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2001-905 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20010905 Date Issued: Friday, January 18, 2002 This is to certify that work requested to be done as shown by Permit Number P20010905 has been completed. Tax Map Number: 523400-309-010-0001-088-000-0000 Location: 53 LUZERNE Rd Owner: FRED & JANE ALEXY TRUSTEES Applicant: BARE BONES FURNITURE, INC. This structure may be occupied as a: By Order of Town Board Certificate of Occupancy (COM) TOWN OF QUEENSBURY c--/-)arvA41 Director of Building Code"nforcement • TOWN OF QUEENSBURY = 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010905 Application Number: A20010905 Tax Map No: 523400-309-010-0001-088-000-0000 Permission is hereby granted to: BARE BONES FURNITURE.INC. For property located at: 53 LUZERNE Rd in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: FRED & JANE ALEXY TRUSTEES Certificate of Occupancy(COlvl) 37 OVERLOOK Dr Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name/ Address Electrical Inspection Agency Plans &Specifications 2001-905 BARE BONES FURNITURE,INC. CERTIFICATE OF OCCUPANCY ONLY.NO STRUCTUAL WORK TO BE DONE $0.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Friday,January 17,2003 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the own Que sb ; u sday,January 17,2002 SIGNED BY for the Town of Queensbury. Director of Building&Co e Enforcement FILE No.191 12/07 'Cl AM 09:42 ID:TOWN OF.OUEENSBURY FAX:518 745 4437 PAGE 3 ORIGINAL BP File# i -9_QS NTemair Mxisliiiest s a. Dept. of Community Development Cerwtif cate O OOr- o Town of Queensbury QCcppast.1'lc y permit 742 Bay Road Queensbury, NY 12804 (518) 761-8256 [For occupancy only, with no work requiring building permit: no fee required for this permit. • Name of Business: 2.r, e,/ues /-- /wf kY-e • Address: /0 o9G/9-/nORE SY- C/L,`!J'47�J..,.!v " /2 tt/ Person in Charge or Manager: 0/v /5/9 s e. Qti /'t 0KJ Business Phone Niunber: 5?f 7(/SQ)07 Type of Business: (i.e.,mercantile, restaurant,hobby shop,plumbing store): Fv2A),Vure_ _Re/r.I • Owner of Property: (3y r`'7 pn/ /S i'a. 1 Address: (53�.57--/Luiz zeg.c) /2 d 6?-) or t023 y - Phone Number: ,(7f . 7 67:57-42)0 7.., Please provide,an accurate layout of your store showing all walls, exits, stockrooms, rest rooms, counters and fixture layout on a separate sheet of paper. Signature: Date: / ;_?-0/ of pe?won submitting this form, Property Tax Map No. / / Notes/Comments: iike41 goy ' -e auu ;'z5�'_t.Zdt4 iifi 12/06/2001 21:20 5187430558 BARE BONES PAGE 02 FILE No.191 12/07 '01 AI 09:42 ID:TOIWN OF OUEENSBURY FAX:518 745 4437 PAGE 4 • Town of Queensbury (-`j(), Fire Marshal's Ofce EMERGENCY CONTACT UPDATE MS 2000 TO: WARREN COUNTY SHERIFF'S DEPT. FAX: 761.6210 • PLEASE PRINT DATE: /2` 2 BUSINESS NAME: / //2..E eatieg e/V. Adt r' ' /C t3USINES6 ADDRESS: /0 e9(5-- Q . 4-571— 61bn-rs i4j/f/- 1 rOf BUSINESS PHONE; � - 0_7 MOIRE CONTACT l: cap PHONE 2.3`7y. TOWN RESPONDING FROM: ' -vaor _ HOME CONTACT 2: ,/-) e PHONE._ c' Yo 2 TOWN RESPONDING FROM: k� / HOME . CONTACT 3: )CC 1.4 r . PHONE :I‘60 TOWN RESPONDING FROM: 6f r°O-r. t1.7f -- Fire Man hai Chris Jones, Deputy Fire Marshal Steve Smith Phone 761-8205, FAX 745-443r Go 4"' L FIR MARSHAL TOWN OF QUEENSBURY 4j QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT r REQUEST RECEIVED PERMIT# C1�I"9I/J NAME 3Rpt T306 E ace. oLoc LOCATION 51 LtA. ?N gel SCHEDULE