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ApplicationC;;7V-1 %tl N A:, • • General Information Tax Parcel ID Number: Zoning District: L Detailed Description of Project [include current & proposed use]: Location of project: ed:�k Q Ueiab 1N j o-( Air -- Will the proposal require a Septic Variance from the Town Board of Health? 14 If the parcel has previous approvals, list application number(s): JJ4V-r1OLQA Town of Queensbury Planning Office- 742 Bay Road Queensbury, NY 12804 - 518-761-8220 2 0 Site Development Data Area / Type Existing sq. ft. Proposed Additions . ft. Total sq. ft. A. Building footprint �_I ' �a O _I 101f61QO B. Detached Garage _U _ _V C. Accessory Structure(s) G,L,{_ D. Paved, gravel or other hard surfaced area J J J7� _ ih�-h `T E. Porches / Decks F. Other G. Total Non -Permeable [Add A-F] i.4, 6_1 I tv r wit 15,1 H. Parcel Area [43,560 sq. ft. / acre] rPercentage of Impermeable Area of Site [I=G/H] Setback Requirements Front [1] 50' 10u 60 . S('0 GJO• rJ(OI Front [2] _ Shoreline -�y i 10 Side Yard [1] 1�310N,0„ ( / 0( 3,1 �&I Side Yard [2] 1)01-0n &-7 I p 1 q41 Rear Yard (1] �O�' Du I Q' S�� to Rear Yard [2] _ Travel Corridor Height [max] 501-oit 2�1 251 Permeability J/LGV No. of parking spaces �q r1S Town of Queensbury Planning Office- 742 Bay Road - Queensbury, NY 12804 - 518-761-8220 3 Floor Area Ratio Worksheet Floor Area Ratio [FAR] is the relationship of building site to lot size dividing the total building square footage by the lot size in square feet, yielding a percentage. The applicable ratios are as follows: Waterfront Residential WR-3A 0.22 WR-1A Professional Office PO 0.22 Highway Commercial Moderate HC-Mod 0.3 Highway Commercial Intensive HC-Int 0.3 Neighborhood Commercial NC-1A 0.22 NC-10 Commercial Industrial CI-1A 0.3 Light Industrial LI-1A 0.3 Heavy Industry HI 0.3 Enclosed Shopping Center ESC-25A See Zoning Administrator Building square footage includes all floors of the primary structure, covered porches, and basements that may be suitable for living space. Detached storage buildings greater than 100 sq. ft. and detached garages are included in the FAR calculations. Building square footage does not include: open decks, docks and that portion of covered docks extending over the water, and one shed 100 sq. ft. or less. All additional sheds are included in the FAR calculations. Note: if E is larger than D, a variance or revisions to your plan may be needed. Please consult w/Staff. Town of Queensbury Planning Office 742 Bay Road Queensbury, NY 12804 518-761-8220 4 Please provide maps / plans Octing the following items. If informationoot submitted, an explanation of why must be provided. 7ba Title, Name, Address of applicant & person responsible for preparation of drawing Deed c North arrow, Tax Map ID, date prepared and scale [minimum I In. = 40 ft.] d Boundaries of the property plotted to scale, zoning boundary e Principal structures, accessory structures with exterior dimensions f Site improvements incl. outdoor storage areas, driveways, parking areas, etc.: existing N©tdi BelrJb & proposed g Setbacks for all structures and improvements: existing & proposed t)_[ h Elevations and floor plans of all proposed and affected structures _ Project sewage disposal facilities, design details, construction details, flow rates, and MLIWtGPAt- 7ba number of bedrooms proposed Water supply [i.e. well] and septic on adjoining lots with separation distances to existing ]vlumo pill or proposed on -site water supply and septic c Separation distances for proposed sewage disposal system to well and water bodies N d Existing public or private water supply [well, lake, etc.]. Method of securing public or /a private water, location, design and construction of water supply including daily water usage e Percolation test location and results P a Number of spaces required for project including calculations and justification: existing & proposed b Number of existing parking spaces, number to be removed, number to maintain and 5 type of surfacing material [e.g., gravel, paved] c Provision for pedestrian and handicap access and parking: existing & proposed d Design details of ingress, egress, loading areas and cutting: existing & proposed e Location and character of green areas [existing and proposed], modification to green S_I area, buffer zone to remain undisturbed f Lighting, location and design of all existing and proposed outdoor lighting t> a On -site & adjacent watercourses, streams, rivers, lake and wetlands b Utility /energy distribution system [gas, electric, solar, telephone]: existing & proposed c>_ c Location, design and construction details of all existing and proposed site improvements including: drains, culverts, retaining walls, fences, fire & emergency zones and I� hydrants, etc. d Square footage of building area proposed for office, manufacturing, retail sales or other _ I commercial activities: existing & proposed Town of Queensbury Planning Office- 742 Bay Road - Queensbury, NY 12804 - 518-761-8220 5 e Signage: Location, size, t design and setback: existing & propos 5 �I f Waiver Request: provide letter with application requesting any waivers: please reference specific items L`£ g Commercial / Industrial Development requires submission of a Landscaping Plan, Stormwater Management Plan, Grading Plan and a Lighting Plan h Identification of Federal, State or County permits required for the project together with a record of application for all necessary permits • F4s,,- a U1 T Town of Queensbury Planning Office 742 Bay Road - Queensbury, NY 12804 - 518-761-8220 b • PROJECT ID NUMBER 617.20 . SEQRAPPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME Cliff H. Nelson Renovations to 543 Queensbury Ave 3.PROJECT LOCATION: Queensbury Warren Municipality County 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 543 Queensbury Ave - 1/2 mile north of Warren County airport 5. IS PROPOSED ACTION: ❑ New ❑ Expansion ❑� Modification / afleration 6. DESCRIBE PROJECT BRIEFLY: Applicant proposed to add 2,032 square feet to the existing second floor office space with the existing 19,980 square foot building. No site alterations are being proposed. 