WEST SIDE of ~OUTL?' ~. '`AvD; ~'o &~G #3 (Mo~~., UuI-r ~17~~ sFvEctcs ©2.~~s~ sr~»z-s~ L~-N~t-~cs, ~~,, 3 3 2 sf C~c w~~ tc "-'~~ 'ToTa~ = Ila6 sF To roor Pi2,iu7 0-~ C-r~.ouNn 2og4 SF ToTti~ 2 STBtt,ll?5 . ~:. r.:,, ., ,. ~:. . Town of Queensbury • Zoning Office - 742 Bay Road • Queensbury, NY 12804.518-761-8238 1 k'`', 3, Area Variance Revised June 2009 Site Development Data ~ ~N,~ ~ Area / ;Try ~~ _ ~~ ~'. r f~~ ~~w~~ , ] `~`s i ` n ~,¢, ~3 ~ ~ ~ ] """ ~A. Building footprint ~~ 74s4 B. Detached Garage N~ C. Accessory Structure(s) ~~~ D. Paved, gravel or other hard surtaced area `Z 1 5) 0 E. Porches /Decks N C R ~~ ,231 S ~ . p F. Other I $5¢ a G. Total Non-Permeable [Add A-F] 328( .H. Parcel Area [43,560 sq. ft. /acre] 4 3~`i(o I. Percentage of Impermeable Area of Site [I=G/H] 7~0 74, ~ ~o Setback Requirements '~ 224 sr Lar~~ey ~ ~ N ~4 N ~4 ~ ~- ~ 'L151 ~ 11.6 5r ~c~s 3!o'7Qj SF ~~ N//~ 1554 ~ 8o st= Cek No~7 S l 1 °I ~ --~ ~ 4 0~2 439q~ 11-10 .02'718 ; 7`742. 2,7 a `7.7.4 a ~" = ~+~A l T I o NS ©Yt~ 1 H~E1? I~~~cBL~ ~121:~45 ~S5"( S~) 1'L~frST. Front [1] ~~ ' ~ 5 5 ,~ 20.E ~~:~ Front [2] ::, ~ /A N~A ~~~ 'C~ A Shoreline ~ll/~ ~~A N~~ 'Ne~,rN Side Yard [1] 2d 18.E 12q S.o u r ~ Side Yard [2] ~Q l 6 16 ~~~~, Vt/ES7 Rear Yard [1] 25 2 ~ G S. S Rear Yard [2] ~ S 20 H~.7 Travel Corridor Height [max] ~ D 2Q. S 24,x" Permeability 4 ~ 25.3 ~ 2 . (i r/a -No. of parking spaces 30 3q 39 '~ " Town of Queensbury • Zoning Office • 742 Bay Road •Queensbury, NY 12804.518-761-8238 z Area Variance Revised June 2009 .Additional Project Information 1. Will the proposal require a Septic Variance from the Town Board of Health? N 6 2. If the parcel has previous approvals, list application number(s): S F' l q - 0 9 3. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Program? Ida 4. Estimated project duration: Start Date q - IZ- I i ± End Date ~ ~ ! 4 -12 ± 5. Estimated total cost of project: __250, Oao, 6. Total area of land disturbance for project: ~9 3'7 sF Floor Area Ratio Worksheet FLOOR AREA RATIO (FAR) -- The relationship of building size to lot size, derived by dividing the total building floor area by the lot size in square feet, yielding a percentage. `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 ARFr4 RATIO"). .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 3 °I °I rv s . ft. Existin Floor Area ! 3 2 s . ft. see above definition `€'ro osed Additional Floor Area 2 s . ft. 'Proposed Total Floor Area l G 2'15 s . ft. Total Allowable Floor Area 13 I Area x O.3 see above table °' `~~~1~0 Town of Queensbury • Zoning Office • 742 Bay Road •Queensbury, NY 12804.518-761-8238 3 Area Variance Revised June 2009 Compliance with Zoning Ordinance - Requesting relief from SECTION: / /~'~-QyZ~ ;Need relief from the requirement(s) listed below which can not be met by the project as proposed. `- (Check all that apply] ®Setba ck ~ Buffer Zone ~ Lot Width ~ Other 1"he 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? n ~ ~ N ~ E s l 2 ~4C31.~ c~+~ r~ c, E s cu rc.L U~' ~+2o.Du.cE~ ~ nr ~-~c; C !-~ ~ ~4GT~ o F TN'!/ 1~ 61 G ~~- ~61~ ~p~ ~G~ S ~ (~/ !~ ~7' l S C~~ I I~ G ~~ E70 ~a'i2, k 5 C,A7~1S 157 X17 c,~ I -~" i-i -~-N-~" C I ~4'fz,.~"~ ~{2-cr~.~ til P. ~. 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? ~~ Q • ~tti E/ T~ C (~cl~J C,. ~5 O V ~-1L T~'E `-(~-~ I N SET~3~4GK.,, ~ i ~~b~ 12~@.ui I ~ Chu ~-~y-Cs ~kC O~J LK 1=0151 ~c,E TNT N G Ta ~ I s To ~ Slc, ~I'lli ~.1-i C-1= T o $~ ~3~,E" T~ u ~ ~-r4-~C ~ .~ ig pl2 oV~ , 3. Whether the requested area variance is substantial? N o , ~= T14-3 .