The URL can be used to link to this page

Site Plan Application1 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 TOWN OF QUEENSBURY Site Plan Review Application 5HYLHZ3URFHVV 1. Required Pre-submission meeting with staff to determine general completeness WREHKHOGQRODWHUWKDQ ZHHNSULRUWR GHDGOLQHGD\ Call (518) 761-8265 or (518) 761-8220 for an appointment. 2. Submittal of complete application: 1 original and 14 copies of the application package by monthly deadline. 3. Determination of application completeness. All necessary information must be provided and appropriate fee(s) paid for consideration for placement on an agenda for that month. 4.,QFRPSOHWH DSSOLFDWLRQV ZLOO QRW EH FRQVLGHUHG IRU SODFHPHQW RQ DQ\ DJHQGD XQWLO DOO PLVVLQJ LQIRUPDWLRQKDVEHHQVXEPLWWHG 5. Submittal to Warren County Planning, if applicable. 6. Planning Board meeting, generally the third & fourth Tuesday 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 drawings must be provided for the next phase of review. If your application was denied, your project cannot proceed as submitted. '2&80(17$7,215(48,5(0(176KDUGFRS\ HOHFWURQLF Please submit RULJLQDO FRSLHVof the completed application package to include: x &RPSOHWHG$SSOLFDWLRQpages 2-9, signed & dated x 3UH6XEPLVVLRQ0HHWLQJ1RWHV signed by staff x &RS\RI'HHG x &KHFNOLVW 3ORW3ODQ x (QYLURQPHQWDO$VVHVVPHQW)RUP for any non-residential project x )HH $100 (0 – 10,000 sq. ft.); $250 (10,001 – 30,000 sq. ft.); $500 (30,001 -100,000 sq. ft.); $1,000 (100,000+ sq. ft.) 6WDII &RQWDFW,QIRUPDWLRQ Craig Brown, Zoning Administrator FUDLJE#TXHHQVEXU\QHW Laura Moore, Land Use Planner OPRRUH#TXHHQVEXU\QHW Sunny Sweet, Office Specialist – Planning VXQQ\V#TXHHQVEXU\QHW Visit our website at ZZZTXHHQVEXU\QHW for further information and forms 2 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 General Information Tax Parcel ID Number: Zoning District: ________________ Lot size: $SSOLFDQW1DPHAddress: Home Phone Cell: Work Phone Fax E-Mail: $JHQW¶V1DPHAddress: Home Phone Cell: Work Phone Fax E-mail 2ZQHU¶V1DPHAddress Home Phone Cell Work Phone Fax E-mail &____/,&RPPHUFLDO/LJKW,QGXVWULDO _____________________$FUHV Detailed Description of Project [includes current & proposed use]: 5HIHU____________________________________________________________________WRWKHSURMHFWQDUUDWLYHIRUDPRUHGHWDLOHGGHVFULSWLRQ Location of project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roposed site development is construction of a grount-mounted solar energy system, located on the Warren County property of the Floyd Bennett Memorial Airport. The project area is at the northwest corner of the airport parcel. The north solar facility proposes 8.3 acres of solar panels. Refer to the project narrative. Location of project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±5HYLVHG2FWREHU 7RZQRI4XHHQVEXU\3ODQQLQJ2IILFH%D\5RDG4XHHQVEXU\1< 352326('3$5.,1*63$&(6)251257+)$&,/,7Y)250$,17(1$1&((48,30(17$1' 9(+,&/(6$5(,1&/8'(':,7+,1$&&(6652$'$5($65()(572352-(&71$55$7,9()25025(,1)250$7,21 N.A. 1$ 5HDU<DUG>@ ! N.A. N.A. 1$ 1$ 1$ 1$ 1$ N.A. N.A. 3(5''62/$53$1(/$55$<+(,*+70$<(;&((' +(,*+7$77+(3/$11,1* %2$5' 6',6&5(7,21 $& $& 1$1$ 1$ 1$ $& 62/$53$1(/$55$<$5($$7$1*/( 2)0$;,080*5281'&29(5$*( 1$1$ 1$1$ 1$1$ 1$ $& $& $& $& $& $& $& $& $& N.A. 4 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 $GGLWLRQDO3URMHFW,QIRUPDWLRQ 1. Will the proposal require a Septic Variance from the Town Board of Health? _______________ 2. If the parcel has previous approvals, list application number(s): _________________________ 3. Does this project require coverage under the New York State Pollutant Discharge Elimination System (SPDES) Permit Program ? _______________ 4. Estimated project duration: Start Date __________ End Date __________ 5. Estimated total cost of project: _______________ 6. Total area of land disturbance for project: _______________ )ORRU$UHD5DWLR:RUNVKHHW FLOOR AREA RATIO (FAR) -- The relationship of building size to lot size, derived by dividing the total building floor area by the lot size in square feet, yielding a percentage. Zoning District Symbol Floor Area Ratio [FAR] Waterfront Residential WR 0.22 Commercial Moderate/ Intensive CM/ CI 0.3 A. The combined area of all square footage, as measure from exterior walls of all structures on the property, including all floors of the structures, garages, basements and attics with more than five (5) feet of ceiling height