Application TOWN OF QUEENSBURY
531 Bay Road, Queensbury, NY 12804 , pAAAVVVYYY
DEPARTMENT OF COMMUNITY DEVELOPMENT ip11�
FILE NUMBER:
I . PROJECT APPLICANT: -T
ADDRESS :
(.
PHONE If : Home : -
PHONE # : Work : 618 - 7Qa -aU7.3
APPLICANT' S AGENT:
ADDRESS :
PHONE if : Home :
PHONE If : Work: nn
PROPERTY OWNER: HU)Q)_) pie .
ADDRESS : RR I 8QK 808
L 66T FOPIT ,4uU, Al`1 /21Sqy
PHONE if : Home : �<j1�- 7� 3-�(cSrl
PHONE # : Work: 51�6- 7q�- ay7�i //��
DY,CRIPTION
wl�J?AL OF PROJECT: 2 A,6)��. /�Q ,(�j cuak,
11r %5Wa14 nJAV_G
DIRECTIONS TO THE PROJECT: Please make as clear as possible,
so Board members & Staff can find your project :
R? -to Eur I �L, EASEc)u eT,QSq GuaKERAD Annvo,c 'ImlleS
SKETCH OR PHOTOCOPY OF OFFICE USE ONLY
ROAD MAP: Tax Map No. /p/-,3-q
Zoning: 14C -1
Variance : A U S
Site Plan : ✓Yes No
Subdiv. : _Yes _�No
CEA: _Yes / No
SEQRA: I , II, Unlisted
Warren Co . : _✓Yes No
APA: _Yes JL No
Wetlands : Yes ,/ No
II . SITE DEVELOPMENT DATA
Tax Map Number : Section 109 Block Lot 4
Zone Classification : HCIA
Area of Parcel 350$ t acres = 1404OW sq. ft .
Maximum Size Building Allowed sq . ft.
Disposition of Parcel :
Existinq
Building Area sq. ft. 306 % of parcel
Paved Area 14N(L sq. ft . u, % of parcel
( including walks )
Green Area AMID sq. ft. K 3 % of parcel
Proposed
CI,
Building Area A08 0 sq. ft . % of parcel
Paved Area /,97pp, 0 sq. ft . /D.(D % of parcel
( including—walks )
Green Area //69/0 ,0 sq. ft . % of parcel
Building Setbacks
Existing Proposed Required
Front Yard 80"D 3y
Front ( if corner) 014 A
Side Yard ( 1 ) B'y D !nD•0 ZC-�
Side Yard ( 2 )
Rear Yard ;{(p. Q—O
Rear Yard ( 2 ) U/
Shoreline N AA AN( �
width D-O260 —
Depth OU• O �(X�
Access (check where applicable)
Town Highway V County State
Length of Frontage
Number of Parking spaces : Existing AO Proposed oZ Q
Town Water: _� Yes No
Town Sewer : Yes No
Any previous Planning or Zoning Board determination regarding
this property?
Present Use of Property: 1&'7U C0/11Si0A) �
Proposed Use of Property: AQ-m Cb1ti,d(O71 Re�c( l2
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
i
Applicant's Signature ,� _ Date 0�O gS
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.
E. North arrow, scale and date.
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
E. Location of all proposed principal and accessory
uses and structures with exterior dimensions and
setbacks .
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.
lU A I . Description of the method of securing public or
private water and location, design and construction
materials of such facilities .
PJ. 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,
n shrubs, gravel, etc. )
r M. Percent of lot which is proposed to be
f� permeable, including composition of ground cover.
f N. Existing watercourses, wetlands, and other
waterbodies .
PIA 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 .
Q. Provision for pedestrian and handicapped access .
R. Location, design and construction materials of
all existing or proposed site improvements including
drains, culverts, retaining walls, and fences .
S . Location of fire and other emergency zones,
including the location of fire hydrants .
A)IA — T. Location of all existing and proposed energy
distribution facilities and other utilities,
including electrical, gas , solar energy, telephone,
etc . For proposed facilities, include design
details and construction materials .
A)1A 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.
PX. General landscaping plan and planting schedule,
including existing trees over 3 inches in diameter.
