Application . •
N IXO N ATTORNEYS AT LAW Jared-C.,Lusk ,
Partner...
P EA B O DY @NIKON PEABO YOLP F 866-402-1491
jlusk@nixonpeabody.com
Nixon Peabody LLP
1300 Clinton Square
Rochester,NY 14604-1792
585-263-1000
November 7, 2013
NOV 0 6 2013
VIA FEDERAL EXPRESS
Craig Brown
Zoning Administrator
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
RE: Application for a Use Variance from the Zoning Board of Appeals and
Site Plan Approval from the Planning Board (along with a Freshwater
Wetlands Permit and Stormwater Management Permit) by Cellco
Partnership d/b/a Verizon Wireless,to Construct and Operate an 96'
Wireless Telecommunications Facility (with an Additional 5' of RF
Transparent Pine Branches) Near 441 Lockhart Mountain Road on Lands
Owned by Lost Chalets,LLC (Tax Parcel No. 265.-1-52) in the Town of
Queensbury, New York(Verizon Wireless' "Pilot Knob" site)
Dear Craig:
By application dated August 9, 2013 and supplemental application materials dated
October 21, 2013, Cellco Partnership d/b/a Verizon Wireless ("Verizon Wireless")to both the
Zoning Board of Appeals and Planning Board for the approvals necessary(the"Application")to
construct and operate a wireless telecommunications facility (the"Project") on property located
near 441 Lockhart Mountain Road in the Town (the "Site"). Thereafter, in correspondence
dated November 4, 2013, the Town's Planner Laura Moore sent three (3) additional criteria
relating to public utilities that the Zoning Board of Appeals will consider in determining its
portion of the Application (the "ZBA Criteria"), and requested Verizon Wireless to respond to
same.
Below are Verizon Wireless' responses to the ZBA Criteria(the ZBA Criteria are
reproduced below in bold italicized type, followed by Verizon Wireless' response in regular
type):
14709115.1
Craig Brown
November 7, 2013
Page 2
I.) That the proposed improvement is a public necessity and that it is required to
render safe and adequate service;
As set forth in Exhibit F of the Application,the Project is necessary to deliver reliable
wireless telecommunications service to Verizon Wireless' Pilot Knob cell.
2.) That there are compelling reasons, economic and otherwise,for permitting the
variance;
See Exhibit F. Currently, there is little wireless telecommunications coverage in the
Pilot Knob cell. The Project will provide the residents, business owners and emergency
service providers in and around the Pilot Knob coverage area with reliable wireless
telecommunications service.
3.) Where the intrusion or burden on the community is minimal, the showing
required by the utility should be correspondingly reduced
As demonstrated by the photosimulations enclosed as Exhibit W to the Application,the
Project will comply with the APA's substantial invisibility requirement since the
proposed tower will hardly be visible from key viewing points.
We look forward to appearing at the November 19, 20 and 21, 2013 meetings of the
Planning Board and Zoning Board of Appeals. Please do not hesitate to contact me if you have
any questions or need any additional information.
Thank you.
Oery truly y; s,
if • C. Lu
JCL/mg
cc: Kathy Pomponio
Sara Colman
Virginia Yamrick, APA
14709115.1
■` I � / .Lusk
`1 /�� N I XO N ATTORNEYS AT LAW Jared C
Partner
• PEABODY NIXONPEABOOY 1 T 585-263-1140
@NIXONPEABOOYLLP F 866-402-1491
' jlusk@nixonpeabody.com
Nixon Peabody LLP
1300 Clinton Square
Rochester,NY 14604-1792
585-263-1000
,c-s.1■1
RECE1
October 21, 2013
direkl
VIA FEDERAL EXPRESS OCR -0 ,r
TOWN OF QUEE 4.URY
Craig Brown ZONING OF
Zoning Administrator
Town of Queensbury
742 Bay Road
Queensbury,New York 12804
RE: Application for a Use Variance from the Zoning Board of Appeals and Site Plan Approval
from the Planning Board (along with a Freshwater Wetlands Permit and Stormwater
Management Permit) by Cellco Partnership d/b/a Verizon Wireless, to Construct and
Operate an 96' Wireless Telecommunications Facility (with an Additional 5' of RF
• Transparent Pine Branches) Near 441 Lockhart Mountain Road on Lands Owned by Lost
Chalets, LLC (Tax Parcel No. 265.-1-52) in the Town of Queensbury,New York(Verizon
Wireless' "Pilot Knob" site)
Dear Craig:
By application dated August 9, 2013, Cellco Partnership d/b/a Verizon Wireless ("Verizon
Wireless") to both the Zoning Board of Appeals and Planning Board for the approvals necessary (the
"Application")to construct and operate a wireless telecommunications facility (the "Project") on
property located near 441 Lockhart Mountain Road in the Town (the "Site").
Thereafter, on September 12, 2013,the Town's engineer(the Chazen Companies) issued a letter
following its review stormwater management and erosion and sediment control aspects of the Project
(the "Chazen Letter"). A copy of the Chazen Letter is attached hereto as Exhibit S (lettered to
correspond with Exhibits A-R submitted with the Application). Verizon Wireless' written response to
the Chazen Letter is enclosed as Exhibit T.
In addition, during the site visit/balloon fly conducted on September 18, 2013, it was
determined that the trees in the vicinity of the proposed tower were taller than originally anticipated.
Therefore, after consulting with APA staff, Verizon Wireless has revised the Project site plan to reflect
a 10' increase in the overall height of the proposed tower from 91' to 101' AGL, as well as to address
several of the issues raised in the Chazen Letter(the "Revised Plan").
•
14684045.1
Craig Brown
October 21,2013
• Page 2
A visual analysis of the proposed tower, including photosimulations and a viewshed map
prepared in accordance with APA guidelines is also enclosed.
Please accept this letter and the following exhibits and enclosures as Verizon Wireless' response
to the Chazen Letter and request to amend the Application to increase to the height of the proposed
tower to an overall height of 101' AGL:
Exhibit S: Copy of the Chazen Letter;
Exhibit T: Copy of the Project Engineer's response to the Chazen letters;
Exhibit U: 11"x 17" copy of the Revised Plan;
Exhibit V: Revised EAF reflecting the Revised Plan; and
Exhibit W: Visual analysis, including viewshed/photolog map.
• Two (2) copies of the Stormwater Pollution Prevention Plan("SWPPP")prepared by
Costich Engineering,P.C.;
• • Six (6) full size copies of the Revised Plan; and
• Thirty(30) copies of this supplemental application package.
We look forward to appearing at the November 19, 20 and 21, 2013 meetings of the Planning
Board and Zoning Board of Appeals.
Please do not hesitate to contact me if you have any questions or need any additional
information.
Thank you.
V-ry truly yo
J. ei . Lusk
JCL//mg
Enclosures
cc: Kathy Pomponio (w/enc.)
Sara Colman(w/enc.)
Virginia Yamrick,APA(w/enc.)
•
'Note that Verizon Wireless' response to the Chazen letter has not yet been forwarded to Chazen.
14684045.1
THE
han� North Country Office
(�/ �— 375 Bay Road, Queensbury, NY 12804
• P: (518)812-0513 F: (518) 812-2205
COMPANIES www.chazencompanies.com
Proud w be Employee Owned' Hudson Valley Office (845)454-3980
Engineers Capital District Office (518)273-0055
Land Surveyors
Planners
Environmental Professionals
Landscaoe Architects
September 12, 2013
Mr. Craig Brown
Zoning Administrator and Code Compliance Officer
Town of Queensbury
742 Bay Road
Queensbury, New York 12804
Delivered via email only: CraigB@queensbury.net
Re: Cellco Partnership d/b/a Verizon Wireless
Town of Queensbury, Warren County, New York
Chazen Project#91300.36
Queensbury Ref. No:Site Plan 50-2013
• Dear Mr. Brown:
The Chazen Companies (Chazen) has received a submission package from your office for the above
project. The Applicant intends to construct a wireless communications tower with an access road and
various appurtenances. Submitted information includes the following:
• Site Plans and Details, prepared by Costich Engineering, dated June 24, 2013 and last revised
July 24, 2013; and,
• Legal and technical document binder, prepared by Nixon Peabody, LLP, dated August 9, 2013.
Your office has requested that we limit our review to the design of stormwater management and
erosion and sediment control items as it relates to compliance to local, state or relevant codes and
regulations. Based upon our review of the information provided, Chazen offers the following comments
for the Town's consideration:
Stormwater Management& Erosion and Sediment Control:
1. Based on the submitted information, the total area of disturbance associated with this
application is unclear. The submitted EAF indicates that 1.44 acres of the site will be developed,
however the title sheet of the project plans indicate the area of disturbance is 0.76 acres. As
such, it is requested that the Applicant clearly identify the area of disturbance and identify the
same, by area, on the plans. It is noted that if disturbance is greater than 1 acre the project will
require coverage under the NYSDEC SPDES General Permit for Stormwater Discharges from
Construction Activities, and will require the preparation of a "full" SWPPP. Also, the project is
• considered a "major" project as it falls within the Lake George watershed and therefore the
Chazen Engineenng,Land Surveying&Landscape Architecture Co.,D.P.C.
Chazen Environmental Services, Inc.
The Chazen Companies, Inc.
Town of Queensbury
Cellco Partnership
September 12,2013
• Page 2
project is required to comply with the Applicable provisions of Chapter 147-11 of Town Code.
Lastly, a Stormwater Analysis has not been provided as part of this submission. The Applicant
shall provide the required analysis for review.A comprehensive review of the application cannot
occur until this analysis is submitted.
2. A legally binding and enforceable maintenance agreement shall be executed between the
facility owner and the Town ensuring that proper maintenance measures will be implemented
for all proposed stormwater management practices. A draft of this agreement shall be provided
to the Town for review.
