Application cont'd._1 N IXON PEABODYLLP
1300 Clinton Square
Rochester, New York 14604
(585)263-1000
Fax: (585)263-1600
Jared C. Lusk
Direct Dial: (585)263-1140
Direct Fax: (866)402-1491
E-Mail: jlusk @nixonpeabody.com AUG 1 2 2013
August 9,2013
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 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
\,v,.\ . P.IXONPEABODY_COM
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;
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 CA 100 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.
2 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.
• 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.
.1 t O -ry trul yours.
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
REVIEW 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.
DOCUMENTATION 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 Imoorequeensbury.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
COMPLIANCE WITH ZONING ORDINANCE
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
Tax 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/bla 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:
Work Phone FaX
(585)321-5435-Kathy Pomponio
E-Mail: 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
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 / 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, ravel or other hard surfaced area 16,062 sq ft proposed gravel
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 P=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
sheet CA100 of the Site Plan.
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
3
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?
NIA
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.
4
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.
A. 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 11n.=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 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 NIA
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
C. PARKING/PERMEABLE AREAS SHOWN ON
SHEET#
1 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
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 8` 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 See application
permits
5
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 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#: 17 41'" S' 13 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 5 ��^�i
Site Development Data Complete ✓Yes No� tc.. .torOte
Setback Requirements Complete Yes Nod Szc
Additional Project Information Complete Y/Yes No
Checklist items addressed ✓Yes No �n ���� J
Environmental Form completed T1PJ Yes NoAQ'4-Pnv�•
Signature Page completed :Yes No
}-Fe\r c.c` ,6c 1-12( G c--e. * Q r cz P.`o -1c/1c.- US.. ..s�t�CI-
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0�- Clc. —' -e .0 f L hf<< L. C UM(3(� CJ e?‹1,00( 4 E
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b1 c vo 1 n`/S 1 i 1 S 4 (/ r re it -r E4C, 1 e/•I..1(f�(r/U., l/i UeN, la4e ei l - &9c,01 Mce s� f J
ii�Xii ;' & Pi ca NAo,A IX c'S
Staff Representative: L) Cc- ' '
Applicant/Agent: IPMIP
Date: 11.1 7 I
6
Town of Queensbury•Zoning Office• 742 Bay Road• Queensbury, NY 12804 •518-761-8238
Use Variance Revised June 2009
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: *See authorization attached as Exhibit Q.
Designates:
As agent regarding: Variance Site Plan Subdivision
For Tax Map No.: Section Block Lot
Deed Reference: Book Page Date
OWNER SIGNATURE: DATE:
APPLICANT'S AGENT FORM:
Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party:
Applicant: Cellco Partnership d/b/a Verizon Wireless
Designates: Nixon Peabody LLP
As agent regarding: x Variance x Site Plan Subdivision
For Tax Map No.: Section Block Lot (See attached) *See cover letter.
Deed Reference: Book Page Date
APPLICANT SIGNATURE: DATE: .____rgZL3___
2.) ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design,
storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be charged
directly to the applicant. Fees for engineering review will not exceed$ 1,000 without notification to the applicant.
3.) AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein, the Owner,
Applicant, and his/her/their agent(s) hereby authorize the Zoning Board or Planning Board and Town Staff to enter the subject
properties for the purpose of reviewing the application submitted.
4.) OTHER PERMIT RESPONSIBILITIES: Other permits may be required for construction or alteration activity subsequent to approval
by the Zoning Board or Planning Board. It is the applicant's responsibility to obtain any additional permits.
5.) OFFICIAL MEETING MINUTES DISCLOSURE: It is the practice of the Community Development Department to have a designated
stenographer tape record the proceedings of meetings resulting from application, and minutes transcribed from those tapes constitutes
the official record of all proceedings.
6.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I, the undersigned, have thoroughly read and understand the
instructions for submission and agree to the submission requirements, I acknowledge no construction activities shall be commenced
prior to issuance of a valid permit. I certify that the application, plans and supporting materials are a true and complete
statement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the
approved plans and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my
agents,will obtain a certificate of occupancy as necessary. I also understand that I/we may be required to provide an as-built survey by
a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy
I have read and agree to the above.