~_. ot= f~e.~-~- '~-Q~ i f2E- M E1~.LTs SH-r, a ~ r4 _ T ~ ~t -r cr:a I ti ~- ~ F ~Z~ ~ ~ ~ ~ -~ ~~i~c7 w N-~ c ~ A-v~.~-= ~M < ~- ~- 4. Whether the proposed variance will have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district? T ~~; ccl ~~c, ~3~ No ~-~yc~s~ L~=t=~2-rs T3~c~-~c sE -(1-(~ r f ~ o ~ ~ ~ S t b~ S = 12 v ~"1~t, ~'-~.k'i' S I L.t/ ~ - I Y ©y ~ ~x~ s-r I ~ ~ N E~t2M ~ l~ ~~~ ~ ~4-~, M65 i ~~z ~, 5. Whether the alleged difriculty was self-created? 6 ~ rtN1~ ~C.I,CC ~ ~ I ICI C U l..T~ (,t~ f~3 ~rL~ t2,.~-`Cd~D Town of Queensbury • Zoning Office • 742 Bay Road •Queensbury, NY 12804 + 518-761-8238. 4 Area Variance Revised June 2009 Submittal of a stamped and signed SURVEY MAP depicting existing and proposed conditions shall include the items as noted below. .~i a N `y 4 ;~'ti ~yl ~ .,fir T„~ 1 Title, Name, Address of applicant & person responsible for re r ti ~' p pa a on of drawing 2 Deed /~ ~ 3 North arrow, Tax Map ID date prepared and sc l i i ~ , a e [m n mum 11n. = 40 ft.] 4 Boundaries of the property plotted to scale z i b , on ng oundary 5. Principal structures accessory structures with t ri di I , ex e or mensions 1 6 Site improvements inc outdoor stor J . age areas, driveways, parking areas, etc.: exisfln & ro osed 9_P P 7 Setbacks for ali structures and improvements: i ti & ex s ng proposed 8 Elevations and floor plans of all proposed and affected structures I . 2 r 8 B_ .;~ . , ~Y ~~y 5!I 1 Project sewage disposal faahhes design details const ti d ~ ' , , ruc on etails, flow rates, and number of bedrooms proposed 2 Water sup l [i e ll & p y . . we ] septic on adjoining lots with separation distances to existing or proposed on~ite water supply and se tic 3 Separation distances for proposed sewa e di l g sposa system to well and water bodies ;~ 4 Existing public or private water supply [well, lake, etc.]. Method of securin construction of water su I indudin datl water usa e 9 public or private water, location, design and I 5 Percolation test location and results ;~ ~ .~ ~ N/~ ~ 1. Number of spaces required for project induding calculations and justification: existing & proposed ::-2 No. of existin arkin s aces numbe t b I , r o e removed, number to mafitaln and a of surfadn material e.., ravel, aved 3 Provision for pedestrian and handicap access and parkin : exi ti & g s ng proposed 4 Design details of ingress egress loading areas and tti , , cu ng: existing & proposed 5 Location and characte f f . r o green areas [existing and proposed], modification to green area, buffer zone to remain undisturbed 6 Lighting, location and design of all existin and o d g pr pose outdoor lighting p .; , 2 _ 8 c 1 On-site &~adjacent watercourses, streams, rivers, lake and wetlands `2 Utili ~/~ ty /energy distribution system [gas, electric, solar, telephone]: existing proposed 3 Location, design and construction details f ll i i I o a ex st ng and proposed site improvements induding: drains, culverts, retaining walls, fences, fire & emergency zones and h drants t y , e c. ' 4 Square footage of bld ' g. area proposed for office, manufacturing, retail sales or other commeraal activities: existing & ,; ro osed =e• Signage: Location, size, type, design and setback: existing & proposed -> ~- f_ Waiver Request: provide letter with application requesting any waivers: please reference spedfic items ~ ~2 LEl'~"Cl2 g Commercial/Industrial Development requires submission of Landscaping, Stormwater Management, Grading & Lighting Plans ~E T h Identification of Federal, State or County permits required for the project together with a record of application for ali necessary ermits TY N /F Town of Queensbury • Zoning Office • 742 Bay Road •Queensbury, NY 12804 •518-761-8238 5 Area Variance Revised June 200 Pre-Submission Conference Form (179-4-0401 1. Tax Map ID 2. ~ ~j - 2. Zoning Classification C 1 3. Reason for Review: Vr~s 121 ~~lJ CE" 5 cJ0 t,(,Cz I-t"i': 4. Zoning Section #: -5. Pre-Submission Meeting Notes; Outstanding Items To Be Addres ed Include: >; ~" ;.