and covered porches. Building square footage does not include: Open deck, docks and that portion of covered docks extending over water and one storage shed of one hundred twenty (120) square feet or less. Any additional sheds will be included. (See “FLOOR AREA RATIO”). B. Commercial or industrial: the total area in square feet as measured from the exterior of the outside walls of a building or structure, and when applicable, the sum total of all floor areas of the principal and accessory buildings or structures on the project site. $ 3DUFHO$UHD ___________________________ sq. ft. % ([LVWLQJ)ORRU$UHD ___________________________ sq. ft. [see above definition] & 3URSRVHG$GGLWLRQDO)ORRU$UHD ___________________________ sq. ft. ' 3URSRVHG7RWDO)ORRU$UHD ___________________________ sq. ft. ( 7RWDO$OORZDEOH)ORRU$UHD ___________________________ (Area x _____) [see above table] *If D is larger than E. a variance or revisions to your plan may be needed. Consult with Staff. 1R 8QNQRZQDVUHODWHGWRSURSRVHGDFWLRQ <HV 1RUWK$FUHV6RXWK$FUHV 127$33/,&$%/( 2FWREHU2FWREHU 5 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 5HTXLUHPHQWVIRU6LWH3ODQ$SSURYDO The Planning Board shall not approve a Site Plan unless it first determines that such site plan meets the following Standards. Please prepare responses to each of the following topics: STANDARDS A.The proposed project furthers or is consistent with the policies of the Town’s Comprehensive Plan. B.The proposed project complies with all other requirements of this Chapter, including the site plan review standards as set forth in Paragraph F of this section, the dimensional, bulk and density regulations of the zoning district in which it is proposed to be located (Article 3 and Table 1), the applicable requirements of all other Articles that apply. C.The site plan encourages pedestrian activity internally and, if practicable, to and from the site with pedestrian paths or sidewalks connected to adjacent areas. D.The site plan must conform to Chapter 136 Sewage and Sewage Disposal, Chapter 147 Stormwater Management Local Law, and other applicable local laws. E.The proposed use shall be in harmony with the general purpose or intent of this Chapter, specifically taking into account the location, character and size of the proposed use and the description and purpose of the district in which such use is proposed, the nature and intensity of the activities to be involved in or conducted in connection with the proposed use and the nature and rate of any increase in the burden on supporting public services and facilities which will follow the approval of the proposed use. F.The establishment, maintenance and operation of the proposed use will not create public hazards from traffic, traffic congestion or the parking of vehicles and/or equipment or be otherwise detrimental to the health, safety or general welfare of persons residing or working in the neighborhood or to the general welfare of the town. Traffic access and circulation, road intersections, road and driveway widths and traffic controls will be adequate. G.Off-street parking and l9oading facilities will be appropriately located and arranged and sufficient to meet traffic anticipated to be generated by the new use. The establishment of vehicle links between parking areas of adjacent properties are provided where feasible. This furthers the Town’s goal of reducing curb cuts and reducing congestion. A twenty-foot wide connection is required. If adjacent properties are either undeveloped or previously developed without having made provision for future linkage, then a future connection must be identified and provided for in the site plan under review for such future linkage when the time arises. The Planning Board may require proof that the applicant has made contact with adjacent property owners for purposes of coordinating linkages with adjacent properties. H.The project shall not have an undue adverse impact upon the natural, scenic, aesthetic, ecological, wildlife, historic, recreational or open space resources of the town or the Adirondack Park or upon the adequate provision of supporting facilities and services made necessary by the project, taking into account the commercial, industrial, residential, recreational or other benefits that might be derived from the project. In making the determination hereunder, the Planning Board shall consider those factors