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Application Sign Variance Revised June 2009 SIGN VARIANCE APPLICATION REVIEW PROCESS 1. Required Pre-Submission meeting with staff to determine general completeness to be held no later than i week prior to deadline day. Cali (518)761-8238 for appointment. 2. Submittal of complete application: 1 original & 14 copies of the application package by monthly deadline. 3. Determination of application completeness. All necessary information must be provided and appropriate feels) 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 supplied. 5. Submittal to the Warren County Planning Board, if applicable. 6. Zoning Board meeting, generally the third and fourth Wednesday of each month. You will be advised in writing as to which meeting to attend. 7. Following the meeting, you will be provided with a copy of the resolution stating the Board's decision on your application. If your application was approved, the next likely step is a Building Permit. Final plansidrawings 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 and 14 copies of the completed application package to include: • Completed Application: pages 1-9 completed, signed&dated • Pre-Submission Meeting Notes: signed by staff • Denial Letter: from the Zoning Administrator • Waiver Request: any request for a waiver from the applicant regarding submission requirements. • Copy of Deed • Survey: stamped, dated&signed • Fee ZONING STAFF&CONTACT INFORMATION Craig Brown,Zoning Administrator craigb*gueensburv.net Laura Moore, Land Use Planner Imoofe(o)gueensbury.net Sue Hemingway, Office Specialist (518)761-8238 Visit our website at www.cueensbury.net for further information and forms. Town of Queensbury-Zoning Otfica•742 Bay Road•Queensbury, NY 12804•518-761-8238 0 i Sign Variance Revised June 2009 General Information Tax Parcel ID Number. 296.18-1-47 Zoning District: Cl-Commercial Intensive Detailed Description of Project [includes current&proposed use]: Redevelopment of a former automotive repair site at Northway Plaza for construction of a new 7,300+/-SF Texas Road House Restaurant. Location of project: Northway Plaza 820 State Route 9 Applicant Name: Wesley Padgett, Development Address: 3060Peachtree Rd. NW __ Manager/RCG Ventures, LLC Atlanta, GA 30305 Home Phone Cell: (404)644-0636 Work'Phone (404)816-5454 ext. 134 FaX (404)816-5445 E-Mailf I IWesleyp@rcgventures.com Agent's Name: Tony Stellato, Address inners Circle CHA Consulting, Inc. Albany, NY 12205 Home Phone Cell: (518)573-6362 Work Phone (518)453-3927 Fax (518)453-4772 E-mail, tstellato@chacompanies.com I Owner's Name Same as Applicant Address Home Phone Cell Work Phone Fax E-mail — ---^ -� Town of Queensbury•Zoning Offce•742 Bay Road•Queensbury, NY 12804.518-761-8238 i Sign Variance Revised June 2009 Site Development Data Area/Type Existing sq.ft. Proposed Total sq. ft. Addition sq.ft A. Building footprint (previously 7,319 7,319 demolished) B. Detached Garage 0 0 0 C. Accessory Structure(s) oumpsterenclosure) 0 600 600 D. Paved,gravel or other hard surfaced area 82,012 57,849 57,849 E. Porches I Decks 0 0 0 F. Other 0 0 0 G. Total Non-Permeable (Add A-F] 82,012 65,768 65,768 H. Parcel Area [43,560 sq.ft./acre] 94,245 94.245 94,245 I. Percentage of Impermeable Area of Site (I=G/H] 87.0% 69.8% 69.8% Setback Requirements . Area Required Existing. Proposed Front[1] 75' N/A 78.6' Front(2] 75' N/A 193.3' Shoreline N/A N/A N/A Side Yard [1] 20'/50'total N/A 78.0' Side Yard [2] N/A N/A N/A Rear Yard[1] 25' N/A 30.1' Rear Yard[2) N/A N/A N/A Travel Corridor 75' N/A 78.6' Route 9 Height[max] 40' N/A 27'-6" Permeability 30% 13% 30.2% 1 No. of parking spaces 77 i N/A 140 Town of Queembury•Zoning Office-742 Bay Road-Queensbury, NY 12804-518-761-8238 2 • Sign Variance Revised June 2009 Compliance with Sign Ordinance Section(s)that apply: 140-6.B(1), 140-6.B(2)b[1], 140-6.B(3)d[2][a], 140-6.6(4)[a] What signs are you allowed to have? Sign Type How many allowed Square Feet Height Wall 1 per road facing wall 30 Freestanding 1 per road entrance 4 5'setback 20' 60 25'setback This application is for a change in the: Number of Signs: from(currently): to(proposed): X Setback for Sign -Section 140-6.B(1) X Size of Sign -Section 140-6.B(2)b[t] Height of Sign X Other(specify) Sections 140-6.B(3)d[2][a]-Allow an additional freestanding sign along Route 9 less than 15'from the property line and 140-6.B(4)[a]-Allow an increase in number Elevation: of freestanding signs for plaza along Route 9 from 2(existing)to 3. If you are proposing to install wall signs,provide a scale drawing of the fagade the sign(s)will be located on,with their location shown. If you are proposing more than two(2)signs,the following information must be provided for each sign (please use additional sheets if necessary) Sign Number see attached (d you are applying for more than one sign) Sign Type Existing Proposed Length Width Total Height Depth for Sq. feet Projecting Walt Frees n in SEE ATTAGHE Pro ecti Illuminated Awnin Property Line Setbacks: Front see attached Side see attached Sign Wording: see attached Town of Queensbury•Zoning Office•742 Bay Road•Qusensbury, NY 12804•518-761.8238 3 Sign Variance Revised June 2009 • The following questions reflect the criteria for granting this type of variance. Please complete them; use additional sheets if needed. 1. Whether an undesirable change will be produced in the character of the neighborhood or a detriment to nearby property will be created by the granting of this sign variance? See attached 2. Whether the benefit sought by the applicant can be achieved by some method,feasible for the applicant to pursue, other than a sign variance? See attached 3. Whether the requested sign variance is substantial? See attached 4. Whether the proposed variance will have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district? See attached • 5. Whether the alleged difficulty was self-created? See attached Additional Proiect Information 1. If the parcel has previous approvals, fist application number(s): N/A 2, Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Program? Yes 3_ Estimated project duration: Start Date April 2015 End Date September 2015 4. Estimated total cost of project: $1,500,000 Town of Queensbury•ZonIng Office•742 Bay Road•Queensbury, NY 12804.518-761-8238 4 i Sign Variance Revised June 2009 Submittal