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Application
New Business Sign Variance No. Review in the month of May 2011 TCT Federal Credit Union 9 Hunterbrook Lane Proposed construction freestanding sign. Relief requested from maximum height restrictions. TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 518-761-8201 April 8, 2411 TCT Credit Union 416 Rowland St Ballston Spa, NY 12020 RE: TCT Glredit Union 9 Bunter Brook Lane, Queensbury Tax Map Parcel No: 289.IS-I 3 Dear TCT Credit Union: I am writing to you in response to my review of your proposal for a new freestanding sign at the above-referenced. property. The proposed freestanding sign will require a'Sign Variance from our Zoning Board of Appeals. Specifically, your proposed sign does not comply with the maximum allowable height restriction .for such a sign I understand that you and your contractor, Saratoga Sign Pro's Inc. are preparing the. necessary application materials for this project. Please note our established submittal deadline and pre-submission meeting requirements when preparing your papers. Should you have any questions regarding the above comments, please do not hesitate to contact this office. Sincerely, Town f Queensbury Craig Brown Zoning Administrator Cc: Saratoga Sign Pro's Inc. CB/sh L:~Craig Bmwn~2011 I~eltas~Deniai'rCl' G~edit Union 4 8 I l.doc "HOME OF NATURAL BEAUTY ... A GOOD PLACE TO LIVE° SETTLED 1763 _ ~~- x ~. ~; ~N~~ . General Information Tax Parcel ID Number: 2 $ 9, ~ S - ~ -'~ Zoning District: ~ O Detailed Description/~of Project [includes current & Proposed use]: Location of project: cI hf uti fir IQr~ Sign Variance. Revised June 2009 ~ n o~ Town of Queensbury • Zoning Office • 742 Bay Road • Queensbury, NY 12804.518-761-8238 1 ~- ~, r ;_ . " ~- ,, A k~ /, Pre-Submission Conference Form 179-4-pop Sign Variance Revised June 2009 1. Tax Map ID ~9/s 2. Zoning Classification (~ 3. Reason for Review: ~ V, ~~ 4• Zoning Section #: ~-~~~~ ~ y~ 9• Pre-Submission Meeting Notes; Outstanding Items To Be A ddr Deed es ed Includ e. General information complete ~ Yes ~No Site Development Data Complete Yes Setback Requirements Complete ~ Yes No No Compliance with Sign Ordinance Yes No Checklist items addressed Yes No Environmental Form completed. Yes No Signature Page completed Yes No Yes No I D ~/NTi ~ Si•9~f-= ~c/i~~,c~ Staff Representative: Applicant /Agent: Date: ~.. ~ ~~, p T ~~ Town of Queensbury • Zoning Office • 742 Bay Road • Queensbury, NY 12804.518-761-8238 6 518-584-1111 Fax 518-587-5094 595 Grand Avenue Saratoga Springs, NY12866 04/03/11 Town of Queensbury Zoning Board The TCT Credit Union Queensbury location has an existing freestanding sign which is located close to the building entrance. It does not provide adequate visibility to traffic and uses an outdated version of the logo graphic and text. All four TCT Credit Union locations have been or are in the process of being re-imaged with this design which was created to conform to all four local ordinances. The desired location for the new Queensbury property sign received a setback variance on February 23, 201 1. While in the process of completing the original application, it was noted that the maximum height in the O zone was reduced from 12 ft to 6 ft. by action of the Town Boazd on Dec. 6~`. Under advisement of the Town Planning Department, the original application