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Application Site Plan Review Applicatio The Site Plan Review process involves presenting a proposal to the Planning Board and answering any questions that may arise regarding your project. As part of its review process,the Town of Queensbury Planning Board notifies the general public and property owners within 500 feet of the proposed project, conducts a public hearing and performs an environmental assessment of the proposal in accordance with the N.Y.S. Environmental Quality Review Act (SEQRA) requirements. This application was designed to solicit the information necessary for applicants to comply with the Town of Queensbury Site Plan Review requirements. A Pre- Application meeting with the Planning Staff is required. Staff members are available by scheduling an appointment, our office is open weekdays between 8:00 a.m. and 4:30 p.m. Town of OueensbM Planning Staff Chris Round, Director/Zoning Administrator Craig Brown, Code Compliance/Zoning Inquiries/Zoning Board Laura Moore/Planning Board SUBMISSION REQUIREMENTS: Please submit one (1) original and nine (9) copies of the completed application package, plot plan and copy of deed (1) with a $25 fee to the Planning Office by the last Wednesday of the month for consideration during the following month. Call or visit our office with any questions. All pages must be completed prior to review by Staff and the Planning Board. - Town of Queensbury Planning Office 742 Bay Road, Queensbury, NY 12804 Phone: (518) 761-8220 Fax: (518) 745-4437 E-mail: planninE�d queensbury.net www.gueensbury.net Last Revised: 06/22/99 General Information Application No.(office use only) Project Location: 276 Dix Avenue Tax Map ID: 110.-1-24.27 Zone Classification: Detailed Description Of Project(include current& proposed use): Replacement warehouse use of existing warehouse space with no site alterations proposed, whatsoever. Applicant: T Address: Sterling Road Suite 200, Fort Lauderdale, FL 33301 Home Phone: Work Phone/Fax: 954-962-9700 (Attention: David G. Hollander Applicant's Agent: Address: Bartlett, Pontiff, Stewart & Rhodes, P.C. One Washington Street Glens Falls NY 12801 Phone: 518-792-2117 Work Phone/Fax: Property Owner. Address: 633 Third Ave New York, NY 10017 Phone: 212-803=3100 Attn: Dermot F. Kell Work Phone/Fax: 212-803-3515 (fax) Directions to Site: Dix Avenue, behind K-Mart Last Revised: 06/22/99 Site Development Data Area/Type Existing(sq. ft.) Proposed Addition Total(sq.ft.) (sq. ft A. Building Footprint 62,000 ---- 62,000 B. Detached Garage 4,000 ---- 4,000 C. Accessory Structure(s) D. Paved, gravel or other hard 114,810 810 ---- 114,810 810 surfaced areas E. Porches/Decks F. Other Total Non-Permeable 180,810 ---- 180,810 Sum A through F Parcel Area 412,565 ---- 412,565 Percent Non-Permeable (Total Non-Permeabl&Parcel Area) 42% ---- 42% Setback Requirements Location Required Existing Proposed Front(1) 50 90 90 Front(2) Shoreline Side Yard(1) 30 50--- 50 Side Yard(2) 30 150 150 Rear Yard(1) 30 130 130 Rear Yard(2) Buffer/Travel Corridor Last Revised: 06/22/99 Checklist Please prepare a map depicting existing and proposed conditions. Failure to complete the following checklist or include all the required information on your plot plan will result in a determination of incompleteness and a delay in the processing of your application. Check/Initial The Applicable Boa Address Each Item Provided Not Applicable Waiver L GENERAL Requested(1 A Title, name, address of applicant and person responsible for X preparation of drawing. B. North arrow,Tax Map ID,date prepared and scale(minimum X 1 in.=40 8.). C. Boundaries of the property plotted to scale,zoning boundary. X D. Location of principal structures and accessory structures with X exterior dimensions- E. Location of site improvements including outdoor storage areas,driveways(existing andproposed),parking areas,etc. F. Setbacks for all structures and improvements. IL WATER&SEWER A Location of on-ate sewage disposal facilities, design details, X construction details, flow rates, and number of bedrooms served B. Location of water supply, (i.e., well) and septic on adjoining X lots with separation distances to existing or proposed on-site water supply and septic. C. Separation distances for proposed sewage disposal system to well and waterbodies. D. Location and description of existing public or private water X supply(well,lake,etc.). Method of securing public of private water, location, design, and construction of water supply including daily water usage. E. Percolation test location and results. III. PAREING/PERMEABLEAREAS A Number of spaces required for project including X - calculation/Justification B. Number of existing parking spaces, number to be removed, X number to remain,and type of surfacing material(e.g.,gavel, payed). C. Provision for pedestrian and handicap access and parldng. X D. Location and design details of ingress, egress, loading areas, X and curbing, Last Revised: 06/22/99 Provided Not Applicable Waiver Address Each Item Requested 1 E. Location and character of green areas(existing and proposed), X modification to green areas buffer zone to remain undisturbed F. Lighting: location and design of all existing or proposed X (existing) outdoor ligInting. IV. ADDMONAL SITE DEVELOPMENT& MISCELLANEOUS A Location of on-site and adjacent watercourses: streams, X rivers,lakes,wetlands. B. Location of proposed and existing: utility/energy distribution X systems(gas,electric, solar.telephone). C. Location,design and construction of all existing and proposed X site improvements including: drains,culverts, retaining walls, fences,fire&emergency zones and hydrants. D. Location and amount/pomon of building area proposed for X office, manufacturing, retail sales, or other commercial activities. E. Signage: location,size,type,design and setbacks. X ADDITIONAL REQUIREMENTS 1) " Waiver Request—Provide a letter to the Zoning Board and/or Planning Board requesting the waivers indicated on the checklist. 