Application L:1Pam Whitingt2007%Applications',Site Plan Review Applicadon_092407.doc
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) 761-8220 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:
Please submit 1 original & 14 copies of the completed application package to include:
• Completed Application: pages 1-9 completed, signed & dated
• Pre-Submission Meeting Notes: signed by staff
Copy of Deed
Plot Plan
Fee 0 - 10,000 sf = $100
10,001- 30,000 sf = $250
30,001- 100,000 sf= $500
100,000 + sf = $1000
ZONING STAFF & CONTACT INFORMATION:
Craig Brown, Zoning Administrator craigbCa gueensbury.net
TBA, Land Use Planner
Pam Whiting, Office Specialist 518-761-8220 pamw,5queensbury.net
Visit our website at www.gueensbury.net for further information and forms
Town of Queensbury Planning Office 742 Bay Road Queensbury, NY 12804 518-761-8220 1
General Information
ax Parcel ID Number: �Z7• 10- ( — z7
rT_,
oning District:
Detailed Description of Project [include current &proposed use]:
EfiDEitiG� �i5'�Pf FF ! / F�1-7 7il�A�Z�E.Ps�rr,�.ry fiUO
ST/� /1'/(�f Tf�iftFfirlFAi'T�rfs
Location of project:
T&4l rz f",a/ // /r�fD
Will the proposal require a Septic Variance from the Town Board of Health? 4/y
If the parcel has previous approvals, list application number(s):
Applicant Name: U/ &M �o ass ' �_
�/f ��G/f 1. 1 ' °� R v 1EwPo� OR
Homy Phone - C II '-t nr° tHfr`vA
:'
235 "m:
Work Phcna
x
E-r:,3i
Agent's Name: AJJ es /f 1//G t'O
MHDr P cre C_ ;
ork Phone a —
7-wvT1#1A1 Eo flG!/�'/t//(/SEt/�1i✓EEl{//f1171- Comp
O.vner's Name l y __s ZSG S�—&,Vv s!vS
? 0 //
TRUY /V /ZJ SZ
"Horne Pnoie`
I KI
Work Phone rax )
+i
x
E-mail ''
Town of Queensbury Planning Office 742 day Road Queensbury. NY 12804 518-761-8220 2
Site Development Data
Area / Type Existing sq. ft. Proposed Total sq. ft.
Additions . ft.
A. Building footprint /60/ iitr- f
B Detached Garage
C. Accessory Structure(s)
D. Paved, gravel or other hard surfaced area $gZ
E. Porches / Decks 71 2�
F. Other -7?9141VI/ "OWYr $333 $ 333
G. Total Non-Permeable [Add A-F] v;4 I Z/ 151
H. Parcel Area [43,560 sq. ft. /acre] 1 132 1 i IT
1. Percentage of Impermeable Area of Site [I=G/H] 632� 7 -7Z9
Setback Requirements
Area Required Existing Proposed
Front [1] � r 311 E r �z iow a 3 1�f, S To ro �nvran '
5DZ To F, l / 7-
Front [2]
Shoreline
Side Yard (1] 25 r 2-1/ 7
Side Yard [2] 2S r 1 g r �D f I
Rear Yard [i]
Rear Yard [2]
Travel Corridor
Height [max] 28 r 2-7 1— 10 rr
Permeability 4��70 6g? Q2 46
No. of parking spaces
Town or Queensbury Planning Office 742 Bay Road - Queensbury NY 12804 518-761-8220 3
Floor Area Ratio Worksheet
Fl r Area Ratio [FAR] is the relationship of building site to lot size dividing the total building square
f otage by the lot size in squar_ feat, yield'iirg a percentage_ The a rplicable ratios are as follows:
Zon Sy—oci F o�oi-A ea Ratio[FrR
Waterfront Residential `+`iR-3A 0.22
i V'JR-1A
Profess;onal Office PO 0.22
Highway Commercial Moderate HC-Mod 0 3
Highway Commercial Intensive HC-Int 03
Neighborhood Commercial NC-1A 0.22
NC-10
Commercial Industrial CI-lA 0.3
Light Industrial LI-1A 0.3
Heavy Industry HI 0.3
Enclosed Shopping Center ESC-25A See Zoning Administrator
Building square footage includes all floor of the primary structure, covered porches, and basements that
may be suitable for living space. Detached storage buildings greater than 100 sq ft. and detached
garages are included in the FAR calculations Building square footage does not include. open decks,
docks and that portion of covered docks extending over the water, and one shed 100 sq ft. or less. All
additional sheds are included in the FAR calculations.
wr .i i• ,V 9p�. ( t 7�'i ti .v I pP I 455 +��1'4 a S r A �ryryVI t,y F '� ,�"rs' 4 'fA_o- g u�+'I't.