did not include a request for height relief. It is now their determination that such relief is necessary in order to proceed with the previously approved sign. We are requesting relief of 28" from the required 72" maximum height in this zone for a total sign height of 100". This will allow the originally proposed design to be used consistently at all TCT branches and permit adequate visibility during winter months when snow banks block up to 4 ft of the sign. Thank you for your consideration, Sincerely, Judy Frolish President www. saratogasignpros.com Queensbury OfFice -_. N solid aluminum face with translucent acrylic letters, push thru style each face 27 sq. ft total height above grade 8'4" SARATOGA SAN PR05 INC. Drawing properly of ~' GRAMD ~ Saratoga Sign Pro's, Inc. SARATOGA SPRINGS, NY 12.866 ,,~ ~,,, Unauthorized reproduction or use Ph. (518)584-1111 Fx. (518)587-5094 is strictly prohibited. ©2010 Internally illuminated cabinet, double faced, s'sIS nom ~~~~~~ Mdde the .~~ day of ________, 1994 •~~ H'"~ ~~Z 4 R C 7/- B~R$N ~Y assoczaT$s, a partnership having the Town og' Queensbury, county of warren and St York,, party of the first Part, and (ices in of New 146 T~ FERAL CREDIT vrRON, with offices located ~at Route ~ oWn of CliSton Park, county of Saratoga and Sta a of New York, Party of the second part considWerTg~ion~f One aDtollar Party o2 the first art, in States, and other good and va11ua0ble ~ s anon®y of a Zlnited party of the second part, does her eration pa'd by the the party of the second art °bY grant and rele se unto . P 'their heirs aAd.assigns orever, Ate' THAT CERTAA~i PIECE OR PARCEL OF LilND situat! , 3~ ~~ ev York, drs °f Uueensbury, county of ida~ren y~q gaated as Lot ~4 as shown on aicertaan map entitled "Cross Roads Park° draum ~ Rourke Associates, L. L. s, and dated Apr~:l 24, 1989 and lastfrevised July 29, 1989, filed in the~Warren County Clerks o~gice on August 30,'1989: ~. land asII se fo~eQnrp~~i~ti~ its that shall ruts recorded September 22, 1989 in dated September 21, Office in Book 7b9 of •Deeds at a the Warren County P 9s 205_ BEING a portion of the lilssociates by BRB Gro b premises conveyed recorded AugL16t 1, 1988 p n Booke T19dof~ July 29, i Deeds at page SZ7&7'8CT to all easements, restrictions or other set forth ort the above-refer~ced ~anp, including 7 limited to a 2A foot wide drainage easement shown on a running along the Southerly bounds of Lot #~4 a~ the no bounds of Lot ¢5_ part ~ ~ s~ ad ~~ the premises herein granted of the P~tY of the se~con ~ art ire •or successors and • P torever_ 141~TD said party of the .first part covenants as fi • FIRST, That the party of the Second part shall enjoy the said premises; SECONO, That said party of the first part will NT the title to said preaise6_ the grantor W~1 receive the ott ides tion for f the Z,i and will hold the rights.to receive such considerati~ .,trust fund to be applied first for the purpose of pay, Co9t of the improvemrtnt'a~ wall apply the sane first of thettotal ofcto..bse sf the'inprovement begone using a~ ame for any other purpose_ 'ith the .989 •and Clerk's to Bay X88 and 43 . natters • ~ . ut not yid map ~t2-erly ito the ,signs TOWS: uietly ~rever ~ . ~ I.aw, ~yanca - as a :g thA o the part zooi~ood md~o:Z1 «oz s~ ~¢r -60t-B88t5:xe~ ,,,,, ,,,, ..