3. The Applicant has provided a detail for the proposed drainage swale; however, it is unclear how
the swale will be protected by erosion. The Applicant shall provide details in accordance with
Section 58.17 of the NYS SSESC regarding the construction of the proposed swale.
4. The Applicant has shown the location of silt fencing; however, it shall be noted that silt fence
must be installed downgradient of all disturbed areas, in accordance with Section SA.19 of the
NYSDEC SSESC. Additionally, the construction specifications presented in the NYS SSESC for silt
fencing shall be included with the detail provided on sheet CA502.
Conclusions and Recommendations
It is our opinion that the applicant should provide clarification for the above items and incorporate the
• changes in subsequent plan submissions.
If you have any questions regarding the above, please do not hesitate to contact me at (518)824-1926.
Sincerely,
Sean M. Doty, P.E., LEED AP, Associate
Senior Project Engineer
cc: Laura Moore,Town Land Use Planner (via email)
Pam Whiting,Town Planning Office Administrator(via email)
File
•
R:\9\91300.91399\91300.00-Town of Queensbury PB Engineer\91300.36•SP 50-2013 Cellco Partnership\91300.36-SP 50-2013 Cellco Partnership_2013-09-12 L1.docz
Project No. 4580
L.,uSTICH
ENGINEERING, P.C. October 10,2013
Sean M.Doty,P.E.,LEED AP, Associate Senior Project Engineer
The Chazen Companies
375 Bay Road
Queensbury,New York 12804
Re: Cellco Partnership d/b/a Verizon Wireless Town of Queensbury,Warren County,NY
Chazen Project 41 91300.36
Queensbury Ref.No:Site Plan 50-2013
Response to Comments
Dear Mr.Doty:
The following are responses to your written comments for the above referenced project. These comments
are as enumerated in your Ietter dated September 12,2013.
Stormwater Management&Erosion and Sediment Control
1. Based on the submitted information, the total area of disturbance associated with this application
• is unclear. The submitted EAF indicates that 1.44 acres of the site will be developed, however the
title sheet of the project plans indicate the area of disturbance is 0.76 acres.As such, it is requested
that the Applicant clearly identify the area of disturbance and identify the same, by area,on the
plans.It is noted that if disturbance is greater than 1 acre the project will require coverage under
the NYSDEC SPDES General Permit for Stormwater Discharges from Construction Activities,and
will require the preparation of a "full"SWPPP.Also, the project is considered a "major"project as
it falls within the Lake George watershed and therefore the project is required to comply with the
Applicable provisions of Chapter 147-11 of Town Code. Lastly,a Stonnwater Analysis has not been
provided as part of this submission. The Applicant shall provide the required analysis for review.A
comprehensive review of the application cannot occur until this analysis is submitted.
On the full EAF the total project area is listed as 1.83 acres which includes the VZW lease parcel and
ingress/egress easement. The 1.44 acres listed on the full EAF is actually the total impervious area
(total of both pre and post construction within the lease parcel and ingress/egress easement). The
existing unvegetated (driveway)area within the project area is 1.04 acres so the resulting increase in
impervious area is actually 0.4 acres.
The project area of disturbance limits is shown on Sheets CA110,CA130 and CA131. The 0.78 acre
project area of disturbance listed on the site plan corresponds to the limits shown on the site plan
and is correct.
Stormwater mitigation measures have been designed such that the project will conform to Chapter
147-11 of the Town Code. A geotechnical report completed by Dente Engineering was recently
received and the soils information provided in that report have been used to design mitigation
• ENGINEERING • LAND PLANNING • SURVEYING
Coctich Fngineering, P.C., Inc. • 217 Lake Avenue • Rochester, New York 14h((5
585-458-3020 • 585-458-2711 (Fax) • (v‘, wcostich.corn
measures. Infiltration tests were completed and in general,the infiltration rates are within expected
•
ranges for the sand and sand/gravel soils. No groundwater was encountered. Stone-filled
infiltration swales and stone infiltration trenches are proposed to detention the stormwater runoff
and reduce the developed peak flow rates below existing levels. Enclosed with this submission is a
copy of the full Stormwater Pollution Prevention Plan.
2. A legally binding and enforceable maintenance agreement shall be executed between the facility
owner and the Town ensuring that proper maintenance measures will be implemented for all
proposed stornnwater management practices.A draft of this agreement shall be provided to the
Town for review.
A draft copy of the Stormwater Maintenance Agreement is located in Appendix III of the enclosed
SWPPP.
3. The Applicant has provided a detail for the proposed drainage swale;however,it is unclear how the
swale will be protected by erosion. The Applicant shall provide details in accordance with Section
5B.17 of the NYS SSESC regarding the construction of the proposed szvale.
To comply with Section 5B.17 of the NYS SSESC,revised details and additional construction
sequence notes have been added to the Site Plan(Sheets CA501 and CA502). To protect the swales
from erosion,the swales will be lined with rip-rap.
4. The Applicant has shown the location of silt fencing;however, it shall be noted that silt fence must
be installed down gradient of all disturbed areas, in accordance with Section 5,4.19 of the NYSDEC
SSESC.Additionally, the construction specifications presented in the NYS SSESC for silt fencing
shall be included with the detail provided on sheet CA502.
• The silt fence detail has been revised on the Site Plan(Sheet CA502) to include the construction
specifications from Section 5A.19 of the NYS SSESC.
If you have any questions or comments,please feel free to contact our office.
Very truly yours,
_- OSTICH ENGINEERING,P.C.
Gd
David A. Weisenreder,P.E.
DAW/erw
Enclosures
h:\job\4580\documents\correspondence\2013-10-10 response to Chaten comments dated 2013-09-12.doc
•
CE#4580
617.20
• Appendix A
State Environmental Quality Review
FULL ENVIRONMENTAL ASSESSMENT FORM
Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may
be significant. The question of whether an action may be significant is not always easy to answer. Frequently, there are aspects of
a project that are subjective or unmeasurable. It is also understood that those who determine significance may have little or no formal
knowledge of the environment or may not be technically expert in environmental analysis. In addition, many who have knowledge
in one particular area may not be aware of the broader concerns affecting the question of significance.
The full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination process
has been orderly, comprehensive in nature, yet flexible enough to allow introduction of information to fit a project or action.
Full EAF Components: The full EAF is comprised of three parts:
Part 1: Provides objective data and information about a given project and its site. By identifying basic project data,it assists
a reviewer in the analysis that takes place in Parts 2 and 3.
Part 2: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides guidance
as to whether an impact is likely to be considered small to moderate or whether it is a potentially-large impact. 1 he
form also identifies whether an impact can be mitigated or reduced.
Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is
actually important.
THIS AREA FOR LEAD AGENCY USE ONLY
DETERMINATION OF SIGNIFICANCE -- Type 1 and Unlisted Actions
• Identify the Portions of EAF completed for this project: [71 Part 1 17 Part 2 17 Part 3
Upon review of the information recorded on this EAF (Parts 1 and 2 and 3 if appropriate), and any other supporting information, and
considering both the magnitude and importance of each impact, it is reasonably determined by the lead agency that:
A. 1 he project will not result in any large and important impact(s) and, therefore, is one which will not have a
significant impact on the environment, therefore a negative declaration will be prepared.
B. Although the project could have a significant effect on the environment, there will not be a significant effect
for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore
a CONDITIONED negative declaration will be prepared.-
` C. The project may result in one or more large and important impacts that may have a significant impact on the
environment, therefore a positive declaration will be prepared
A Conditioned Negative Declaration is only valid for Unlisted Actions
Ccllco Partnership a•'b!a Vcrizon Wireless-Pilot Knob Wireless Telecommunications Facility
Name of Action
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 Preparer (If different from responsible officer)
August 6,2013,Revised 9/13/2013 & 101 7/2013
Date
Page 1 of 21
PART 1--PROJECT INFORMATION
• Prepared by Project Sponsor
NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect on the
environment. Please complete the entire form, Parts A through E. Answers to these questions will be considered as part of the
application for approval and may be subject to further verification and public review. Provide any additional information you believe
will be needed to complete Parts 2 and 3.
It is expected that completion of the full EAF will be dependent on information currently available and will not involve new studies,
research or investigation. If information requiring such additional work is unavailable,so indicate and specify each instance.
Name of Action Cellco Partnership dfb/a Verizon Wireless-Pilot Knob Wireless Telecommunications Facility
Location of Action(include Street Address,Municipality and County)
441 Lockhart Mountain Road,Town of Quecnsbury, Warren County(T.A.#t265.-I-52 Parent Parcel)
Name of ApplicantlSponsor Cellco Partnership d/b/a Verizon Wireless
Address 175 Calkins Road
City/PO Rochester State NY Zip Code 14623
Business Telephone 585-321-5435 Kathy Pomponio
Name of Owner(if different) Lost Chalets,LLC
°al Address 441 Lockhart Mountain Road
City/PO Lake George State NY Zip Code 1 2845
Business Telephone 518-668-3000(James Feeney)
Description of Action:
Celled Partnership d/b/a Verizon Wireless is proposing a 96'monopine(101'overall height w/RF Simulated Pine Branches),an
11'-7"x30'-1"equipment building on a 11'-7"x30'-l"concrete pad within a 42'x50'fenced(6'tall with barb wire top)compound,along
with other associated improvements.Access to the site via existing driveways from 12'Lockhart Mountain Road and a proposed 12'
wide gravel driveway.
Page 2 of 21
Please Complete Each Question--Indicate N.A. if not applicable
• A. SITE DESCRIPTION
Physical setting of overall project, both developed and undeveloped areas.