7. AMOUNT OF LAND AFFECTED: Initially 5.46 acres Ultimately 5.46 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ❑✓ Yes ❑ No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential ❑� Industrial RICommercial Agriculture ❑ Park / Forest / Open Space ❑Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) aYes El No If yes, list agency name and permit / approval: Town of Queensbury - Building Permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes No If yes, list agency name and permit / approval: 11I22.-.A''S A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? LJres No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Spo r Na P Hall (Architect\Agent for the Applicant) Date: November 20, 2008 Signature If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Aaencv) A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.4? 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, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A cornmunity's existing plans or goats as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1-05? Explain briefly: C7. Other impacts(including changes in use of either quantity or type of energy? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? lt yes, explain briefly: ❑ Yes ❑ No E. IS THERE, OR IS THERE Yes 1:1 No LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: 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 of significance mustevaluate the potential impactof the proposed action on theenvironmental characteristics of the CEA. Check this box it you have identified one "mom potentially large orsignificant adverse impactswhich MAY occur. Then proceed directly to the F 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 ai WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting determination. Name of Lead Agency Print or Type Nam of Responsible r in ea gency Title of Responsible Officer Signature of Responsibler in Lead Agency gnature of Preparer (if different from responsible officer) 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: r. IV'C `,✓ A Owner: Designates: e}}jy l 14AU. IFUCAWEWA 4AW A46+� nV-Gi'Ue*a As agent regarding: Variance Site Plan Subdivision For Tax Map No.: Qom$ Section Block 2' Lot } VO OWNER SIGNATURE: Page Date DATE: 2.) ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design, stone 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. If there is a discrepancy such record and the handwritten minutes taken by the designated stenographer, the handwritten minutes shall be deemed the official record. 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 statement/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. _ /% SIGNATURE OF APPLICANT: ' DATE: &/Mf/V . 2Z9 ,,, QQ SIGNATURE OF AGENT: DATE: 0) AV &16 Town of Queensbury Planning Office- 742 Bay Road - Queensbury, NY 12804 - 518-761-8220 9 RUCINSKI HALL ARCHITC TURE Ronald Richard Rucinski Ethan Peter Hall 627 Maple Avenue Saratoga Springs NY 12866 Voice 518 580 1905 Fax 518 584 5012 Email ronrr@nycap.rr.com ephall@nycap.rr.com Renovations to 543 Queensbury Avenue — Cliff H. Nelson 20 November. 2008 Craig Brown — Town of Queensbury Planning and Zoning Department 742 Bay Road Queensbury NY 12804 Dear Mr. Brown, At the above referenced project location the applicant is requesting waivers for Storm Water Management, Grading, Lighting & Landscaping requirements. The major reason for the waiver request is that the project entails mainly interior office space within an existing building. The amount of new space being provided will not affect the existing site and all existing systems will be capable of handling the small amount of additional interior renovations being proposed. Detailed explanations follow; • Stormwater Management Plan: The current site is approximately 5.46 acres, of which 64,571 sq. ft. or 27% is covered by building and gravel or paved surfaces. The proposed new construction will not increase the building or hard surfaces coverage on the overall site. The current stormwater management on site is functioning adequately and as no new construction is being proposed which will affect the site we request a waiver from the stormwater management plan requirement. • Grading Plan: There will be no disturbance in existing grading. Therefore we are requesting a waiver from the grading plan requirement. • Lighting Plan: There will be no increase in site lighting. Therefore we are requesting a waiver of the lighting plan requirement. • Landscaping Plan: There will be no changes to the existing Landscaping. Therefore we are requesting a waiver of the lighting plan requirement. If there are any questions regarding these waiver requests please give me a call to discuss. Regards, Ethan Peter Hall Architect Y1V & H ConsWc[iWAmencm Paintball Supply\Pape orkMaiver I. W 20 Nov 2008.dm ram---- _..7717!!q &t �.� , Pl. r Jan ub v9 u9:bba Ron Ruclnslu 518-584-5012 p.1 RUCINSKI HALL ARCHITECTURE Ronald Richard Rucinski Ethan Peter Hall 627 Maple Avenue Saratoga Springs NY 12866 Voice 518 5801905 Fax 518 584 5012 Email ronrr@nycap.rr.com ephall@nycap.rr.com Transmittal To: Craig Brown — Town of Queensbury — Planning & Zoning Department From: Ethan Hall Date: 5 January, 2009 Re: 543 Queensbury Ave — Cliff Nelson The applicant has requested that this project be withdrawn from consideration by the Planning Board at this time. Please let me know if there are any questions regarding this project. Cc: Cliff Nelson (w/attachments) Y:1V & H ConstrurtionVvmcrican PaintbaU SupplylPnpawoMTran=itW 5 Jm 2009.dm 1