5
Primary Structure
First Floor i
Second Floor
Basement (living space]
Covered or enclosed porches
Covered docks
Guest House
Apartment o✓6� A6 7Z
Detached Garage[s]
Shed 1 shed 100 s . ft or less exempt'
Covered Dock or Boathouse oortion or. land]
Other describe
A. Lot area Acres x 43,560 = l 5 F I I 152-
B Total allowable Floor Area = A x (see table for veluel SF
I C. Existing Floor Area t3t3i from above lines
D. Remainlna Area. oientialh deielooable = B minus C
E. Procosed Area of Construction '7 33
Note: if E is larger than D, a variance or revisions to your plan may be needed. Please consult
w/Staff.
Town cr Queer.stury Planning Office 742 Bay Rcad QueersC,�r; NV 12sn4 516-761-8221 4
DO NOT WRITE ON THIS PAGE: ITEMS TO BE IDENTIFIED BY STAFF DURING PRE-SUBMISSION MEETING
You should use this page for guidance when drafting your application; however, it will be completed by a staff
member. Submittal of a plot plan depicting existing and proposed conditions shall include the items as noted
below. Failure to include all required information may result in a determination of incompleteness and a delay in
the processing of your application. Legend. R [required] N/A[not applicable].
R N/A GENERAL •'rj r r w` a.ds
Title, Name. Address cf applicant & person responsible for preparation of drawing dtiS/r6P S/
Deed / �oPfi tuB�n7TT�p I,, BRy�/rf/.4L fit�ixlCArio�v
North arrow, Tax Map ID, date prepared and scale [minimum 11n. = 40 ft.] 57
Boundaries of the property plotted to scale, zoning boundary S/
Location of principal structures, accessory structures with exterior dimensions s/
Location of site improvements incl. outdoor storage areas, driveways [existing & proposed] parking
areas, etc. S/
Setbacks for all structures and improvements Sy
Elevations and floor plans of proposed structures f}T TY�G//t`Q w /�Ga�L��fcj j70rG5
WATER&+SEWEw 3 tiae`,. 4�• ft"� f 1
Location of on-site sewage disposal facilities, design details, ccns;;uct!on details, flow rates, and number
of bedrooms proposed L,�tiT1'/o�vf pif/ S!
Location of water supply,[i.e. well] and septic on adjoining lots with separation distances to existing or
proposed on-site water supply and septic s/
Separation distances for proposed sewage disposal system to well and water bodies A'4�'T 1
Location and description of existing public or private water supply [well, lake, etc.]. Method of securing
public or private water, location, design and construction of water supply includin oily ter usage
Percolation test location and results aOG�¢T7dsri CA/ S y 'fZ 5tf4T eev 5Z r,&IMOra�
PARKING/PERMEABL'E AREAS �✓�T e0/n/r�� G ��OTrz'—T-1' ,;..'4.�
ema a
Number of spaces required for project cl Z::,g ea:cL:a' rs and justification
umber of existing parking spaces, number to be removed, number to maintain and type of surfacing
material [e.g., gravel, paved]
Provision for pedestrian and handicap access and parking
Location and design details of ingress, egress, loading areas and cutting
Location and character of green areas [existing and proposed], modification to green area, buffer zone to
remain undisturbed
Lighting, location and design of all existing or proposed outdoor lighting
^AD.DITIONAL SITE DEVELOPMENT AND MISE�LAN�OUS ;r#^ /�]ai7, '4k
Location of on-site & ad acent watercourses, streams, rivers lake and wetlands S[
Location of proposed & existing: utility ienergy distribution system [gas, electric, solar, telephone; sy
Location, design and construction of all existing and proposed site improvements including: drain;,
culverts, retaining walls, fences, fire & emergency zones and hydrants S/ -
Location and amount"portion of building area proposed for office, manufacturing, retail sales or other
commercial activities 4__'r7_ COmirr�G/!jG
Town of Queensbury Planning Office 742 Bay Road Queensbury, NY 12304 518-761-8220 5
ADDITIONAL SITE DEVELOPMENT AND MISCELLANEOUS CONT'D. la
/�yF ,
Signage: Location, size, type, design and setback
Waiver Request: provide letter with application requesting any waivers /VYJ w ffrv,595/ffQU�i'
Commercial / Industrial Development requires submission of a Landscaping Plan, Stormwater
Management Plan, Grading Plan and a Lighting Plan
The Board may request other elements as considered necessary
Identify any Federal, State or County permits required for the project A bit/3
Please submit record of application for approval status of all necessary permits required from Federal,
✓ /" AF orltER PER�yTi .vr�o
State and County officials
Sf. k,/qf yh�ry, l pt7M,-1 At2 —,,ectJ
� L GI�t[ l crr.f
Date lit, Staff Member.