1. Present Land Use:n Urban C]Industrial n Commercial I I Residential (suburban) n Rural (non-farm)
0 Forest n Agriculture 0 Other Top of the World Golf-Course
Lease Parcel 0.23 + Permanent Access Easement 1.60
2. Total acreage of project area: 1.53 I!- acres.
APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION
Meadow or Brushland (Non-agricultural) 0.40 acres 0.28 acres
Forested 0.39 acres 0.11 acres
Agricultural (Includes orchards, cropland, pasture, etc.) acres acres
Wetland(Freshwater or tidal as per Articles 24,25 of ECL) acres acres
Water Surface Area acres acres
Unvegetated (Rock, earth or Fill) driveway 1.04 acres 1.431 acres
Roads, buildings and other paved surfaces acres 0.009 acres
• Other(Indicate type) acres acres
3. What is predominant soil type(s)on project site? BdC Bice Very bouldery fine sandy loam Per NRCS Web Soil Survey
a. Soil drainage: 0 Well drained 100%of site n Moderately well drained %of site.
11 Poorly drained %of site
b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land
Classification System? n/a acres (see 1 NYCRR 370).
4. Are there bedrock outcroppings on project site? Yes 11 No
a. What is depth to bedrock 0.7>6' On feet) Pcr Dente Gcotcch report
5. Approximate percentage of proposed project site with slopes:
0 0-10% 90% 010- 15% 10% C] 15%or greater %
6. Is project substantial) contiguous to, or contain a building, site, or district, listed on the State or National Registers of
Historic Places? II Yes 0 No
7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? I I Yes Q No
g, What is the depth of the water table? 5.5' (in feet) Pcr Dente(icwtcch Report
9. Is site located over a primary, principal, or sole source aquifer? n Yes 0 No
• 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? n Yes CI No
Page 3 of 21
11. Does project site contain any species of plant or animal life that is identified as threatened or endangered? ®Yes 0 No
• According to:
No per NYSDI:(. Natural I tentage Program letter dated 12 20 2012.
Identify each species:
12. Are there any unique or unusual land forms on the project site? (i.e.. cliffs, dunes, other geological formations?
fYes U No
Describe:
13. Is the project site presently used by the community or neighborhood as an open space or recreation area?
0 Yes ❑No
If yes, explain:
l-si;ting gnll cnur,e
14. Does tlx:present site include scenic views known to be important to the community? D Yes 0 No
15. Streams within or contiguous to project area:
Nn.
a. Name of Stream and name of River to which it is tributary
16. Lakes, ponds, wetland areas within or contiguous to project area
Per the National Wetlands Inventory Maps,there are no federal wetlands in the project area. Per APA mapping,there are APA
wetlands approximately 893'-ti—southwest of the project area associated with the existing pond.
b. Size (in acres):
It) -
•
Page 4 of 21
• 17. Is the site served by existing public utilities? 0 Yes ❑No
a. If YES, does sufficient capacity exist to allow connection? 0 Yes El No
b. If YES, will improvements be necessary to allow connection? 0 Yes ❑No
18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and
304? fYes 0 No
19. Is the site located in or substantiall contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL,
and 6 NYCRR 617? El Yes . No
20. Has the site ever been used for the disposal of solid or hazardous wastes? [JYes No
a. Project Description
1. Physical dimensions and scale of project (fill in dimensions as appropriate).
a. Total contiguous acreage owned or controlled by project sponsor: 1-�3 acres. (Least parcel&access)
b. Project acreage to be developed: 0.4 acres initially; 0.4 acres ultimately.
c. Project acreage to remain undeveloped: 0.39 acres.
d. length of project, in miles: N/A (if appropriate)
e. If the project is an expansion, indicate percent of expansion proposed. N/A %
f. Number of off-street parking spaces existing N/A ; proposed 2
g. Maximum vehicular trips generated per hour: 2-3 month (upon completion of project)?
h. If residential: Number and type of housing units:
One Family Two Family Multiple Family Condominium
Initially N/A
Ultimately
i. Dimensions(in feet)of largest proposed structure: 96' height; 11'-7" width; 30'-I" length.
(101'overall) slwlter
j. Linear feet of frontage along a public thoroughfare project will occupy is?
30' ft. access/utilties easement
2. How much natural material (i.e. rock, earth, etc.) will be removed from the site?
0 tons/cubic yards.
3. Will disturbed areas be reclaimed 0 Yes ❑No �N/A
a. If yes, for what intended purpose is the site being reclaimed?
grading and steeling
b. Will topsoil be stockpiled for reclamation? 0 Yes n No
c. Will upper subsoil be stockpiled for reclamation?Cl
Yes ❑ No
4. How many acres of vegetation (trees, shrubs, ground covers)will be removed from site? 0.4 acres.
Page 5 of 21
5. Will any mature forest (over 100 years old)or other locally-important vegetation be removed by this project?
• El Yes Q No
6. If single phase project: Anticipated period of construction: 3 months, (including demolition)
7. If multi-phased: N/A
a. Total number of phases anticipated (number)
b. Anticipated date of commencement phase 1:(number)
(including demolition)
c. Approximate completion date of final phase: month year.
d. Is phase 1 functionally dependent on subsequent phases? n Yes n No
10; after project is complete
8. Will blasting occur during construction? Q Yes n No
9. Number of jobs generated: during construction 0
10. Number of jobs eliminated by this project 0
11. Will project require relocation of any projects or facilities? ED Yes Q No
If yes, explain:
12. Is surface liquid waste disposal involved? ❑Yes Q No
a. If yes. indicate type of waste(sewage. industrial, etc)and amount
b. Name of water body into which effluent will be discharged
13. Is subsurface liquid waste disposal involved? Ej Yes Q No Type
14. Will surface area of an existing water body increase or decrease by proposal? n Yes Q No
If yes, explain:
15. Is project or any portion of project located in a 100 year flood plain? n Yes Q No
16. Will the project generate solid waste? n Yes Q No
a. If yes, what is the amount per month? tons
b. If yes, will an existing solid waste facility be used? n Yes n No
c. If yes, give name _ ; location
d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? ❑Yes ❑ No
i
Page 6 of 21
e. If yes, explain:
17. Will the project involve the disposal of solid waste? El Yes CI No
a. If yes, what is the anticipated rate of disposal?
b. If yes. what is the anticipated site life? years.
18. Will project use herbicides or pesticides? nYes D No
19. Will project routinely produce odors(more than one hour per day)? ! 1 Yes CI No
20. Will project produce operating noise exceeding the local ambient noise levels? I l Yes Q No
21. Will project result in an increase in energy use? Q Yes n No
If yes, indicate type(s)
Electric
400 amps,240/120V, 1P
22. If water supply is from wells, indicate pumping capacity N/A gallons/minute.
23. Total anticipated water usage per day N/A gallons/day.
24. Does project involve Local, State or Federal funding? n Yes CI No
If yes, explain:
Page 7 of 21
25. Approvals Required:
411 Type Submittal Date
City. Town, Village Board 0 Yes 0 No
(-� Site Plan Approval
City. Town, Village Planning Board 0 Yes ( I N• o
Use Variance
City, Town Zoning Board U Yes n N• o
City, County Health Department I J Yes 0 No
Other Local Agencies
•■ ("''�
Freshwater Wetlands Permit
113 Yes 1 1 N• o
Stormwater Permit
(as part of site plan review)
Other Regional Agencies
El Yes Y No
(� Adirondack Park Agency
State Agencies a, Yes i l No
Federal Agencies [1 Yes Q No
C. Zoning and Planning Information
1. Does proposed action involve a planning or zoning decision? Yes t J No
If Yes, indicate decision required:
❑Zoning amendment a Zoning variance ❑New/revision of master plan n Subdivision
0 Site plan ❑ Special use permit n Resource management plan Other
•
PageBof21
2. What is the zoning classification(s) of the site?
• fop of the World Pt!D(Planned Unit Development)
3. What is the maximum potential development of the site if developed as permitted by the present zoning?
N'A
4. What is the proposed zoning of the site?
tiatnc as ex istln,
5. What is the maximum potential development of the site if developed as permitted by the proposed zoning?
N/A
6. Is the proposed action consistent with the recommended uses in adopted local land use plans? D Yes No
7. What are the predominant land use(s)and zoning classifications within a V4 mile radius of proposed action?
°ID Land Uses: f=orest,Golf Course,Residential
Zoning Districts:Top of the World PUD,land Conservation 10 Acre,Rural Residential 5 Acre,
8. Is the proposed action compatible with adjoining/surrounding land uses with a Y mile? Q Yes No
9. If the proposed action is the subdivision of land, how many lots are proposed? N/A
a. What is the minimum lot size proposed?
Page 9 of 21
10. Will proposed action require any authorization(s)for the formation of sewer or water districts? ❑Yes 0 No
•
11. Will the proposed action create a demand for any community provided services(recreation, education, police, fire protection?
❑Yes 0 No
a. If yes, is existing capacity sufficient to handle projected demand? n Yes n No
12. Will the proposed action result in the generation of traffic significantly above present levels? El Yes 0 No
a If yes, is the existing road network adequate to handle the additional traffic. ❑Yes ❑No
D. Informational Details
Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts
associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them.
E. Verification
I certify that the information provided above is true to the best of my knowledge.
Applicant/Sponsor ' ism Celle()Partnership d/b/a Verizon Wireless Date 8/6/2013 Rev.9/13/2013
% & 10/17/2013
Signature ' !-�1�`t�" L/� �. ` ' l
Title David A. Weisenreder,P.E.-Costich Engineering-Project Engineer,Agent for Applicant
If the action is in the Coastal Area, and you are a state agency,complete the Coastal Assessment Form before proceeding with this
assessment.
•
Page 10of21
PART 2 - PROJECT IMPACTS AND THEIR MAGNITUDE
Responsibility of Lead Agency
• General Information(Read Carefully)
In completing the form the reviewer should be guided by the question: Have my responses and determinations been
reasonable? The reviewer is not expected to be an expert environmental analyst.
The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of
magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for
most situations. But,for any specific project or site other examples and/or lower thresholds may be appropriate for a
Potential Large Impact response,thus requiring evaluation in Part 3.
