Site Plan ApplicationTax Parcel ID Number: 302.8-1-16 & 17
Zoning District:
Lot size:
General Information
CI - Commercial Int
46,900 SF
Detailed Description of Project [includes current & proposed use]:
Existing professional offices to be renovated and reused as professional offices - project includes renovation of one existing exterior
entry canopy, construction of one new exterior entry canopy with a handicap accessible lift and a new covered entry canopy on the
rear of the building with steps to grade and a new concrete walk to the parking area
Location of project:
Applicant Name:
Adirondack Retirement Specialists
Address:
351 Bay Road, QBY NY 12804
Home Phone
Cell:
716-531-6266
Work Phone
518-761-6184
Fax
E-Mail:
markam1256@gmail.com
Agent's Name:
Rucinski Hall Architecture
Address:
134 Dux Ave, Glens Falls NY 12801
Home Phone
Cell:
518-260-2888
Work Phone
518-741-0268
Fax
518-741-0274
E-mail
ephall@nycap.rr.com
Owner's Name
Adirondack Retirement Specialis
Address
351 Bay Road, QBY NY 12804
Home Phone
Cell
716-531-6266
Work Phone
Fax
518-761-6184
E-mail
markaml256@gmail.com
Site Plan Review application — Revised October 2016
Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804
RUCINSKI HALL ARCHITECTURE
Ronald Richard Rucinski
Ethan Peter Hall
134 Dix Avenue
Glens Falls NY 12801
Voice 518 7410268
Fax 518 741 0274
Email ephall@nycap.rr.com
Project Description — Renovations to the 310 Bay Road — Adirondack Retirement
Specialists
The project will be minor exterior renovations to the existing facility located at 310 Bay Road in the
Town of Queensbury. The facility was formerly a professional office and will be used as
professional offices for Adirondack Retirement Specialists (ARS).
The existing lot was two parcels when it was purchased by Adirondack Retirement Specialists and
has been combined into one lot as indicated on the revised deed of 26 August 2022. The parcel is
46,900 SF or just over 1 acre in size and the current lot coverage is 46.87%. The existing building
is located 11'-10" from the front property line where a 75' front yard setback is required and 9'-7"
from the northerly property line where 20' side yard setback is required, therefore the existing
building is pre-existing, non -conforming. The existing floor area ratio is 13.58% where 30% is the
maximum allowed.
The building is a converted residence that had previous additions in 1992, 1996 & 1999. There is a
paved parking area that extends from the main entry drive off the south side of the building to the
rear of the property and there are currently 39 parking spaces. The site has on site stormwater
management practices that handle the roof run-off and parking lot drainage via eave drip lines,
vegetated swales and a drywell at the rear of the property which controls the parking lot run-off.
There are entrances to the building from the Bay Road sidewalk, which is no longer used, and two
separate entrances to the building on the south side of the building. There is currently a wooden
ramp to the eastern entry porch which provides handicap access to the building and there is an
elevator in the building to access the second story. However currently the access requires
handicapped persons to go through one office suite to access the elevator and the ramp is in need
of replacement.
The project will entail the removal of the access sidewalk from the Bay Road sidewalk to the
building and renovations to the two south side entry canopies. The western entry will have a new
wheelchair lift provided that will allow better access to the elevator without having to go through
another office suite and the eastern entry porch will be rebuilt to remove the existing wooden ramp.
A new entry will be added on the north side of the building for ARS staff only. This new entry will be
connected to the rear parking area where the ARS staff will park leaving the parking along the south
side of the building for clients.
All existing landscaping will be removed and new landscaping will be installed along with new
planter beds along the drip line of the roofs as indicated on the main floor plan drawing A-2. The
landscaping will be similar to that of the existing ARS offices located at 351 Bay Road across the
street from the main entry to Lowes. Signage is existing and will remain in the location shown with
new sign faces for Adirondack Retirement Specialists. Exterior lighting is existing building mounted
YAAdirondack Retirement Specialists%310 Bay RoadTaperworkTroject description.doc
light fixtures that will remain. All new entries will have under canopy lighting provided in the soffits
of the new canopies and all new fixtures will be downcast fixtures with cut-off lenses.
Existing paving will be altered on the south side of the building to allow for the reconstruction of the
two entries on the south side of the building and a new concrete walk will be provided for client
access to both new entry canopies. All other parking will remain in the current configuration and a
new concrete sidewalk from the existing rear parking area to the new north entry porch will be
provided as indicated. All existing stormwater management is adequate and will be maintained.
Site permeability will be decreased slightly as the pavement area is being increased for the new
walks and rear entry canopy, site impervious surfaces will increase to 48.53% or 1.66% increase
overall which is still below the 70% impervious allowed in the Cl zone.
The new entry porch additions will have a pitched roofs to match the existing building with eave
trench infiltration along the south, west and north sides of the building. Finishes on the new
additions and the existing building and will have enhancements to provide an aesthetically pleasing
appearance that will be complementary to the existing adjoining properties.
We look forward to meeting with the board to discuss this project.
YAAdirondack Retirement Specialists\310 Bay RoadTaperworkTroject description.doc 2
Site Development Data
Area / Type
Existing sq. ft.