',. k/lf ...Ala, dcr;rOA k/.'Tks ri7�/3
Si gnat ['Alp Prin Na a (Adolicantl Da signed
g r [ Cellco Partnership d/b/a Verizon Wireless,by its 7/711 3
i�i„ . - . —' "� Attorneys Nixon Peabody LLP.Jared C.Lusk.Eso. •
Si• - re [Agent] Print Name [Agent] Datersi ed
9
Town of Queensbury•Zoning Office • 742 Bay Road •Queensbury, NY 12804•518-761-8238
Site Plan Review Revised June 2009
Site Plan Review Application
Review Process:
• Initial meeting with Zoning Administrator
• Pre-submission meeting with staff is required to determine general completeness
To be held no later than 1 week prior to deadline submittal - Call (518) 761-8220 for an appointment
Application submittal: One (1) original and 14 copies of the application package with application fee
c Determination of application completeness and placement on an agenda.
Submittal to Warren County Planning Department, if applicable.
• Planning Board meetings are generally the third & fourth Tuesday of each month. You will be advised in
writing as to which meeting to attend.
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. If your
application was denied your project cannot proceed as submitted.
Documentation Requirements:
1 original & 14 copies of the completed application package with one (1) copy of deed
Fee:
$100: 0 to 10,000 sf
$250: 10,001 to 30,000 sf
$500: 30,001 to 100,000 sf
$1000: 100,000+ sf
Zoning Staff & Contact Information:
Craig Brown, Zoning Administrator craigb @queensbury.net
Laura Moore, Land Use Planner Imoore(a�queensbury.net
Pam Whiting, Office Specialist 518-761-8220 pamwqueensburv.net
Visit our website at www.queensbury.net for further information and forms
Town of Queensbury Planning Office. 742 Bay Road • Queensbury, NY 12804 • 518-761-8220 1
Site Plan Review Revised June 2009
General Information
Tax Parcel ID: 265.-1-52 (Tower Parcel) Access Parcels: 252.-1-5.2;252.-1-13.1;
252.1-1-11; 252.-1-12; 252.-1-5.1;252.-1-12
Zoning District: Top of the World PUD
Current Use: Vacant/Forested Land
Proposed Cellco Partnership 86'+/- monopine with an 11'-7" x 30'-0" telecommunications
Proposed Use:
chatter nn a rnnrrete pad with other assoriatpd improvements See site plan
Location of project: Near 441 Lockhart Mountain Road, Lake George, NY 12845
Applicant Name Cellco Partnership d/b/a Verizon Address: 175 Calkins Road, Rochester, NY
Wireless 14623
Home Phone Cell:
Work Phone Fax
(585) 321-5435 - Kathy Pomponio
E-Mail: Kathy.Pomponio @Verizonwireless.com
Agent's Name: Nixon Peabody LLP,Jared C. Lusk, Esq. Address: 1300 Clinton Square, Rochester, NY
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
Town of Queensbury Planning Office. 742 Bay Road • Queensbury, NY 12804 • 518-761-8220 2
14550736.1
Site Plan Review Revised June 2009
Site Development Data
Area /Type Existing sq. ft. Proposed Total sq. ft.
Addition sq. ft.
A. Building footprint 348.2 sq.ft. (11"-7"x
NIA 348.2
30") proposed shelter
B. Detached Garage
C. Accessory Structure(s)
D. Paved, gravel or other hard surfaced area 16,062 sq.ft.proposed gravel
driveway and compound 16,062
E. Porches/ Decks N/A
F. Other N/A
G. Total Non-Permeable [Add A-F] 16,410.2
H. Parcel Area [43,560 sq. ft. I acre] 29 223,532.8
I. Percentage of Impermeable Area of Site [1=G/H] 0% .01%
*TBD. The setback requirements in
Setback Requirements the Top of the World PUD remain
unknown. Proposed setbacks are set
forth on sheet CA100 of the Site Plan.
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
Town of Queensbury Planning Office. 742 Bay Road . Queensbury, NY 12804 • 518-761-8220 3
Site Plan Review 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?