The impacts of each project, on each site,in each locality,will vary. Therefore,the examples are illustrative and have been
offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to answer each question.
The number of examples per question does not indicate the importance of each question.
In identifying impacts,consider long term,short term and cumulative effects.
Instructions (Read carefully)
a. Answer each of the 20 questions in PART 2. Answer Yes if there will be any impact.
b. Maybe answers should be considered as Yes answers.
c. If answering Yes to a question then check the appropriate box(column 1 or 2)to indicate the potential size of the impact. If
impact threshold equals or exceeds any example provided, check column 2. If impact will occur but threshold is lower than
example,check column 1.
d. Identifying that an Impact will be potentially large(column 2)does not mean that it is also necessarily significant. Any
large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simply asks that it
be looked at further.
e. If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART 3.
f. If a potentially large impact checked in column 2 can be mitigated by change(s)in the project to a small to moderate
impact,also check the Yes box in column 3. A No response indicates that such a reduction is not possible. This must be
explained in Part 3.
1 2 3
Small to Potential Can Impact Be
11) Moderate Large Mitigated by
Impact Impact Project Change
Impact on Land
1. Will the Proposed Action result in a physical change to the project
site?
NO n YES n
Examples that would apply to column 2
• Any construction on slopes of 15%or greater, (15 foot n n Yes ONo
rise per 100 foot of length),or where the general slopes
in the project area exceed 10%.
• Construction on land where the depth to the water table n n Yes nNo
is less than 3 feet.
• Construction of paved parking area for 1,000 or more n C n Yes n No
vehicles.
• Construction on land where bedrock is exposed or U LI Yes nNo
generally within 3 feet of existing ground surface.
• Construction that will continue for more than 1 year or n n n Yes El No
involve more than one phase or stage.
• Excavation for mining purposes that would remove n n n Yes nNo
more than 1,000 tons of natural material(i.e.,rock or
soil)per year.
•
Page 11 of 21
1 2 3
Small to Potential Can Impact Be
Moderate Large Mitigated by
• Impact Impact Project Change
• Construction or expansion of a santary landfill. ❑ ❑ ❑Yes nNo
• Construction in a designated floodway. ❑ ❑ nYes nNo
• Other impacts: ❑ ❑ nYes nNo
2. Will there be an effect to any unique or unusual land forms found on
the site?(i.e.,cliffs,dunes,geological formations,etc)
fNO ❑YES
• Specific land forms: ❑ ❑ nYes nNo
Impact on Water
3. Will Proposed Action affect any water body designated as protected?
(Under Articles 15,24,25 of the Environmental Conservation Law,
ECL)
NO ❑YES
Examples that would apply to column 2
• • Developable area of site contains a protected water body. n ❑ n Yes ❑No
• Dredging more than 100 cubic yards of material from channel of ❑ ❑ ❑Yes ❑No
a protected stream.
• Extension of utility distribution facilities through a protected water I I ❑ ❑Yes ❑No
body.
• Construction in a designated freshwater or tidal wetland. n ❑ n Yes nNo
• Other impacts: ❑ ❑ n Yes nNo
4. Will Proposed Action affect any non-protected existing or new body of
water?
n NO RYES
Examples that would apply to column 2
• A 10%increase or decrease in the surface area of any body of ❑ ❑ n Yes ❑No
water or more than a 10 acre increase or decrease.
• Construction of a body of water that exceeds 10 acres of surface ❑ ❑ n Yes nNo
area.
• Other impacts: ❑
I ❑Yes I I No
•
Page 12 of 21
1 2 3
Small to Potential Can Impact Be
Moderate Large Mitigated by
• Impact Impact Project Change
5 Will Proposed Action affect surface or groundwater quality or
quantity?
❑NO ❑YES
Examples that would apply to column 2
• Proposed Action will require a discharge permit. n ❑ nYes n No
• Proposed Action requires use of a source of water that does not ❑ ❑Yes n No
have approval to serve proposed(project)action.
• Proposed Action requires water supply from wells with greater n n ii Yes n No
than 45 gallons per minute pumping capacity.
• Construction or operation causing any contamination of a water I 1 I 1 1 1 Yes ❑No
supply system.
• Proposed Action will adversely affect groundwater. l l ❑ ❑Yes n No
• Liquid effluent will be conveyed off the site to facilities which ❑ ❑ n Yes ❑No
presently do not exist or have inadequate capacity.
• Proposed Action would use water in excess of 20,000 gallons ❑ ❑ ❑Yes n No
per day.
• Proposed Action will likely cause siltation or other discharge into 11 1 1 Yes n No
an existing body of water to the extent that there will be an
III obvious visual contrast to natural conditions.
Proposed Action will require the storage of petroleum or ❑ ❑ ❑Yes n No
chemical products greater than 1,100 gallons.
• Proposed Action will allow residential uses in areas without ❑ ❑ ❑Yes n No
water and/or sewer services.
. • Proposed Action locates commercial and/or industrial uses n ❑ I !Yes n No
which may require new or expansion of existing waste treatment
and/or storage facilities.
• Other impacts: n ❑ ❑Yes n No
•
Page 13 of 21
1 2 3
Small to Potential Can Impact Be
Moderate Large Mitigated by
Impact Impact Project Change
•
6. Will Proposed Action alter drainage flow or patterns,or surface water
runoff?
❑NO ❑YES
Examples that would apply to column 2 ❑ ❑ ❑ ❑
• Proposed Action would change flood water flows Yes No
• Proposed Action may cause substantial erosion. El ❑ ❑Yes ❑No
• Proposed Action is incompatible with existing drainage patterns. ❑ ❑ ❑Yes ❑No
• Proposed Action will allow development in a designated ❑ ❑ ❑Yes ❑No
floodway.
• Other impacts: El ❑ ❑Yes ❑No
IMPACT ON AIR
7. Will Proposed Action affect air quality?
I INO ❑YES
Examples that would apply to column 2
• Proposed Action will induce 1,000 or more vehicle trips in any I I ❑ ❑Yes ❑No
• given hour. [�
• Proposed Action will result in the incineration of more than 1 ton ❑ ❑ ❑Yes I I No
of refuse per hour.
• Emission rate of total contaminants will exceed 5 lbs. per hour ❑ ❑ Ekes ❑No
or a heat source producing more than 10 million BTU's per
hour.
• Proposed Action will allow an increase in the amount of land El ❑ Ekes I-1 No
committed to industrial use.
• Proposed Action will allow an increase in the density of ❑ ❑ ❑Yes ❑No
industrial development within existing industrial areas.
• Other impacts: ❑ El Elves ❑No
IMPACT ON PLANTS AND ANIMALS
8. Will Proposed Action affect any threatened or endangered species?
ii NO ❑YES
Examples that would apply to column 2
• Reduction of one or more species listed on the New York or El ❑ ❑Yes ❑No
Federal list, using the site,over or near
• the site,or found on the site.
Page 14 of 21
1 2 3
Small to Potential Can Impact Be
Moderate Large Mitigated by
• Impact Impact Project Change
• Removal of any portion of a critical or significant wildlife habitat. ❑ ❑ ❑Yes ❑No
• Application of pesticide or herbicide more than twice a year, ❑ El ❑Yes ❑No
other than for agricultural purposes.
• Other impacts: ❑ ❑ ❑Yes ❑No
9. Will Proposed Action substantially affect non-threatened or non-
endangered species?
El NO ❑YES
Examples that would apply to column 2
• Proposed Action would substantially interfere with any resident ❑ ❑ ❑Yes ❑No
or migratory fish, shellfish or wildlife species.
• Proposed Action requires the removal of more than 10 acres of ❑ ❑ ❑Yes ❑No
mature forest(over 100 years of age)or other locally important
vegetation.
• Other impacts: ❑ ❑ ❑Yes ❑No
40 IMTURAL r LAND ES
10. Will Proposed PACT Action ON affect AGRICUL agricultual land
R resourcesOURC?ES
❑NO ❑YES
Examples that would apply to column 2
• The Proposed Action would sever,cross or limit access to ❑ ❑ ❑Yes ❑No
agricultural land (includes cropland,hayfields,pasture,vineyard,
orchard,etc.)
• Construction activity would excavate or compact the soil profile of El ❑ ❑Yes ❑No
agricultural land.
• The Proposed Action would irreversibly convert more than 10 ❑ ❑ ❑Yes ❑No
acres of agricultural land or, if located in an Agricultural District.
more than 2.5 acres of agricultural land.
III
Page 15 of 21
1 2 3
Small to Potential Can Impact Be
Moderate Large Mitigated by
Impact Impact Project Change
• The Proposed Action would disrupt or prevent installation of ❑ I I I I Yes I I No
agricultural land management systems(e g.,subsurface drain
lines,outlet ditches,strip cropping);or create a need for such
measures(e.g.cause a farm field to drain poorly due to
increased runoff).
• Other impacts: ❑ ❑ ❑Yes ❑No
IMPACT ON AESTHETIC RESOURCES
11. Will Proposed Action affect aesthetic resources?(If necessary, use
the Visual EAF Addendum in Section 617.20,Appendix B.)
nNO ❑YES
Examples that would apply to column 2
• Proposed land uses,or project components obviously different ❑ El ❑Yes n No
from or in sharp contrast to current surrounding land use
patterns,whether man-made or natural.
• Proposed land uses,or project components visible to users of ❑ ❑ ❑Yes ❑No
aesthetic resources which will eliminate or significantly reduce
their enjoyment of the aesthetic qualities of that resource.
• Project components that will result in the elimination or ❑ n nYes n No
• significant screening of scenic views known to be important to
the area.
• Other impacts: ❑ ❑ n Yes n No
IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES
12. Will Proposed Action impact any site or structure of historic,
prehistoric or paleontological importance?
nNO ❑YES
Examples that would apply to column 2
• Proposed Action occurring wholly or partially within or ❑ ❑ ❑Yes ❑ No
substantially contiguous to any facility or site listed on the State
or National Register of historic places.