of a stamped and starred SURVEY MAP depicting existing and proposed conditions shall include the items as noted below. A. GENERAL SHOWN ON SHEET# 1 Title,Name,Address of applieam&person responsible for preparation of draw" Title block 2 Deed Attached 3 North arrow,Tax Map ID,date prepared and scale[minimum 1In,-40 fi.l Title block 4 Boundaries of We property plotted to scale,zoning boundary _ Subdivision plat 5 Principal structures,accessory structures with exterior dimensions C-05 6 Site Improvements Incl.outdoor storage areas,driveways,parking areas,etc.: existing 8 proposed C-05 7 Setbacks for aft structures and Improvements: existing J.proposed C-05 8 Elevations and floor plane of all proposed and affected structures Attached B. .i* WATERBSEWER -SHOWN ON -. I`.t3HEET# 1 Project sewage disposal facilities,design details,construction details,flow rates,and number of bedrooms proposed N/A 2 Water supply[is.weli]&septic on adjoining lots with separation distances to existing or proposed on-sfle water supply and N/A SLptic 3 Separation distances for proposed sewage disposal system to well and water bodies N/A 4 Existing public or private water supply[well,lake,etc.]. Method of securing public or private water, location, design and N/A construction of water supply Including daily water usage 5 Percolation test location and results N/A PARKING I PERMEABLE AREAS SHOWN" SHEET#� . t Number of spaces required for project Including calculations and justification: existing IL proposed C-05 2 No.of edsting patkingspaces,number to be removed,number to maintain and type of surfacing material e. ., ravel, 3 Pfoviskm for pedestrian and handicap access and parking: existing A proposed C-05 4 Design details of ingress,egress,loading areas and cutting: existing&proposed C-05 5 Location and character of green areas[existing and proposedl,modification to green area,buffer zone to remain undisturbed C-08 6 Lighting,location and design of all existing and proposed outdoor lighting C-10 D. ADDITIONAL SITE DEVELOPMENT AND MISCELLANEOUS SHOWN ON . . SHEET:# 1 On-site&adjacent watercourses,streams,rivers,lake and wetlands Subdivision plat 2 Utility lenergy distribution system[gas,elecbic,solar,telephWel: existing A,pruposed C-07 3 Location,design and constmclion details of all existing and proposed site improvemems inctuding: drams,culverts,retaining walls,fences,fire&emergency zones and hydrants,etc. Site plans 4 Square footage of bldg. area proposed for office, manufacturing, retail sales or other commercial activities: existing & C-05 proposed e Signsge: Location,site.type,design and setback existing&proposed Sign package f Waiver Request: provide letter with application requesting arty waivers: please reference specific Items Attached g Commerdaillndustrfal Development requires submission of Landscaping,Stemwater Management,Gradkg&Lighting Plans Site plans h Identification of Federal.State or County permits required for the project together with a record of application for all necessary EAF ermits Town of Queensbury-Zoning Office-742 Bay Road-Queensbury,NY 12804.518-761-8238 5 Sign Variance Revised June 2009 iPre-Submission Conference Form [179.4-0401 1. Tax Map1O 296,18-1-47 2. Zoning Classification Cl-Commercial Intensive 3. Reason for Review: Sign Variances 4. Zoning Section 9: 140-6.8(1), 140-6.B(2)b[1], 140-6.B(3)d[2][a], 140-6.B(4)[a] 5. Pr"ubmission 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 Compliance with Sign Ordinance i Yes No Checklist items addressed _Yes No Environmental Form completed _Yes _No Signature Page completed _Yes —No • Staff Representative: Applicant f Agent: Date: Town of Oueensbury•Zoning Office•742 Bay Road•klueensbury, NY 12804•518-761.8238 6 Signature Page Sign Variance Revised June 2009 This page includes the 1.)Authorization to Act as Agent Form: 2.) Engineering Fee Disclosure; 3.)Authorization for Site Visits; 4,) Other Permit Responsibilities; 6.) Official Meeting Disclosure and 6.) Agreement to provide documentation required_ OwxsR's AGENT FORM: Complete the following it 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 Stock _Lot Deed Reference: _Book _Page Date OWNER SIGNATURE: DATE: APPUCANT'8 AGENT FORM: Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party Owner. RCG Ventures,LLC Designates: CHA Consulting,Inc. As agent regarding: X Variance Site Plan Subdivision For Tax Map No.: 296.18Section 1 Block 47 Lot Dead Reference: 4M Book 208 Page 7l12NMate 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 of 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 histherlthepr 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 approvaf by the Zoning Board or Planning Board, it is the applicants responsibility to obtain any additional permits. 5.1 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 Ilia official record of a1 prongs. 6.) AGREEMENT TO PROVIDE DOCUMENTATION REMIRE6: 1, the undersigned, have thoroughly read and understand the instructions for submission and agree to the submission requirements, I acknowledge no construction activities shell be commenced prior to issuance of a valid permit I certify that fhe application, plans and supporting materiels are a true and complete statement/dascription of the existing conditions and the work proposed, and that all work will be performed in accordance with the Approved plans and in conformence with local zoning regulation. I admowledge that prior to occupying the families proposed,I dr my agents,will obtain a cartitrcate of occupancy as necessary. f also understand that ifwe may be required to Provide an as-buift survey by a Iicensed land surveyor of all rawly constructed fimgrias prior to issuance of a certificate of occupancy I have read and agree to the above Wesley Padgett/RCG Ventures,LLC JZ Sig turd pplicagt Print Name[Applicant] Date signed / Anthony Stellat0(CHA Consulting,Inc. npent) Print Name[Agent) Date signed Town of Queensbmy-Zoning Office•742 Bay Road•Queensbury,NY 1<804.518-761-8238 9 • ATTATCHMENT TO SIGN VARIANCE APPLICATION Texas Road House December 15, 2014 SIGN INFORMATION Note, see sign drawings in Attachment 7 for additional information. Sign#1 -Freestanding Sign—"TEXAS ROADHOUSE"with logo Length: 11'-0" Width: 6'-4" Height: 15'-0" (compliant) Sign Area: 66.33 sq. ft. (compliant) Setback: 4'-6" (variance required) No. of signs per road entrance: 2 existing, 1 proposed (variance required) Sign#2—Wall Sign Front Elevation—"TEXAS road house"with logo Length: 33'-0" Width: 7'-0" Height: 25'-0" (compliant) Sign Area: 128.5 sq.ft. (variance required) Sign#3—Wall Sign Left Elevation—"TEXAS road house"with logo Length: 5'-7" • Width: 3'-3" Height: 15'-0" (compliant) Sign Area: 18.1 sq.ft. (compliant) VARIANCE APPLICATION QUESTIONS The following questions reflect the criteria for granting this type of variance. 