Yes
4. Estimated project duration: Start Date TBD End Date TBD (approximately 2-3 months)
5. Estimated total cost of project: TBD
6. Total area of land disturbance for project: 0.76+1-acres
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 CM 0.3
Commercial Intensive 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.
`TBD. The applicable FAR remains unknown for the Top of
the World PUD.
Parcel Area sq. ft.
Existing Floor Area sq. ft. [see above definition]
Proposed Additional Floor Area sq. ft.
Proposed Total Floor Area sq. ft.
Total Allowable Floor Area Area x ) [see above table]
Town of Queensbury Planning Office. 742 Bay Road • Queensbury, NY 12804 • 518-761-8220 4
Site Plan Review Revised June 2009
§ 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.
F. The establishment, maintenance and operation of the proposed use will not create public hazards from traffic, traffic congestion or the parking
of vehicles and/or equipment or be otherwise detrimental to the health, safety or general welfare of persons residing or working in the
neighborhood or to the general welfare of the town. Traffic access and circulation, road intersections, road and driveway widths, and traffic
controls will be adequate.
G. Off-street parking and loading facilities will be appropriately located and arranged and sufficient to meet traffic anticipated to be generated by
the new use. The establishment of vehicle links between parking areas of adjacent properties are provided where feasible. This furthers the
Town's goal of reducing curb cuts and reducing congestion. A twenty-foot wide connection is required. If adjacent properties are either
undeveloped or previously developed without having made provision for future linkage, then a future connection must be identified and
provided for in the site plan under review for such future linkage when the time arises. The Planning Board may require proof that the
applicant has made contact with adjacent property owners for purposes of coordinating linkages with adjacent properties.
H. The project shall not have an undue adverse impact upon the natural, scenic,aesthetic.ecological,wildlife, historic, recreational or open space
resources of the town or the Adirondack Park or upon the adequate provision of supporting facilities and services made necessary by the
project, taking into account the commercial, industrial. residential, recreational or other benefits that might be derived from the project. In
making the determination hereunder. the Planning Board shall consider those factors pertinent to the project contained in the development
considerations set forth herein under§ 179-9-080 of this chapter, and in so doing, the Planning Board shall make a net overall evaluation of
the project in relation to the development objectives and general guidelines set forth in§ 179-9-080 of this Article.
I. The provision for and arrangement of pedestrian traffic access and circulation.walkway structures, control of intersections with vehicular traffic
and overall pedestrian convenience shall be safe and adequate for pedestrian movement. Pedestrian connections between adjacent sites
shall be provided to encourage pedestrian use.
J. Stormwater drainage facilities will prevent an increase of post development drainage flows as compared to pre-development drainage flows.
Drainage of the site shall recharge ground water to the extent practical. Surface waters flowing off-site shall not degrade any streams or •
adversely affect drainage on adjacent properties or public roads. Facilities shall be in conformance with the drainage standards of Chapter
147 of the Town Code and the Town of Queensbury Subdivision Regulations where applicable.
K. The water supply and sewage disposal facilities will be adequate and will meet all applicable and current requirements set forth by Department
of Health regulations and Chapter 136 of the Town Code.
L. The adequacy, type and arrangement of trees, shrubs and other suitable plantings, landscaping and screening shall effectively provide a
visual and/or noise buffer between the applicants and adjoining lands. including the maximum retention of existing vegetation and •
maintenance, including replacement of dead or deceased plants.
M. Fire lanes,emergency zones, and fire hydrants will be adequate and meet the needs and requirements of emergency service providers.
N. The design of structures, roadways and landscaping in areas susceptible to ponding, flooding and/or erosion will minimize or avoid such
impacts to the maximum extent practicable.
