Loading...
Application l • rece TOWN OF QUEENSBURY 531 Bay Road, Queensbury, NY 12804 DEPARTMENT OF COMMUNITY DEVELOPMENT FILE NUMBER: '51 - �Q5 I . PROJECT APPLICANT: ADDRESS : 9� Pi7LIJOOD Ufi Ovee-n512krq PHONE If : Home: 7 -z 0y& PHONE $ : Work: APPLICANT' S AGENT: ADDRESS : PHONE II : Home : PHONE Ik : Work: PROPERTY OWNER: �i'/yyl� /95 f� GOUG ADDRESS : PHONE S : Home : PHONE # : Work: DESCRIPTION OF PROJECT: DIRECTIONS 10 THE PROJECT: Please make as clear as possibly, so Board members & Staff can find your pro]]ect • �/^ - CAY 6i'd. fvrn �nro G1/�u>c�d - Lid /�v-i7�irz� o n Ln - 19a Z - �r//hi a r/haae ti .SKETCH OR PHOTOCOPY OF OFFICE USE ONLY �) RO D MAP: Tax Map No . _ - 6 ,31 _ Cq� Zoning: IQ Variance : A U S o J Site Plan: --'Yes No C Subdiv. :Q _Yes �No�\ CEA: _Yes ✓No SEQRA: I, II, Unlisted rl / Warren Co . : ✓Yes No APA: _Yes c-� No /�� °� Wetlands : _Yes No II . SITE DEVELOPMENT DATA Tax Map Number: Section 9/o2 Block Lot Zone Classification : 17r- / 5 Area of Parcel acres = /B&8. 32, sq. ft . Maximum Size Building Allowed sq. ft . Disposition of Parcel : Existing Building Area qB 5 sq. ft . % of parcel Paved Area sq. ft . % of parcel ( including walks ) Green Area sq. ft. % of parcel Proposed 138'S Building Area sq. ft . IS % of parcel Paved Area © sq. ft . % of parcel • ( including walks ) Green Area sq. ft . % of parcel Building Setbacks Existing Proposed Required Front Yard Front ( if corner) Side Yard ( 1 ) sS S S 30 Side Yard ( 2 ) )5 a0 20 Rear Yard 70 &0 30 Rear Yard ( 2 ) Shoreline Width Depth eAccess ( check where applicable) Town Highway County State Length of Frontage Number of Parking spaces : Existing 15- Proposed /5" Town Water : v Yes No Town Sewer : V Yes No Any previous Planning or Zoning Board determination regarding this property? /90 Present Use of Property: V/lileVha�2 - u Pj dU.6 A��7O'YO Proposed Use of Property: vlL/P(b A COMPLETE APPLICATION IS NECESSARY FOR PLACEMENT ON THE PLANNING BOARD AND ZONING BOARD OF APPEALS AGENDAS - APPLICANT PLEASE READ The Planning and Zoning Office requires 10 copies of your site plan or variance application and maps, one original and 9 copies, along with supporting documentation. Also required are 2 copies of the deed and survey plat. In addition to the $25 . 00 fee for site plan applications and the $50 . 00 fee for variance applications, the applicant is required to pay for the costs related to engineering review. Applications may be referred to the Town Consulting Engineer for review of septic design, storm drainage, etc . The hourly rate charge for the engineer review will be charged directly to the applicant. Fees for engineering review will not exceed $1 , 000 . 00 without notification to the applicant. Other permits may be required for construction or alteration subsequent to approval by the Planning Board or Zoning Board of • Appeals . It is the applicant ' s responsibility to obtain these. I, the undersigned, have thoroughly read and understand the instructions for submission, agree to the submission requirements and completed the checklist. Furthermore, it is the practice of the Department of Community Development to have a designated stenographer tape record the proceedings of meetings resulting from applications, and that minutes transcribed from those tapes constitute the official record of all proceedings . If there is a discrepancy between such record and the handwritten minutes taken by the designated stenographer, the handwritten minutes shall be deemed the official record. I HAVE READ AND AGREE TO THE ABOVE STATEMENT Applicant' s Signature 10, 1,4 Date _9-26-gb Applicant' s Agent Signature Date QUEENSBURY APPLICATION COMPLETENESS CHECKLIST ✓ Application fee for each application. ✓ Original plus 9 copies ✓ Required Signatures ✓ Location Map ✓ Adequate Plot Plan. Other The Plot Plan: Draw to scale (preferably 1 inch = 40 feet or less ) a detailed description of the proposed site. Failure to • include all the required information on your site plan will result in a determination of incompleteness and a delay in the processing of your application. * Items A through M must be included on the Plot Plan for the site plan review application and all variance applications . * Items N through Z shall be included on the Plot Plan if applicable. P N/A {> A. Title of drawing, including name and address of applicant and persons responsible for preparation of such drawing. ✓ / B. North arrow, scale and date. ✓ i� C. Boundaries of the property with dimensions in feet, including zoning boundary delineations . ✓ / D. Location of all existing principal and accessory structures and their uses with exterior dimensions and lot-line and waterfront setbacks . P - Provided N/A - Not Applicable P N/A p 7 E . Location of all proposed principal and accessory uses and structures with exterior dimensions and setbacks . /-7 F. Location of any existing or proposed easements, driveways, outdoor storage and refuse containment areas, including setbacks and dimensions of the structures . G. Location of existing and proposed sewage disposal facilities including lot line, waterfront and well setbacks . For proposed system or if expanding use, include design details, construction materials, flow rates or number of bedrooms served and percolation test results . Also, location of existing sewage and water systems on adjoining lots . • H. Location and description of existing public or private water supply. I . Description of the method of securing public or private water and location, design and construction materials of such facilities . /� fl J. Total number of existing parking spaces, including the number of