Applicant/Agent:
r
Town of Queensbury Planning Office 742 Bay Road Queensbury, NY 12304 518-761-8220 6
14=1"1111W—Taal 12
PROJECT 1.0 NUMBER 617.20 SEAR
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I—PROJECT INFORMATION (To be completed by Applicant or Project spcnson
I APPUGANi5P7
50ft e ,w 2, ppCJECT NAME
PROJECT LOCATION: p
Municipality
a PRECISE LOCATION[Street atldreas and road Intersecaons.prominent Iancmadts, etc or provide map)
-rkler �IX70r1 V1V4a1W V-//4:�;7. aa,po�D
Li9KE��4R66
5 IS PROPOSED ACTION-
0 N.,rr ❑EAOanaiOn Modilicaticnlansistor
6. DESCRIBE PROJECT BRIEFLY:
l�Ernol�frf� 2 6xisnv�ch`Biv� CppvrTrju�T ivclr/,aP�siG�il,�6
G��/Jib'/d�-'yjrJ�Y vr//PSTE'bvr?�k ft/t/O STO.Q/ji!-r/i9TEQlo�TPDdS
AMOUNT OF LAND FF CTEO:
Ind'alY 1:;PI acles Ulllmae.N aCre
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
XYes ❑No 11 No.oescrlpe bde0y
9. WHAT 15 PRESENT LAND USE IN VICINITY OF PROJECT?
Ill Residential ❑IndusMal ❑Commercial ❑Agriculture ❑PawForesVOpen P.C. ❑Other
D"ar.ce:
10 DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING.NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL.
STATE OR LOCAUIy'?pa1�s
❑Yea {,No ❑yes.tisl agency(sl an0 permlVapp�ovala
t 1 DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL?
❑Ya! y:./�NO It yes, lie:agency name and permiVapproval
12 AS A RESULT O1��FF PROPOSED ACTION WILL EXISTING P£RMITIAPPROVAL REQUIRE MODIFICATION?
❑ O Yes No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE AppLa^'uzCon namy N'� / ✓ Date:
Si pnatur
If the action Is In the Coastal Area, and you are a state agency, complete the I
Coastal Assessment Form before proceeding with this assessment
OVER
1
Town of Queensbury Planning Office- 742 Bay Road Queensbury, NY 12804 518-761-8220 7
PART II—ENVIRONMENTAL ASSESSMENT(To be completed by Agency)
A DOES ACTION EXCEED ANY T. b5 I THRESHOLD IN 6 NYdRp PART S17 a+ It yes.coorolnate Ins review Orocess ono use the FULL EAF.
❑Yes ❑No
e WILL ACTION RECEIVE CCCRC INATEC iE'PcR AS PROVIC ED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 6176? If No.a nnatne axlaf atian
miy be Supersecttd by anomer m.a.'Ou agency
❑Yes ❑No
C. COULD ACTION RESULT IN ANY ACv ERS_EFFECTS ASSOCIATED'WITH THE FOLLOWING:tAnswen may be handwdttee,i1 legible)
at Erabng au C..,ity. s .ace or gmuncwa:ar quatil'y or quantity. noise levels, existing traffic patterns, a01id waste production or Cisocsal.
polencat tar erasion,Cl ainage m ucodm,prcolem9?Explain onefly
CZ AeVhehc agricultural archaeological hntcfn or ot.^.ef natural or cultural resources:or community or nelgnoomocd character?Explan ol.af1y
GS. Vegetation or fauna ran.snellllsh or woolife Soecles, significant habitats,Of threatened or endangered species?Explain brlelty.