1. Whether an undesirable change will be produced in the character of the neighborhood or a detriment to nearby property will be created by the granting of this sign variance? No. The project is located in a Commercial Intensive zoning district at the intersection of two busy commercial corridors. Commercial signs of the type,number and scale of the signs proposed are typical of the area. 2. Whether the benefit sought by the applicant can be achieved by some method, feasible for the applicant to pursue,other than a sign variance? No. Visibility is of critical importance to the success of a restaurant. Texas Road House operates 400 restaurants in 46 states. As a result,the company has gained extensive experience in the importance of adequate sign visibility to the success of the restaurant. 3. Whether the requested sign variance is substantial? No. The proposed signs fit the scale of the proposed project, and provide a compliment to its architectural character. Additionally, the proposed signs are compatible in number and scale to those located at existing businesses along the Route 9 and Quaker Road corridors. 4. Whether the proposed variance will have an adverse effect or impact the physical or environmental conditions in the neighborhood district? No. As stated above,the project is located in a Commercial Intensive zoning district at the intersection of two busy commercial corridors. Commercial signs of the type, number and scale of the signs proposed are typical of the area. Additionally,there are three large existing billboards located on Route 9 directly across the street from the project site. These billboards compete significantly with the signs of local businesses. 5. Whether the alleged difficulty was self-created? No. Visible signage is important to every business, but it is of critical importance to the success of a restaurant because a large component of patronage is attributable to drive by traffic. Without adequate signage, many would-be customers could potentially miss the opportunity to spot the Texas Road House signage in time to make the appropriate lane change or slow down sufficiently to enter the plaza,and then decide to continue on their way to another establishment. There are numerous other well-signed, highly visible restaurant choices in this area. The need for a sign variance is a function of existing neighborhood conditions combined with typical observed customer behavior. ID 40 Attachment 2 40 Full Environmental Assessment Form (FEAF) Full Environmental Assessment Form Part I -Project and Setting Instructions for Completing Part 1 • Part 1 is to be completed by the applicant or project sponsor. Responses become part of the application for approval or funding, are subject to public review,and may be subject to further verification. Complete Part l 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;indicate whether missing information does not exist, or is not reasonably available to the sponsor;and,when possible,generally describe work or studies which would be necessary to update or fully develop that information. Applicants/sponsors must complete all items in Sections A&B. In Sections C,D&E,most items contain an initial question that must be answered either"Yes"or"No". If the answer to the initial question is"Yes",complete the sub-questions that follow. If the answer to the initial question is"No",proceed to the next question. Section F allows the project sponsor to identify and attach any additional information. Section G requires the name and signature of the project sponsor to verify that the information contained in Part I is accurate and complete. A.Project and Sponsor Information. Name of Action or Project: Texas Road House Restaurant Project Location(describe,and attach a general location map): Northway Plaza,820 State Route 9,Town of Queensbury,Warren County,NY Brief Description of Proposed Action(include purpose or need): Redevelopment of an outparcel at Northway Plaza to include construction of a new 7,300 SF+/-Texas Road House restaurant on the site of a former automobile service station that has been previously demolished. The project will also include associated site and drainage work,repaving,landscaping and connection to existing water and sewer services. • Name of Applicant/Sponsor: FEail: phone:(404)616-5454,ext. 134 RCG Ventures,LLC,attention Wesley Padgett,Development Manager Wesleyp@rcgventures.com Address:3060 Peachtree Rd.NW,Suite 400 City/PO:Atlanta State:GA Zip Code:30305 Project Contact(if not same as sponsor;give name and title/role): Telephone:(518)453-3927 CHA Consulting,Inc.,attention Tony Stellato,PE E-Mail: tstellato@chacompanies.com Address: 3 Winners Circle City/PO: State: Zip Code: Albany NY 12205 Property Owner (if not same as sponsor): Telephone: same as sponsor E-Mail: Address: City/PO: State: Zip Code: • Page 1 of 13 B.Government Approvals B.Government Approvals,Funding,or Sponsorship. ("Funding"includes grants,loans,tax relief,and any other forms of financial assistance.) Government Entity If Yes: Identify Agency and Approval(s) Application Date Required (Actual or projected) a.City Council,Town Board, ❑Yes®No or Village Board of Trustees b.City,Town or Village ®Yes❑No Town of Queensbury Planning Board December 15,2014 Planning Board or Commission Subdivision and Site Plan Review c.City Council,Town or ®Yes❑No Town of Queensbury ZBA December 15,2014 Village Zoning Board of Appeals Sign Variance d.Other local agencies ❑Yes®No e.County agencies ®Yes❑No Warren County Highway Department TBD Work Permit for connection to storm sewer f.Regional agencies ❑Yes®No g.State agencies ❑Yes®No It.Federal agencies ❑Yes®No i. Coastal Resources. i. Is the project site within a Coastal Area,or the waterfront area of a Designated Inland Waterway? ❑Yes WINo ii. Is the project site located in a community with an approved Local Waterfront Revitalization