those to remain or to be removed, those to be paved, those to be graveled, and total number of proposed new paved spaces and proposed graveled spaces, including basis for determining parking adequacy. / K. Location and design of all existing and proposed outdoor lighting facilities . L. Percent of lot which is presently permeable, including composition of ground cover (grass, shrubs, gravel, etc. ) ✓� /� M. Percent of lot which is proposed to be permeable, including composition of ground cover. N. Existing watercourses, wetlands, and other waterbodies . n 0. Proposed maximum daily water usage in gallons per day. P - Provided N/A - Not Applicable P N/A P. Location and design of all existing and proposed parking and loading areas, showing driveways, ingress, egress, handicapped parking and curbing. For proposed parking and loading areas, include design details, construction materials and dimensions. yjh Q. Provision for pedestrian and handicapped access . /1L19 R. Location, design and construction materials of all existing or proposed site improvements including drains , culverts, retaining walls, and fences . T S . Location of fire and other emergency zones, including the location of fire hydrants . T. Location of all existing and proposed energy • T distribution facilities and other utilities, including electrical, gas, solar energy, telephone, etc . For proposed facilities, include design details and construction materials . N U. Location, setbacks, and size of all existing and proposed signs, including design and construction details of proposed signs . V. Location and proposed development of all buffer areas, including existing vegetative cover and screening of storage or refuse areas . W. Identification of the location and amount of building areas proposed for office, manufacturing, retail sales or other commercial activity. • /Y _ X. General landscaping plan and planting schedule; including existing trees over 3 inches in diameter. N Y. Grading and stormwater management plan, showing existing and proposed contours and including drainage calculations . Z . Other elements integral to the proposed development or considered necessary by the Boards and staff. Z2 . SEQRA Determination. P - Provided N/A - Not Applicable PROJECT I.D.NUMBER 617.21 SEQR 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 sponsor) 1. APPLICANI MPONSO I 2. PROJECT NAME 3. PROJECT LOCATION' v� n Municipality !Y/J�'e/"),{J,r;A(J7c >/ County A. PRECISE LOCATION(Street address and road intersects minent landmarks,etc.,or provide map) 91 104ou>eic-d ll V /9y //oft0 S. IS PROPOSED ACTION: Li New LaExpansion ❑Modificationlalteration 6. DESCRIeE PRCJECT BRIEFLY: , /0 7 6Dli ��l6 uo Bf}G r�U/L.t9irJ6 7. AMOUNT OF'.;. rECTED: Initially Ultimately acres 8. WILL PROFOSEO ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTICNS-. IL XYes i i1 No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY �cO-�F PROJECT? 0Residential Cl industrial y15;Commercial El Agriculture L Park/ForesUOpen space ❑Cther Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GCVE=NMENTAL AGENCY(FEDERAL STATE OR LCCAL)? Ell Yes 9No If yes, list agency(s) and permitlapprovals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes XiNo If yes, list agency name and permit/approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? ❑Yes No I CERTIFY THAT THE INFORMATION /PROVIDED -fABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ��7 AppllcanVsponsor name; C •� LU /1 rQ ( Date: _91 Signature: w �- • n/� w If.thesectionIS.tn the.Coastal.Area,and ouare.a.statea ene com fete.the:::: Y 9 Yr P Coastal Assessment Form before proceeding with this assessment OVER 1 PART II—ENVIRONMENTAL ASSESSMENT (To oe completeu uy ry­..y) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR.PART 617.12? If yes,coordinate the review process and use the FULL EAF. _r ❑Yes ❑No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration may be superseded by another Involved agency. ❑Yes ❑No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten, If legible) Ct. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character? Explain briefly. CS. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered species? Explain briefly. CS. A community's existing plans or goals as officially adeptee.or a change in use or intensity of use of land or other natural resources?E.•ctain briefly. C5. Growth, subsequent development,or related activities likely to be Induced by the proposed action? Explain briefly. I ' C6. Long term, short term,cumulative,or other effects not identified in C1L5?Explain briefly. C7. Other Impacts(including changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE,OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes ❑No If Yes,exotain briefly PART III—DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For 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 (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and if) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. FCheck ox if you have identified one or more.potentially large or significant adverse impacts which MAY roceed directly to the FULL EAF and/or prepare a positive declaration. ox if you have determined, based on the Information and analysis above and any supporting n, that the proposed action WILL NOT result in any significant adverse environmental impacts on attachments as necessary, the reasons supporting this determination: Name ai lead A{envy Print or Type Name of Responsible Officer in Leaa Agency i itle or Responst a Officer i 4. car in Lead Agency �— Signature of Preparer(I different from responsible anscer) ' ---- ' ignature or Rrponvbie Of Date 2