Application Area Van nce Revised June 2009
General Information
Tax Parcel ID Number: 3 is, � L—S '-/
Zoning District:
M/�R_
Detai Pd Description of Project [includes current&proposed use]:
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Location of project:
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Town of Queensbury•Zoning Office• 742 Bay Road•Queensbury, NY 12804•518-761-8238 1
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Area Variance Revised June 2001
Pre-Submission Conference Form f179.4-04011
• 1. Tax Map ID 3iS� 6 -Z 'S`l
2. Zoning Classification y2
3. Reason for Review:
4. Zoning Section #:
5. Pre-Submission Meeting Notes; Outstanding Items To Be Addressed Include:
Deed Yes _No
General Information complete Yes No
Site Development Data Complete Yes o
Setback Requirements Complete es No
Additional Project Information Complete Yes No
FAR addressed es AW No
Compliance with Zoning Ordinance Yes No
Checklist items addressed Yes No
Environmental Form completed es No
Signature Page completed Yes _No
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Staff Representative:
Applicant/Agent:
ate:
Town of Queensbury-Zoning Office- 742 Bay Road- Queensbury, NY 12804.518-761-8238 6
OC a V 'ante Revised June 200E
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General Infor ;
• Tax Parcel ID Number: .3
Zoning District: M�X,
Detajjqd Description of Project [includes current& use
proposed :�
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Location Of project: n TOWN OF QUEENSBUR"
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Town of Queensbury•Zoning Office• 742 Bay Road• Queensbury, NY 12804•518-761-8238 1
Area Variance Revised June 2
• Site Development Data
A. Building footprint G?
B. Detached Garage ` ( 3
C. Accessory Structure(s)
D. Paved, gravel or other hard surfaced area
E. Porches/ Decks
1 O
F. Other
G. Total Non-Permeable [Add A-F] I IF,
H. Parcel Area [43,560 sq. ft. /acre]
101000
I. Percentage of Impermeable Area of Site [I=G/H]
Setback Requirements
Front[1]
Front[2]
Shoreline
Side Yard [1]
1U 30 .10130
Side Yard [2]
Rear Yard [1]
o ,3 Q
Rear Yard [2]
Travel Corridor
Height [max]
Permeability
No. of parking spaces
Town of Queensbury•Zoning Office• 742 Bay Road•Queensbury, NY 12804•518-761-8238 2
Area Variance Revised June 200E
Additional Project Information
• 1. Will the proposal require a Septic Variance from the Town Board of Health? llya
2. If the parcel has previous approvals, list application number(s):
3. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Program?
N 0
4. Estimated project duration: Start Date ova End Date
5. Estimated total cost of project: 3l Cay
6. Total area of land disturbance for project: t KC) s� . T-7k- .
Floor Area Ratio Worksheet
FLOOR AREA RATIO (FAR) --The relationship of building size to lot size, a by dividing the total building
floor area by th lot size in square feet, yielding a percentage.
Waterfront Residential WR 2
Commercial Moderate CM 0.3
Commercial Intensive CI 0.3
A. The combined area of all square footag as measure f exterior walls of all structures on the property, including all
floors of the structures, garages,square
is and ics with more than five (5) feet of ceiling height and covered
porches. Building square footage does no 'nclu : Open deck, docks and that portion of covered docks extending
over water and one storage shed of one h ad twenty (120) square feet or less. Any additional sheds will be
included. (See"FLOOR AREA RATIO").
B. Commercial or industrial: the total area i quare fe as measured from the exterior of the outside walls of a building
or structure, and when applicable, the m total of all or areas of the principal and accessory buildings or structures
on the project site.
Parcel Area s , ft.
Existing Floor Area s . ft. see above definition
Proposed Additio I Floor Area s .
Proposed To I Floor Area s
Total Allowable Floor Area Area x rsee above table
x
Town of Queensbury•Zoning Office• 742 Bay Road•Queensbury, NY 12804 •518-761-8238 3
Area Variance Revised June 2M
Compliance with Zoning Ordinance
• Requesting relief from SECTION: / 7 /p- 3-Oy-0
Need relief from the requirement(s) listed below which can not be met by the project as proposed.
[Check all that apply] Ip Setback ❑ Buffer Zone ❑ Lot Width ❑ Other
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 area variance?
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2. Whether the benefit sought by the applicant can be achieved by some method, feasible for the applicant to
pursue, other than an area variance? 0
3. Whether the requested area variance is substantial?
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4. Whether the proposed variance will have an adverse effect or impact on the physical or environmental
conditions in the neighborhood or district?
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5. Whether the alleged difficulty was self-created?
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Town of Queensbury•Zoning Office•742 Bay Road• Queensbury, NY 12804 •518-761-8238 4
Area Variance Revised June 200
Submittal of a stamped and siqned SURVEY MAP depicting existing and proposed conditions shall include the items as noted below.