Program? ❑Yes[Z]No iii. Is the project site within a Coastal Erosion Hazard Area? ❑Yes®No C.Planning and Zoning • C.I. Planning and zoning actions. Will administrative or legislative adoption,or amendment of a plan,local law,ordinance, rule or regulation be the ❑Yes®No only approval(s)which must be granted to enable the proposed action to proceed? • If Yes,complete sections C,F and G. • If No,proceed to question C.2 and complete all remaining sections and questions in Part I C.2.Adopted land use plans. a.Do any municipally-adopted (city,town,village or county)comprehensive land use plan(s)include the site ®Yes❑No where the proposed action would be located? If Yes,does the comprehensive plan include specific recommendations for the site where the proposed action ®Yes❑No would be located? b.Is the site of the proposed action within any local or regional special planning district(for example: Greenway ®Yes❑No Brownfield Opportunity Area(BOA);designated State or Federal heritage area;watershed management plan; or other?) If Yes,identify the plants): Remediaton Sites:V00141 c. Is the proposed action located wholly or partially within an area listed in an adopted municipal open space plan, ❑Yes®No or an adopted municipal farmland protection plan? If Yes, identify the plan(s): • Page 2 of 13 C3. Zoning a. Is the site of the proposed action located in a municipality with an adopted zoning law or ordinance. ®Yes❑No If Yes,what is the zoning classification(s) including any applicable overlay district? CI-Commercial Intensive,Design Guideline Area Travel Corridor Overlay District Underground Utilitv Overla District___ b. Is the use permitted or allowed by a special or conditional use permit? ®Yes❑No c. Is a zoning change requested as part of the proposed action? ❑Yes®No If Yes, i. What is the proposed new zoning for the site? CA. Existing community services. a.In what school district is the project site located?Queensbury School District b. What police or other public protection forces serve the project site? Warren County Sheriff,New York State Police c. Which fire protection and emergency medical services serve the project site? Queensbury Central Fire Protection District No. West Glens Falls EMS District d. What parks serve the project site? Hovey Pond Park Warren County Bikeway Cole's Woods Crandall Park(City of Glens Falls) D.Project Details D.I.Proposed and Potential Development a.What is the general nature of the proposed action(e.g.,residential, industrial,commercial,recreational;if mixed, include all components)? Commercial • b.a.Total acreage of the site of the proposed action? 2.16 acres b.Total acreage to be physically disturbed? 2.30 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 22.87 acres c. Is the proposed action all expansion of an existing project or use? ❑Yes®No i. If Yes,what is the approximate percentage of the proposed expansion and identify the units(e.g.,acres,miles,housing units, square feet)? % Units: d.Is the proposed action a subdivision,or does it include a subdivision? ®Yes❑No If Yes, i. Purpose or type of subdivision?(e.g.,residential,industrial,commercial; if mixed,specify types) Commercial ii. Is a cluster/conservation layout proposed? ❑Yes®No iii. Number of lots proposed? 2 iv. Minimum and maximum proposed lot sizes? Minimum 2.16 acres Maximum 20.71 acres e.Will proposed action be constructed in multiple phases? ❑Yes®No i. If No,anticipated period of construction: 5 months ii. If Yes: • Total number of phases anticipated • Anticipated commencement date of phase I (including demolition) month year • Anticipated completion date of final phase month year • Generally describe connections or relationships among phases,including any contingencies where progress of one phase may determine timing or duration of future phases: • Page 3 of 13 f.Does the project include new residential uses? ❑Yes®No If Yes,show numbers of units proposed. One Family Two Family Three Family Multiple Family four or more Initial Phase • At completion of all phases g.Does the proposed action include new non-residential construction(including expansions)? ®Yes❑No If Yes, i.Total number of structures 1 ii. Dimensions(in feet)of largest proposed structure: 27'-6" height; 90 width; and 110'length iii. Approximate extent of building space to be heated or cooled: 7,319 square feet h. Does the proposed action include construction or other activities that will result in the impoundment of any ❑Yes®No liquids,such as creation of a water supply,reservoir,pond,lake,waste lagoon or other storage? If Yes, i. Purpose of the impoundment: ii. If a water impoundment,the principal source of the water: ❑ Ground water❑Surface water streams[]Other specify: id. If other than water, identify the type of impounded/contained liquids and their source. iv. Approximate size of the proposed impoundment. Volume: million gallons;surface area: acres v. Dimensions of the proposed dam or impounding structure: height; length vi. Construction method/materials for the proposed dam or impounding structure(e.g.,earth fill,rock,wood,concrete): D.2. Project Operations a.Does the proposed action include any excavation,mining,or dredging,during construction,operations,or both? Yes No (Not including general site preparation,grading or installation of utilities or foundations where all excavated materials will remain onsite) If Yes: • i.What is the purpose of the excavation or dredging? ii. How much material(including rock,earth, sediments,etc.)is proposed to be removed from the site? • Volume(specify tons or cubic yards): • Over what duration of time? iii. Describe nature and characteristics of materials to be excavated or dredged,and plans to use,manage or dispose of them. iv. Will there be onsite dewatering or processing of excavated materials? [-]Yes[]No If yes,describe. v. What is the total area to be dredged or excavated? acres vi. What is the maximum area to be worked at any one time? acres vii. What would be the maximum depth of excavation or dredging? feet viii. Will the excavation require blasting? ❑Yes❑No & Summarize site reclamation goals and plan: b.Would the proposed action cause or result in alteration of, increase or decrease in size of,or encroachment ❑Yes®No into any existing wetland,waterbody,shoreline,beach or adjacent area? If Yes: i. Identify the wetland or waterbody which would be affected(by