- Deed General Information complete Yes ~ Yes ~No No _ Site Development Data Complete Yes No Setback Requirements Complete Yes No Additional Project Information Complete F Yes No AR addressed Yes No Compliance with Zoning Ordinance Yes No - Checklist items addressed Yes No Environmental Form completed Signature Pa e l t Yes No ~ g comp e ed Yes No J~f'fUlt~-L L ~5~G-N~IiU~ ~::~ A~2~9i~ u~ ~:.:: `~ G9Gc ~;..: -a: /. j iD~l! _pv~-, ;.Staff Representative: Applicant /Agent: ~/(,~,,~ . Date: ~ ~~ Town of Queensbury • Zoning Office • 742 Bay Road •Queensbury, NY 12804.518-761-8238 6 ~~~r Area Variance Revised June 2009 1416-4 (11!95)-Tent 12 PROJECT f.0. NUMBER 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM PART l--PROJECT INFORMATION For UNLISTED ACTIONS Only (To be completed by Applicant or Project sponsor) 1. APPLICANT ?SPONSOR ~TA~Y3 (~-IUMY 1 g~' }~'T'(i 2. PROJECT NAME ~OD~'~~ =N}~ 3. PROJECT LOCATION• / 1...~ . ;': MunicipaNty lY~c ~V ~J' ~(,~,~„`'{ ~~ ~ A /~~ 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map! ~ ~ $9 ST~r-t'E ~1' ~ ~ ~.1E'~'I~1513k12~1~ ~~`'~ 2 ~•~p 202d SF ~EGKS~ST/c1(2.3 ~ ~,-~C~. #3 7. AMOUNT OF LAND AFFECTEa SEAR 5. IS PROPOSED ACTION: ^New ®Expansion ^Modification/alteraUOn 6 DESCRIBE PROJECT BRIEFLY ~~D To ~.t57tn~G Lo~,13Y~ N,~ SIGf~i Ttn~Er2, H.C.. 2~~~ ~oP`( d B. WIII~~LL PROPOSED ACTION COMPLY WFTH ExISitNG ZONING OR OTHER t7tISTING LAND USE RESTRICTIONS? ro.Yes ^ No If No, describe briefly WHAT IS PRESENT LAND USE IN VIGNITY OF PROJECT? ^ ReaidenUal ^Induatrlal ®Commeroial [] g4rbultur9 ^ park/ForesUODen apace ^ Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAy? ^Yes ®,No If yes, Ilet apency(s) and permlUapprovals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ^Yes ~No if yes, list agency name and perm(Uapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMR/APPROVAL AEOUIRE MODIFICATION? ^Yes ~.NO i CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApplicanUsponsor name: Ip ~•~'(,( ~' {-{~~ ~ _/1 !' I / Date: ~J Signature: ~ ~~~ `~'1F'u: L~iA~ If the action is in the Coastai Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment• OVER 1 Town of Queensbury • Zoning Office • 742 Bay Road •Queensbury, NY 12804 •518-761-8238 ~ Area Variance Revised June 2009 PART 11--ENV)RONMENTAL ASSESSMENT (To be completed by Agency) ' A. DOES ACTION EiX~CEED ANY TYPE t THRESHOLD IN 6 NYCRR PART 617.d9 If yes, coordinate the review process and use the FULL EAF. ^ Yes i,al No B. WILL ACTION RECEIVE COORDINATED gEV1EW AS PROVIDED FOR UNLISTED ACTIONS IN 8 NYCRR, PART 617.69 ii No, a negative declaration may de superseded by another involved agency. ^ Yes ~ Ho C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be Handwritten, (f legible) Ct. Existing air quality, surface or groundwater quality or uand potential for erosion, dra(nage or (loodin q tY. noise levels, existing traffic paftsms, solid waste production or disposal, '~A - ' ^ g problemal Explain briefly: ~Q G(-~-~C ~5 C2. Aesthetic agricultural, archaeologkal, historic, or other natural or cultural resources; or community or neighbortwod