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Sketch Plan applicationRevised: 8/3/05 Subdivision — Sketch Plan Subdivision Application — Sketch Plan Stage The subdivision process consists of three phases or presentations to the Planning Board: Sketch Plan, Preliminary Stage and Final Stage. The application provides information that is required for each stage. The following is a brief description of each stage: • Sketch Plan: This stage provides the applicant an opportunity to present a concept plan of the subdivision to determine requirements of SEQRA, NYSDOH, NYSDEC and other state agencies, requirements of local county and town agencies, clustering per Article IX and the proposed layout with regard to goals and objectives of the Town Master Plan and other Articles of these regulations. • Preliminary Stage: This stage is the first step following sketch plan to ensure that the subdivision meets all requirements of the Zoning Ordinance, Article VIII, Design Standards, to receive public comments, to ensure the proposed subdivision addresses all issues raised during sketch plan, and finally to initiate formal review of the proposed subdivision. • Final Stage: This is the second step of the two step review process to ensure the proposed subdivision meets all state and local regulations related to provision of public services, to ensure all issues raised during preliminary have been addressed, to receive additional public comment if necessary and to facilitate the orderly approval of phases of the proposed subdivision. This application was designed to solicit the information necessary for the applicant to comply with the Town of Queensbury Subdivision regulations. A Pre -Application meeting with the Planning Staff is required. Staff members are available by appointment during the hours of 8:00 a.m. to 4:30 p.m. Town of Oueensbury Planning Staff Marilyn Ryba Executive Director of Community Development Craig Brown Zoning Administrator Bruce Frank Code Compliance Officer Stuart Baker Senior Planner George Hilton GIS Administrator Susan Barden Land Use Planner Submission Requirements: Please submit fifteen copies, one (1) original and fourteen (14) copies of the completed application, 1 (one) copy of deed, and the appropriate fee to the Planning Office by the specified date (see Meeting Date Information). Town of Queensbury Planning Office 742 Bay Road, Queensbury, NY 12804 Phone: (518) 761-8220 Fax: (518) 745-4437 E-mail: planning@gueensbury.net www.gueensbury.net Page 9 — To be submitted Revised: 8/3/05 Subdivision — Sketch Plan Application No. (Office Use Only) General Information Pre -Application Mtg. Date: (Office Use Only) Application Stage Submitted (Check One): Sketch Plan Stage Preliminary Stage Final Stage Indicate the following: Number of lots proposed Residential - R or Commercial - C Lot acreage Project Location: Tax Map No.: Zone Classification: Lot size: x 17 c 20,000 t to 85,402t sq. ft. not including residual wetland lot #17 Bay Road, Queensbury, NY 12804 296.15-1-28 Professional Office 26.15 acres Detailed Description of Project (include current and proposed use): vacant land, commercial subdivision for Professional Offices Applicant Name: Legacy Land Holdings, LLC Address: 50 Country Club Road QuPPngbvey, NY 19804 Home Phone: Work Phone / Fax: 792-4462/798-5200 Applicant's Agent Name: Jarrett -Martin Engineers. PLLC Address: 12 E. Washington Street Glens Falls, NY 12801 Home Phone: Work Phone / Fax: 792-2907/798-1864 Name of Property Owner: 1 egsy Land Holdings, Address: 50 Country Club Road Queensbury. NY 12804 Work Phone/Fax: 792-4462/798-5200 Directions to Site: Bay Road @ Walker Lane Page 10 — To be submitted Revised: 8/3/05 Subdivision — Sketch Plan § A183-6. Sketch Plan Review Plan Details and Requirements A. The applicant shall submit fifteen (15) copies, one original and 14 copies, of a sketch plan for a parcel of land which has not been clear-cut within five (5) years. Such subdivision sketch plan shall be prepared by a licensed professional engineer, a licensed professional land surveyor with properly executed New York State Education Department Exemption N or a licensed landscape architect. [Amended 11-11-1993 by L.L. No. 3-1993]. Check each box to indicate information has been provided. B. Such sketch plan shall contain the following elements and information for the purpose of sketch plan review: El SURVEY. The sketch plan shall be laid out on a survey prepared by a licensed professional land surveyor or a licensed professional engineer with a properly executed New York State Education Department Exemption N. Such survey shall be prepared at a scale of one (1) inch equals fifty (50) feet zero (0) inches, clearly showing: ® The boundaries of the subdivision. l Topographic features, including existing grade contours at two -foot contour intervals, United States Geological Survey datum. ® Existing watercourses, including lakes, ponds, wetlands, streams or intermittent streams. Areas of existing vegetation, including wood lots and individual freestanding trees over six (6) inches diameter at breast height Areas within the designated one -hundred -year floodplain, as determined by the United States Department of Housing and Urban Development Flood Insurance Program. +� Existing man-made features, including the location and sizes of power lines, pipelines, buildings and structures, storm drains and culverts and wells and septic tanks, and fields of adjoining properties. Existing rights -of -way and/or easements across or adjacent to the proposed subdivision. 