name,water index number,wetland map number or geographic description): • Page 4 of 13 U. Describe how the proposed action would affect that waterbody or wetland,e.g.excavation,fill,placement of structures,or alteration of channels,banks and shorelines. Indicate extent of activities,alterations and additions in square feet or acres: iii. Will proposed action cause or result in disturbance to bottom sediments? ❑Yes❑No If Yes,describe: iv. Will proposed action cause or result in the destruction or removal of aquatic vegetation? ❑Yes❑No If Yes: • acres of aquatic vegetation proposed to be removed: • expected acreage of aquatic vegetation remaining after project completion: • purpose of proposed removal(e.g.beach clearing, invasive species control,boat access): • proposed method of plant removal: • if chemical/herbicide treatment will be used,specify product(s): v. Describe any proposed reclamation/mitigation following disturbance: c. Will the proposed action use,or create a new demand for water? ®Yes(][No If Yes: i. Total anticipated water usage/demand per day: 8,610 gallons/day a Will the proposed action obtain water from an existing public water supply? ®Yes❑No If Yes: • Name of district or service area: Town of Queensbury Water Department • Does the existing public water supply have capacity to serve the proposal? ®Yes❑No • Is the project site in the existing district? ®Yes[]No • Is expansion of the district needed? ❑Yes®No • Do existing lines serve the project site? ®Yes❑No iii. Will line extension within an existing district be necessary to supply the project? []Yes 92IJo If Yes: • Describe extensions or capacity expansions proposed to serve this project: • Source(s)of supply for the district: iv. Is a new water supply district or service area proposed to be formed to serve the project site? ❑ Yes®No If,Yes: • Applicant/sponsor for new district: • Date application submitted or anticipated: • Proposed source(s)of supply for new district: v. If a public water supply will not be used,describe plans to provide water supply for the project: vi. If water supply will be from wells(public or private),maximum pumping capacity: gallons/minute. d. Will the proposed action generate liquid wastes? ®Yes❑No If Yes: i. Total anticipated liquid waste generation per day: 8,610 gallons/day ii. Nature of liquid wastes to be generated(e.g.,sanitary wastewater, industrial; if combination,describe all components and approximate volumes or proportions of each): Sanitary wastewater iii. Will the proposed action use any existing public wastewater treatment facilities? ®Yes❑No If Yes: • Name of wastewater treatment plant to be used: Glens Falls Wastewater Treatment Plant • Name of district: Queensbury Consolidated Sanitary Sewer District • Does the existing wastewater treatment plant have capacity to serve the project? ®Yes❑No • Is the project site in the existing district? ®Yes❑No • Is expansion of the district needed? ❑YesONo • Page 5 of 13 • Do existing sewer lines serve the project site? ®Yes❑No • Will line extension within an existing district be necessary to serve the project? ❑Yes®No If Yes: • Describe extensions or capacity expansions proposed to serve this project: i iv. Will a new wastewater(sewage)treatment district be formed to serve the project site? ❑Yes®No If Yes: • Applicant/sponsor for new district: • Date application submitted or anticipated: • What is the receiving water for the wastewater discharge? v. If public facilities will not be used,describe plans to provide wastewater treatment for the project,including specifying proposed receiving water(name and classification if surface discharge,or describe subsurface disposal plans): vi. Describe any plans or designs to capture,recycle or reuse liquid waste: e. Will the proposed action disturb more than one acre and create stormwater runoff,either from new point ®Yes❑No sources(i.e.ditches,pipes,swales,curbs,gutters or other concentrated flows of stormwater)or non-point source(i.e.sheet flow)during construction or post construction? If Yes: i. How much impervious surface will the project create in relation to total size of project parcel? Square feet or 1.51 acres(impervious surface) Square feet or 2.16 acres(parcel size) ii. Describe types of new point sources. Swales and closed drainage pipes iii. Where will the stormwater runoff be directed(i.e.on-site stormwater management facility/structures,adjacent properties, groundwater,on-site surface water or off-site surface waters)? Om site swales and pervious pavement to off-site closed drainage system(existing) • If to surface waters,identify receiving water bodies or wetlands: • Will stormwater runoff flow to adjacent properties? ®Yes❑No iv. Does proposed plan minimize impervious surfaces,use pervious materials or collect and re-use stormwater? ®Yes❑No f. Does the proposed action include,or will it use on-site,one or more sources of air emissions,including fuel ❑Yes®No combustion,waste incineration,or other processes or operations? If Yes, identify: i. Mobile sources during project operations(e.g.,heavy equipment,fleet or delivery vehicles) ii. Stationary sources during construction (e.g.,power generation,structural heating,batch plant,crushers) iii. Stationary sources during operations(e.g.,process emissions,large boilers,electric generation) g.Will any air emission sources named in D.2.f(above),require a NY State Air Registration,Air Facility Permit, []Yes®No or Federal Clean Air Act Title IV or Title V Permit? If Yes: i. Is the project site located in an Air quality non-attainment area? (Area routinely or periodically fails to meet ❑Yes❑No ambient air quality standards for all or some parts of the year) ii. In addition to emissions as calculated in the application,the project will generate: • Tons/year(short tons)of Carbon Dioxide(CO,) • Tonslyeaz(short tons)of Nitrous Oxide(NZO) • Tons/year(short tons)of Perfluorocarbons(PFCs) • Tons/year(short tons)of Sulfur Hexafluoride(SF,) • Tons/year(short tons)of Carbon Dioxide equivalent of Hydroflourocarbons(HFCs) • Tons/year(short tons)of Hazardous Air Pollutants(HAPs) Page 6 of 13 h.Will the proposed action generate or emit methane(including,but not limited to,sewage treatment plants, ❑Yes No landfills,composting facilities)? If Yes: i. Estimate methane generation in tons/year(metric): • ii. Describe any methane capture,control