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6.05 6.5 TRANSIENTS\Northeast Realty Development Polito&Quinn—4-15-19 RESOLUTION APPROVING TRANSIENT MERCHANT/TRANSIENT MERCHANT MARKET LICENSE FOR NORTHEAST REALTY DEVELOPMENT/KEVIN QUINN/NAOMI POLITO RESOLUTION NO.: ,2019 INTRODUCED BY: WHO MOVED ITS ADOPTION SECONDED BY: WHEREAS, Northeast Realty Development/Kevin Quinn/Naomi Polito (Northeast Realty) has submitted an application to the Queensbury Town Board for a Transient Merchant/Transient Merchant Market License to conduct a transient merchant market from June 4th through June 8th, 2019 in the parking lot at 1650 State Route 9, Queensbury to sell assorted motorcycle and non- motorcycle products, services and displays in accordance with the provisions of Town Code Chapter 160, and WHEREAS, the application is essentially identical to applications submitted by the applicant in previous years and since the Queensbury Planning Board conducted site plan review of the prior applications, it is not necessary to again refer the application to the Planning Board for site plan review, NOW, THEREFORE, BE IT RESOLVED, that in accordance with the requirements set forth in Queensbury Town Code §160-8, the Town Board hereby grants a Transient Merchant/Transient Merchant Market License to Northeast Realty Development/Kevin Quinn/Naomi Polito to conduct a transient merchant market in the parking lot located at 1650 State Route 9, Queensbury, subject to the following: 1. Northeast Realty must pay all fees as required by Town Code Chapter 160; 2. Northeast Realty must submit a bond in the amount of$10,000 as required by Chapter 160; 3. Northeast Realty must submit proof of authorization to do business in New York and authorization of agent to receive service of summons or other legal process in New York; 4. The License shall be valid only from June 4th through June 8th, 2019 from 9:00 a.m. to 9:00 p.m. and the license shall expire immediately thereafter; 5. Northeast Realty shall advise the Town Board of any vendor changes from previous years; 6. Northeast Realty must revise its submitted plot plan to accurately depict the planned vendor locations prior to the Town Clerk's issuance of the License; 7. Northeast Realty must provide to the Town Clerk its proof of a current/renewed occupancy permit from the New York State Department of Transportation for parking in the area along Route 9 prior to the Town Clerk's issuance of the License; 8. The Transient Merchant License shall not be assignable; and 9. Northeast Realty must comply with all regulations specified in Town Code §160-8; and BE IT FURTHER, RESOLVED, that the Town Board further authorizes and directs Town Code Enforcement Personnel to rigorously enforce the terms of the Site Plan, and BE IT FURTHER, RESOLVED, that the Town Board further authorizes and directs the Director of Planning, Zoning and Code Compliance to send a certified copy of this Resolution to the Warren County Sheriff and also contact the Warren County Sheriff to request that the Warren County Sheriff's Office enforce off-road parking issues on Route 9 and throughout the community. Duly adopted this 15th day of April, 2019, by the following vote: AYES : NOES : ABSENT : • TOWN OF QUEENSBURYC 742 Bay Road, Queeusbury, NY. 12804-5902 12019MemorandumSBURY1C1wTo: Caroline Barber, Town Clerk 01.6 From: Craig Brown, Zoning Administrator Date: April 1, 2019 Re: Northeast Realty Development-Transient Merchant License I have reviewed the recently revised application for renewal against the 2018 application and find that the current submittal appears to be consistent with last year's submittal with the following exceptions/concerns. Project description: While the description of goods, etc. is identical to the previous applications stating "Assorted products and services" the current application does not offer a list of these "products and services" or vendors for Board consideration. Per a previous; 2011, conversation with Mr. Quinn,the vendor list may be the same as previous years with the addition of a couple of low intensity vendors, (i.e. Fallen Soldiers, etc.). Consideration may be given to the option that at least any vendor changes will be brought to the attention of the Town Board by Mr. Quinn. Plot Plan: The plot plan submitted depicts the areas of operation for the event with no specifics on individual vendor locations. Consideration may be given to having the plan revised to show the planned vendor locations prior to the Town Clerk issuance of the license. Annual