Ca A=ommunIV,s SAW,.,Plana ar gdals as ar'ICiauy adopted.Of A change in Lisa Or Intensity Of use 011and or Other natural reaoufceat Exotam ofierly
CS. Growth,sIbeequenl devalopmant.Or related activllies likely to be InCuCad by the PIOPOSPp actlonl Explain brlelly
Ca. Long term,snort term,cumulative,or other affects not Identified In CI C57 Explain briefly
C7 Other Impacts(Including changes in use Of either quantity or type of energy)?Explain brlelly
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA7
❑Yoe ❑No
E. IS Ta ERE.OR IS THERE LIKE'Y TO 6E CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
❑YSS ❑No If Yes,explain oderty
PART III—DETERMINATION OF SIGNIFICANCE(To be completed by Agency)
INSTRUCTIONS: For Orion adverse affect Identified above,determine whether It IS substantial,large,important or otherwise significant.
Each effect should be assessed in connection with Its (a) setting i.e. urban of rurap; (b) probability of occurring; (c) duration; (d)
Irreversibility;(a)geographic Scope;and(q magnitude. If necessary, add attachments or reference supporting materials. Ensure that
explanations contain suf iclent detall to show that all relevant adverse Impacts have been identified and adequately addressed. If
question 0 Of Part II was checked yes,the determination and significance must evacuate the potential Impact of the proposed action
on the environmental characteristics 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 positive declaration.
❑ 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
AND provide on attachments as necessary, the reasons supporting this determination:
Name Or leap Ajencf
Prtnl or TIps'-me or A.ddx ixxe GIIiCN m Leao Ajehr, i ilte 01 e{pOns.oie Onn,.'
).ynlh.re Or e5ppn40te 1I.CS1 n{el.Aayn[Y ),na Wre of reParer in a.nerent horn re{oo .........i: i
Vote
2
Town of Queensbury Planning Office 742 Bay Road Queensbury, NY 12804 518-761-8220 8
Signature Page
This page Includes the 1.)Authorization to Act as Aganl Form:2.) Englneef ng Fee Disclosure; 3.)Authorization for
Site Vmis: 4.) Other Permit Responsibilltles: 5.) Official Meeting Disc osura and 6.) Agreement to provide
documentation required
OWNER'S AGENT FORM:
Complete Um follow-v hV If Ulu OWNER Of the,ptOpei ty is twl8ro sanw a9 titer applicant
Owner. 7X/7UT 19_9 _
Designates: / 41W_
As agent regarding. ,Variance_X Site Plan _Subdivision
For Tax Map No.: ZZ7,W Section Block 7 Lot
Deed Refe rice: X B k Z _Page j�Y'�Oate
OWNER SIGNATURE:I ifDA rE: / C
APPLICANT'S A09w FORM:
Cooriplala the following If the APPLICANT is unable to attend the meeting or wishes to be represented by another
pate Owner. Ti wr oxml�/ON�/►�
Designates:
As agent regarding: Variance-Site Plan__SubdMalon
For Tax Map No.: �1 Section �_Block _2 Z Lot
Deed Raf a: Book page jDate
OWNER S(GNATURE: gay -e DA" E�. d
2) E INEEBING FEE DISCLOOURE. Appllcadons may be referred to the Tow consulting englnear for ml" of septic
dealgn,storm dralnags,arc.es dstennlnsd by the Zoning of Planning Daparlmont F 43 br angineenng rill a services via be
charged directly to the applicant. Faso for anglnearing review will not exceed Z 1,000 viantA notification to the applicant.
3.). AUT)JOWAT10N FOR 917E Vf9179: By signing Letts page and submltang the 1ppilcadon materials attached herein, the
Owner.Applicant, and NwherllFalr agaW3)hereby authorize the Zoning Board or PI inning Board and Town Staff to enter the
sublecl properties for the purpose of reviewing the application submitted.