INSPECTION ON 1-2,.RD A *ANYTIME A'pROVED IA YES NO EXITS AISLE WIDTHS X EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS ARE ALARM SYSTEM / FIRE SPRINKLER SYSTEM A FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE IG 5ilt',.Ek'fry/ i( CHIMNEY WOOD STOVE FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT REMARKS: ❑ OK TO THIS DATE — j i p c tvoo l ¢iwpl £ oiY\ &�17, 2 G bk ( ( eLed\/ (v1 460 - P ed . aVew INSPSUP.PUB INSP TOR uQ �D ‘ ri°5 I./44 01 10 :00AM e.0 o j, p 5 - ,. i 5 „r NEW YORK STATE UNIFORM FIRE PREVENTION AND BUILDING CODE . .,,� '{ �,' 4 j c FIRE INSPECTION REPORT �t)- ' .. , 761-8205 FIRE MARSHAL'S OFFICE 742 BAY ROAD, OUEENSBURY,NY 12804-5902 ��`44. Occupant (a i ttobt fie, Address Telephone And� FD \ ii.A4k14 6-Mitt I�oNE�.fu{Nluft 51 L� erNe 1� �F 3 7y�:oao7 Contact Person . Received By Date Inspector.- on /2/ oi - S ❑Sprinkler 4Af1L'J Wet El Ti Y , I 1 Dry I ! Supression Mt/Adel Iri 3 , � 10 Detection ❑Heat Alarm E Local S 0/ ❑ Supervised ND MO. ❑Smoke PIO El Supervised FAILURE TO CORRECT CODE VIOLATIONS NOTED.WITH AN"X" MAY RESULT IN APPROPRIATE LEGAL ACTION AGAINST YOU OR.YOU ESTABLISHMENT AS DIRECTED BY LAW. • PART 1161 EMERGENCY ACCESS 5l PART 1172 COMBUSTIBLE FIBERS 0. ( ) 1161.1. General Requirements ei 44. ( ) 1172.1 General Requirements 45. ( ) 1172.2 Loose Storage PART 1162 MEANS OF EGRESS iG D' ' 46. (. ) 1172.3 Baled.Storage � � 0' 1. ( ) 1162.1 General Requirements 66, � � t�� 2. ( ) 1162.2 .Obstructions C ? b 1A PART 1.173 DUST 3. () 1162.2g Aisles 1171 47. ( ) 1173.1 General.Requirements 4.. `$J 1162.3 Lighting and Exit Signs 5. (• ) 1162.4 Elevator Warning,Signs 1- ,". PART 1174 HAZARDOUS MATERIALS 6.. ( ) 1162.5 Openings in Fire Walls and SeparationdOw- 48. ( ) 1174.1 General.Requirements 7. ( ) 1162.6_Exterior EgresG (. ) 1174.2 Corrosive Liquids 8.: ( .) 1162.7 Facilities for the Handicapped. : ' A e'50• ( ),1174.3 Flammable Solids + al I 51. ( ) 1174.4 Highly Toxic Materials Part 1163 EQUIPMENT AND SYSTEMS '.n--` 52. ( 1174.5 Oxidizing Materials 9. ( ) 1163.1 General Requirements' �k, . ).'1174.6 Poisonous Gases . 10. ( ) 1163.2 Fuel Gas Systems ���ly 54. ( ) 1174.7 Radioactive Materials . •11. .( ) 1163.3 LPG,Containers and Tanksvprival 55. ( ) 1174.8 Unstable Chemicals 12. ( ) 1163.5 LPG,Tank Paint 13. ( ) 1163.6 Fuel Oil Systems PART 1175 COMPRESSED GASES 14. ( ) 1163:8 Heating Systems ' ,i'(A)� ]-Q 56. ( ) 1175.1 General Requirements 15. ( ) 1163.9 Chimneys,Flues,Gas Vents 1� j�_"1 57. ( ) 1175.3 Hydrogen 16. ( ) 1163.10 Incinerator and Compactors '- ( C i(1'58. ( •) 1175.4 Flammable Anesthetics 17. ) 1163.11 Electrical Systems Cl-ai. .0 �. . ( ) 1175.5 Nonflammable Medical Gases. 18. ( ) 1163.12 Commercial Cooking Equipment //c� ,:Y0. 19. ( ) 1163.13a Water Supply 1.c0 ,", 1163:RT 1176 EXPLOSIVES 20. ( ) 1163.13b Sprinkler System `` tan . • ( ) 1176.1 General Requirements 21. ( ) 1163.13c Standpipe System e. 136 22. ( ) 1163.13d Fire Pumps W ►N PART 1178 MATERIAL FOR WELDING AND CUTTING 23. ( ) 1163.13e Yard Hydrant System ( 61. ( ) 1178.2 Weking and Cutting 24. ( ) 1163.13f Portable Fire Extinguisher . b� 4,1 62..:( )•1178.3 Oxy-Fuel Welding and Cutting. 25. ( ) 1163.13g Fire Alarm System At'�"' k&,' . '63. ( ) 1178.4 Electric Arc-Welding and Cutting 26. ( ) 1163.13h Fire and Smoke Detectors iV 27.. ( ) 1163.13i Foam and Chemical Extinguishing Systel" PART 1191 FIRE SAFETY SAFEGUARDS I►� 64. 