Proposed
Addition sq. ft.
Total sq. ft.
A. Building footprint
3,215
0
3,215
B. Detached Garage
NA
NA
NA
C. Accessory Structure(s)
196
0
196
D. Paved, gravel or other hard surfaced area
18,321
668
18,989
E. Porches / Decks
249
111
366
F. Other
NA
NA
NA
G. Total Non -Permeable [Add A-F]
21,981
779
22,760
H. Parcel Area [43,560 sq. ft. / acre]
46,900
0
46,900
I. Percentage of Impermeable Area of Site [I=G/H]
46.87%
-
48.53%
Setback Requirements
Area
Required
Existing
Proposed
Front [1]
75'-0"
11'-10"
59'-3", 33'-9" & 92'-0"
Front [2]
NA
NA
NA
Shoreline
75'-0"
NA
NA
Side Yard [1]
20'-0" min
9'-7"
1T-5" North porch
Side Yard [2]
50'-0" total
63'-8"
42'-7" & 43'-8"
Rear Yard [1]
25'-0"
561'-8"
561'-8"
Rear Yard [2]
NA
NA
NA
Travel Corridor
75'-0"
11'-10"
59'-3", 33'-9" & 92'-0"
Height [max]
40'-0"
33'-8"
33'-8"
Permeability
30%
53.13%
51.47%
No. of parking spaces
1/300 SF gross
39
1 39
Site Plan Review application — Revised October 2016
Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804
1.
Additional Project Information
Will the proposal require a Septic Variance from the Town Board of Health? No
2. If the parcel has previous approvals, list application number(s): SP 57-92, 62-99, 31-94, 4-96
3. Does this project require coverage under the New York State Pollutant Discharge Elimination System
(SPDES) Permit Program ? No
4. Estimated project duration: Start Date Dec. 2022 End Date May 2022
5.
Estimated total cost of project: $300,000
6. Total area of land disturbance for project: +1- 5,000 SF
Floor Area Ratio Worksheet
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.
A.
Parcel Area
46,900
sq. ft.
B.
Existing Floor Area
6,369
s . ft. see above definition]
C.
Proposed Additional Floor Area
360
s . ft.
D.
Proposed Total Floor Area
6,729
sq. ft.
E.
Total Allowable Floor Area
14,070
(Area x 0•3 [see above table]
*If D is larger than E. a variance or revisions to your plan may be needed. Consult with Staff.
Site Plan Review application — Revised October 2016
Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804
§ 179-9-080 Requirements for Site Plan Approval.
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.
The establishment, maintenance and operation of the proposed use will not create public hazards from traffic, traffic congestion or the
F _
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.
1.
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.
Stormwater drainage facilities will prevent an increase of post development drainage flows as compared to pre -development drainage flows.
J.
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.
jv
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.
p.
The site plan conforms to the design standards, landscaping standards and performance standards of this chapter.
5
Site Plan Review application — Revised October 2016
Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804
RUCINSKI HALL ARCHITECTURE
Ronald Richard Rucinski
Ethan Peter Hall
134 Dix Avenue
Glens Falls NY 12801
Voice 518 741 0268
Fax 518 741 0274
Email ephall@nycap.rr.com
Response to A-O Standards — Adirondack Retirement Specialists — 310 Bay Road
The following are responses to questions A thru O of the site plan review standards.
A. The project is an existing two story office building, the proposed addition will be a single story wood framed entry
canopy in three locations to the office use and therefore the project is consistent with the Town's Comprehensive
Plan
B. The project requires variances from the requirements of 179-3-040 including front & side yard setback. These
variances have been applied for though the Town Zoning Board of Appeals.
C. The site is a in the travel corridor of Bay Road and has existing side walks for pedestrian activities.
D. The property is connected to the municipal sewer system.
E. The proposed use is an office use in the Cl zone and is in keeping with the surrounding area and will have similar
aesthetic features to the surrounding properties in the area.
F. The property driveway access is existing and therefore little additional traffic is anticipated in or around the subject
parcel.
G. Off street parking is provided as depicted and the existing driveway is in conformance with the Town
requirements.
H. Steps have been taken to minimize any adverse effects on the environment. The additions are being done over
the lawn area and on the side back of the building away from the travel corridor.
I. The site is accessed from Bay Road, a public road and all utilities come in from to the property from Bay Road.
J. Steps have been taken to manage the roof drainage through existing gutters and downspouts. The percolation
rate of the soil is acceptable, and the soil make-up is mainly medium sands and gravel and the ground water
location is at least 40" below existing ground surface at the existing infiltration devices. There are no current
stormwater issues on the existing site and no modifications are being proposed to the stormwater management
devices.
K. Existing water supply is municipal.
L. The existing lot is planted with trees and shrubs which are overgrown and will be removed and
replaced/enhanced as indicated on the landscaping plan.
M. The existing site is on a public road, Bay Road, and is adequate for emergency vehicle access.
N. All proposed work will prevent ponding, flooding and/or erosion.
O. The site plan takes as many steps as possible to conform to all design standards and reduce the environmental
impact as much as possible for the project. Proposed lighting will be recessed downcast fixtures with cut-off
lenses mounted at the personnel entrances to the proposed multi -use space and no additional parking lot lighting
is proposed.