2) SKETCH PLAN. The proposed sketch plan shall show the following: 12 The names and addresses of all applicants, if an individual or partnership, and the names and addresses of principal officers of a corporation. The name and address of the owner(s) of land on which the subdivision is to be located. A location map showing the property included in the proposed subdivision and all contiguous properties of the proposed subdivision and all properties within five hundred (500) feet in each direction from the boundary line of the proposed subdivision along any contiguous street or highway. All properties shall be identified by lot and parcel number and names of owners. The location and width of proposed street right-of-way and pavements. Page 11— To be submitted Revised: 8/3/05 Subdivision — Sketch Plan U The proposed arrangement and approximate area, width, length and setback requirements of each lot and street pattern for the purpose of demonstrating to the Board the proposed location of streets allows for lot layout in accordance with the Zoning Ordinance for the zoning district or districts in which the subdivision is located. U A sketch grading and drainage plan prepared by a licensed professional engineer or landscape architect or licensed professional land surveyor with a properly executed New York State Education Department Exemption N. Such plan shall indicate the general slope of the land and method of draining stormwater, including proposed culverts, storm drainage structures and retention ponds. ❑ A sketch landscape plan (for over twenty -lot subdivisions) prepared by a licensed landscape architect. Such plan shall set forth those trees and vegetation to be removed and those trees, plantings and vegetation to remain or to be planted. ❑ Any parcels of land proposed to be dedicated to public use, such as parks, recreation areas, conservation areas or scenic easement. 3) ENVIRONMENTAL ASSESSMENT FORM 9 An environmental assessment describing the potential environmental impact of the proposed subdivision on the adjoining area and the Town of Queensbury, including the environmental assessment short form, and proposed actions to minimize potentially adverse environmental impacts shall be submitted. Additional environmental information may be required in accordance with the provisions of the State Environmental Quality Review Act. (4) OTHER ❑ Such additional information and exhibits the developer or the Planning Board may feel necessary to describe the project and its compliance with the requirements of these regulations shall be submitted. (5) FEES ❑ There is no fee for Sketch Plan Review. ❑ In addition to the fee listed on the schedule of fees, the Town Board may charge a fee to developers of projects requiring legal and technical review, provided that the fee charged reflects the actual cost of the legal and technical assistance to the Planning Board. ❑ A Recreation Fee of $500 per lot/dwelling unit is required to be paid at the time a building per it pplication is submitted. Date: 3 It3 0 7 for providing the above information) Page 12 — To be submitted Revised: 8/3/05 Subdivision — Sketch Plan 1e-16.4 (111951—Text 12 PROJECT I.D. NUMBER 617.20 SEOR 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 Legacy Land Holdings, LLC Fairfield Professional Offices 3. PROJECT LOCATION: Municipality Oueensbury County Warren a. PRECISE LOCATION (Street appeal and road intersections, prominent landmarks, sic., or provide map) Southwest corner of Bay Road & Walker Lane 5. IS PROPOSED ACTION: New ❑Expansion ❑ Modiilcation/alterallon 6. DESCRIBE PROJECT BRIEFLY: Commercial subdivisin for professional offices. 7. AMOUNT OF LAND AFFECTED: 14.05t 14.05± Initially acres Ultimate) acres B. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ® Yes ❑ No If No, describe briefly 9. W�JH�77AT IS PRESENT LAND USE IN VICINITY OF PROJECT? )5 Residential ❑Industrial f1commemial ❑Agriculture ❑ Park/Forest/Open space ❑Other Deaulbe 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. STATE OR LOCAQ? - Ekes ❑ No If yes, list agencyls) and pennitlapprovals NYS DEC, SPDES, SWPPP 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes ®No If yes, list agency name and parrnlUapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? ❑Yes ®NO I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant sponsor n Dale: 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 1 13 Revised: 8/3/05 Subdivision — Sketch Plan PART II —ENVIRONMENTAL ASSESSMENT (To be completed by Aoencv) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR PART 617.4? If yea, 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) C1. 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 agricultural. archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain brielly C3. Vegetation or fauna. fish. shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: Ca. 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 C5. Growth, subsequent development. or related activities likely to be induced by the proposed action? Explain bnefly. CS. Long term, short term. cumulative, or other effects not Identified in Cl-CS? 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? ❑Yes ❑No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes ❑No It 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; to) duration; (d) Irreversibility; la) geographic scope; and (q magnitude- If necessary, add attachments or reference supporting material& Ensure that explanations contain sufficient del to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part It 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: Name of Lead Agency Print or Type Name of Rinipo.s,Ible Officer in Lead Agency Title of Responsible Officer Signature of ltnp<,nsible ¢et 7Le Agency ignature of Freparerf eren[ from response e o icer note • Revised: 8/3/05 Subdivision -Sketch Plan SIGNATURE PAGE This Page includes the Authorization to Act as Agent Form, Engineering Fee Disclosure, Authorization for Site Visits, Other Permit Responsibilities and Agreement to provide documentation required. Complete the following if the OWNER of the property is not the same as the applicant Owner's Agent Form Owner: Legacy Land Holdings, LLC Designates:. Jarrett -Martin Engineers, PLLC As agent regarding Variance _ Site Plan X Subdivision For Tax Map No.: 296.15 Se0on 1 Block 28 Lot Deed Reference: 14_ 2 2 Page 1/27 03 Date SIGNATURE: (Owner)3 `� (Date) Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party: Applicant's Agent Form Owner: Legacy Land Holdings, LLC Designates: TnrrPtt-Martin En cars, PTIC As agent regarding: _ VArliance —Site Plan x Subdivision For Tax Map No.: 296. 15 e 1 Block 8 Lot SIGNATURE: (Owner) � r (Date) 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. 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. PLEASE NOTE: 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. OFFICIAL MEETING MINUTES DISCLOSURE: It is the practice of the Community Development Dept. 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 Wriderstand the instructions for submission, and agree to the submission requirements and completed th c ist. s /3 07 SIGNATURE OF APPLICANT: to SIGNATURE OF AGENT: Date 3 0 7 age 15 —To be submitted