••••~J wnsKEOF, ~ the partF - o~- hereunto set his hand and Seal the ~ the ~ir`s`t•~ ~ rt has written, y an~d~~year fir above IN P'RESENCg OF: B~lY h.SSnctdmrd --~ • • u~37IL1S -' STBTE OF ld$ii YOR1C• COUNTY OF WARj~~ ~ ' SS : • • an his ~ day of subscriber, . pes'sonally apPear"e ., 199, before e, ~e known, who being by me duly sworn, d ~ DESIINTIS, to ma rQSides at Queensbury, I~iew York pose and say hat ha BAY ASSOCII-TES, the Co• and that he is .a Part r exe4uted tLe above inst oration described in, andwhich corporation, ~nt% that he knows the seal f s~ that the seal affixed to -said instrument is such .corporate seal; than it vas so affixed by order of thl Board of Directors of said corporation and thereto by like ord~e, that be signed his name ~.ct~ ~= S. icy c~- v~rr-ec- ,y~,~ ~" ~ S~ ~~ ~~ ~ ~~~.~. ~,~_, Z00/ZOOd mdlO~Zl ItOZ 6l ~¢f X60/vBHAIS:x¢a ~.,, ,~, MAP REFE7REMCES ~. war a' ~avosm suaan~rar - as r ~s roar of 0: auEn ~c r+. np er M.a Aaw~ sax u.s ALSO KNG1lM AS fA065RQ~9~S Plli[ c -f ~FEO~-L:. CRF..Ot r' vNl on1 n ' og` E / ~s~.ry ~ N~i ~ 2g0y Ny$ U ~ 5R / ~ nor ~~ ?~5i5s Sq.FI. 0.58: Ac. •r ~~ ~/ ~ Nom` \~_ /3, ~~ ``~\ ~~ .. ~~ ~q ~ SOT 5 ~rr~' .,~, l'k3 . ~ a N o- 0 N ~ ~ ,~9'-46 -35" N lADO' / 2 r O / MAP OF SURVEY of londs of T.C. T. FEDERAL CRED/ T UNION TOWN OF QuEEN.SBIX+tY, SCALE: 1" . 30' 11'IL[4/ 1 ~ L~Mt 7MYt')p- M1/10~/ WARREN COUNTY, iVEW YORK DEC. 16. 1994 N! ..f /o01VRK~ ASSOtYATES L.inrrM trw/ lwrrysa ~'+ s~wMir ApK o a 61sr M.iI Sw1A 6Anb /ii/6~, K C /ZAIQlr LOT /'~ ~ Sew: plof Plant ~` I Sign Variance Revised June 2009 General Information Tax Parce ID Number: ? S 9, ! S - ~ - ~ Zoning Di 'ct: ~ Q Detailed escription of Project [includes curn~nt & proposed use]: r _ _ ~ ~ ~ i n c h o~ nP..~ Location o project: q ~ 2 ,,,,,~,.,..,..,... ~. ~..,~.: ~ K,c, inn ~ r a u s n - ~ S ~ n Home Phon Vlfork Phone .~!$~~$~ 1t! 1 E-.Mail: ~jk~®Sglrw.i~gs~,n .e A'genYs`Na e: 5c+a1 cis ~ I.arc Home Phone Work Phone E=mail C)wner's Na e; j ~ ed~.r~i C~cdi~- U.~•o r1 Home Phone If ~ }~;~.}s Work Phone ,* Lh ~~~$ ~~-7ob2r E may( _ ~~'v ~ ~c+'~ C~i . orq Address: .; f9S ~9'i-a~d+ Aw~t~,r,,e,, Ce(I~ _ B- ~ - + . - 7 13Y3 s~ a - s - Sa ~ r ~1 , .Address ; ' Cell: .Fax: <~ Address - ~ `` ~ ~ i ~ Qo~J~4.hd$i'~eet Ceti ~ i~ lJ so za Fax of Queensbury • Zoning OFBce • 742 Bay Road - Queensbury, NY 12804.518-761-8238 1 Sign Variance Revised June 2~ Site Development Data Area / .Type ` _ .'Existing sq, fti ~ Proposed.. Total sq},ft: . Additiion~s : ft. ~ , A. Building ootprint " lSoos /(oQG s9 B. Detach Garage C. Accesso Structure(s) d i D. Paved, g vel or other hard surfaced area `~°qz ~'' ' gog2 s9 ~ E. Porches Decks d F'. Other G. Total No -Permeable [Add A Fj ~b Z92 ..- !O 692. H. Parce! Ar a [43,~p ~. ~ / acxej- ss sis f ~- 1s srS'r ~ i. Percentag of Impermeable Area ~of Site [I=G/Hj c/ ~a /b ~~ la Setback Requirements Ar a s ~ Requrett . ` x ~ Existing ~ =.= Proposed _ ~ ~ gym. LL : .a . r , _., - -.. Front [1] ~S ~7~ ~7~ Front [2] Shore ine Side Ya d [1] ~ ~ o f ya ~ Side Ya d [2J N~r~ a~ ~ ~] 2 ~ ~ Z Rear Ya d [1J Rear Ya d [2] Travel C r ridor Height [ ] ~O ~ Perinea itity 3~v No. of parkin spaces own of Queensbury • Zaring Office • 742 Bay Road - Queensbury, NY 128t)W • 518-761-8238 ~ )09 C~ $E > -W Thi Elegy If yo their If yon addi~~ Sign Prope Sign Sign Variance Revised June ~m lian with Si n Ordinance action(s) t apply: Cf/~T~ /y!