• Any impact to an archaeological site or fossil bed located within ❑ ❑ ❑ Yes ❑No
the project site.
• Proposed Action will occur in an area designated as sensitive ❑ ❑ I I Yes n No
for archaeological sites on the NYS Site Inventory.
S
Page 16of21
1 2 3
Small to Potential Can Impact Be
Moderate Large Mitigated by
IIIImpact Impact Project Change
• Other impacts:
El ❑ n Yes n No
IMPACT ON OPEN SPACE AND RECREATION
13. Will proposed Action affect the quantity or quality of existing or future
open spaces or recreational opportunities?
n NO n YES
Examples that would apply to column 2
• The permanent foreclosure of a future recreational opportunity. ❑ ❑ n Yes n No
• A major reduction of an open space important to the community. ❑ ❑ I-1 Yes ❑No
• Other impacts: ❑ ❑ n Yes [1 No
IMPACT ON CRITICAL ENVIRONMENTAL AREAS
14. Will Proposed Action impact the exceptional or unique
characteristics of a critical environmental area(CEA)established
pursuant to subdivision 6NYCRR 617.14(g)?
[NO YES
IIIList the environmental characteristics that caused the designation of
the CEA.
Examples that would apply to column 2
• Proposed Action to locate within the CEA? ❑ n Yes n No
• Proposed Action will result in a reduction in the quantity of the ❑ ❑ n Yes Ohio
resource?
• Proposed Action will result in a reduction in the quality of the ❑ ❑ n Yes INo
resource?
• Proposed Action will impact the use,function or enjoyment of the ❑ ❑ n Yes n No
resource?
• Other impacts: I ❑ [iYes 0 N
•
Page 17of21
1 2 3
Small to Potential Can Impact Be
Moderate Large Mitigated by
• Impact Impact Project Change
IMPACT ON TRANSPORTATION
15. Will there be an effect to existing transportation systems?
❑NO ❑YES
Examples that would apply to column 2
• Alteration of present patterns of movement of people and/or ❑ ❑ ❑Yes ❑No
goods.
• Proposed Action will result in major traffic problems. ❑ ❑ ❑Yes ❑No
• Other impacts: ❑ ❑ ❑Yes ❑No
IMPACT ON ENERGY
16. Will Proposed Action affect the community's sources of fuel or
energy supply?
0 N ❑YES
Examples that would apply to column 2
• Proposed Action will cause a greater than 5%increase in the ❑ ❑ ❑Yes ❑No
use of any form of energy in the municipality
S . Proposed Action will require the creation or extension of an ❑ El 11 Yes El No energy transmission or supply system to serve more than 50
single or two family residences or to serve a major commercial
or industrial use.
• Other impacts: El ❑ ❑Yes ❑No
NOISE AND ODOR IMPACT
17. Will there be objectionable odors, noise,or vibration as a result of
the Proposed Action?
❑NO ❑YES
Examples that would apply to column 2
• Blasting within 1,500 feet of a hospital, school or other sensitive ❑ ❑ ❑Yes I-1 No
facility.
• Odors will occur routinely(more than one hour per day). I I ❑ ❑Yes ❑No
• Proposed Action will produce operating noise exceeding the ❑ ❑ ❑Yes ❑No
local ambient noise levels for noise outside of structures. [1 (�
- Proposed Action will remove natural barriers that would act as a ❑ l l I I Yes l t No
noise screen.
• • Other impacts: I I ❑ El Yes ❑No
I
f1.....-. 40 ..[ 01
1 2 3
Small to Potential Can Impact Be
Moderate Large Mitigated by
• Impact Impact Project Change
IMPACT ON PUBLIC HEALTH
18. Will Proposed Action affect public health and safety?
nNO ❑YES
• Proposed Action may cause a risk of explosion or release of ❑ El hazardous substances(i.e. oil,pesticides,chemicals, radiation, ❑Yes nNo
etc.)in the event of accident or upset conditions,or there may be
a chronic low level discharge or emission.
• Proposed Action may result in the burial of'hazardous wastes" ❑ ❑ Yes nNo
in any form(i.e.toxic,poisonous, highly reactive, radioactive,
irritating,infectious,etc.)
• Storage facilities for one million or more gallons of liquefied El (�❑ ElYes ❑No
natural gas or other flammable liquids.
• Proposed Action may result in the excavation or other ❑ C ❑Yes El No
disturbance within 2,000 feel of a site used for the disposal of
solid or hazardous waste.
• Other impacts: ❑ ❑ Ekes nNo
S IMPACT ON GROWTH AND CHARACTER
OF COMMUNITY OR NEIGHBORHOOD
19. Will Proposed Action affect the character of the existing community?
nNO DYES
Examples that would apply to column 2
• The permanent population of the city,town or village in which the El C Yes C No
project is located is likely to grow by more than 5%.
• The municipal budget for capital expenditures or operating n ❑ nYes _,_•No
services will increase by more than 5%per year as a result of
this project. �
• Proposed Action will conflict with officially adopted plans or CI CI (
Oyes I INo
goals.
• Proposed Action will cause a change in the density of land use. El LI ('�
Dyes t l No
• Proposed Action will replace or eliminate existing facilities. El El nYes ❑No
structures or areas of historic importance to the community.
• Development will create a demand for additional community
El El nYes Li No
services(e.g.schools,police and fire,etc.)
•
Page 19 of 2 i
1 2 3
Small to Potential Can Impact Be
Moderate Large Mitigated by
Impact Impact Project Change
• Proposed Action will set an important precedent for future ❑ ❑ n Yes n No
projects.
• Proposed Action will create or eliminate employment. ❑ ❑ n Yes El No
• Other impacts: ❑ ❑ ❑Yes ❑No
20. Is there,or is there likely to be,public controversy related to potential
adverse environment impacts?
fNO [YES
If Any Action in Part 2 Is Identified as a Potential Large Impact or If you Cannot Determine the Magnitude of
Impact, Proceed to Part 3
•
•
Page 200121
• Part 3 - EVALUATION OF THE IMPORTANCE OF IMPACTS
Responsibility of Lead Agency
Part 3 must be prepared if one or more impact(s)is considered to be potentially large,even if the impact(s)may
be mitigated.
Instructions (If you need more space,attach additional sheets)
Discuss the following for each impact identified in Column 2 of Part 2:
1. Briefly describe the impact
2 Describe(if applicable)how the impact could be mitigated or reduced to a small to moderate impact by
project change(s).
3. Based on the information available,decide if it is reasonable to conclude that this impact is important.
To answer the question of importance,consider:
! The probability of the impact occurring
! The duration of the impact
! Its irreversibility,including permanently lost resources of value
! Whether the impact can or will be controlled
! The regional consequence of the impact
! Its potential divergence from local needs and goals
! Whether known objections to the project relate to this impact.
•
Page 21 of 2 1
• PART II- IMPACT ASSESSMENT(To be completed by Lead Agency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617.4? If yes,coordinate the review process and use the FULL EAF
Yes t.J No
8. 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.
n Yes No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,if legible)
C1. Existing air quality,surface or groundwater quality or quantity,noise levels,existing traffic pattern,solid waste production or disposal,
potential for erosion,drainage or flooding problems? Explain briefly:
C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character'?Explain briefly
C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened orendangered ?
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:
C6. Long term,short term,cumulative,or other effects not identified in Cl-05? Explain briefly:
• C7. Other impacts(including changes in use of either quantity or type of energy'? Explain briefly:
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA(CEN? Slf fires,explain briefly:
nYes nNo
E. IS THERE,OR IS THERE LIKELY TO BE.CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain:
Yes n No
PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important or otherwise significant Each
effect should be assessed in connection with its(a)setting(i.e.urban or rural);(b)probability of occurring:(c)duration;(d)irreversibility,(e)
geographic scope;and(f)magnitude. If necessary,add attachments or reference supporting materials. Ensure that explanations contain
sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked
yes,the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA.
Checkthis box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL
EAF andlor 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 actior
WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this
determination.
Name of Lead Agency Date
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
• Signature of Responsible Officer in Lead Agency Signature of Preparer Of different from responsible officer)
h (e t l< mk.
Via Certified Mail Return Receipt
RECEIVED Tracking No. 7012 1010 0000 2033 9805
• . \£A/YORK STATE
AUG 292013 Adirondack
parkagencv
NOTICE OF INCOMPLETE PERMIT APPLICATION
Nixon Peabody LLP APA Project No. 2013-174
Project Sponsor: Authorized Representative:
Kathleen Pomponio - Real Estate Manager Jared Lusk, Esq.
New York RSA No. 2 Cellular Partnership Nixon Peabody, LLP,
d/b/a Verizon Wireless 1300 Clinton Square
175 Calkins Road Rochester, NY 14604
Rochester, NY 14623
Date Application Received: August 12, 2013
Type of Project: Subdivision into sites and major public utility use
involving the lease of a 100 foot by 100 foot parcel for
construction of a new 86 foot above ground level (AGL)
telecommunications tower to be concealed as a simulated pine tree.
The total height of the simulated tree will be 91 feet (including
crown and concealment branching) . Verizon Wireless is proposing to
install a twelve panel antenna array (at a centerline height of 77
feet AGL) on the tower and construct a 12± foot by 30± foot
• equipment shelter. Access to the facility will originate from Top
of the World Road and a new 1200± foot long gravel drive is to be
constructed. Utilities will be extended underground along the new
access road within the access and utility easement . The proposed
project is located within the Town of Queensbury, a town which
administers an Agency-approved Local Land Use program.