NYS DOT permit: This is important as the area along Route 9 can only be used for parking, if and only if, the applicant gets a current/renewed occupancy permit from the New York State Department of Transportation. No current DOT permit was included with this submittal. Typically, an updated DOT permit is presented prior to the Town Clerk issuance of the license. While the plot plan appears to show the Town of Queensbury/Town of Lake George line; portions of the proposed use are shown in the Town of Lake George. The town line is the limit of our authority and we cannot consider or approve the use of lands in the Town of Lake George. The Town Board may wish to require'an actual survey map location of the Town line to address this jurisdictional issue. As noted in several past review letters, the parking of motorcycles and other vehicles that occurs along Route 9 during this event numbers in the hundreds. This lack of sufficient onsite parking should be addressed. Uncontrolled parking and pedestrian traffic along and across, arguably, the busiest highway in town during the planned event weekend is a health,safety and welfare concern that should be addressed. p41 •�"% Transient Merchant/Transient Merchant Market Revised June 2009 03) Cj= A T ri N OF QUEENSBURY TOWN BOARD APPLICATION !� 0� A 1ENT MERCHANT/ TRANSIENT MERCHANT MARKET 4 Subrr t 1 fair , to the Town Clerk along with $100 application fee plus applicable Town Clerk t DATE: 6�Q APPLICANT'S NAME: 4f �d A2 & ' ADDRESS: Q Q 1. Federal ID#: • 2. NY State Sales Tax No.: 3. Location of Market: ,/42�i��Of/ j 4. Dates& Hours of Operation: QK/4/- aoh%�Q/� 5. Description of Goods,Wares, Commodities or Services to be offered for sale or to be used for the purpose of bidding for services: &���d/0��� "i /� 193. 6. Other Information to Be Provided: A. If application is filed by an agent,the name of the firm or person represented and written authorization by the firm authorizing the representation. B. Authorization of an agent to receive Service of Summons. C. A plan or map showing the location of the proposed market in proximity to property boundaries and any other temporary or permanent structure on the lot, the plan or map shall also show the location of the vendors within the market the provisions for dedicated parking vehicular access to and from the site, the zoning district in which the market is to be located,provisions for water supply and sewage disposal. Signature of Applicant Date: ./�Q/, Signature of Agent: (IA) Town of Queensbury Planning Office-742 Bay Road•Queensbury,NY 12804.518-761-8220 1 Site Plan Review Revised June 2009 • General Information Tax Parcel ID: 07 2Z ---71' .---->,7 7 7 -/ J Zoning District: 4r Current Use: Ahz_5'ad "izzco fi 45,435 - , Proposed Use: 576 elY ' . Location of project: 40 L.3E sea- 9 Applicant Name i - Address: Home Phone Cell; lfe 98 4/&12.51t OMPI Work Phone Fax 7 p 95 log av? E-Mail: Agent's Name: ii , A > / Address: Wig/V/i 70 k 9/.53 5,6, Home Phone Cell: Work Phone ,.8 Fax 52 ffea_--2A6( E-mail Owner's Name: Address ii/EDgod 61.77./ - le W-7 (gi739 / Home Phorte Cell Work Phone Fax j)e .e,ezie ,52e&e (6,246T E-mail Town of Queensbury Planning Office-742 Bay Road-Queensbury,NY 12804-518-781-8220 2 Site Plan Review Revised June 2009 Site Development Data Area/Type Existing sq.ft. Proposed Total sq.ft. Addition sq.ft. A. Building footprint B. Detached Garage C. Accessory Structure(s) D. Paved,gravel or other hard surfaced area E. Porches!Decks F. Other G. Total Non-Permeable [Add A-F] H. Parcel Area [43)560 sq.ft./acre] / I. Percentage of Impermeable Area of Site [1=G/H1 Setback Requirements Area Required Existing Proposed Front[1] / /a9 Front[2] Shoreline Side Yard[1] Side Yard[2] Rear Yard[1] /g) Rear Yard[2] Travel Corridor Height[max] Permeability No.of parking spaces 03-- /&9 Town of Queensbury Planning Office-742 Bay Road•Queensbury,NY 12804 518-761-8220 3 Site Plan Review Revised June 2009 Additional Project Information 1. Will the proposal require a Septic Variance from the Town Board of Health? /20 2. If the parcel has previous approvals, list application number(s): / 77- 7(193 3. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Program? /20 4. Estimated project duration: Start Date End Date / . 