~ , hat signs you allowed to have? ign Type How many allowed Square Feet Height Wall j roc :-- Freest nding ~ // ~ ~~ b s applica n is for a ~ in the: Number of Sins: from (currently): to (Proposed)- Setback for Sign Size of Sign Height of Sign Other (speafy) ~ation: u are pro ing to install wall signs, provide a scab drawing of the facade the sign(s) will be located on witl location , hown. .~ are pr sing more than two (2) signs, the following information must be provided for each sign (please u; :ional s is if necessary) Number. (if yiw are applying for more than one sign) Sig Type Existing Proposed Length Width Total Height Depth for . feet P 'eC{' Wall Frees ndin f~ Z+~ a7 F O Pro'e _ , . n ;, Illumin ted - `''~ Awnin rty Line vana~ etbacks: Front S ~ ~L~~,~ Side ~O~' Wordin ~G"r ~Y2f•~1fi U~ tOYl Town of Queensbury -Zoning t3ffioe - 742 Bar Read • Qtteensbury, NY 12804.518-T61-8238 2009 ~e Sign Variance Revised June 2009 The foltow~ng questions reflect the criteria for granting this type of variance. Please complete them; use additional beets if needed. 1. Wh ther an undesirable d~ange will be produced ~ the character of the neighborhood or a detriment to nea y property will be created by the granting of this sign variance? ~i 'cam Lo nun^ s ~i v~e~ ~ ct~ r s e i •• 2. W er the benefit sought by the applicant can be achieved by some method, feasible for the applicant to purl , other than a sign variance? -- %C?~h l/I P.t~~h-~' 111 i9 .c E'L~.~ric, l#•-.or~ n~ .~. lr- ..~4., c.. L.:- .Ll-`-- - - - ~ , r' ~ ~ eJiq~t 4+~d -~t~~f : Co«pl~a~.v-ce. urtct~et new c.~dc wo~c-td. ~~dVd. ~ff, ~~,j+iq~." 3. Whe r the requested sign variance is substantial`? J r ~ t~ { - r 13~ 11'! riE.t b fto['' 0 1~ec. k ° _ r iS _ - rt^ ba~tKs. 4. Whe the proposed variance will have an adverse effector impact on the physical or environmental cond ' ns in the nei hYorhood or district? .... ~ ~. _ _ _ mot= ~,e ~eesi- nclino .fir d it i n } i~~ S tlr~t~,' 1, L,.r s.n~~- -• • s e ., b dck. +~+e vi~- ~ hei~r~~i~ s,~,s aid w+~ ~ntiance ~a.~~.~'tcx~. 5: Whe r the alleged d~ffcutty was If-cxeat ? .. .a lire .~-,.,c.~_ ..~_. o...__h_ ~ ~ _ ~_ / .._ r - t ~ ~ ~ 1. If the 2. Does 3. 4. Additional Proiect Information Zit °(~ S ~.,~~.n ~1 has previous approvals, list application number(s): ~y-31p _ Z ~ 3 ~~lr ~u ~ project require coverage under the NYS DEC Stormwater Pollution Prevention Program? project duration: Start Date ~S ~A End Date °7~_ total cost of project:~~~/5O, .°-" Town of Queensbury • Zoning Office • 742 Bay Road • ~ueensbury, NY 12804.518-761-8238 4 Sign Variance Revised June 2009 depicting existing and proposed conditions shall include the items as noted A ~ T'itle, N ~° : - GENENAL _ '- ;, ~ _ Address of applicant 8 persarr respor~l@ for preparation of drawing SHOWN ON SHEET #. , 2 Deed 3 North a Tax Map lD date prepared and scale [rr~r>Kntrrn 1t = 40 ft 4 Bourxiaries , n. j the property plotted m scale zonin bpundar A A 5 Princ~ai , g y . acx~essory struclixes y~h exterior ~~~ 6 7 Site im Setbacks is ind. outdoor sbrage areas. driveways. parking areas. etac.: existing $ proposed aM strucbres and ~; @ ~ 8 Elevations p Moor pions of aM proposed and afleced sh~trchmes j . Project .i WATERS:SEWEft~, ; disposal faa'lities, design details. oonstructiorr detail, Mow rates. and number ~ bedrooms proposed SHVYVN>ON 2 ~' Water su se tic (Le. weUj & septic on adjolYng lots witir separation b existing or proposed an~ite water supply and . 