1191.1.General Precautions 28. ( ) 1163.14 Elevator Equipment ��Q l �/; ( . ) n c-\1 65. ( ) 1191.2 Exterior protection PART 1164 SPECIAL PROPERTY USES WI 66. ( ) 1191.3 Interior Protection 29. ( ) 1164.2 Assembly.Spaces 67. C. ) 1191.3b Combustible Decorations 30. ( ) 1164.3 Self-Service;Regular Service;Garages I �j 68. ( ) 1191.3d Portable heaters 31. ( ) 1164.5 Abandonment or Removal,Storage Tank b 32. ( ) 1164.6 Dry Cleaning Plants PART 1192 FLAME PRODUCING.DEVICES • . 33. ( ) 1164.8 Lurhber Yards �l / 69. ( ) 1192.1 General Requirements . . 34. ( ) 1164.9 Tents and Air Supported Structures e{ D 1 70. •( ) 1192.2 Asphalt Kettles • ft;15-t ‘•. MO`1 35.. ( ) 1164.11 Vehicle Wrecking and Junk Yards J / ,p_536. ( ) 1164.14 Marinas and Boat Yards Q .Kp 1 f PART 1193 FIRE SAFETY EQUIPMENT ✓ !! 1 71. .( ) 1193.1 General Requirements 5 PART 1171 FLAMMABLE AND COMBUSTIBLE LIQUIDS V`. �. 5' 4 37. ( .) 1171.1 General Requirements 0,1(1 Q I PART 1194 FIRE SAFETY SIGNS AND INSTRUCTIONS h rO o(&' 38. ( ) 1171.2 Storage Tanks 1 FOOL'72. ( • ) 1194.1. General Requirements t . 39. ( ) 1171.3 Portable Tanks and Containers 1 r e p�Ct t,\,/ 40. ( ) 1171.4 Dip Tanks PART 1195 FIRE SAFETY TRAINING 41. ( ) 1171.5 Spray Finishing 73. ( ) 1195.1 General Requirements 42. ( ) 1171.6 Electrostatic Apparatus PART 1196 FIRE DEPARTMENT NOTIFICATION 43. ( ) 1171.7 D Cleaning 74.. ( ) 1196.1 'General Requirements EX.1 519 Al fKZ-EASE -DooR A WofKity OA (n,)TQ , - General Information • Application No.(Office Use Only) 53-55 l y Qrn # cash Project Location: 58r55--1uzerne Road Tax Map ID: 18.-1-4 Zone Classification: LI-IA . Detailed Description of Project; (include current&proposed use): change in use from paper werahni p to furniture warehouse with the site changes. Applicant: FLR Partnership Address: c/o Fred Alexy 39 Overlook Drive, Que.ensbury. ,NY 12804 Home Phone:. 798-1189 Work Phone/Fax: . Applicant's Agent: - Jon G. Lapper, fsq. Address: One Washington Street Glens Falls, NY 12801 Home Phone: Work Phone/Fax: • 792-2117 Property finer. Same as Applicant >,. • • Address: • Home Phone: Watt Phone I Fax: DirectionstoSite: North side of Luzerne Road • . Site Development Data Area I Type , Existing sq.ft. - .Proposed Addition Total sq.ft. - sq.ft.. A.Building Footprint 29,528 N/A 29,528 B. Detached Garage. .. • _-- _ C. Accessory Structure(s) • -- , D. Paved,gravel or other hard surfaced areas 40,187 9,890 50,077 E. Porches/Decks _-- F. Other Total Non-Permeable 0 (SumAthroughF) 69,715 79,605 - Parcel Area 166,051 166,051 PementNon-Permeable 41.98 47.94 (Total Non-Permeable/Parcel Ana) . • • Setback Requirements Required Existing Proposed Front(1) ' . . 50 26.58 26.58 Front(2) . - . .. .. ._- . Shoreline -- -- Side Yard(1) • 30 . 21.70 _ 21.70 Side Yard(2) '30 . • +/-60 +/-60 Rear Yard(1) 30 +/-150. . 50 Rear Yard(2) Buffer/Travel Corridor -- -- -- Height ' 50 +/-30 no change Permeability 30 • 58.02 52.06 . Sign Setback -- -- -- - -711.1 HABITABLE SPACE.<CI 381> . • 711.1(a) SIZE. ' • - ' 711.1(a)(1)A dwelling unit shall contain at least one habitable spate which shall have a mitiimtun floor area of 150'square feet With a minimum horizontal dimension of 10 feet. Other habitable spaces,except kitchens,shall have a minimum floor area of SO square feet with a minimum horizontal dimension of 7 feet. . 