Location of Project: Top of the World Road
Warren County: Town of Queensbury
Land Use Area: Rural Use
Tax Map# : Section: 265 Block: 1 Parcel: 52
Section: 252 Block: 1 Parcel : 5. 1 & 6
Dear Ms . Pomponio and Mr. Lusk:
The Adirondack Park Agency recently received your permit
application which provided important information regarding your
proposed project . After reviewing this information, we have
determined that your application is incomplete. Attached is a
list of information required for a complete application. This
information is necessary to help staff fully understand the
proposed project and to enable the Agency to make the
determinations required to meet the applicable criteria for
issuance of a permit .
• Please be aware that the project review period established by law
will not begin until the Agency has received all of the requested
information identified on the attached list and has mailed to you
P.O. Box 99 • NYS Route 86• Ray Brook,NY 12977 •Tel: 518 891-4050• Fax: 518 891-3938 • www.apa.ny.gov
Jared Lusk, Esq.
August 27, 2013
• Page 2 of 3
a Notice of Complete Permit Application. Do not undertake your
project until a permit has been issued by the Agency. "Undertake"
includes, but is not limited to, any construction activities, such
as excavation or other land disturbance, tree cutting, and
installation of driveways or roads, or in the case of subdivision,
the conveyance of any lots.
*This Notice is issued pursuant to Section 809 (2) (b) Adirondack
Park Agency Act and Section 572 . 7 of the Adirondack Park Agency
Rules and Regulations .
(2
�3
Dte��` Richard E. Weber III ..r
Deputy Director (Regulatory Programs)
Adirondack Park Agency
REQUESTED INFORMATION
• APA Project No. 2013-174
Please provide the information listed below. If you have any
questions regarding this Notice of Incomplete Application or the
project review process , please contact APA Environmental Program
Specialist (EPS) Virginia Yamrick who is assigned to review your
project. If the EPS has not yet been to the project site,
please contact the EPS and arrange for a site visit . Site
visits should be scheduled well in advance.
Please be advised that if you substantially change the project
at any time, the application may be deemed a "new application, "
a new review period will begin, and other information may be
required.
If you decide to withdraw the project application or postpone it
for more than six months, please inform the Agency in writing so
Agency records can be kept current and our attention can be
focused on active projects.
•
'Jared Lusk, Esq.
August 27, 2013
Page 3 of 3
• Additional Information
Based on the application materials submitted to date, we request
the following additional information to further clarify your
proposal and to enable the Agency to make the required findings
and determinations:
1 . The project site is located within the Lake George Park
Commission boundary. The application materials indicate
that you have not submitted an application to that Agency.
Please provide them with a copy of the application
materials and forward a copy of all correspondence,
determinations, or approvals issued from that Agency in
order to ensure a coordinated review.
2 . Please contact Agency staff at your earliest convenience to
arrange for a visual analysis . Please be aware the analysis
will require evaluation from Lake George, as well as from the
local roadways within a 5 mile radius of the project site.
3 . Top of the World Road is a private roadway owned by the Top
of the World Homeowners Association. Please provide the
• signature of the individual authorized on behalf of the
Association authorizing access over that portion of the
privately owned roadway.
4 . The Local Government Notice Form for the project indicates
that a Use Variance is required from the Town of Queensbury
for the proposed project. Pursuant to §574 . 6 of the
Agency' s Rules and Regulations, "the Agency will not
approve a project which has been denied a permit or which
is a prohibited use under local zoning requirements and
other local laws or ordinances". Please forward copies of
all minutes of meetings, correspondence, determinations, or
approvals issued from the Town of Queensbury.
5 . Based upon review of the site plan it is unclear why the
access road is located as proposed (Station 7+25 to 12+00) .
Please evaluate what alternative access may be available
along existing paths and/or driveways . During the site
visit, Agency staff will discuss and evaluate alternative
access to the tower site.
REW:VY: slp
•
APA Form (1b1 Public Notice Letter)
May 2004 IL= RECE� D
Adirondack
parkagency AUG 16 113
MAJOR PROJECT PUBLIC NOTICE
TOWN OF
APPLICATION RECEIVED ZONING URY
OFFICE
APA PROJECT No . 2013-174
Date: August 15, 2013
The purpose of this Notice is to inform you that the permit application
described below was received by the Adirondack Park Agency on August 12, 2013,
and to solicit any written comments you may have regarding it at this time.
When the application has been deemed complete by the Agency, another notice with
a more detailed project description will be provided to you, and you will have
another opportunity to provide written comment relevant to the Agency's review.
This notice is being sent to adjoining landowners to the project site to the
extent they were identified in the application; the Chairman of the County
Planning Board; Chairman of the Regional Planning Board, if any; the chief
elected officer, clerk and planning board chairman, if any, of the town or
village where the project is located; and the Adirondack Park Local Government
Review Board.
It is not necessary to respond to the letter unless you want to do so. If you
wish to provide written comments, mail them to Virginia Yamrick, the assigned
APA Environmental Program Specialist.
PROJECT SPONSOR, LOCATION AND DESCRIPTION
The Agency received an application on August 12 , 2013 from Cellco Partnership
d/b/a Verizon Wireless for a project proposed it The Town of Queensbury,
Warren County, on or near Lockhart Mountain Road in an area designated as
Rural Use on the Adirondack Park Land Use and Development Plan Map. The tax
map number of the property site is: Section 265, Block 1, Parcel 52 and
Section 252, Block 1, Parcels 5.1 & 6. The attached map shows the approximate
location of the project site. The Agency is currently reviewing the
application for completeness.
The project is briefly described as follows :
Subdivision into sites for the construction and operation of a new 86 foot
telecommunications tower with associated antennas, an equipment shelter
(approximately 11 feet, 7 inches by 30 feet) , and access road improvements .
The project requires an Agency permit as it is a new major public utility use
in a Rural Use area and the structure is greater than 40 feet in height.
Date Richard E. Weber III
Deputy Director (Regulatory Programs)
REW:VY:slp
cc: Cellco Partnership d/b/a Verizon Wireless - Kathleen Pomponio
Lost Chalets LLC aka Top of the World Golf
Jared Lusk, Esq.
Adjoining Landowners
Town, County & LGRB officials
P.O.Box 99•NYS Route 86•Ray Brook, NY 12977• 518 891-4050•518 891-3938 fax •www.aoa.ny.aov
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APA Project 2013-174
��,ditaBURY
� � 742 Bay Road, Queensbury, NY 12804-5902 518-761-8201
August 13,2013 hip
Kathy Pomponio
Cellco Partners
d/b/a Verizon Wireless TOWN OF QUEENS
175 Calkins Road
Rochester,NY 14623
Jared C. Lusk
Nixon Peabody,LLP
1300 Clinton Square
Rochester,NY 14604
RE: Cellco Partnership d/b/a Verizon Wireless
Near 441 Lockhart Mountain Road—Top O'The World PUD
Tax Map Number: 265.00-1-52 (Tower Parcel);
Tax Map Numbers: Access Parcels: 252.00-1-5.2, 13.1, 11, 12, 5.1,and 15
Cellular Communications Facility with 86 ft.+/- Monopole with Shelter
Dear Ms.Pomponio and Mr. Lusk:
I am writing to you in response to your applications submitted to the Community Development
Office for the proposed project referenced above.
The property in question is located entirely within a Planned Unit Development (PUD) zoning
district within the Town of Queensbury. Within the PUD district a Telecommunications Tower
or Facility is not listed as an allowable use, therefore, a Use Variance and Site Plan Review are
required for this project.
I understand that a Major Project application has been filed with the Adirondack Park Agency.
Our office is in receipt of a copy of that application.
Since you have submitted the Use Variance and Site Plan Review applications together, as such;
this letter will serve as the necessary denial letter for the processing of your applications.
Sincerely,
M
Craig Brown,
Zoning Administrator
CB/sh
L:\Craig Brown\2013 Letters\Denial Cellco Verizon Top 0-The World 08 13_13.doc
"HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE"
SETTLED 1763
LOCAL GOVERNMENT NOTICE FORM
If your local town or village has zoning or other regulations which apply to your project, the
Adirondack Park Agency will be unable to issue a permit if the town or village has either (a)
refused to grant a necessary permit or(b) the project would be a prohibited use in that
jurisdiction.
Accordingly, the Adirondack Park Agency will not complete your permit application until you
describe your project to municipal officials and have the form below completed by a local
official and returned to the Agency.
******************************************************************************
TO: Adirondack Park Agency
FROM: Town of Queensbury
To be completed by the applicant:
Applicant Name: Cellco Partnership d/b/a Verizon Wireless
Landowner Name: Lost Chalets, LLC/Top of the World Golf Resort, Inc.