41 9TMER PEaMrf RESP➢NAWILITIES� Other parmks may be ragWrad ror moat .k=n or alteration aWwity-Waequant to
approval by the Zoning Beard or Plowing Bond. It Is U's apPlicenra respcnsrbgl y to t tYah any additional pwrrao.
5..1 OFFICIAL MEETING MINUTES DIOCLOSURC It Is ire prset-0 of the Comm fifty Cevakepmort Department to have a
designated stenographer We record the procoadhga of meetings resulting fmm a,ptiatbn, and minutes transcribed from
theas taeea eonaftwo the official rsmrE of all proceedings. It there Is a dlserapaney such rococo and the hand.Mtlen minutes
taken by live designated etendgrap her,the handwritten minutes shag be deemed the a isfal record.
E.1 AGREEMCNT T9 PROVIDE pOCUMCNTATION R!GUIRI0: L the urdorcignr 1,have torpughly read and rrdarstvW
tee hauvetlrona br aubrtgsalon and agree m Me aubmisdon roquLsnrnts, I aeknow ledge no construction sotddse sines be
mmnrrced prior to Issuance of a valld permtL I car* tat the app!icaton, plans and supporting materials are a tow and
oorrtptete slatsrnentdsacffplion of the "Ung torditkins and the work proposed, and met Y work was be panDntim In
so nilm a halm dhe apprcvsd parks artd h oonrantwira with beat zoning regulation . I an/ohdwladge taw prior to ocoupyhg
the fadtitiee pmr*@ i, t r my perm,"I Mrain a narr"ki,of rwr pancy as maces,sry 1 also understand that LWs may he
r"k**d to provide in a9-butt survey by a licensed land sure yor o1 all newly son atueted fseNtlp prior ID b"ance of a
tartirate of occupancy
I have read and agree to the above.
SIGNATURE OF APPLICANT: e� DATE: --
t
SIGNATURE OF AGENT: ja�g DATE:
Tawr or QUMnebury Plennkrg Olrw.a Tat Bay Road Oueonsbury.NY 2604 - 618-78 220 0
TOWN OF QUEENSBURY
742 Bay Road, Queensbury NY 12804-5902 5 18-761-820I
March 24, 2008
Tom Hutchins, P.E.
169 Haviland Road
Queensbury, NY 12804
RE: David & Lois Arakelian, Site Plan No. 5-2008
14 Trout Pavilion Road, Pilot Knob
Dear Tom:
This letter will confirm our conversation on March 24, 2008, at which time I stated the
following.
If a parcel of land has had an existing structure and sanitary sewage disposal system on
that parcel, and you replace that structure and sanitary sewage system with a new
structure and new sanitary sewage disposal system, the New York State Department of
Health considers this a replacement system.
In 2007, 1 had this conversation with Mike Shaw, P.E. for the Department of Health, to
make sure that the Town of Queensbury was interpreting the Sanitary Sewage Disposal
regulations of the Department of Health correctly, and Mr. Shaw, at that time, stated that
if there has been an existing structure and system on a piece of property, it is not
considered new, and therefore you can take the exemption for any criteria related to
replacement systems for that particular parcel.
This has been consistent with how I've enforced the Sanitary Sewage regulations for the
past 20 years, as the Director of Building and Code Enforcement.
Based on the above information, this is considered a replacement system of an existing
system that has existed on this particular parcel for the Arakelians, and therefore the fill
system may be placed up to the 100 foot boundary from the shores of Lake George, and
be considered compliant under our regulations of Chapter 136.