71I.1(a)(2)Habitable space shall have a trirrinarrrn height of 7 feet 6 inches,except that for habitable space under . . a sloping roof the*min_+mnni height in at least 50 percent of the floor area shall be 7 feet 6 inches and the area where • the height is lest that five fear shall not be.considered in computing required floor area.<CI-734> 711.1(a)(3)Where exposed beams projeci below the ceiling of habitable space, and such beams occupy an area of . . 5 percent or more of the area of the ceiling,the height of the space shall be measured from • finished floor to the underside of beams. Where the ratio is less than 5 percent,the height to the underside of beam shall be nor less than.?feet.'[A.\ iDED EFFECTIVE JULY 26, 19951. • 711.1(b)LOCATION LN RESPECT TO GRADE LEVEL. Floor Ievel of habitable space shall not be more than four feet below the average adjoining finished grade. No habitable space shall be located in cellars, except that • • below-grade space is permitted as habitable space where in conformity with the following conditions: ' 7I 1.1(b)(I)the gad:adjoining one etteaior wall for the entire width of the habitable space is at or Iower than the floor level of the habitable space; . • 711.1(b)(2)the depth-is nor More than four times the height;and- • 7I1.1(b)(3)such space conforms to all other requirements for habitable space; • 711.2 NON-HABITABLE SPACE' •. . 711.2(a) Nonhabitable space shall be provided with light and ventilation adequate for the intended use of each . space. Bathrooms and toilet rooms shall have provisions for privacy. - 711.2(b) Bathrooms, toilet rooms. kitchenettes. corridors and recreation rooms shall have a minimum height of seven feet. PART 712-LIGHT:AND VENTILATION . 712.1(a)LIGHT. .. • 712.1(aXI)Habitable space,except kitchens. shall be provided with natural light through one-or more windows,, skylights,transparent or translucent panels,or any combination thereof that face directly on legal open spaces at least five feet wide above the adjoining finished glade, or above a roof The amount of light • . shall be equivalent to that transmitted through clear glass equal in area to not less Than eight percent of the floor area of the habitable space.<AL-102> - 712.1(a)(2)Kitchens shall be provided with artificial lighting equipment and may also be provided with natural light. • 712.1(b) VENTILATION.' Habitable space shall be provided with ventilation in accordance with either of the following:. ' • . 712.i(b)(1)natural ventilation through openable parts of windows or other openings in exterior avails that face legal open spaces at least fare feet wide above the adjoining finished grade or above a roo or ' ' through openable parts of skylights,providing total clear ventilation area equal to not less than four percent of the . total floor area of each habitable space; . 712.l(b)(2)mechanical ventilation in accordance with the quantities set • forth•in section 1004 2(c)(l). [AMENDED EFFECTIVE JULY26, 1993] r 712.2 N ONH ABITABLE SPACE. • 712.2(a)LIGHT. Kitchenettes,bathrooms and toilet rooms shall be provided with light of sufficient intensity and so distributed as to permit the maintenance of sanitary conditions and the safe use'of the space and the appliances, equipment and fixtures. ' 712.2(b) VENTILATION. Kitchenettes, bathrooms and toilet rooms shall be provided with ventilation in . accordance with either of the following: •. • 712.2(b)(1)natural ventilation as set forth in 712.1(b)of this Part,except that such openable areas shall be not less • than 1-1/2 square feet for bathrooms or toilet rooms and not Iess than three square feet for • kitchenenes;or 7122(b)(2). mechanical ventilation in accordance with the quantities set forth.in section 1004.2(c)(1). • [AMENDED EFFECTIVE 31JLY 6,19951 . • • • • • • • Checklist-Please prepare a map depicting existing and proposed conditions. Failure to complete . the fallowing 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.