pertinent to the project contained in the development considerations set forth herein under § 179-9-080 of this Chapter, and in so doing, the Planning Board shall make a net overall evaluation of the project in relation to the development objectives and general guidelines set forth in § 179-9-080 of this Article. I.The provision for and arrangement of pedestrian traffic access and circulation, walkway structures, control of intersections with vehicular traffic and overall pedestrian convenience shall be safe and adequate for pedestrian movement. Pedestrian connections between adjacent sites shall be provided to encourage pedestrian use. J.Stormwater drainage facilities will prevent an increase of post development drainage flows as compared to pre-development drainage flows. Drainage of the site shall recharge ground water to the extent practical. Surface waters flowing off-site shall not degrade any streams or adversely affect drainage on adjacent properties or public roads. Facilities shall be in conformance with the drainage standards of Chapter 147 of the Town Code and the Town of Queensbury Subdivision Regulations where applicable. K.The water supply and sewage disposal facilities will be adequate and will meet all applicable and current requirements set forth by Department of Health regulations and Chapter 136 of the Town Code. L.The adequacy, type and arrangement of trees, shrubs and other suitable plantings, landscaping and screening shall effectively provide a visual and/or noise buffer between the applicants and adjoining lands, including the maximum retention of existing vegetation and maintenance, including replacement of dead or deceased plants. M.Fire lanes, emergency zones and fire hydrants will be adequate and meet the needs and requirements of emergency service providers. N.The design of structures, roadways and landscaping in areas susceptible to ponding, flooding and/or erosion will minimize or avoid such impacts to the maximum extent practicable. O.The site plan conforms to the design standards, landscaping standards and performance standards of this chapter. 6 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 &KHFNOLVW$SSOLFDWLRQIRU6LWH3ODQ5HYLHZ. Application materials and site plan shall include sufficient information for the Board to review and provide a decision. The applicant is to provide a site plan drawing and all attachments that address items A-V. The applicant may request a waiver from A-V and is to provide reasons for waiver(s) requested. Please label information to be submitted. 5(48,5(0(176Sheet # A.A vicinity map drawn at the scale that shows the relationship of the proposal to existing community facilities which affect or serve it, such as roads, shopping areas, schools, etc. The map shall also show all properties, identify owners, subdivisions, streets and easements within 500 feet of the property. Such a sketch may be superimposed on a United States Geological Survey map of the area. B.The site plan shall be drawn at a scale of forty feet to the inch (1” = 40 feet) or such other scale as the Planning Board may deem appropriate, on standard 24” x 36” sheets, with continuation on 8 l/2 “x 11” sheets as necessary for written information. The information listed below shall be shown on the site plan and continuation sheets. C.Name of the project, boundaries, date, north arrow, and scale of the plan. D.Name and address of the owner of record, developer, and seal of the engineer, architect or landscape architect. If the applicant is not the record owner, a letter of authorization shall be required from the owner. E.The location and use of all existing and proposed structures within the property, including all dimensions of height and floor area, all exterior entrances, and all anticipated future additions and alterations. F.The location of all present and proposed public and private ways, off-street parking areas, driveways, outdoor storage areas, sidewalks, ramps, curbs, paths, landscaping, walls and fences. Location, type and screening details for all waste disposal containers shall also be shown. G.The location, height, intensity and bulb type (sodium, incandescent, etc.) of all external lighting fixtures. The direction of illumination and methods to eliminate glare onto adjoining properties must also be shown in compliance with § 179-6-020. H.The location, height, size, materials and design of all proposed