Sincerely,
TOWN OF QUEE SBURY
David Hatin, Director
Building and Code Enforcement
DH/mg
"HOME OF NATUFL\L BEAUTY . . . A GOOD PLACE TO LIVE"
SETTLED 1763
Permit Number (town use)
Town of Queensbury--
Application for Stormwater Management Permit
Under Chapter 147, Stormwater Management, LL 4-99
THIS APPLICATION IS FOR A
Major Project Q Minor Project
1. OWNER []INDIVIDUAL []PARTNERSHIP pASSOCIATION []CORPORATION []MUNICIPALITY []AGENCY
NAME T�GlT�fi`l�'!Gl�i% //�iG PHONE Z35- 3
MAILING ADDRESS
CITY yj��l STATE AlY ZIP CODE
2. AGENT []SAME AS OWNER []CONTRACTOR []ATTORNEYACONSULTANT []CONTACTPERSON
NAME ffGITGf/`� PHONE
MAILING ADDRESS 1 �lGff/1//�RJ
CITY STATE �/ ZIP CODE
3. CONTRACTOR 0 SAME ASAGENT //
NAME Q� T��� PHONE �p_ 6�46
MAILING ADDRESS �GQ 1�4h' 6W
CITY 7vtLJ STATE ZIP CODE
4. PROJECT LOCATION
FACILITY NAME(If not residential) 1PROPERTY
ECTION ZZ7. Ill BLOCK ��� LOT Z7
—---- — TREET P��T�/�� �v�1�L --
ZONING CLASSIFICATION IS PRESENTLY
VACANT PARTIALLY DEVELOPED 0 DEVELOPED&OCCUPIED
IS PROPERTY PART OF A SUBDIVISION? XNo 0Yes, name of subdivision
5. PROJECT DESCRIPTION
PROJECT
46 9�- Y. lti/9>TTF i�Tf.�fY�ST�rI STDrP/J1lf//�J�'le�ir�oLS
PROJECT INVOLVES:
XEarthwork/Landscaping Tree Clearing 9House Construction or Addition ADrivewayConstruction
AGarage Construction []Detached Structure )(Septic System Q Modification of a Stormwater Device
Q Other
UICRAIGITEMPLATEa,STWATAPPSTOWN STORMWATER APPL.DOCII/2000 Page 1 of 3
PRVt'"LL)USt U NO: �oenW4(Seavmal) RnIdenual(year-rauntl) LlAs;ods+m UPuMic ❑Cornmemal
PROPOSED 6TARTING D..TE PROPOSED COMPLETION DATE
.. ❑ESCRIBE THE MArnai IS. SLOPE OF THE PROPERTY IN THE PROJECT AREA-
()OS% (Level)At-10% (Gi dual ak") Q 10-15% (Moderate slope) C Grsater dwn 16%(Stoop slope)
IS ANY PORTION OF THIS 4CTINTTY FOR WHICH A PERMIT IS SOUGHT NOW BEGUN OR COMPLETED?
p Yes No (Ir yea,pkesa a plain)
S. CALCULATIONS & Ct INTROLS
TOTAL AREA OF PROPER" Y l FT2 (drde one)
TOTAL AREA OF LAND DIE TURSiiUiCE: S FfY(do not tnciuda Hess of atormwater Controls)
TOTAL AREA OF NEWLY C tEATED IMPERVIOUS 8URFACE: /h1:w FT'r
TOTAL VOLUME OF STORI 'WATER TO BE CONTROLLED: (see in000AT
W
TYPE OF STORAi�kAYBR Cr ,NTROL MEASUP.ES TO BE USED:
(�l�'F/L7YiiiTl✓dz wj%
HAS AN ER0810N CONTRO .PLAN BEEN PREPARED? XYss,plan is attached 0 No
1140. please Conlaol y w County Sol&W atar Cons ion Dist ict for asalswrx)a:
Warm Candy 132.3-3- 1e
T. t§ t9lNlrt.
Dw�O BIe poewsbW of Hits ei p11ce00h-5ir"r}'psrsiiiiivel may need to viall Ude site far the purpose of Gq;5dWhg---
measurlrg"or photn phk 7 ske CWA11 iOM.
1 authoetze town personnal tc conduct such a eke Inspectlor�as A no
I f
?s!I to ba centeded prior A anytitsInspadlon A no
41
eby MTirm Heat the kdofmab sn on this form erg ail attscfvnerrls submxtad hfulm4h is true to the best of my
wledge and bcd1aL As a con 100n to the�rence of a permfl,the appi wt accepts full legal responeibtiRyf"
3ge,dkzd and kwvscL or v hatevOr lraturs, and by Whomever cuifervd. "Ing cut of dw project described
a� �+ nd save frarmte3s the tsvn from sUfts,ac�Cna, damages and costs d ovary name
s SIGNATURE OF OWNER /] ^� DATE
810NATUREOFAGENTf DATE
t5�/I
INCLWE MTH THIS P4)IW:
.9 SHO 10aatflgrl pop
® Peu}aat ptswj.a.,>) ; x 11 asjsu;pet> "( 14 A IiouR 41%eti>Vr.�,LarartasgvrAhan 14Xt
Nis arse I it .aP;tii�rbmt fa, Sttr6�iFx Ry
A Attachment A h�OT r or pA*ct1 .