character? Explain briefly: Na . C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered apecles? Explain briefly: Na Cd. A cllom'' munltys existing plans a goals as officially adopted, or a change in use orlntenairy of use of land or other natural resources? Explain briefly I~ Q C5. Growth, subsequsnt devebpmeny or related activities likely to.Oe Induced by the proposed action? Explain briefly. d C6. Lonq term, short term, eumulatlve, or other effects not identified in C1-C59 Explain briefly. Q C7. Other Impacts (Including changes (n use of either quantity or type of energy)T Explain briefly. No D, WILL THE PROJtEo1CT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERUT(CS THAT CAUSED THE ESTABLISHMENT OF A CEAT ^ Yea lot No E. IS THERE. Op t3 THERE LIKELY TO BE, CONTROVERSY RELATED TO P07ENTIAL ADVERSE ENVIRONMENTAL lMPACTS9 ^ Yes ~ No if Yes, explain briefly PART Ill-DETERMINATION OF SIGNIFICANCE Cro be completed by Agency) INSTRUCTIONS: Fw each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed In connection with its (a) setting (t.e, urban or rarely (b) probability of .occurring; (c) duration; (d) Irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachntenta or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination and signiftcanoe must evaluate the potential impact of the proposed action on tfie environmental charectertstics of the CEA. ^ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a poslt(ve declaration. ^ Check this box l f 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 AND provide on attachments as necessary, the reasons supporting this determination: Name o Lea Agency Print or YPe ame o Respons' e O icer in Lea gency tt O capons ! ICH Signature o esponsi a cur in Lea Agency , gnature reparcr (I ~ ercnt rom response e o icer Date 2 Town of Queensbury • Zoning Office • 742 Bay Road •Queensbury, NY 12804 •518-761-8238 8 Area Variance Revised June 2009 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. nl.....-.,r., w..~..-..-_. ~••••~•~ v r-•v ~~~^ ^ VRIYI. Complete the following if the OWNER of the property is not the same as the applicant Owner: ~ 1= T~[3 `S.p~cu Wt K ~~-l{4T"? ~ Designates: C ~r 12`{ ~-~,~ ~,(. ~ As agent regarding: / Variance Site Plan Subdivision For Tax Map No.: 2.zf3 Section ~_ Block 5~o 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 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 mstrucfions for submission and agree to the submission requirements, I acknowledge no construction activities shall be commenced I~. prior to issuance of a valid permit. I certify that the application, plans and supporting materials are a true and complete ;~ ~tatement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the ~,-a{~proved 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 ~-licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy I have read and agree to the above. ~}~ , Sl nature [ pplicant] Pnnt Name [Applicant) Date signed G~12~ ~A~~~ 4-e-i I Signat re [A nt] Print Name [Agent] Date signed Town of Queensbury • Zoning Office • 742 Bay Road •Queensbury, NY 12804.518-761-8238 ~ 9 AF-r~~, __. .a._. _ -- _ ~ _ i 1 . _____ -- ~~~~~r~~r)_ ~c~~TTt . c~~~~ ........_ .... ........ .......... _ _ _ _ _ ___ __ __ _ To ~ ~ ~ __ "~. c~ r I !~ G _ O ~~~~~- f t~ _t~~3`t ~_L_o ~c ~,,u_--r~-! _ _ _ _ ~ L ~ o ~'-~-~ ~ ~ ~ l S ~ ~._ i ~ ~ ~~ c~,. ~ ~ ~ 1--~- awl, ~ l C ~~ __ ~_'~-~~c,t~a-t s+~- 12~~,c,~_~~-c-`~-'.~~_ T~±r--s~~-. ,~.vr~~°ri~ ~ _ _~ _ __ _ .................-.............. _ _ New "~~~.e~ ?-~__ /~~c~~s _ C~..