or elimination measures included in project design(e.g.,combustion to generate heat or electricity,flaring): i.Will the proposed action result in the release of air pollutants from open-air operations or processes,such as ❑Yes®No quarry or landfill operations? If Yes: Describe operations and nature of emissions(e.g..diesel exhaust,rock particulates/dust): j.Will the proposed action result in a substantial increase in traffic above present levels or generate substantial ❑Yes®No new demand for transportation facilities or services? If Yes: i. When is the peak traffic expected(Check all that apply): ❑Morning ❑Evening []Weekend ❑Randomly between hours of to ii. For commercial activities only,projected number of semi-trailer truck trips/day: iii. Parking spaces: Existing Proposed Net increase/decrease iv. Does the proposed action include any shared use parking? ❑Yes❑No v. If the proposed action includes any modification of existing roads,creation of new roads or change in existing access,describe: vi. Are public/private transportation service(s)or facilities available within '/:mile of the proposed site? ❑Yes❑No vii Will the proposed action include access to public transportation or accommodations for use of hybrid,electric ❑Yes❑No or other alternative fueled vehicles? viii. Will the proposed action include plans for pedestrian or bicycle accommodations for connections to existing ❑Yes❑No pedestrian or bicycle routes? k.Will the proposed action(for commercial or industrial projects only)generate new or additional demand ❑Yes®No for energy? (not above previous use of site) If Yes: i. Estimate annual electricity demand during operation of the proposed action: ii. Anticipated sources/suppliers of electricity for the project(e.g.,on-site combustion,on-site renewable,via grid/local utility,or other): iii. Will the proposed action require a new,or an upgrade to,an existing substation? ❑Yes❑No 1.Hours of operation. Answer all items which apply. i. During Construction: ii. During Operations: • Monday-Friday: 7 AM-5 PM • Monday-Friday: Noon-10 PM • Saturday: 7 AM-5 PM • Saturday: Noon-10 PM • Sunday: • Sunday: Noon-10 PM • Holidays: • Holidays: Noon-10 PM Page 7 of 13 m.Will the proposed action produce noise that will exceed existing ambient noise levels during construction, ❑Yes mNo operation,or both? If yes: i. Provide details including sources,time of day and duration: U. Will proposed action remove existing natural barriers that could act as a noise barrier or screen? ❑Yes mNo Describe: n.. Will the proposed action have outdoor lighting? mYes❑No If yes: i. Describe source(s),location(s),height of fixture(s),direction/aim,and proximity to nearest occupied structures: Parking lot pole mounted fixtures 20'high downward directed full cutoff lens 20'-100'from restaurant(nearest occupied structure) minimal light trespass beyond parking lot. ii. Will proposed action remove existing natural barriers that could act as a light barrier or screen? ❑Yes mNo Describe: o. Does the proposed action have the potential to produce odors for more than one hour per day? ❑Yes mNo If Yes,describe possible sources,potential frequency and duration of odor emissions,and proximity to nearest occupied structures: p.Will the proposed action include any bulk storage of petroleum(combined capacity of over 1,100 gallons) ❑Yes mNo or chemical products 185 gallons in above ground storage or any amount in underground storage? If Yes: i. Product(s)to be stored H. Volume(s) per unit time (e.g.,month,year) iii. Generally describe proposed storage facilities: q. Will the proposed action(commercial,industrial and recreational projects only)use pesticides(i.e.,herbicides, m Yes []No insecticides)during construction or operation? If Yes: i. Describe proposed treatment(s): As necessary to protect landscaping from pests and disease All federal and state laws will be followed and best practices utilized for application. ii. Will the proposed action use Integrated Pest Management Practices? ❑ Yes mNo r.Will the proposed action(commercial or industrial projects only)involve or require the management or disposal m Yes ❑No of solid waste(excluding hazardous materials)? If Yes: i. Describe any solid waste(s)to be generated during construction or operation of the facility: • Construction: 30 tons per month (unit of time) • Operation : 10 tons per month (unit of time) ii. Describe any proposals for on-site minimization,recycling or reuse of materials to avoid disposal as solid waste: • Construction: Materials will be ordered in quantities appropriate for the project to minimize cost and waste. • Operation: Recycling of cardboard metals plastic and glass will follow Warren County recycling practices id. Proposed disposal methods/facilities for solid waste generated on-site: • Construction: transport to a licensed waste facility or transport to licensed recycling facility • Operation: transport to a licensed waste facility or transport to licensed recycling facility Page 8 of 13 s.Does the proposed action include construction or modification of a solid waste management facility? ❑ Yes® No If Yes: i. Type of management or handling of waste proposed for the site(e.g.,recycling or transfer station,composting,landfill,or other disposal activities): ii. Anticipated rate of disposal/processing: • Tons/month,if transfer or other non-combustion/thermal treatment,or • Tons/hour,if combustion or thermal treatment iii. If landfill,anticipated site life: years t.Will proposed action at the site involve the commercial generation,treatment,storage,or disposal of hazardous ❑Yes®No waste? If Yes: i. Name(s)of all hazardous wastes or constituents to be generated,handled or managed at facility: H. Generally describe processes or activities involving hazardous wastes or constituents: iii. Specify amount to be handled or generated tons/month iv. Describe any proposals for on-site minimization,recycling or reuse of hazardous constituents: v. Will any hazardous wastes be disposed at an existing offsite hazardous waste facility? Yes No If Yes: provide name and location of facility: If No:describe proposed management of any hazardous wastes which will not be sent to a hazardous waste facility: E.Site and Setting of Proposed Action E.1. Land uses on and surrounding the project site a.Existing land uses. i. Check all uses that occur on,adjoining and