A Environmental Ass sotridnt dorm (for A58Jdr pralestd anW
Fa&ry to kxiude any era of Me n: Tukod rams kg!maul!8T en kwarr0&go notice errd delay AI proc ussing your
gpp&;etba Permits end epprovat may be requ6ed from othor agondes.
rw iv , V.0,iy
L1CAA MTEW AT'cSVSWIATAPPQTOWr STORUWATER APPLOOC t V2000 Pape 2 of 3
- -the attached Schedule A.-- -- - •-••• � � ncu eppfuveu plans anD supieut to the cunurtions ustea on
Approved by on Permit Expires
, Zoning Administrator Dale
CONDITIONS OF APPROVAL
ATTACHMENT A
to Stormwater Management Permit Application
Permits or approvals required from other agencies
Agency Permit or Approval Date Applied Date Issued
Adjoining Property Owners. /tTT7�l�f�
List all parcels within 500 feet
Tax Parcel Number Name Mailing Address
L:ICRAIMTEMPLATESSTWATAPPSTOWN STORMWATER APPL.DOC 11/2000 Page 3 of 3
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Taus I Current (Current Property
Map Location Acres Frontage Depth Land iTotal SchoolAddress Address (Deed
P 9wnur 1 Owner 2 class CityB State IIP
Number. assessment Assassmant DU(rmt Code 1 2 Book
227.6- '1279 PILOT _ Lk• 1279 NO Ksa[[fklll
1-t KNOB 0.0 1.0]999996185 0 0 712900 1012000 G PCR� KAH N,IE AN 0 No Value 210 pilot 12844 3001
C d Knob Rd Value Boy NY
227.6- MAYFLOWER Lake KO$ETT1, 427New
O J90000021453 0 0 15000 i15000 Geor JAC UELINF Kamer NO Loudonville 12205 6B0
14 LANE,OFF d Q NO Value ?i! value NY
Cstl 'iM pd
ak2 (I 1-3 KNOB
KNO PILOT HOWLAND- Howland, 92 W NO I(
U J900000095ll 0 0 531300 Bfi)900 C,d�'a.000NE,ANN IComm n Fairport NV d4450 1J]J
1-] KNOB RD a �- Y i1p Church
9s j5t Value
227.6- S4 Lake ROSE,-,I 417 New
1.4 - -
MAYFLOWER 't 0 -0 1081100 1431000 G crge RESIDENCE
LN :No Value 210 Komar NValue° Albany NY 11304 1600
Cad '(TRUST l Rd
227.6- 5 _ Lake
MAYFLOWER 0.80000001192, 0 0 91400 163600 GeQ,r THINGVELLIA, Mohawk No Lake
15 LN LLD No Value 210 Mountain Value (George NY 12845 3251
Rd
z0 - - -- _
2 D.6- Lake 1006 r
1.6 MAYFLOWER 0 S 0 0 824000 1300000 Georoe PATNAUDE. Pa[naude, DlBalla No 5<henactadY 12303 1336
LN Cstl ',ROBERT Warb. Dr Value NY
Z 2].6- 16 Lake_ 'STUTZ- 1 f
MAYFLOWER 0.569999992947 0 0 685400 �898000 G or a MILLER, PO eos No IBatbkIll I", No
1J 9_ NO Value 210
LN Cad XIL_GA i IZJ Value '.BJY NY Value '
237.10- Lake
1.5.1 BEAN RD 0.070000000298 0 a ',2000 2000 G r9e CONWAY, Conway, 1!-I-' 3Bean No 'Kattskill j128J4 3366
Cad
- "R,By (`Laura Rd Value !Bay NV
Ok-
BEAN RD O.100000031921 0 !!0 131500 11500 G orse CHR25TOP NE R, Christopher, 11 Bean No Kaltskill
1•S.2 JEFFREY Carol 31l Rd value BaY NY �13844 1200