5. Estimated total cost of project: 6. Total area of land disturbance for project: Floor Area Ratio Worksheet FLOOR AREA RATIO(FAR)—The relationship of building size to lot size, derived by dividing the total building floor area by the lot size in square feet, yielding a percentage. Zoning District Symbol Floor Area Ratio[FAR] Waterfront Residential WR 0.22 Commercial Moderate CM 0.3 Commercial Intensive CI 0.3 A. The combined area of all square footage,as measure from exterior walls of all structures on the property,including all floors of the structures, garages, basements and attics with more than five (5) feet of ceiling height and covered porches. Building square footage does not include: Open deck docks and that portion of covered docks extending over water and one storage shed of one hundred twenty (120) square feet or less. Any additional sheds will be included. (See'FLOOR AREA RATIO"). B. Commercial or industrial;the total area in square feet as measured from the exterior of the outside walls of a building or structure,and when applicable,the sum total of all floor areas of the principal and accessory buildings or structures on the project site. Parcel Area sq.ft. Existing Floor Area sq ft (see above definition] Proposed Additional Floor Area sq.ft. Proposed Total Floor Area sq ft. Total Allowable Floor Area (Area x )[see above table] Town of Queensbury Planning Office-742 Bay Road•Queensbury,NY 12804•518-781-8220 4 • Site Plan Review Revised June 2009 179-9-050 Application for Site Plan Review Application for site plan approval shall be made to the Planning Board using forms supplied by the Board.Application materials and the site plan shall include sufficient information for the Board to make its findings under§179-9-070 and 179-9-080 below. In determining the content of the site plan and supporting documentation, the Planning Board may waive certain requirements if the Planning Board deems such requirements or information unnecessary for the type of project proposed. Any such waiver shall be made in writing,and shall contain statements of the reasons why the waived information requirements are riot necessary for an informed review under the circumstances. The Planning Board may grant such waivers on its own initiative or at the written request of an applicant.Such request shall set forth the specific requirements that are requested to be waived and the reasons for the requested waiver. Absent any waiver or waivers,an application for Site Plan Review shall include the following: Shown REQUIREMENTS on 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. B The site plan shall be drawn at a scale of forty feet to the inch(1"=40 feet)or such other scale as the Planning Board may deem appropriate, on standard 24"x 36" sheets, with continuation on 8h" x 11" sheets as necessary for written information. The information listed below shall be shown on the site plan and continuation sheets. C Name of the project,boundaries,date,north arrow,and scale of the plan. D Name and address of the owner of record,developer,and seal of the engineer,architect,or landscape architect If the applicant is not the record owner,a letter of authorization shall be required from the owner E The location and use of all existing and proposed structures within the property,including all dimensions of height and floor area,all extort-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. 0/ H The location,height,size,materials,and design of all proposed signs. 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 4. Storm drainage system including existing and proposed drain lines,culverts,catch basins,headwalls,endwails,hydrants, 61, manholes,and drainage swales. // Plans to prevent the pollution of surface or groundwater,erosion of soil both during unng and after construction, excessive nuxrff,and flooding of other properties,as applicable. A Stormwater Pollution Prevention Plan(SWPPP) for all land development activities (excluding agricultural activtiles)on the site that results in land disturbance of 1-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 ^/�I land disturbance of less than 1-acre. ,J K Existing and proposed topography at two-foot contour intervals,or such other contour Interval as the Planning Board shall allow. All elevations shall refer to the nearest United States Coastal and Geodetic Bench Mark. If any portion of the parcel Is within the 100- year floodplaln,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. (P�, L A landscape plan showing all existing natural land features that 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 Includingj � sizes and types of plants. Water sources include ponds,lakes,wetlands and watercourses,aquifers,flood plains, / / and drainage retention areas. M land Use District boundaries writhin 