0. The site plan conforms to the design standards. landscaping standards and performance standards of this chapter.
Town of Queensbury Planning Office. 742 Bay Road ' Queensbury, NY 12804 ' 518-761-8220 5
Site Plan Review Revised June 2009
§ 179-9-050 Application for Site Plan Review
Application for site plan approval shall be made to the Planning Board using forms supplied by the Board. Application materials and the
site plan shall include sufficient information for the Board to make its findings under§ 179-9-070 and 179-9-080 below. In determining
the content of the site plan and supporting documentation, the Planning Board may waive certain requirements if the Planning Board
deems such requirements or information unnecessary for the type of project proposed. Any such waiver shall be made in writing, and
shall contain statements of the reasons why the waived information requirements are not necessary for an informed review under the
circumstances. The Planning Board may grant such waivers on its own initiative or at the written request of an applicant. Such request
shall set forth the specific requirements that are requested to be waived and the reasons for the requested waiver. Absent any waiver
or waivers, an application for Site Plan Review shall include the following:
Shown
REQUIREMENTS on Sheet
A A vicinity map drawn at the scale that shows the relationship of the proposal to existing community facilities which affect or serve it. GA001-
such as roads, shopping areas, schools, etc. The map shall also show all properties, identify owners, subdivisions. streets, and GA003
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 CA100-
i appropriate, on standard 24" x 36" sheets, with continuation on 8%" x 11" sheets as necessary for written information. The CA131
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. CA100
D Name and address of the owner of record.developer, and seal of the engineer, architect,or landscape architect. If the applicant is
not the record owner, a letter of authorization shall be required from the owner GA001
E The location and use of all existing and proposed structures within the property, including all dimensions of height and floor area. all CA100-
exterior entrances.and all anticipated future additions and alterations. CA101
F The location of all present and proposed public and private ways, off-street parking areas, driveways, outdoor storage areas, CA100 -
sidewalks, ramps, curbs, paths. landscaping, walls, and fences. Location, type, and screening details for all waste disposal CA101
containers shall also be shown.
G The location, height, intensity, and bulb type(sodium, incandescent,etc.) of all external lighting fixtures. The direction of illumination
and methods to eliminate glare onto adjoining properties must also be shown in compliance with§179-6-020. CA500
H The location, height. size. materials, and design of all proposed signs. N/A
I The location of all present and proposed utility systems including: CA100-
1. Sewage or septic system; CA101
2. Water supply system:
3. Telephone,cable, and electrical systems; and
4. Storm drainage system including existing and proposed drain lines, culverts, catch basins, headwalls, endwalls, hydrants,
manholes,and drainage swales.
J Plans to prevent the pollution of surface or groundwater, erosion of soil both during and after construction, excessive runoff, and No
flooding of other properties, as applicable. A Stormwater Pollution Prevention Plan (SWPPP) for all land development activities SWPPP
(excluding agricultural activities) on the site that results in land disturbance of 1-acre or more. A SWPPP shall comply with the CA130-
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 CA131
land disturbance of less than 1-acre.
K Existing and proposed topography at two-foot contour intervals, or such other contour interval as the Planning Board shall allow. All CA 110
elevations shall refer to the nearest United States Coastal and Geodetic Bench Mark. If any portion of the parcel is within the 100- CA 130
year floodplain, the area will be shown, and base flood elevations given. Areas shall be indicated within the proposed site and within CA 131
50 feet of the proposed site where soil removal or filling is required,showing the approximate volume in cubic yards.
i
L A landscape plan showing all existing natural land features that may influence the design of the proposed use such as rock outcrops, No land-
stands of trees, single trees eight or more inches in diameter, forest cover, and water sources, and all proposed changes to these scaping
features including sizes and types of plants. Water sources include ponds. lakes, wetlands and watercourses, aquifers. flood plains, sheet CA
and drainage retention areas. 100-CA1311
M Land Use District boundaries within 500 feet of the site's perimeter shall be drawn and identified on the site plan. as well as any
Overlay Districts that apply to the property. GA003
Town of Queensbury Planning Office. 742 Bay Road • Queensbury, NY 12804 • 518-761-8220 6
Site Plan Review Revised June 2009
N Traffic flow patterns within the site. entrances and exits, and loading and unloading areas, as well as curb cuts on the site and within N/A-
100 feet of the site. The Planning Board may. at its discretion. require a detailed traffic study for large developments or for those in unmanned
heavy traffic areas,which shall include: site
1. The projected number of motor vehicle trips to enter or leave the site. estimated for weekly and annual peak hour traffic
levels;
2. The projected traffic flow pattern including vehicular movements at all major intersections likely to be affected by the
proposed use of the site:
3. The impact of this traffic on levels of service on abutting public streets and at affected intersections. Existing and proposed
weekly and annual peak hour traffic levels and road capacity levels shall also be given.