3 Q Separation FYLCtIflA tL tstanoes for proposed sewage disposal system to well and water bodies _ K tit:~re uetnr c.wJ.. Ludt I.J.s ..a..i ^I~IL~J ~ ___ ~.~. ~~.{,~ yam- _ _ __ , _---r ._........ w ww.w,y rwwa, aw ~nt•a•c miaow, tlJt:OtKJrt, Q@,Sr9n ana L'on.SY V4.M1 wd161 ~~ 5 Percolation location and resuMs . , : , RAFi~tfNGa P'E[iNEA@CE 3HQII~IN'~NC ~S~EET#'s ,. 1 Number of oes required for project lrcudmg calarlations and jcafion: existirg $ pnopos@d s rrvvrs~vrt r peaesaran ana narw~cap access ana parKirg: existing ~ proposed 4 Design detai of . egress, kraditrg areas and suiting existing $ prrpposed 5 Location a dtarar~er of green areas [existing ark proposed), rrtodMiCatiort b green ~. buffer zone b rerrralt ur~brrbed 6 Lighting, l and design of aM e~dsWig and proposed outdoor Mgtttirg 4= ADBITiON/1t: SITE ~ /i~• _ SHE3IAIN ON:': 2 ,-, .~ .. ~,. .. - ~ ~ _~ ~ : =.. ~ _ t tic _ ,. .. ,,SHEET i€ 1_ On-site & ad t watercourses, streams, rivers, hake and wetlands 2 Utility lane distritxition system [gas, elastic, solar, telephor-@j: existing g pra'pas,ed 3 Location, d and oonsbuction details of aM exisfirrg and proposed site impravemenls ' walls, fencx3s fire & emergency zones and hydrants, eta. ~~ ~~~, retaining 4 Square foo of bldg, area proposed for otMoe, rrrarrrg, retail sales or other ootrrnercial activities: existing $ sail e Signage: tier. size. type. desigtr and setback existing 8 proposed f Waiver R provide letter with application rer~resting any waivers: @ r spedfic items I g I Cat-merCiaUi~usUiai Development requires subrt»sion of Landscaping. StoimYira~ Managerrrer-t, Grading ~ Lighting Piat-s _ __ h Identification l=ederal. State ar County hermits r for the pn~jed bgett>er with a record ~ appkptiort for a~ necessary .. Town of Queensbury • Zoning tMioe • 742 Bay Rand • Queens[airy, NY 12804.51&761-8238 5 Pre-Submi 1. Tax 2. Zon 3. Rea ~. 4. Zoni 5. Pre Deer Gene Site Setb Com Ch Envir Signa Sign Variance Revised June 20fl sion Conference Form 17~9-4-040 ap ID ~.0 7. /S'~ '3 i g Classification f~ n for Review: ,~, r/. hDQ ~ j~-~~ ~~~,/rF g Section #: 1..~/,~/~~Q /~O ubmission Meeting Notes; Outstanding Items To Be Addres Include: Yes No I Information complete Yes No evelopment Data Complete Yes No k Requir~nents Complete Yes No liance with Sign Ordinance Yes No ist items addressed Yes No nmental Form completed Yes No re Page completed Yes No .... ~ /J~ ~~ -,~ ~ ~ r ~" c~v,y ~~ ~ ~tJ C~irl~t~~= ~/~9vC digs=t= ~~/i.~~.c! ~~,E' ,, l 0 ,Q~NTiy~. Staff Represen Applicant / Ag date: five: t: " ~~„ Town of Queenstwry • Zoning Office • 742 Bay Road • Queensbuty, NY 12804.518-761-8238 6 Sign Variance Revised June 2009 - --- 1 s~~.zo SEAR ~-Pa.Adlu c Sts 6>trinonnMnw Ctralllp RmrM/W ' SHORT ENViRQNMENTAL ASSESSMENT FORM Fo. uNUSTEp ACTIONS otter PART 1- OJECT INFORMATION (To be cpnpMied t7y ~ic~ ~ ptp1~ sPon~ ~ . APPU ~sPONSOn, z. PRO.IEGT NAME Unl Scsrai~uc~a n TGT C`,+r~clt~r Onlca- nl~ si r~ 3. PROD t.OGtT101it M ~ t?Ns 1G u ~ Q.if ~ a. PR LOCATION addrps ~d ~. Porn w+d~a. ~. « n+aPl ~t~>r1'~Qf ~ ~CO~ LA.RG 5. IS ACnOIt ~O~Iun ^ - 6. BE PRO.