Y:Wdirondack Retirement Specialists1310 Bay Road\Paperwork\Response to A-O standards. doc
§ 179-9-050 Checklist -Application for Site Plan Review.
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 AN. The
applicant may request a waiver from AN and is to provide reasons for waiver(s) requested. Please label
information to be submitted.
REQUIREMENTS
Sheet #
A.
A vicinity map drawn at the scale that shows the relationship of the proposal to existing community facilities which affect
All
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 8112 "x 11" sheets as necessary for written
C-1
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.
All
D.
Name and address of the owner of record, developer, and seal of the engineer, architect or landscape architect. If the
All
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
C-1
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
C-1
containers shall also be shown.
G.
The location, height, intensity and bulb type (sodium, incandescent, etc.) of all external lighting fixtures. The direction of
C-1
illumination and methods to eliminate ,, lare onto adi oinime . ro erties must also be shown in compliance with § 179-6-020.
H.
The location, height, size, materials and design of all proposed signs.
C-1
l
The location of all present and proposed utility systems including:
C-1
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
C-1
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 S WPPP 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
C-1
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.
A landscape plan showing all existing natural land features than may influence the design of the proposed use such as rock
L.
C-1 & A-2
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
C-1
as any Overlay Districts that apply to the property.
6
Site Plan Review application — Revised October 2016
Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804
REQUIREMENTS (CONTINUED)
Sheet #
N.
Traffic flow patterns within the site, entrances and exits, loading and unloading areas, as well as curb cuts on the site and
C-1
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.
0.
For new construction or alterations to any structure, a table containing the following information shall be included:
C-1
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.
1. Floor Plans.
p.
EX-1 thru
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)
A-5
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.
NA
R.
Plans for disposal of construction and demolition waste, either on -site or at an approved disposal facility.
C-1
S.
Plans for snow removal, including location(s) of on -site snow storage.
C-1
T.
An Environmental Assessment Form ("EAF") as required by the SEQRA regulations, with Part 1 completed by the Applicant
Yes
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.
j J.
If an application is for a parcel or parcels on which more than one use is proposed, the applicant may submit a single
Yes
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.
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.
Yes
Site Plan Review application — Revised October 2016
Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804
Town of Queensbury Site Plan Pre -Submission Conference Form / Section 179-9-040
1.
Applicant Name: Adirondack Retirement Specialists
2. Tax Map ID
302.8-1-16 & 302.8-1-17 Location: 310 Bay Road
3. Zoning Classification Cl 46899.6 SF
4. Reason for Review: Applicant proposes to complete access renovations and other alterations to an existing 2-story building
5. Zoning Section #:
179-3-040 Cl,
6. Pre -Submission Meeting Notes:
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
Provided Outstanding; Please provide by
x deed infot Lion shows lots to 6e merged per 8/2612022 document
x
NA
x porch areas need to be confirmed
x new construction not clear on ap or drawing
FOIL needed, then update application
need to confirm 388 vs 360?
signs, stormwater
x
Applicant proposes to complete access renovations and other alterations to an existing 2-story building.
The plans indicate there are two south side entry porches to be renovated, a new entryway to be created on
the north side and a renovation of the first story area on the west side. Site Plan for alternations and new
construction to a building in the Cl zone. Area Variance for setbacks.
reviewed - site plan and variance application, site drawings, survey, deed, elevations and floor plans
Items to be updated or provided
1) page 3 site data - confirm access being renovated and new access area be constructed - square footage
2) page 3 setback - set up data sheet with three porch projects with setbacks to each -not legible on plan,
missing information on data sheet. Need to confirm size and setback relief - for areas of new construction
3) page 4 FOIL request for past projects
4) page 4 floor area - need to confirm square footage overall
5) page 6 and 7 - need information on signs, floor plans need dimensions, construction areas need to be
noted on the plans, dimensions for setbacks need to be to construction areas, landscaping plan needs
supporting information, identify waivers being requested ie stormwater, lighting.
6) signature needed
Staff Representative: Laura Moore via email 10131/2022
Applicant / Agent:
Date: 10/31 /2022
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:
For Tax Map No.:
Deed Reference:
OWNER SIGNATURE:
APPLICANT'S AGENT FORM:
Variance Site Plan Subdivision
Section Block Lot
Book Page Date
DATE:
Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party:
Owner: Adirondack Retirement Snecialists - Adam
Designates: Rucinski Hall Architecture
As agent regarding:
For Tax Map No.:
Deed Reference:
OWNER SIGNATURE: d-...�,�
Variance Site Plan Subdivision
Section Block Lot
Book Page Date
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 RESPONSIBH.ITIES: 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.
6.1 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
Uwe 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.
Adam Mark
Signature [Ap li;9&
Print Name [Applicant]
Ethan Hall _
Signature [Agent] Print Name [Agent]
12 Oct 2022
Date signed
12 Oct 2022
Date signed
Site Plan Review application — Revised October 2016
Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804