• • eck/Initial Each Box - P—P vvided ADDB.i✓SS EAR IZEM . N�—Natbre WR—WaiverRcaussled . P . .NA WR - GENERAL . . • X A. Title,name,address of applicant&person responsible forp preparation of drawing • X . •B. North:aiaow,Tax Map JD,bate pt pared and scale(minimum I in.=40 ft.) • X ' C. Boundaries of the property plotted to scare,zoning boundary • X D.. Location of principal structur ,accessory structures with exterior din ons E. Location of site improvements including outdoor storage areas,driveways(existing ' • X ' • and�,parking as,etc. - • • X F. Setbadd for all structures and improvements X __G. Elevations of proposed structures. • • WATER&SEWER • A. Location of on-site sewage disposal.facilities, design details, construction details, • X now rates,and number of bedrooms served .. B. Location of water supply (i.e. well) and septic.on adjoining lots with separation - X .ems to existing orproposed on-site water supply and septic X C. Separation distances for proposed sewage disposal system to well andwatesbodies. • D. Location and description of existing public or private water supply(well,lake,etc.). X Method of securing public of private water,location, design and construction of • water supply includlngdaily water usage. X E. Percolation test location and results. • PARKING IPERMEABLE AREAS X • ' A. •No.of spaces required for project including calculations and justification. B. No. of existing parting spaces, no. to be removed, no.to maintain and type of X surfacing material(e.&gravel,.l . • . X . . C. Provision for pedestrian and lip access and parking. -• x _ D. Location ad design details of ingress,.egtess,loading areas andtartting. E. Location and character of green areas(existing and •proposed),ninndification to green - .X • area;buffer zone to remain undisturbed.. . •. • X F. Lighting.locationanddesignofall existingor proposed outdoor lightin. . ADDITIONAL SITE DEVELOPMENT AND MISCELLANEOUS NEOu S t X .A. Location of one&adjacent ems:streams,rivers,lake and wetlands. B. Location of proposed&existing utihty(energy distributions systems (gas,ems, X solar,telephone -• - C. • Location,design,and construction of all existing and proposed site improves X including drains, adverts, retaining walls, fences, fire & emergency zones and • hydrants. • D. Location and amount/portion of building area proposed AT office;manufactming, . . X • retail sales,or other commercial activities. x - _ E. Sigge: Location,size,type,design and setback - 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 and Industrial Developtnent requires submission of a Landscaping Plan, a Sto mwater Management Plan,a Grading Plan,and a Lighting 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 required from Federal,.State and County Officials. 6. Other Fees may apply—Engineering Fees,Recreation Fees • • • • • • • • • • • • • • ' 14.16.4(1tIR5)Text:12 - • PROJECT 1.D.