~CT BRIt~LY: ~h St41~t~~'-on a~ ~2C,~'Q+~t J S igrl r. antou r of t~ 1 !o Sg ~ r t ~ tMC ,~ s. wnu ~-yACrwN oo1~Y rwTir, oasnNO mNNVS on oTNe~ E~sra~ w+o tes~ oNS? ^Y p~Np If No, dq~lb~ pMyr .. _ ' S Min ~~t ~~~:e~ c~ ~;~$~j dke -try Cade ~~,~t~ ~ 8. WHAT PREBENf tM10 Usk IN VK~gTY Ot= PgOJEGT'T ^ ^I~WUStrial ^ Opp spaq ^Othar ~~+ t0. DOB~CTiON INVOLVE A Pt3iM~r APPROYAt, OR FtMOplB, NOW OR ULTIMATELY FROM ANY OTHER CiOyEfEiMElITAL A(iENC1! , STA OR ~? Yp T'" h ye+. ttst apanay(q aad ~ 7 f . pOE~ ANY ~p~T OF THE ACT10N HAyE A CfAiRg~ITLY VALIO PEtMpT pp Appp~/AL? ^ Yas No H yea, Rrt spw~ naraa and p~1A~ppeowl 12. AS A RESULT Of PROPOSED ACTION WN,L EIOSTNrB PER19r1APPROtIAL REQUIRE MOOIFMCATlON7 1 CERTIFY THAT THE INfORMATiON PROVIpt~ ABOVE ~ TRUE TO THE BEST OF MY KNOM/LEOpE nLat ~ ~ L.'f' Cl mil/ 'T„~ ~ pate: ~. / ~ _. Sipnatws: 11 1119 aCdtJfl 1S ~1 th9 C09StN AMi, 9114 yptl ~ • ~1• ~ 0 ~ Coastal ASfeSi1110111 FOQN b910f9 pf+Og9~ rllllh 11119 ifit~9911NNf! OVER Town of Queensbury • Zoning Office • 742 Bay Road • Queensbury, NY 12804.51&761-8238 ~ Sign Variance Revised June 2009 PART fi ENVIRONMENTAL ASSESSMENT (To ba completed by Agency) A ODES CftON EXCEED ANY TYPE 1 THRESHOLD tN s NYCpp PART 6t7.a? It yes, ~ tlia ~, aro~ss ano u~ the FUtI FJ1F. ^ ^No 8. WILL CTlON RECEIVE COORDINATE REVIEVII AS PROVIDEp FOR UNLISTED mQ ~ ^ ~ ar+otftsr i~YOiraa +~YNiaY. ACTIONS IN 8 NYCRR, PART st7.s? It No, a re>peNw dseNatiwi C. COU ACTION RESULT tti ANY ADVERSE EfFECiS ASSOCIATED Vii1TM THE POL.LOw1Ne: (Ar~sarars mstr ua ~ it iesieia! Ct, ist ~ ~ e ~ +. p 0 A~o6N~9~ mss. a><isW~y tnNb Pa/Uraf. aoUd waat~ ProducNan a Oisposat, C2 ~tIW~ apriaulturaL arehaeolopigi, hlaloric, ar orhar nMtwai a cWlttrd reso~pos~ or eommetnhy a nalgnbatwod tmaractaR Explain txiefy; C3. Viipetation or fauna. Ibh. shesgSA a wAdUh spsGss, sipnilicant haOitW. o- ~naatenad or andanpand ~a~ip7 Explain brlefilr C4. AICOmmunRys existing lpana or pawls as Wlictaly a~Ptad. a a c1~a~ga in ~s or intenanY W uss of isnd ar other nanuai rosowossp pcpiatgi pryapy ~- i n. subsequent dewtopmaeq, ar seteted aetirhies Ipcey btie b~Ww:ed tyr the propwaa actionT Explain txie(gr. C& Wew lerit~ ~wtt term. aan~Irs~ w other Nlaals aot ideMMMO in C11S? ExWsM lrieM- t:7. lergaats pAChlAklp dlinpq UI Yee d eWlsr QltMfid ar type ar aferph? ~ ~• D. YJILL E PROJECT HAVE /1N IMPACT ON THE ENVIRONMBITAL THAT C/1U6ED THE ESTABUSHN@rT OF A CEA? ^Y ^No E. IS TH OR !8 THERE LIKELY TO aE. OONiROVERBY Rt3AT~ TO PDT@/TIAL ADYERBE BIVif~/Y~ENTAL IMPACTS? ^Y ^No if Yes, sxpWn txrblgr PART 1l1- t7ttY11NATiON OF SI~iNIFN.ANCE (To be c:ompletad bf- qO~Y) INSTRU N& For each edrarse e/teot idslMlRsd allow, deEennhw wheths- R b xl~antial, large, irnpor~ tx oMerwtse sl~tiflcant. Each a should be a~sed in cpNtecUal with its W setting M.a urban or ruralX tb) probaWUty of oaxuring; (cj duration; (d) irrsvs IitY; {e~ geoprapfflc scope; slut (fj nlepNtllde. R Y, add ateaa~alants or refererloe supptxtlnp matsrlata. Ensure that explan one contain suHicNtrt detaN to sheer that aN relevant adverse lmp~ heYe heal idetttifled and edegttately addressed. If quest) O of Ptut ti was ttiNCked yes, tfle dsbnpbgdion end ~ ~t svsitwte ihs Psi krrWct of the proposed action on the -aanentai eharacterislip of the CEA. ^ k this box tf you haws identified one tx more potentially Iarge or significant adverse impacts which MAY oc r. Then proceed directly to the FULL EAF and/or prepare a positive declaration. ^ C k thla box it you hatre determined, teased on the Information arm analysis above and-any supporting A prof i~ on a~tlactl~merU actlort ~'~ NOT result in any significant adverse environmental impacts rlecessarly the reasons supporting this determination: er tevd /~ ,~ee~ ( it Oats 2 Town of Queenstwry • Zoning OfFioe • 742 Bay Road • Qtreenstwry, NY 12804.518-761-8238 g :. . Sign Variance Revised June 2009 Signature Page This page i eludes the 1.