near the project site. ❑ Urban ❑ Industrial ® Commercial ❑ Residential(suburban) ❑ Rural(non-farm) ❑ Forest ❑ Agriculture ❑ Aquatic ® Other(specify):cemetery ii. If mix of uses,generally describe: b.Land uses and covertypes on the project site. Land use or Current Acreage After Change Covertype Acreage Project Completion (Acres+/-) • Roads,buildings,and other paved or impervious surfaces 1.88 1.51 (0.37) • Forested 0 0 0 • Meadows,grasslands or brushlands(non- agricultural,including abandoned agricultural) 0 0 0 • Agricultural 0 0 0 (includes active orchards,field,greenhouse etc.) • Surface water features 0 0 0 (lakes,ponds,streams,rivers,etc.) • Wetlands(freshwater or tidal) 0 0 0 • Non-vegetated(bare rock,earth or fill) 0 0 0 • Other Describe:Lawn/landscape 0.28 0.65 .37 Page 9 of 13 c. Is the project site presently used by members of the community for public recreation? ❑Yes®No i. If Yes:explain: d.Are there any facilities serving children,the elderly,people with disabilities(e.g.,schools,hospitals,licensed ❑Yes®No day care centers,or group homes)within 1500 feet of the project site? If Yes, i. Identify Facilities: e.Does the project site contain an existing dam? ❑Yes®No If Yes: i. Dimensions of the dam and impoundment: • Dam height: feet • Dam length: feet • Surface area: acres • Volume impounded: gallons OR acre-feet ii. Dam's existing hazard classification: W. Provide date and summarize results of last inspection: f.Has the project site ever been used as a municipal,commercial or industrial solid waste management facility, ❑Yes®No or does the project site adjoin property which is now,or was at one time,used as a solid waste management facility? If Yes: i. Has the facility been formally closed? ❑Yes[:] No • If yes,cite sources/documentation: ii. Describe the location of the project site relative to the boundaries of the solid waste management facility: W. Describe any development constraints due to the prior solid waste activities: . g.Have hazardous wastes been generated,treated and/or disposed of at the site,or does the project site adjoin ❑Yes®No property which is now or was at one time used to commercially treat,store and/or dispose of hazardous waste? If Yes: i. Describe waste(s)handled and waste management activities,including approximate time when activities occurred: h. Potential contamination history. Has there been a reported spill at the proposed project site,or have any ®Yes❑ No remedial actions been conducted at or adjacent to the proposed site? If Yes: i. Is any portion of the site listed on the NYSDEC Spills Incidents database or Environmental Site ®Yes❑No Remediation database? Check all that apply: ® Yes—Spills Incidents database Provide DEC ID number(s): 1311866 ® Yes—Environmental Site Remediation database Provide DEC ID number(s): V00141 ❑ Neither database ii. If site has been subject of RCRA corrective activities,describe control measures: iii. is the project within 2000 feet of any site in the NYSDEC Environmental Site Remediation database? ®Yes❑No If yes,provide DEC ID number(s):V00141 iv. If yes to(i),(ii)or(iii)above,describe current status of site(s): V00141 -Classification Code C-Comoleted 1311866-Incident closed 9/2/2014 Page 10 of 13 v. Is the project site subject to an institutional control limiting property uses? ❑Yes®No • If yes,DEC site ID number: • Describe the type of institutional control(e.g.,deed restriction or easement): • Describe any use limitations: • Describe any engineering controls: • Will the project affect the institutional or engineering controls in place? ❑Yes❑No • Explain: E.2. Natural Resources On or Near Project Site a.What is the average depth to bedrock on the project site? over 20 feet b.Are there bedrock outcroppings on the project site? ❑Yes®No If Yes,what proportion of the site is comprised of bedrock outcroppings? % c.Predominant soil type(s)present on project site: Sand/silt fill&glaciofluvial deposit 100% d.What is the average depth to the water table on the project site? Average: over 20 feet e. Drainage status of project site soils:® Well Drained: 100%of site ❑ Moderately Well Drained: %of site ❑ Poorly Drained %of site f.Approximate proportion of proposed action site with slopes: ® 0-10%: 95 %of site ® 10-15%: 5 %of site ❑ 15%or greater: %of site g. Are there any unique geologic features on the project site? ❑Yes®No If Yes,describe: h.Surface water features. i. Does any portion of the project site contain wetlands or other waterbodies(including streams,rivers, ❑Yes®No ponds or lakes)? ii. Do any wetlands or other waterbodies adjoin the project site? ®Yes❑No If Yes to either i or ii,continue. If No,skip to E.21. iii. Are any of the wetlands or waterbodies within or adjoining the project site regulated by any federal, ®Yes❑No state or local agency? iv. For each identified regulated wetland and waterbody on the project site,provide the following information: • Streams: Name Classification • Lakes or Ponds: Name Classification • Wetlands: Name Unnamed federal wetlands Approximate Size Unknown • Wetland No.(if regulated by DEC) v. Are any of the above water bodies listed in the most recent compilation ofNYS water quality-impaired ❑Yes®No waterbodies? If yes,name of impaired water body/bodies and basis for listing as impaired: i.Is the project site in a designated Floodway? ❑Yes[Z[No j.Is the project site in the 100 year Floodplain? ❑Yes®No k.Is the project site in the 500 year Floodplain? ❑Yesoto I.Is the project site located over,or immediately adjoining,a primary,principal or sole source aquifer? ®Yes❑No If Yes: i.Name of aquifer:Principal Aquifer • Page 11 of 13 in. Identify the predominant wildlife species that occupy or use the project site: N/A-existing shopping plaza n. Does the project site contain a designated significant natural community? ®Yes❑No If Yes: i. Describe the habitaticommunity(composition,function,and basis for designation): Pitch Pine-Scrub Oak Barrens H. Source(s)of description or evaluation: NYSDEC-auto generated iii. Extent of community/habitat: • Currently: 700.0 acres • Following completion of project as proposed: 700.0 acres • Gain or loss(indicate+or-): 700.0 acres o. Does project site contain any species of plant or animal that is listed by the federal government or NYS as ❑Yes[Z]No, endangered or threatened,or does it contain any areas identified as habitat for an endangered