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/SPONSDR 2. PROJECT NAME • FLR Partnership Change in Use. • • 3. PROJECT LOCATION: 53-55 Luzerne Road Muniaroelity Queensbury. • county Warren . 4. PRECISE LOCATION(Street address end read Intersemlons,prominent-landmarks,etc.,or provide mep) ' . • North side of Luzerne Road at Pine Street intersection 5. IS PROPOSED ACTION: • ❑New. 0 Expansion Ca Morin lcatlonratteratIon .6. DESCRIBE PROJECT BRIEFLY: ' Change in use from paper warehouse to furniture warehouse • • • 7_ AMOUNT OF LAND AFFECTEL): • _ Initially 3.812 acres • .ultimately 3.812' acres . B. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Dyes : 0 No If No.describe briefly . , • • • 9. WHAT.IS PRESENT LAND USE IN VICINRY OF'PROJECT? ®Residential ninduaria! 0 Commercial El Agriculture Dpark?Forestfopen space El Other • Oescrlbe: • Mixed uses - . 1D. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAL)? • • OYes ®No If yes;list apency(s)and permit/approvals . • . '11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? . MI Yes ' ONo• If yes,list agency name end permit/approval '' . • • ' Existing site is approved. .. ' it. ArS+�,A RESULT OF PROPOSED ACTION WILL EXISTING'P.ERMlT/APPRO L REQUIRE MODIFICATION? . LS1Yes . ONo Site plan modification an boundary line modification'. , I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE T. • Applicant/sponsor narrre FLR- Partnership Date; • 11/8/01 • Slgnature: • (Jon C. Lapper. Esq. as attorney for applicant) . • I he action is in the Coastal Area, and you are a state agency,complete the Coastal Assessment Form before proceeding with this assessment- . • OVER - _ • . 'I - PART it=ENVIRONMENTAL ASSESSMENT(To be completed by Agency) . A: DOES'ACTION EXCEED ANY TYPE•I THRESHOLD 1N 6 NYCRR PART 617.4? If yes,cooniinate the review process and use the FULL EAF. . '0yes CI No • - 13. WiLL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617:62• K No,a negative declaration • may be superseded by another inVolred agency. DYes CI No • • C. COULD ACTION-RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,If legible) . CI. 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 probtenis?Explain briefly; C2..Aesthetic agricultural archaeological.historic,or othei•natural or cultural resources;or community a neighborhood character?Explain briefly: C3.Vegetation or fauna,fish,shellfish or witdlife•specles➢,significant habitats,or threatened or endangered species?Explain briefly: • 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 , CS. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly, Cs. Long term,short tam,cumutattver.or other effects not identified In Ci-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 CEA? Cl Yes 0 No - E. IS THERE,OR IS THERE LIKELY TO SE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? • • ❑Yes El No It Yes,explain briefly • • PART Ili—DETERMINATION OF SIGNIFICANCE(To be completed by Agency) • INSTRUCTION& 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)probabiiity•of occurring;(c) duration;(d) Irreversibility;fe)geographic scope;-and((),magnitude.If necessaryr add attachments or reference•supporting.materials. Ensure that • explanations contain sufficient detail 10-show that all relevant adverse impacts have•betin 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. • • Q 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 andfor prepare a positive declaration. . . Q 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 of Lead