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 *0 a Town of QueensburyPlanningOffice-742 BayRoad•Queensbury,NY 12804•518-761-8220 6 ry 6 Site Plan Review Revised June 2009 N Traffic flow patterns within the site,entrances and exits,and loading and unloading areas,as well as curb cuts on the site and within 100 feet of the site. The Planning Board may,at its discretion,require a detailed traffic study for large developments or for those in heavy traffic areas,which shall include: 1. The projected number of motor vehicle trips to enter or leave the site,estimated for weekly and annual peak hour traffic levels; 2. The projected traffic flow pattern Including vehicular movements al all major intersections likely to be affected by the proposed use of the site; 3. The impact of this traffic on levels of service on abutting public streets and at affected Intersections. Existing and proposed weekly and annual peak hour traffic levels and road capacity levels shall also be given 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 retail operation,office,storage,etc.; 2. Estimated maximum number of employees; ,�} 3. Maximum seating capacity,where applicable;and g /A 4. Number of parking spaces existing and required for the intended use. U C P 1. Floor Plans. 2. Elevations at a scale of one-quarter inch equals one fool(1/4"=1 foot)for all exterior facades of the proposed structure(s)and/or alterations to or expansions of existing facades,showing design features and indicating the type and color of materials to be used. a Q Soil logs,water supply well and percolation test results,and storm runoff calculations,as needed to determine and mitigate project impacts. • 9/ R Fens for disposal of construction and demolition waste,either on-site or at an approved disposal facility. /! S Plans for snow removal,Including location(s)of on-site snow storage. T An Environmental Assessment Form(TAP),as required by the SEQRA regulations,with Part 1 completed by the Applicant shall be jij, submitted as part of the application. If the proposed project requires a special use permit and an EAF has been submitted in conjunction with a special use permit application,a duplicate EAF is not required for the sde plan application.. U if an application is for a parcel or parcels on which more than one use is proposed,the applicant may submit a single application for all such uses provided the proposed uses are accurately delineated on a site plan drawn pursuant to the requirements set forth above. The Planning Board may grant the application with respect to some proposed uses and not other,. For purpoece or reviewing an application (and for SEQRA compliance) all proposed uses on a single parcel or on contiguous parcels shall be considered together. V A brief narrative statement on how the project proposed for review furthers or is consistent with the vision,goals and policies in the Town's Comprehensive Plan. Town of Queensbury Planning Office•742 Bay Road•Queensbury,NY 12804.518-781-8220 7 Site Plan Review Revised June 2009 Pre-Submission Conference Form 1179-4-0401 1. Tax Map ID 2. Zoning Classification 3. Code Reference for Review: 4. Ordinance Reference#: 5. Pre-Submission Meeting Notes;Outstanding items To Be Addressed Include: Deed Yes No General Information complete Yes No Site Development Data Complete Yes No Setback Requirements Complete Yes No Additional Project Information Complete Yes No *Coverage under DEC SWPPP Program Yes No FAR Worksheet complete Yes No Standards addressed Yes No Checklist items addressed Yes No Environmental Form completed Yes No Signature Page completed Yes No *Armlicapt must Provide office with Notice of Intent(NOI):SWPPP Acceptance Form.DEC letter issuing permit number, Notice of Termination(NOT) Staff Representative: Applicant Agent: Date: Town of Queensbury Planning Office-742 Bay Road•Queensbury,NY 12804 518-761-8220 8 • 617.2© Appendix B Short Environmental Assessment Form Instructions for Completing Part l-Project Information. The applicant or project sponsor is responsible for the completion of Part]. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part I. 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 1?/ 4 ,fiver' , . Name of Action or Project: / rre 27 Ai/6 - Project Location(describe,and attach a location map): Brief Description of Proposed Action: reed/ Name of Applicant or Sponsor. Telephone: .1 E-Mail: Address: PO eix 4 297 City/PO: State: Zip Code: I.Does the proposed action only invoIfe the legislative adoption of a plan,local law,ordin ce, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ;r may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 1� 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: 3.a.Total acreage of the site of the proposed action? s'f acres b.Total acreage to be physically disturbed? /, acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed ction. 