or threatened species? p. Does the project site contain any species of plant or animal that is listed by NYS as rare,or as a species of Yes®No special concern? q.is the project site or adjoining area currently used for hunting,trapping,fishing or shell fishing? ❑Yes®No If yes,give a brief description of how the proposed action may affect that use: • E.3. Designated Public Resources On or Near Project Site a. Is the project site,or any portion of it,located in a designated agricultural district certified pursuant to ❑Yes®No Agriculture and Markets Law,Article 25-AA,Section 303 and 304? If Yes, provide county plus district name/number: b.Are agricultural lands consisting of highly productive soils present? ❑Yes®No i. If Yes:acreage(s)on project site? ii. Source(s)of soil rating(s): c. Does the project site contain all or part of,or is it substantially contiguous to,a registered National ❑Yes®No Natural Landmark? If Yes: i. Nature of the natural landmark: ❑Biological Community ❑ Geological Feature ii. Provide brief description of landmark,including values behind designation and approximate size/extent: d.Is the project site located in or does it adjoin a state listed Critical Environmental Area? ❑Yes®No If Yes: i. CEA name: ii. Basis for designation: iii. Designating agency and date: Page 12 of 13 e. Does the project site contain,or is it substantially contiguous to,a building,archaeological site, or district ❑Yes®No which is listed on,or has been nominated by the NYS Board of Historic Preservation for inclusion on,the State or National Register of Historic Places? If Yes: i. Nature of historic/archaeological resource: ❑Archaeological Site ❑Historic Building or District • ii. Name: ---i- -- .__.--- — ----- iii- Brief description of attributes on which listing is based: f. Is the project site,or any portion of it, located in or adjacent to an area designated as sensitive for ®Yes E]No archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory? g. Have additional archaeological or historic site(s)or resources been identified on the project site? ❑Yes®No If Yes: i. Describe possible resource(s): _ ii. Basis for identification:It. Is the project site within fives miles of any officially designated and publicly accessible federal,state,or local ®YesQNo scenic or aesthetic resource'? If Yes: i. Identify resource:Adirondack Park it, Nature of.or basis for,designation(e.g.,established highway overlook,state or local park, state historic trail or scenic byway, etc.): Stateprotedted area iii. Distance between project and resource: approximately a miles. i. Is the project site located within a designated river corridor under the Wild,Scenic and Recreational Rivers ❑Yes®No Program 6 NYCRR 666? If Yes: i. ldentifv the name of the river and its designation: U. Is the activity consistent with development restrictions contained in 6NYCRR Part 6669 Yes[]No F.Additional Information • Attach any additional information which may be needed to clarify your project. If you have identified any adverse impacts which could be associated with your proposal,please describe those impacts plus any measures which you propose to avoid or minimize them. G. Verification I certify that the information provided is true to the best of my knowledge. Applicant/Sponsor ame Anthony Stellato/CHAConsufing Inc Date December 15,2014 Signature Title Applicants Engineer_____ If V PRINT FORM Page 13 of 13 EAF Mapper Summary Report Friday, December 12, 2014 10:47 AM Disclaimer. The EAF Mapper is a screening tool intended to assist project sponsors and reviewing agencies in preparing an environmental assessment form(EAF).Not all questions asked in the EAF are y fi1 answered by the EAF Mapper.Additional information on any EAF question can be obtained by consulting the EAF workbooks. Although q{ s-Rd the EAF Mapper provides the most up-to-date digital data available to DEC,you may also need to contact local or other data sources in order to obtain data not provided by the Mapper.Digital data is not a substitute for agency determinations. M 4 £ k t4, SC45 v F � rai n t �t titer lIRCkN.Fsri n!j T{cn"rom. t&a ltNermep i SYea�tttrduiars, the Kati ty v B.i.i [Coastal or Waterfront Area] No B.i.ii [Local Waterfront Revitalization Area] ;No ---- , _...... _ - .... -- _-------- .. __... . . C.2.b. [Special Planning District] Yes-Digital mapping data are not available for all Special Planning Districts. Refer to EAF Workbook. C.2.b. [Special Planning District- Name] Remediaton Sites:V00141 E.1.h [DEC Spills or Remediation Site 'Yes Digital mapping data for Spills Incidents are not available for this Potential Contamination History] location. Refer to EAF Workbook. E.1.h.i [DEC Spills or Remediation Site Yes Listed] E.1.h.i [DEC Spills or Remediation Site- Yes Environmental Site Remediation Database] E.1.h.i [DEC Spills or Remediation Site- V00141 DEC ID Number] E.1.h.iii [Within 2,000'of DEC Remediation Yes Site] EA.h.ui[Within 2,000'of DEC Remediation iV00141 Site-DEC ID] E.2.g [Unique Geologic Features] No E.2.h.i[Surface Water Features] No E.2.h.ii [Surface Water Features] 'Yes E.2.h.iii [Surface Water Features] Yes-Digital mapping information on local and federal wetlands and waterbodies is known to be incomplete. Refer to EAF Workbook. E.2 h v[Impaired Water Bodies] 'No E.2.i. [Floodway] i Digital mapping data are not available or are incomplete. Refer to EAF Workbook. -.------ _, E.2J. (100 Year Floodplain] 1 Digital mapping data are not available or are incomplete. Refer to EAF Workbook. Full Environmental Assessment Form - EAF Mapper Summary Report I E.2.k. [500 Year Floodplain] Digital mapping data are not available or are incomplete. Refer to EAF Workbook. E.2.1. [Aquifers] Yes E.2.1. [Aquifer Names] Principal Aquifer E.2.n. [Natural Communities] Yes E.2.n.i [Natural Communities-Name] Pitch Pine-Scrub Oak Barrens E.2.n.i[Natural Communities-Acres] 700.0 E.2.o. [Endangered or Threatened Species] No E.2.p. [Rare Plants or Animals] No E.3.a. [Agricultural District] No E.3.c. [National Natural Landmark] No E.3.d [Critical Environmental Area] No E.3.e. [National Register of Historic Places] Digital mapping data are not available or are incomplete. Refer to EAF Workbook. _. „ --------- E.3.f. [Archeological Sites] ;Yes E.3.i. [Designated River Corridor] No Full Environmental Assessment Form - EAF Mapper Summary Report