2) Commercial Development Activities will require submission of a Landscaping Plan, Stormwater Management Plan and a Grading Plan. 3) Other elements integral to the proposed development as considered necessary by the reviewing board 4) Identify any Federal.State or County permits required for the project's schedule. 5) Please submit record of application for approval status of all necessary permits from Federal. State and County officials. 6) Other Fees may apply—Engineering Fees,Recreation Fees For Office Use Only- Reviewed by Application fee received Original and 9 copies of Application and Plot Plan submitted Required Signatures Other. Last Revised: 06/22/99 14-164(12/97)--q PROJECT 1D 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 Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME SITCO LLC 276 Dix Ave 3. PROJECT LOCATION: _ Municioality niiPPnqhiiry County Warren 4. PRECISE LOCATION:(Street address and road intersections,prominent landmarks,etc.,or provide map) Dix Ave, behind K-Mart 5. IS PROPOSED ACTION: ❑ New ❑ Expansion K Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: replacement of existing warehouse space with new tenant 7. AMOUNT OF LAND AFFECTED: InNallydWL--3 acres Ultimately aoo. 3 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? CK Yes ❑ No 11 no,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? 0 Residential M Industrial 15 Commercial ❑ Agriculture ❑ Park/ForesVOpen Spam. ❑ Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING.NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(Federal,State or Local)? Cl Yes 2 No If yes,list agency(s)and pennitiapprovals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? - >rK Yes Cl No If yes,list agency name and permiUapproval ` site plan approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? 0 Yes ❑ No site paln for new tenant I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApphcanVSponsorName SITC0, LLC Date 2-4-00 Signature If the action is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER FEE-04-2000 15:52 ESDC FINRHCE 212 303 3556 F.02 3igaam Page Thu Page =dud= the Author uhair to Act as Agent Fam, Engwoering Fvv DISC lrxuro, Other Permit It"Waibilitum and Agreement to provide dooumetnaticn requined- cormlas the following ift�hee,QW NER of tho propwty is rm the wns u rho applicant! _ Qwmes Agora Fo *-p Vat4TaL D04jelyti¢ -1f /au.}1 i%t+ Owner: r 6 xe State WKy (gyp _(per Ovww Name) s spates:A (Print AppliCDWAgent Name) As agent tegardutg __' Yarieurs X Site Play Subdivision Fa Tax Map No.: Sactim 110 Bk)& 1 L at .4 27 Deed Re&tarce: Book 1a71i ge 4 p� SIGNATURE: ' (Gmher) 4-QG Date Qeretot F, Kelly, RVP Cerrtplste the follawmg if the AEULrANT is usable to attend tho meeting rut wisPres to be reproeeated by anatim party: Applicant's Ages Form Applioaat ITGO. LLC _ (Prim Appliaat Nance) Desipmes: Jon Laoner. Esa. �(Print AgeaNuft) As agent regarding: vie _, _ . -Site Alert Subdivision For Tax Map No.:Section M Block 1 L.et L27 SIGNATURE: (Applieaut) 2-4-00 Date r laE Fee DLelomre• Applications may be roferrsd to the Town owz*mg engineer for rrwaw of bc demp. storm dmmage, do. as determined by the Zonmi; or Phrxung Dspsnmeat. Fees for engmeeting review services will bo Charged directly to the applicant. Fees for OwAl ng review will nd oaoeed S I,000 without motif Kim to the sWhmg ftO : Omer Perm rye)•be required for Co muctitxt or altuatioa artiviry subsequont to sppmva(by the Zw'ftS Baud andfar Phoning Board. It is the appiic"'s raepoosiWkYto obtain any mkikimutl pemrits. Af W Maeemv MkOI 11iodowre: It is dro practice of Comtrrmrity Developmom Depart anent to haw a dutl�t transcribed #ammaphosser Wore recon!fire proasedip/s�mxtiaBe resukiol from apPlirat,;m.cud tbtt minutes _ tapes Constitaa the official record of all proceedings. If there is a discrepancy between such record end the handwrMw minutes taken by the designated stonogtapher, the bmdwr&m minutes shall be deemed the ofrmW record. 1.the underaiged,have thvronoly read and understand the itatructiom for Submission,spw to the sabmiosimt regpirmmm ad completed the eheddiat APPUCANT'S SIGNATURE: X bats APPMANT'S AMT SIGNATURE; X C •Date po- Y, � taetRevered: U(i17,2r9.9 PART II—ENVIRONMENIRAL ASSESSMENT (To be completed by Agency�All 1 C,�")rlrc-o A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. ❑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, it legible) Cl. 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: te I�O C2. Aesthetic,agricultural,archaeological,historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: th I 0 C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats,or threatened or endangered species?Explain briefly: 00 C4. A community's existing plans or goals as officially adopted,or a change in use or intensity of use of land or other natural resources?Explain briefly. Ij 0 _ C5- Growth,Subsequent development,or related activities likely to be induced by the proposed action? Explain briefly. Np C6. Long term,short term,cumulative,or other effects not identified in C1-05? Explain briefly. 00 C7. Other impacts(including changes in use of either quantity or type of energy)?Explain briefly. PO D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? ❑Yes No E. IS THERE, OR I T ERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes L4 No If Yes,explain 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 (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. If question D of Part II was checked yes, the determination and significance must evaluate 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: Agency Crat LU/1 S Pnnt op,Typ� Name RRewonvble Oificer in Lead Agency T' e r espo ble O ker cA 9gn ure of Responsible 011r ea gencv Signature of Preparer pi drfferent from onsib a of ci a/ate /o�� � Date 2