. f '
1 Title ame, ddress of applicant& rson res ible fo preparation of drawing
2 Dee
3 North arrow,Tax Map ID,date prepared and scale[minimum 11n.=40 ft.]
4 Boundaries of the property plotted to scale,zoning boundary
5 Principal structures,accessory structures with exterior dimensions
6 Site improvements Incl.outdoor storage areas,driveways,parking areas,etc.: existing&proposed
7 Setbacks for all structures and improvements: existing&proposed
8 Elevations and Floor plans of all proposed and affected structures
1 Project sewage disposal facilities,design details,construction details,Now rates,and number of bedrooms proposed
2 Water supply[i.e. well]&septic on adjoining lots with separation distances to existing or proposed on-site water supply and
septic
3 Separation distances for proposed sewage disposal system to well and water bodies
4 Existing public or private water supply [well, lake, etc.]. Method of securing public or private water, location, design and
construction of water su I includingdailywater usage
5 Percolation test location and results
IN 11111i
-1 Number of spaces required for project including calculations and justification: existing&proposed
-2 No.of existin arkin s aces,number to be removed,number to maintain and a of surfacingmaterial e. ., ravel,paved]
3 Provision for pedestrian and handicap access and parking: existing&proposed
4 Design details of ingress,egress,loading areas and cutting: existing 8 proposed
5 Location and character of green areas[existing and proposed],modification to green area,buffer zone to remain undisturbed
6 Lighting,location and design of all existing and proposed outdoor lighting
iOn-site&adjacent watercourses,streams,rivers,lake and wetlands
Utility/energy distribution system[gas,electric,solar,telephone): existing&proposed
3 Location,design and consWctlon details of all existing and proposed site improvements induding: drains,culverts,retaining
walls,fences,fire 8 emergency zones and hydrants,etc.
i.4. Square footage of bldg. area proposed for office, manufacturing, retail sales or other commercial activities: existing &
ro osed
e- Signage: Location,size,type,design and setback: existing&proposed
f Waiver Request: provide letter with application requesting any waivers: please reference specific items
g Commercial/lndustdal Development requires submission of Landscaping,Stonnwater Management,Grading&Lighting Plans
h Identification of Federal,State or County permits required for the project together with a record of application for all necessary
permits
•
Town of Queensbury•Zoning Office• 742 Bay Road•Queensbury, NY 12804• 518-761-8238 5
Area Variance Revised June 200!
Pre-Submission Conference Form r17779-4-0401 J 1. Tax Map ID JS 6 -Z S
2. Zoning Classification m !)2
3. Reason for Review: f `l� �.�=,7444 /=t /
4. Zoning Section #: l 77- 3 - 49 L/C?-
5. Pre-Submission Meeting Notes; Outstanding Items To Be Addressed Include:
Deed t//Yes _No
General Information complete Yes ��No
Site Development Data Complete _Yes �fJ0
Setback Requirements Complete as E No
Additional Project Information Complete Yes No
FAR addressed as hW No
Compliance with Zoning Ordinance Tl�Yes No
Checklist items addressed Yes No
Environmental Form completed es No
Signature Page completed _Yes _No
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Staff Representative:
Applicant/Agent:
ate: G' �2
Town of Queensbury•Zoning Office-742 Bay Road• Queensbury, NY 12804-518-761-8238 6
Area Variance Revised June 200E
Signature Page
This page includes the 1.) Authorization to Act as Agent Form: 2.) Engineering Fee Disclosure; 3.) Authorization for Site
Visits; 4.) Other Permit Responsibilities; 5.) Official Meeting Disclosure and 6.) Agreement to provide documentation
required.
OWNER's AGENT FORM:
Complete the following if the OWNER of the property is not the same as the applicant
Owner:
Designates:
As agent regarding: Variance_Site Plan Subdivision
For Tax Map No.: Section Block Lot
Deed Reference: Book Page Date
OWNER SIGNATURE: DATE:
APPLICANT'S AGENT FORM:
Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party:
Owner:
Designates:
As agent regarding: Variance_Site Plan Subdivision
For Tax Map No.: Section _Block Lot
Deed Reference: Book Page Date
OWNER SIGNATURE: DATE:
'F2.]L ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design,
storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be charged
directly to the applicant. Fees for engineering review will not exceed$ 1,000 without notification to the applicant.
3.) AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein, the Owner,
Applicant, and his/her/their 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.) OTHER PERMIT RESPONSIBILITIES: Other permits may be required for construction or alteration activity subsequent to approval
by the Zoning Board or Planning Board. It is the applicant's responsibility to obtain any additional permits.
5.) OFFICIAL MEETING MINUTES DISCLOSURE: It is the practice of the Community Development Department to have a designated
stenographer tape record the proceedings of meetings resulting from application,and minutes transcribed from those tapes constitutes
the official record of all proceedings.
6.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I, the undersigned, have thoroughly read and understand the
instructions for submission and agree to the submission requirements, I acknowledge no construction activities shall be commenced
prior to issuance of a valid permit. I certify that the application, plans and supporting materials are a true and complete
ktatement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the
.approved plans and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my
agents, will obtain a certificate of occupancy as necessary. I also understand that I/we may be required to provide an as-built survey by
a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy
I have read and agree to the above. �t�
VLF 4✓t_� �/L... G �� l
Signature [ icant] Print Name A plicant] Date signed
gnature [Agent] Print Name [Agent] Date signed
Town of Queensbury-Zoning Office - 742 Bay Road-Queensbury, NY 12804-518-761-8238 9