~ot~~T~ ~o ;_ Cn _ _ ,----. __ __ _ oa~~.-- ___ __ _ _ ___ __ _ ___ ___ __ _ ____ _ _ ~r+~~ ___a.~~ _c-~o~vc.~_p-- -~.~ 1~ ~ ~E~ ~ r., c S~Y~,t~.Tt~S~.4 __ _ ~3l~ Cam 1 ~F ~ _ __ ~- _ _ -- . __ _ _ _ __ __ _ ___ - - _ __ ~.. ~ ~°~ _ ~4 ~~~-r _ Qty ~1~~--~-~- --fix ~ ~-~-~r ~.~~ L~~,~- C~a~ ~_~ av~~., ~_xf5~t.«~_ you --_~'~__I'4:,4~ce.~' ~u~~~~~s ~r4GE 2 GF _ _ _ ......... ......... _ __ _ _ ................._.. __ _ c,l--~ ~~ C ~' T~4 ~' I~~wt ~ ~ .,°~ o ~___ 'J~-~ ~. _r/ xl sYrr ~ c __ _ _ tN ~ ~~_ err QV ~S2 _ _~~t~~r'J r~c~ ~t~v_~~ ~Cm~,~c~~~r~.~ _ _ _ _ _ __ ~ __. ,_ _ - ~~ ~_ _ _ ~/1~~4~t ~~ --~"0 12 ~,---t_ _ -3-~-Jr_t~ ._ ~Q_urc~t ~._ _ -- _ ____ _ _. _. _ ~'J~4G~ f j p ~ S r C'-~rn_ _-- -kU~~ v ~-~a„ - __ - _. _. _.._ ~ ~ i ~ r+s.. ~~J.~ ' °.4..e.._ ! 4t ,. j. ~F/ {...! / 1~~,4, b-.._ ~ riJ._t`~Y~t~.s~ . -.. _ _- _ __ _ L.ac~,~ _C .._ ............... ~,4 ____ _ __ ._ _ J L..L C~ ~-~" f [~_G ~~ k cwt ~ _ O. N._ _ ~ ~~ 2 `~rf't~,t,~ __ :: r~o i~r ~ ~ Mpg ~~rn~r image, 4uux4vu pixeis~ nttp:nprogressngntmg.com/rrocilmagesi4vv~YJ6 ~4 s i.~pg of 1 4/28/2009 1:26 PM `~ U ~ 6"t" S l(~/~ i 1t-~ ~ t~ ~~~,~~, ~ 1.,~ 1.... ~ ~~ CJ ~C~ ~ , ;: '~ - ~-O`~ ~ Incandescent 5" Cylinders Outdoor Wall Mount Type -20 -30 -31 -82 P5674 ^ ^ ^ ^ P5675 ^ ^ ^ ^ Finish Metallic Dimensions (Inches) Catalog No. Bronze White Black Gray Lamping A B C D P5674 -20 -30 -31 -82 1-75w PAR30, 5 7-1/4 8 2-1/2 65w BR30 P5675 -20 -30 -31 -82 2-75w PAR30 5 14 8 7 A P5674 Progress lighting 701 Millennium Blvd. Greenville, South Carolina 29607 TT v 1~ C I ,~ .1 P5675 Specifications: General • Extruded aluminum ,125 wall thickness one piece cylinder • Cast aluminum wall bracket • P5674 -Down lighting • P5675 - Up/Down lighting. P8799-31 top cover lens recommended when unit is used outdoors • Interior finish matches exterior finish M un in • Covers any outlet box • Cast mounting bracket is 4-1/2" square • Outlet box mounting bracket supplied permitting attachment of unit to wall with one almost invisible set screw Electrical • Medium base porcelain socket with nickel plated brass screw shell in • Bronze finish -specify "20" suffix • White finish -specify "30" suffix • Black finish -specify "31 "suffix • Metallic Gray finish -specify "82" suffix Accessories • P8799-31 Top lens cover for P5675 fixture La lin • UL-CUL wet location listed - P5674 and P5675 with top cover • P5675 UL-CUL listed for indoor use with no cover Rev. 1 /04 www. progresslig hting.com ®~~' '1~/ ~ L L S WFIA7 ARE THEY? Dry wells are open-ended concrete cylinders with openings in the walls. They are similar to infiltration trenches but smaller with inflow from pipe; commonly covered with soil and used for drainage areas of less than 1 acre. They are designed exclusively to accept rooftop runoff from residential and commercial buildings. CAN I U5E A DRY WELL FOR MY PROJECT? As with infiltration trenches, the use of dry wells is severely restricted 6y soils, water table, slope and contributing area conditions. Dry wells must be situated a minimum of ten feet away from the building foundation. Rooftop gutter screens should be installed to trap any particles, leaves and other debris from entering the dry well and clogging soils. HOW MUCH WILL IT C05T? The cost of a dry well is higher than the use of vegetative buffers, grass swales and filter strips. Dry wells average between $900 and $1,40D. -, , _..~ _ _ __ .. _~ ~~ ~ Ream - ~ ~ ~ ~ Pond i B/aodl ~ _ - _ _ r - ---- - - _ _____ ty hER Bwr • _. - - - _ - RD ~1 CUTOFF RD ~ ~ p~rK ~ I . 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