APA Project Number(if available): ---
Project site location: Town/Village: Queensbury Tax Map Number: 265.-I-52;252.-1-5.1;252.-1-15
Project type/description: Wireless Telecommunications Facility
If the project involves subdivision,please provide the appropriate local official a copy of the proposed plat as
part of the project description with the plan title and date recorded in the space provided above./
To be completed by the Town/Villa,t;e: Does the Town/Village have land use controls? r✓ Yes _RNo
If Town/Village has zoning, provide Zoning District Name(s): '(nn of L W¢((Gt Figs �1cc U14.4 IK�G
Is this"use"allowed in the zoning district(s)? _Yes /No
Is the project prohibited by any local law or ordinance? Yes V No / /JSe A�IR
E
✓ J
Is a municipal permit, variance or other approval required for this project? Permit / Variance V
I/No
(Specify: �i;1C Q�h
Has the municipality issued any decision on this project? Yes V No
Provide explanation for any decisions on this project or inconsistencies the project may have with local laws or
any continents you wish to provide to the Agency about the project:
Provide daytime telephone number if official signing this form wishes to
discuss this project with Agency staff: (
Signature of Zoning Official or Planning Board Chair(or Mayor/Supervisor if no such official exists)
Crct; 1 (ocien Zoe MAIM iS 47a✓ 7 l� 13
Name and Tit (Print) Date
• Return this form to the: Adirondack Park Ar;encv, PO Box 99, Ray Brook,NY 12977
Or fax: 518-891-3938
14541016.1
Use Variance Revised`JuunneL2009
Ce Pre-Submission Conference Form [179-4-0407 `'"
1. Tax Map ID 265.-1-52 Access Parcels: 252.-1-5.2;
2. Zoning Classification Top of the World PUD 252.-1-13.1; 252.-1-11; 252.-1-12;
252.-1-5.1; 252.-1-15
3. Reason for Review: CEO Determination
4. Zoning Section #: I 7 9- 5-- 1 3 C�
5. Pre-Submission Meeting Notes: Outstanding Items To Be Addressed Include:
Deed Yes No
Compliance with Zoning Ordinance ✓Yes No
General Information complete ,,Yes No /�
Site Development Data Complete V Yes No. `c.0'-'
Setback Requirements Complete Yes No StCkS' t.r�CC��
Additional Project Information Complete ,/ Yes No
Checklist items addressed V.Yes No � �7reOe
Environmental Form completed 7-7,06-1- Yes No4P —Pn+,r• n
Signature Page completed Yes No
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Staff Representative: - L CZ t 'c,' '~
i
Applicant/Agent:
Date: • 7
•
6
Town of Queensbury•Zoning Office• 742 Bay Road • Queensbury, NY 12804 • 518-761-8238
Use Variance Revised June 2009
General Information
•ax Parcel ID Number: 265.-1-52 (Tower Parcel) Access Parcels: 252.-1-5.2; 252.-1-13.1;252.-1-11;
252.-1-12; 252.-1-5.1; 252.-1-15
Zoning District: Top of the World PUD
Detailed Description of Project [includes current & proposed use]:
Proposed Cellco Partnership d/b/a Verizon Wireless 86'+/- monopine with an 11'-7" x 30'-0" telecommunications shelter
on a concrete pad, together with other associated improvements. See the site plan package enclosed herewith.
Location of project:
Near 441 Lockhart Mountain Road; Lake George, NY 12845
Applicant Name: I Cellco Partnership Address: 175 Calkins Road, Rochester. NY
d/b/a Verizon Wireless 14623
Home Phone Cell:
Work Phone (585) 321-5435- Kathy Pomponio FaX
E Mail: Kathy.Pomponio @Verizonwireless.com
j
I
Agent's Name: Nixon` Peabody LLP, Jared C. Lusk, Address: 1300 Clinton Square, Rochester, NY
Esq. 14604
Home Phone Cell:
Work Phone Fax
(585) 263-1140 (866) 402-1491
E-mail jlusk @nixonpeabody.com
Owner's Name Lost Chalets, LLC Address 441 Lockhart Mountain Road, Lake
George, NY 12845
Home Phone Cell
Work Phone Fax
(518)668-3000
E-mail
•
2
Town of Queensbury•Zoning Office• 742 Bay Road • Queensbury, NY 12804 • 518-761-8238
14550547.1
NIXON PEABODYLLP
• 1300 Clinton Square RECEIVED
Rochester, New York 14604
(585)263-1000 AUG 12 2013
Fax: (585)263-1600
Jared C. Lusk TOWN OF QUEENSBURY
Direct Dial: (585)263-1140 ZONING OFFICE
Direct Fax: (866)402-1491
E-Mail: jlusk @nixonpeabody.com
August 9, 2013
VIA FEDERAL EXPRESS
Craig Brown 1SE VARIANCE NO.
Zoning Administrator G SIGN
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
RE: Application for a Use Variance from the Zoning Board of Appeals and
• Site Plan Approval from the Planning Board (along with a Freshwater
Wetlands Permit and Stormwater Management Permit) by Cellco
Partnership d/b/a Verizon Wireless, to Construct and Operate an 86'
Wireless Telecommunications Facility (with an Additional 5' of RF
Transparent Pine Branches) Near 441 Lockhart Mountain Road on Lands
Owned by Lost Chalets, LLC (Tax Parcel No. 265.-1-52) in the Town of
Queensbury, New York(Verizon Wireless' "Pilot Knob" site)
Dear Craig:
Cellco Partnership d/b/a Verizon Wireless ("Verizon Wireless"), is a public utility and
wireless telecommunications licensee of the Federal Communications Commission("FCC"). To
provide adequate wireless service in and around the northeast portion of the Town of
Queensbury (the "Town"), Verizon Wireless proposes to construct and operate a wireless
telecommunications facility on property located near 441 Lockhart Mountain Road in the Town
(the "Site").
The Site consists of an approximately 100' x 100' leased portion of a 670.88 acre parcel
of land owned by Lost Chalets, LLC (Tax Parcel No. 265.-1-52) with access over Tax Parcel
Nos. 252.-1-5.2; 252.-1-13.1; 252.-1-11; 252.-1-12 (which are all subject to a pre-existing
recorded access easement (Liber 672, Page 348)) and Tax Parcel Nos. 252.-1-5.1 and 252.-1-15.
The facility will consist of a 86' "monopine" (with an additional 5' of RF transparent pine
branches) and wireless communications antennas, a 11'-7"x 30' equipment shelter, together
• with other site improvements, all as shown on the enclosed site plan prepared by Costich
Engineering, P.C.
14514758.1
WWW. NIXONPEABOD'Y.COt,1
V
• Craig Brown
•
August 9, 2013
Page 2
The Site is located in the Town's Top of the World PUD zoning district. Since wireless
telecommunications towers are not permitted in the Top of the World PUD zoning district(see
Town Code §179-5-130(C)), a Use Variance from the Zoning Board of Appeals is required. If
the Zoning Board of Appeals grants Verizon Wireless' request for a Use Variance, Site Plan
Approval by the Planning Board will also be required(see Town Code § 179-5-130(F)).1 In
addition, application forms for a Freshwater Wetlands Permit and Stormwater Management
Permit have been included in this application booklet. A Major Project application is being
simultaneously filed with the Adirondack Park Agency (a copy of which is enclosed herewith).
Please accept this letter and the following exhibits and enclosures as Verizon Wireless'
Application for a Use Variance, Site Plan Approval, Freshwater Wetlands Permit, and
Stormwater Management Permit(the"Application"):
Exhibit A: Completed, Town-supplied application forms for(1) a Use Variance, (2)
Site Plan Approval, (3) a Freshwater Wetlands Permit, and(4)a
Stormwater Management Permit2;
Exhibit B: Project description;
• Exhibit C: Applicable legal standards;
Exhibit D: Compliance with the Town's Telecommunications Tower Ordinance and
general Site Plan Review submission requirements;
Exhibit E: Compliance with the Town's Use Variance standards;
Exhibit F: Site Selection/Design Analysis containing a Radio Frequency("RF")
Analysis, Propagation Studies, and Justification for the Proposed Antenna
Design;
Exhibit G: FCC Licenses;
Exhibit H: Copy of Lease and access easement agreement;
Exhibit I: Full environmental assessment form ("EAF")3;
Exhibit J: Proof of intermunicipal notification;
1 Despite numerous attempts,Verizon Wireless has been unable to determine whether there are any additional
bulk/area requirements applicable to the Project within the Top of the World PUD. Proposed setbacks are set
forth on sheet CA100 of the enclosed Site Plan. Should it later be determined that additional zoning
approvals/variances are required,please allow this application to serve as the application for same.
'' As detailed in the enclosed letter from Costich Engineering and as discussed at the pre-application meeting held
• on August 7,2013,the Project Engineers and continuing to gather the site data necessary to complete the
Stormwater Management Permit application form and will submit same to the Town in early September.
3 A visual addendum will be submitted upon completion of the required balloon flys,the scheduling of which is to
be coordinated with both the Town and the APA.
14514758.1
NIXON PEABODY LLP
• Craig Brown
August 9, 2013
Page 3
Exhibit K: Verizon Wireless' co-location policy;
Exhibit L: Tower removal letter;
Exhibit M: Deed to the landowners' properties;
Exhibit N: Preliminary topographical viewshed analysis;
Exhibit 0: EME letter;
Exhibit P: Proof of compliance with applicable FAA Notice Requirements;
Exhibit Q: Landowners' consent letters; and
Exhibit R: 11 x 17 copy of Project Site Plan.
• Six (6) copies of the Site Plans for the Project prepared by Costich Engineering, P.C.
III • Thirty(30) copies of this Application.
• $800 payable to the Town for the Use Variance, Site Plan Approval, Freshwater
Wetlands Permit, Stormwater Management Permit, and Telecommunications Tower
Application fees.
Because this facility is located within the Adirondack Park, the Town must refer this
application to the Warren County Planning Board pursuant to General Municipal Law §239-m.
An extra copy of this Application has been included for such referral.
We respectfully request that the Application be placed on the September 24 and 25, 2013
meeting agendas for the Planning Board and Zoning Board of Appeals.
Please do not hesitate to contact me if you have any questions or need any additional
information.
Thank you.
-ry trul yours,
4-(d'C. Lusk
JCL/las
• Enclosures
cc: Kathy Pomponio (w/ enc.)
Sara Colman(w/enc.)
14514758.1
NIXON PEABODY LLP
Use Variance Revised June 2009
USE VARIANCE APPLICATION
41102EVIEW PROCESS
1. Required Pre-Submission meeting with staff to determine general completeness to be held no later
than 1 week prior to deadline day. Call (518) 761-8238 for appointment.
2. Submittal of complete application: 1 original & 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. Incomplete applications will not be considered for placement on any agenda until all missing information
has been supplied.
5. Submittal to the Warren County Planning Board, if applicable.
6. Zoning Board meeting, generally the third and fourth Wednesday 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
plans/drawings must be provided for the next phase of review. If your application was denied your
project cannot proceed as submitted.
•OCUMENTATION REQUIREMENTS:
Please submit 1 original and 14 copies of the completed application package to include:
• Completed Application: pages 1-9 completed, signed & dated
• Pre-Submission Meeting Notes: signed by staff
• Denial Letter: from the Zoning Administrator
• Waiver Request: any request for a waiver from the applicant regarding submission requirements.