0 Urban o Rural(non-agriculture) 0 Industrial /ommercial ❑Residential(suburban) CI Forest ❑Agriculture 0 Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO 'k N/A a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? y/ 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: 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: v, 10. Will the proposed action connect to an existing public/private water supply? NO YES If Yes,does the existing system have capacity to provide service? 0 NO 0 YES If No,describe method for providing potable water: 11.Will the proposed action connect to existing wastewater utilities? NO YES If Yes,does the existing system have capacity to provide service? 0 NO 0 YES If No,describe method for providing wastewater treatment: 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? tof b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? V 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 13 Agricultural/grasslands 0 Early mid-successional C] Wetland 0 Urban 0 Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ,/ 16.Is the project site located in the 100 year flood plain? NO YES 10/ 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? 0 NO YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ©NO❑YES Page 2 of 4 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,darn)? If Yes,explain purpose and size: 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE • Applicant/sponsor name: Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I, Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6, Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public l private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? • Page 3 of 4 No,or Moderate small to large • impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. o Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. 0 Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) • Page 4 of 4 • Site Plan Review 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.)required. Other PermitResponsibilities, S.) Official Meeting Disclosure and 6.) Agreement to provide documentation OWNER'S AGENT FORM: Complete the following if the OWNER of the property is not the same as the applicant Owner: Designates: As agent regarding: Variance Site Plan Subdivision For Tax Map No.: Section Block Lot Deed Reference: Book Page Date OWNER SIGNATURE: DATE: APPLICANT'S AGENT FORAM: Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party: Owner Designates: As agent regarding: Variance Site Plan Subdivision For Tax Map No.: Section Block Lot Deed Reference: Book Page Date OWNER SIGNATURE: DATE: 2.) ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design, storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be charged directly to the applicant. Fees for engineering review will not exceed$1,000 without notification to the applicant 3.) AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein,the Owner, Applicant and his/heritheir 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. 4.1 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 ail proceedings. 6.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I, the undersigned, have thoroughly read and understand the instructions for submission and agree to the submission requirements, I acknowledge no construction activities shall be commenced prior to issuance of a valid permit I certify that the application, plans and supporting materials are a true and complete statement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the approved plans and In conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed,I or my agents,WU 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 ad and e to the above. 4119 67)/4/3 icent] P r Vs)A OA) - g ure[ t] Print Name[Agent] D e s' ned Town of Queensbury Planning Office.742 Bay Road•Queensbury,NY 12804•518-761.-8220 11 .y, - i s I. liI - I. t:? a g I. m .i - _- ? i�.. _ :Zgla: a i Nor I et I. 0 - • e - o - ...‘ ' g 'I . -, . . . •a., 1 0 _ i 11 1 -, , ‘ ......_____,. , , ... _ . I. `.- j i ea j —_ . _ 1 s4'd. - - t t - _ I %` 1 k. �,. - 'Li I. S V Z .,(;) •cti_ d CI) n -- :� - ,� fit. ? I S • J • a , ......... ...... i • 0 i o o i I.". V �i a t i � g • t it 14 • .� t •Ng t I : i.