signs. I.The location of all present and proposed utility systems including: 1. Sewage or septic system; 2. Water supply system; 3. Telephone, cable and electrical systems; and 4. Storm drainage system including existing and proposed drain lines, culverts, catch basins, headwalls, endwalls, hydrants, manholes and drainage swales. J.Plans to prevent the pollution of surface or groundwater, erosion of soil both during and after construction, excessive runoff and flooding of other properties, as applicable. A Stormwater Pollution Prevention Plan (SWPPP) for all land development activities (excluding agricultural activities) on the site that results in land disturbance of one acre or more. A SWPPP shall comply with the requirements of the DEC SPDES MS-4 General Permit and Chapter 147 of the Town of Queensbury Code. It shall be at the discretion of the Planning Board as to whether a SWPPP or an erosion and control plan shall be required for a site plan review project land disturbance of less than one acre. K.Existing and proposed topography at two-foot contour intervals, or such other contour interval as the Planning Board shall allow. All elevations shall refer to the nearest United States Coastal and Geodetic Bench Mark. If any portion of the parcel is within the 100-year floodplain, the area will be shown and base flood elevations given. Areas shall be indicated within the proposed site and within 50 feet of the proposed site where soil removal or filling is required, showing the approximate volume in cubic yards. L.A landscape plan showing all existing natural land features than may influence the design of the proposed use such as rock outcrops, stands of trees, single trees eight or more inches in diameter, forest cover and water sources and all proposed changes to these features, including sizes and types of plants. Water sources include ponds, lakes, wetlands and watercourses, aquifers, floodplains and drainage retention areas. M.Land Use District boundaries within 500 feet of the site’s perimeter shall be drawn and identified on the site plan, as well as any Overlay Districts that apply to the property. & & 6LWH3ODQ 'RFXPHQWV && &6LWH3ODQ $SSOLFDWLRQ && && && & 1$ 1$ 1$ && && && 6:333 6WRUPZDWHU 1DUUDWLYH & && && & 6XUURXQGLQJ /DQG2ZQHUV =RQLQJ)LJXUH 7 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 5(48,5(0(176&217,18('Sheet # N.Traffic flow patterns within the site, entrances and exits, loading and unloading areas, as well as curb cuts on the site and within 100 feet of the site. The Planning Board may, at its discretion, require a detailed traffic study for large developments or for those in heavy traffic areas, which shall include: 1. The projected number of motor vehicle trips to enter or leave the site, estimated for weekly and annual peak hour traffic levels; 2. The projected traffic flow pattern including vehicular movements at all major intersections likely to be affected by the proposed use of the site; 3. The impact of this traffic on levels of service on abutting public streets and at affected intersections. Existing and proposed weekly and annual peak hour traffic levels and road capacity levels shall also be given. O.For new construction or alterations to any structure, a table containing the following information shall be included: 1. Estimated area of structure to be used for particular purposes such as retain operation, office, Storage, etc.; 2. Estimated maximum number of employees; 3. Maximum seating capacity, where applicable; and 4. Number of parking spaces existing and required for the intended use. P.1. Floor Plans. 2. Elevations at a scale of one-quarter inch equals one foot (1/4” = 1 foot) for all exterior facades of the proposed structure(s) and/or alterations to or expansions of existing facades, showing design features and indicating the type and color of materials to be used. Q.Soil logs, water supply well and percolation test results, and storm water runoff calculations as needed to determine and mitigate project impacts. R.Plans for disposal of construction and demolition waste, either on-site or at an approved disposal facility. S.Plans for snow removal, including location(s) of on-site snow storage. T.An Environmental Assessment Form (“EAF”) as required by the SEQRA regulations, with Part 1 completed by the Applicant shall be submitted as part of the application. If the proposed project requires a