} Authorization to Act as Agent Form: 2.} Engineering Fee Disclosure; 3.) Authorization for Site visits; 4.) then Permi# Responsibilities; 5.) Off~ial Meeting Disclosure and 6.) Agreement to provide documentation required- OWNER'S A ENT FORM: Complete th following if the OWNER of the property is not the same as the applicant owner. "T'CT ~~~>r 1 ~X;e~ t-1~~.oin Designates: Snraitiaa SraF, A.v' /e~ As agent regarding: /Varianoe Site Plan Subdivision For Tax Map No.: Section Block Lot Deed Rerfp nce: Book Page Date OWNER SI NATURE:• _ DATE: '7 "~ ~ ; _ . - APPLICANT'S AGENT FORM: " Complete th 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 Pian Subdivision For Tax Map No.: Section Block Lot Deed Reference: Book Page Date OWNER SI NATURE: DATE: 2. ENGINE ING FEE DISCLOSURE: Appr~oms may tie referred to the Town consulting engineer for review of septic design, storm drainag ,etc. as determined by the Zoning or Planning Department Fees for engineering review services will be charged directly to the ppGcant Fees for ergineering review wifi not exceed ~ 1,000 without notification to the applccant 3. AUTHOR TION FOR SITE VISITS: BY signing this page and submitting the application materials attached herein, the Owner, Applicant, an his/her/their agent(s) hereby authorize the Zon"ag Board or Planning Board and Town Staff to enter the subject ' "properties for a purpose of reviewing the applicati~ , "4. OTHER P RAAtT RESPONSIBILITIES: Other perrrn'ts may be required for construction ~ alteration activity subsequent to approval liy the Zoning card or Planning Board. It is the applicant's responsibtiity to obtain any additional permits. 5. OFFICIAL FETING MINUTES DISCLOSU : !t is the practice of the Community Deveblxment Deparment b have a designs#ed stenographer pe record the proceedings of meetings resulting from application, and minutes transcribed from those the offiaal re rd of a8 proceedings. tapes constitutes ~. Ht7KCCm ~v r r V rKVYrut uU(,'UIgENTpTIpN RE IRED: I, the undersigned, have thor~OUgtily read and understand the instructions fo submission and agree to the submission requirements, I ackrwwledge no construction activities shall be commenced prior to issue of a valid permit. I certify that the application, plans and supporting materials are a true and complete statementld 'ption of the existing conditions and the work proposed, and that as work wfii be performed in accordance with the approved pia and in conformance wdh beat zoning regulations. 1 ada~owiedge that prior do occupying fhe facilities proposed, I or my agents, will ob 'n a certificate of occupancy as necessary, 1 also understand that Uwe may be required to provide an as-built survey by a licensed land surveyor of all newly c:onsbuded faaTities prior m issuarx:e of a certificate of aecupancy 1 have read a d agree to the above. S' " ature [A pligntJ Print Name (Applit:antj D e igned Signature [A ent] Print Name [Agent] Date signed Town of Queensbixy • Zoning Office • 742 Bay Road • Queensbury, NY 12804.518-761-8238 9