Csd
ke
227.30 :CHRISTOPHER, 11 Bean No Kattskill
11 BEAN Rp 0.41999998d88) 0 0 56000 227200 G or9e.'JER REV Rd Value 'Bay NY
1.6 NO Value 1314 12944 1424
Can f217.10- Lake 15220
;1-] BEAN RD 0.6399999SS69S 0 0 60000 60000 George KREBS, Krebs, 13 Harbour No Fort Myers
Cad ELIZABETH Ronald 3- Isle Dr Value FL 3390E 1234
I....... Lalre 'L
12],10- _ _
1 O KREBS. IKrabs, 15220 No ers
(Fort Me 37 BEAN AD O.81999999280 0 0 66600 290700 George Harhour Y
1 B Cs -' RON4L0 Elisabeth 210 Isle Or Value FL D9a8 13]4
1122).10- Lake - _
32 BEAN RD 1,25999999046 0 0 1506000 11808500 Geor STONE, PO Box No Nashville
'ld1 9e (Stone,LR15 260 37212 1500
Cad
LAWRFNCE I 12158a Value IN
1-).10- Like MICHAELS, Michaels, 30 Bean No Kattskill
30 BEAN RO0.889999985695 0 0 661600 �,t600000 George
1-23 Csd DAVID] ,Lynne 23� Rd Value ,Bay NV 112844 812
Lake
27
124 1- 2a BEAN RD L09000003338 0 D �632700 '975200 Geor SEVERANCE, Ow No Quenfbury No
.CPC ge Glass John 260 WENDY , Or erlo0k e
Value 'NY 13804 Value '
Zl).10- L �ShL'rH, 4 Bean No Kattskill !
J BEAN AD 4.e100 000 329 2 O -0 94600 1]t500 CIA DOUGLAII No Value ! Rd 'Value Bay NY
1-IS 1129" 1126
u
237.10- 245 PILOT ILakE JRAAELIA N. �bBkella n, _- - ----
1-2d KNOB RO 2,1400001049 '0 10 1534800 2302000 G_,q GEORG£ Barbara 33.Q der es Value Troy NY Ii12180 value
Cad
14 TROUT ! Lake
Z 11.10- 750
PAVILION '].Jfi9999B85 Sfi 0 �0 �,3600000 1300000 eeor9e TROUT No No
Value Troy NY 12181 value
l47 NO Value 210 Second
AD Cad - PAVILION INC Ava
19 TROUT lake
321.10_ PAVLLION 'O,J]99999W 636 D -0 1539fi00 912fi 00 G> mge ANTHONY J613 No Fort Myers No
1-28 RD Cstl ]ACQ UELIN No Value i210 Da0sni0 value FL 33919 Value
Z17.10- 121 TROUT Lake
PAVILION O.a600000aB]JS 0 0 526600 '1125000 Georg e_IROURK C, l�RRurke, PO Box No KatHkll
1-29 RD ! C d ROBERT Barbara 230 4 Value Bay NY S384A '1015
29 TROUT Laka
22).10- East
PAVILION p,660000036326 0 0 842400 5010800 Geor RICHARlLLD. Cranes t0 4 Cherry Na -.13061 1386
1.20 9'-_ 3� GreenkU4h
RD ". Csrl NICXARO Frances ,Vale Value 'XY
'Z1].l0• �22 TROUT Lake
PAVILION ROURKE, !0.ourka, PO B9f NO Katts kill
01230000001192 a 0 42500 �84300 G=ore ROBERT IBalbafa J
1•]1 'SRO ,Csd V31ue Bay NY 123" 1015
217.10- 'ZA TROUT Lake
FAVILLION 0.310000002]ei 0 0 46000 200700 George. ROURKF, .Rourke, PO eos No Kattlkill
1-33 Wd RO Bl0.T 'BarOeraZ10 J Value ,Bay NY l2BJJ 3015
RD
217.10- PILOT KNOB ARAAELIAN. 750 No No
1-37 0.0..OfF 0.159999996414 0 0 1500 3500 Ca, GEORGE No
Val
31L Second Value Troy NY 12180 Value
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