special use permit and an EAF has been submitted in conjunction with a special use permit application, a duplicate EAF is not required for the site plan application. U.If an application is for a parcel or parcels on which more than one use is proposed, the applicant may submit a single application for all such uses, provided the proposed uses are accurately delineated on a site plan drawn pursuant to the requirements set forth above. The Planning Board may grant the application with respect to some proposed uses and not others. For purposes of reviewing an application (and for SEQRA compliance) all proposed uses on a single parcel or on contiguous parcels shall be considered together. V.A brief narrative statement on how the project proposed for review furthers or is consistent with the vision, goals and policies in the Town’s Comprehensive Plan. &6:333 6WRUPZDWHU 1DUUDWLYH 1$ 3URMHFW1DUUDWLYH 1$ && 3URMHFW1DUUDWLYH 1$ 3URMHFW1DUUDWLYH 3URMHFW1DUUDWLYH 1$ 1$ )($) 3URMHFW 1DUUDWLYH 6LWH3ODQ 'RFXPHQWV 6:333V 6WRUPZDWHU 1DUUDWLYHV &6:333 Town of Queensbury Site Plan Pre-Submission Conference Form / Section 179-9-040 1. Applicant Name: __________________________________________________ 2. Tax Map ID ________________ Location: _______________________ 3. Zoning Classification __________ 4. Reason for Review: __________________________________________________________ 5. Zoning Section #: ________________________ 6. Pre-Submission Meeting Notes: Provided Outstanding; Please provide by Deed ____ _____________ General Information complete ____ _____________ Site Development Data Complete ____ _____________ Setback Requirements Complete ____ _____________ Additional Project Information Complete ____ _____________ FAR addressed ____ _____________ Requirements for Site Plan-Standards ____ _____________ Checklist items addressed ____ _____________ Environmental Form completed ____ _____________ Signature Page completed ____ _____________ Staff Representative: ________________________________ Applicant / Agent: ________________________________ Date: ___________ Northern Gateway Renewables 297.15-1-1/510.06ac 443 Queensbury Avenue /So. Side of Hicks Road CLI Project includes 31 ac of fenced area with 8.3 acre of ground mounted 5.MW solar array farm on property of the County Airport 179-5-140 Renewable, 179-10 SUP Solar, 179-3-040 CLI, Chapt 94 X X X X NA X X X None difficult with North and South together " Chris Clark & Dallas Manson? titles needed Laura Moore via email 07/07/2022 Applicant proposes to utilize 31 acres of the 510 sq ft parcel for a 8.3 acre 6.6MW or 5.0MW? solar farm on land of the Warren County Airport. Project site work is within 100 ft of designated wetland and disturbance of existing wetland areas for placement of solar panels. Project work includes fencing, stormwater management, and equipment areas. The increase in hard surfacing is 0.86 ac of hard surfacing with equipment pads. Site work proposed in the wetland is in three specific areas and other site work is adjacent. Site disturbance of 34.10ac. Panel height is 16.5 to 19.5 affic Site Plan, Special Use Permit, Freshwater Wetlands Permit, work on slopes 15% greater. Items reviewed: site plan application, site plan drawings, SWPPP 1) Clarification needed on MW 6.6 (EAF) or 5.0 (Narrative) 2) Any information from Army Corp in regards to wetlands - reviewed DEC confirming wetland boundary 3) Separate North and South - Project Narrative, Site Plan Review Requirements, Special Use Permit general criteria and specific criteria, and EAF 4) will need dimensions on the equipment unit and individual concrete pad 5) confirm with emergency service road width needs and drive length 6) any lighting needs? 7) is there a glare study? 8) Plans with 100 ft buffer area for wetland should be denoted for Army Corp and DEC 9) Wetlands permit should note both Army Corp and NYSDEC 10) signature page - will need names and titles as part of signature page 8 9 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 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: _______________ 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 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 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 [Applicant] Print Name [Applicant] Date signed ____________________________ ___________________________ __________________ Signature [Agent] Print Name [Agent] Date signed