• Copy of Deed
• Survey: stamped, dated & signed
• Fee
ZONING STAFF & CONTACT INFORMATION
Craig Brown, Zoning Administrator craigb ,gueensbury.net
Laura Moore, Land Use Planner Imoore(?queensbury.net
Sue Hemingway, Office Specialist (518) 761-8238
Visit our website at www.queensbury.net for further information and forms.
0
Town of Queensbury• Zoning Office• 742 Bay Road • Queensbury. NY 12804 • 518-761-8238
Use Variance Revised June 2009
Pre-Submission Conference Form 1179-4-0401
1. Tax Map 1D 265.-1 52 Access Parcels: 252.-1-5.2;
2. Zoning Classification Top of the World PUD 252.-1-13.1; 252.-1-11; 252.-1-12;
252.-1-5.1: 252.-1-15
3. Reason for Review: CEO Determination
4. Zoning Section #: 1 2 - S' 1 ' 0
5. Pre-Submission Meeting Notes; Outstanding Items To Be Addressed Include:
Deed Yes No
Compliance with Zoning Ordinance .-- Yes No
General Information complete ✓Yes No 49^ (
�
Site Development Data Complete ✓Yes No
Setback Requirements Complete Yes Nor-
5t4 ck5,TA..12COLe
Additional Project Information Complete ✓Yes No
Checklist items addressed _ ✓Yes No an �� J
Environmental Form completed T./PO- Yes 7 NoAP'-env``
Signature Page completed Yes No
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Staff Representative: J CL- —
Applicant/Agent:
Date: 1
•
6
Town of Queensbury•Zoning Office• 742 Bay Road•Queensbury, NY 12804•518-761-8238
.4111 COMPLIANCE WITH ZONING ORDINANCE Use Variance Revised June 2009
1) The Statutes describe a Use Variance to mean the authorization by the Zoning Board of Appeals
for the use of land for a purpose which is otherwise not allowed or is prohibited by the applicable
zoning regulations.
2) In deciding a request for a Use Variance the Zoning Board of Appeals [ZBA] may not grant a Use
Variance without a showing by the applicant that the applicable zoning regulations and
restrictions have caused an unnecessary hardship. In order to prove such hardship, the applicant
must prove for each and every use permitted under the regulations for the applicable zoning
district that:
a. The applicant cannot realize a reasonable return, provided that return is substantial as
demonstrated by competent financial evidence.
b. The alleged hardship relating to the property in question is unique, and does not apply to a
substantial portion of the district or neighborhood.
c. That the requested Use Variance, if granted will not alter the essential character of the
neighborhood
d. That the alleged hardship has not been self created.
1
Town of Queensbury •Zoning Office• 742 Bay Road • Queensbury, NY 12804 • 518-761-8238
Use Variance Revised June 2009
General Information
•ax Parcel ID Number: 265.-1-52 (Tower Parcel) Access Parcels: 252.-1-5.2; 252.-1-13.1;252.-1-11;
252.-1-12;252.-1-5.1;252.-1-15
Zoning District: Top of the World PUD
Detailed Description of Project [includes current &proposed use]:
Proposed Celico Partnership d/b/a Verizon Wireless 86'+/- monopine with an 11'-7" x 30'-0"telecommunications shelter
on a concrete pad, together with other associated improvements. See the site plan package enclosed herewith.
Location of project:
Near 441 Lockhart Mountain Road, Lake George, NY 12845
Applicant Name: Cellco Partnership Address: 175 Calkins Road, Rochester, NY
d/b/a Verizon Wireless 14623
Home Phone Cell:
kMail:ork Phone (585) 321-5435 Kathy Pomponio FaX
Kathy.Pomponio @Verizonwireless.com
Agent's Name: Nixon Peabody LLP,Jared C. Lusk, Address: 1300 Clinton Square, Rochester, NY
Esq. 14604
Home Phone Cell:
Work Phone (585) 263-1140 Fax (866)402-1491
E-mail jlusk @nixonpeabody.com
Owner's Name Lost Chalets, LLC Address 441 Lockhart Mountain Road, Lake
George, NY 12845
Home Phone Cell
Work Phone Fax
(518)668-3000
E-mail
II
2
Town of Queensbury•Zoning Office • 742 Bay Road• Queensbury, NY 12804 • 518-761-8238
14550547.1
Use Variance Revised June 2009
Site Development Data
• Area I Type Existing sq. ft. Proposed Total sq. ft.
Addition sq. ft.
A. Building footprint ,348.2 sq.ft.(11"-7"x
N/A 30")proposed shelter 348'2
B. Detached Garage N/A
C. Accessory Structure(s) N/A
D. Paved, gravel or other hard surfaced area 16,062 sq.ft.proposed grave
g driveway and compound 16,062
E. Porches/ Decks N/A
F. Other N/A
G. Total Non-Permeable [Add A-F] 16,436.4
H. Parcel Area [43,560 sq. ft. / acre] 29,223,532.8
I. Percentage of Impermeable Area of Site [I=G/H] 0% .01%
*TBD. The setback requirements in the
Setback Requirements Top of the World PUD remain unknown.
Proposed setbacks are set forth on
• of the Site Plan.SheetcA,00
Area Required Existing Proposed
Front [1] TBD
Front [2] TBD
Shoreline TBD
Side Yard [1] TBD
Side Yard [2] TBD
Rear Yard [1] TBD
Rear Yard [2] TBD
Travel Corridor TBD
Height [max] TBD
Permeability TBD
No. of parking spaces TBD
ID
3
Town of Queensbury•Zoning Office • 742 Bay Road•Queensbury, NY 12804•518-761-8238
Use Variance Revised June 2009
Submittal of a stamped and signed SURVEY MAP depicting existing and proposed conditions shall include the items as noted
below.
1111k. GENERAL SHOWN ON
SHEET#
1 Title, Name,Address of applicant&person responsible for preparation of drawing GA001
2 Deed
GA003
3 North arrow, Tax Map ID,date prepared and scale[minimum 1In.=40 ft.] GA003
4 Boundaries of the property plotted to scale.zoning boundary GA003
5 Principal structures, accessory structures with exterior dimensions CA100 CA101
6 Site improvements incl. outdoor storage areas,driveways, parking areas. etc.: existing&proposed CA130 CA131
7 I Setbacks for all structures and improvements: existing&proposed CA100 CA101
8 ' Elevations and floor plans of all proposed and affected structures CA500
B. WATER&SEWER SHOWN ON
SHEET#
1 Project sewage disposal facilities,design details, construction details,flow rates. and number of bedrooms proposed N/A
2 Water supply [i.e. well] & septic on adjoining lots with separation distances to existing or proposed on-site water supply and N/A
septic
3 Separation distances for proposed sewage disposal system to well and water bodies N/A
4 Existing public or private water supply [well. lake, etc.]. Method of securing public or private water, location, design and N/A
construction of water supply including daily water usage
5 • Percolation test location and results N/A
o PARKING!PERMEABLE AREAS SHOWN ON
SHEET#
Number of spaces required for project including calculations and justification: existing&proposed 'N/A
2 No. of existing parking spaces, number to be removed, number to maintain and type of surfacing material[e.g.. gravel, paved] N/A
3 Provision for pedestrian and handicap access and parking: existing&proposed CA100 CA132
4 Design details of ingress,egress, loading areas and cutting: existing& proposed CA100/110/132
5 Location and character of green areas[existing and proposed], modification to green area, buffer zone to remain undisturbed CA132
6 Lighting, location and design of all existing and proposed outdoor lighting CA500
D. ADDITIONAL SITE DEVELOPMENT AND MISCELLANEOUS SHOWN ON j
SHEET#
1 On-site&adjacent watercourses,streams. rivers, lake and wetlands CA130/CA131
2 Utility/energy distribution system[gas,electric,solar,telephone]: existing&proposed N/A
3 Location, design and construction details of all existing and proposed site improvements including: drains, culverts, retaining
walls,fences,fire&emergency zones and hydrants. etc. CA100-CA130
4 Square footage of bldg. area proposed for office, manufacturing, retail sales or other commercial activities: existing & N/A
proposed
e Signage: Location, size,type,design and setback: existing&proposed
CA180-CA181
f Waiver Request: provide letter with application requesting any waivers: please reference specific items
N/A
g Commercial/Industrial Development requires submission of Landscaping, Stormwater Management, Grading&Lighting Plans
CA130-CA131
h Identification of Federal, State or County permits required for the project together with a record of application for all necessary
permits See application
•
5
Town of Queensbury •Zoning Office • 742 Bay Road • Queensbury, NY 12804 • 518-761-8238
Use Variance Revised June 2009
Additional Project Information
1. 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): N/A
3. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Program?
N/A
4. Estimated project duration: Start Date End Date
5. Estimated total cost of project:
6. Total area of land disturbance for project: 0.76+/- acres
The following information is needed by the Zoning Board of Appeals and reflects the criteria for granting a
Use Variance. Please respond to each item; use additional sheets if needed:
1 . The applicant cannot realize a reasonable return, provided that return is substantial as
demonstrated by competent financial evidence.
See Exhibit E.
2. The alleged hardship relating to the property in question is unique. and does not apply to a
substantial portion of the district or neighborhood.
See Exhibit E.
3. That the requested Use Variance, if granted will not alter the essential character of the
neighborhood
See Exhibit E.
4. That the alleged hardship has not been self created.
See Exhibit E.
Please take note:
• Responses to items 1-4, above, must be provided for review by the Zoning Board of Appeals.
• New York State Town Law 267-b requires that the Zoning Board of Appeals deny the variance
- if any one, or more of the factors listed above is NOT PROVEN.
•
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Town of Queensbury• Zoning Office• 742 Bay Road • Queensbury, NY 12804 • 518-761-8238