Agency Print or type Name of Responsible Officer in Lead Agency. ' • Title of Responsible Officer Signature of Responsible Officer in-Lead Agency . • Signature of Prepa• rer(II different from responsible officer) , • . • Date 2 • • • . • •• . Signature Page This Page includes the Authorization to Act as Agent Form, Engineering Fee Disclosure, Other Permit • RespOnsilifilies and Agreementto provide documentation required. • Complete thefollowing ifthe OWNER ofthe property is notthe same•as the applicant • • • • Owner's Agent Form • Ovvner: FLR. Partnership . Designates:. Jon C. Lapper, -Esq •• As agent regarding Variance X Site Plan. Subdivision For Tax Map No.: 18 Section 1 Block 4 Lot . Deed Re.ferwce: • oak " • e Date SIGNATURE: • (Owner) (Date) • • • Complete the following if the APPLICANT is unabl d the meeting or wisheato be represented by another party: - • APpfitant's Agent Form •-Owner• : • Designates: - • • As.agent regarding: Variance Site Plan Subdivision . For Tax Map No.: - Section Block - Let • SIGNATURE: • (Owner) (Date) • . Ensrineerioa 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 withoutnotification to the Applicant. . . lease Note: Other permits may be required for construction or alteration activity subsequent to approval by the Zoning Board or Planning Board. It is die applicant's responsibilityto obtain any additional permits.. . • - Official Meeting IVEnntet Disclosure.. It is•the practice of the Community.DevelopmenrDept.to-have a.: .„. designated stenographer tape record the proceedings of meetings resulting from application,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,the undersigned,have thoroughly read and understand the instructions for submission,agree to the submission requirements and cornpleted,the cheeldist. SIGNATURE OF APPLICANT: • -Date • • • . • •SIGNATURE OF AGENT: -Date • • • • • • * �b C-Q . ff�/YO, 1 CY '' . • .% _. -1\3 . . Q : )(0 92.111:)-611-23' • , __or?) 3411°113 49404. 3?)/(t4.- i • . 1-> L c-ii--1 z c/(7 meals 7rvrs- �� � r r Fre.L16_ 1-bidg.v 1m ,... _LI r - . . ' ... -------- -Pj 3 N) v‘ 7 °�� MAP REFERENCES: NO. 1 LANDS N/F OF MAP OF A SURVEY THE TOWN OF QUEENSBURY o OF LANDS OF LANDS N/F OF FRED ALEXY, LEO MONANAN THE CITY OF GLENS FALLS CL AND ROBERT GEH DATED DECEMBER 23, 1981 RVISED MAY 24, 1993 BY W.J. ROURKE, ASSOCIATES S83'41'47"E LICENSED LAND SURVEYORS 169.00' NO. 2 MAP OF LANDS BELONGING TO 3 LIMA 1. WALCZAK EASEMENT To DATED JANUARY 12, 1976 NIgGgRq MOH WK � ,�� o REVISED JULY 27, 1982 POWER CORPORATION �•"� o, BY COULTER & McCORMACK o LANDS OF o LICENSED LAND SURVEYORS -- 1 N NIAGgRq MOHAWK POWER CORPORATION Z DEED REFERENCE: S82'46 20"E 178, 20' FRED H. ALEXY, ET. AL. a TO a FLR ASSOCIATES, LTD 'd DATED JUNE 10, 1997 IN BOOK 1024 PAGE 126 a 0 0 a�i z REFER TO SUBDIVISION 'b Q) o 11-1993 U APPROVED 6-15-93 o p � Cd � V � O � w 76,182 sq.ft. c 'd o 1.75 acres 0 o 'd o o a o i� 166,541 sq.ft. r7 ay o 3.82 acres c E" O LANDS N/F OF Z THE CITY OF GLENS FALLS �517� lOT LINE or AND F N/F OF ���eR�:������ THE CITY 0 GLENFALLS gS o PEW jib 173, 83, ',•o PROPOSED LOr LINEN80 3 47»W 3 W 0 N � O CQ cM O w BUILDING BUILDING i z ^/ R o N z N z 168.39' T L UZ N80 52 3"I 8W 29.3' �' 1V 171,390 �y N N80 33 47ftW b ROAD �' a 00 94 Cq co m� Detv 8, GRAPHIC SCALE 4 s0 0 zs 50 100 zoo S --1 ( IN FEET NOTE: 1 inch = 50 ft 1 ALL INFORMATION SHOWN IS FROM MAP REFERENCES: DWG. NO. 01281 Tw 00 U-38l f � -. ' �