A114 Y. Grading and stormwater management plan, showing
existing and proposed contours and including
drainage calculations .
A11A Z . Other elements integral to the proposed
development or considered necessary by the Boards
and staff .
�IM 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. APPLICANT/SPONSOR
2. PROJECT NAME
f �12 W0 b Atc
3. PROJECT LOCATION• �
Muni ipatity uCEk) County
I. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc.,or provide mao)
n10KTH Of- ic,6166 O AakEk t2D - 6A6—j pF 6n of oeb o5T
rylap _ocLu06b
S. IS PROPOSED ACTION:
L New 0 Expansion ❑Modification/alteration
6. DESCRIBE PROJECT BRIEFLY:
�3 /46W L ReAcu iz bcu,5
L u.s I ba&U JR;qf-r 6pai <e ��ti�l Pavo
7. AMOUNT OF LAND AFFECTED,
Initially ---L—C acres Ultimately _ �• act es
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
Yes ❑No If No,describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
❑Residential ❑Industrial Commercial ❑Agriculture ❑Park/Forest/OpensFaceDescribe: I-Cther
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL
STATE OR LOCAL)?
Yes ❑No If yes, list agency(s)and permiVapprovals
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL?
❑Yes 11 No If yes, list agency name and permiVapproval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
❑Yes ®No
I CERTIF.YC THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant/sponsor name: t J`_Mk)1&i4 I (a/} ),OA[) —J`ik Date:
Signatur
------------
x -• - If.the--action.is do the.Coastal.Area,and you are..a.state agency,:Do=ment
..Coastal Assessment Form before proceeding with this assessA
OVER
1
PART II—ENVIRONMENTAL ASSESSMENT (To be completea Dy Agency)
A. DOES ACTION CEED ANY TYPE I THRESHOLD IN 6 NYCRR.PART 617.12? If yes,coordinate the review process and use the FULL EAF.
❑Yes 99NO
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration
may be supersedf 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, archaeological, historic,or other natural or cultural resources;or community or neighborhood character! Explain briefly:
CO. Vegetation or fauna,fish,shellfish or wildlife species, significant habitats,or threatened or endangered species? Explain brtefly:
10
G:. A community's existing plans or goals as officially adeFteq,or a change in use or intensity of use of land or other natural resources?Explain briefly.
C5. Growth,suubsequent development,or related activities.likely to be Induced by the pr000sed action? Explain briefly.
C
C6. Long term,short
ttterm,cumulative,or other effects not identified in C1-05? Explain briefly.
• N V
C7. Other impacts(Including changes in use of either quantity or type of energy)?Explain briefly.
l
D. IS THERE,OR IS LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
❑Yes No If Yes,explain briefly
PART 111—DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important or otherwise signific2:it.
Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d)
irreversibility; (a) geographic scope; and (f) 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.
❑ 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 Lead Agency
Print or Type Name of Responsible Officer in Lead Agency Title or Responsible Officer
1
,
---- Signawre of Pfeparer(I di emat mm responsible anicerl '
--� - Signature of Responsible Officer in Lead Agency
Date
2
Nom)
lo;;r
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`r ►�,r Twee n Goty
TOWN OF QUEENSBURY
531 BAY ROAD,QUEENSBURY, N.Y. 12804-9725 (518)745-4400
June 20 , 1995
Stan Gannon
Top 0 ' The World Auto Body
619 Quaker Road
Queensbury , NY 12B04
Dear Stan,
I apologize for the delay in responding to your inquiry
regarding the ditch on your property .
Our records do not indicate that this is a stream .
Therefore , we do not have any regulations regarding the filling
or modification of this area .
If you require any additional information regarding this:
issue please contact me .
Sincerely ,
4
J in,
S . Govals ki
d Com e pliance Officer
JSG/mg
"HOME OF NATURAL BEAUTY. . . A GOOD PLACE TO LIVE"
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❑ Prepare Reply for _ ❑ File P� 1 �
Signature ❑ Return to me � 1T
❑ Information ❑ -- - "`w _
❑ Approval ❑ —
❑ Prepare final/draft in Copies
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