O For new construction or alterations to any structure, a table containing the following information shall be included: N/A
1. Estimated area of structure to be used for particular purposes such as retail operation, office,storage,etc.;
2. Estimated maximum number of employees;
3. Maximum seating capacity,where applicable; and
4. Number of parking spaces existing and required for the intended use.
P 1. Floor Plans. CA500
2. Elevations at a scale of one-quarter inch equals one foot(114"= 1 foot)for all exterior facades of the proposed structure(s) and/or
alterations to or expansions of existing facades,showing design features and indicating the type and color of materials to be used.
Q Soil logs, water supply well and percolation test results, and storm runoff calculations, as needed to determine and mitigate project N/A
impacts.
R Plans for disposal of construction and demolition waste,either on-site or at an approved disposal facility. N/A
S Plans for snow removal, including location(s)of on-site snow storage. N/A
T An Environmental Assessment Form("EAF"), as required by the SEQRA regulations,with Part 1 completed by the Applicant shall be v-
submitted as part of the application. If the proposed project requires a special use permit and an EAF has been submitted in separate
conjunction with a special use permit application,a duplicate EAF is not required for the site plan application.. document
U If an application is for a parcel or parcels on which more than one use is proposed,the applicant may submit a single application for
all such uses provided the proposed uses are accurately delineated on a site plan drawn pursuant to the requirements set forth The project
above. The Planning Board may grant the application with respect to some proposed uses and not others. For purposes of will comply
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 -separate
Town's Comprehensive Plan. document
Town of Queensbury Planning Office. 742 Bay Road • Queensbury. NY 12804 • 518-761-8220 7
Site Plan Review Revised June 2009
Pre-Submission Conference Form f179-4-0401 Access Parcels: 252.-1-5.2; 252.-1-13.1;
252.1-1-11; 252.-1-12;252.-1-5.1;
1. Tax Map ID 265.-1-52 .252.-1-12
Top of World PUD
2. Zoning Classification
3. Code Reference for Review: 179-5-120(F)
4. Ordinance Reference#: (1 e,,...) ('e \`6,..,`)€
5. Pre-Submission Meeting Notes; Outstanding Items To Be Addressed Include:
Deed L7Yes No
General Information complete VYes No
Site Development Data Complete i/Yes No /
Setback Requirements Complete Yes ✓No�CS ks t� P�
Additional Project Information Complete Yes ._,-No, a r— T7
*Coverage under DEC SWPPP Program Yes It-/fr NovAaec l ac 1--e- a
FAR Worksheet complete Yes No Iu r- r•et.'e'eCfr-e
Standards addressed iYes No x4....h.1-4 I
Checklist items addressed t-' Yes No
Environmental Form completed IIpe. A ems` e.�d.•v^" "Nferd fe-'"" No
Signature Page completed ._41/ Yes ✓Jo2feed&(gAct4"(-
AP kcC �( Q ce �� A---o C �"L.--�C' 51 (lCA
F ) Q, 12Q0- >e.teGt 4 P p<<c-c c c- i .F--r'cc c ci `� ea YG4o
479C nA c,&-)c.4e C ? `('D c rYtc&+\O n r
L Qu O'iv�cje C
A, S,),), ,, °LQ cs c Ft>esJ4LU( c ,-)-.).G.4 (cncJS r<(r1( f-
i A_Dc_)(\C tt-- d7.9 Ca v f W/ i\// 100,0 e, 010 j n,,ltit c,,Q`fk,ci
-_ (-CAA.) til Ct(-- y X11 sC S -r-ax ,fie `,-,c.,,v, r ,r t ,4,G,?
4 r l xl� t-c' fx rel/ .4ix,s r
*Applicant must provide office with Notice of Intent(NOD; SWPPP Acceptance Form, DEC letter issuing permit number;
Notice of Termination (NOT)
•
Staff Representative: v ct PSI
Applicant/Agent: IMI_
Date:
Town of Queensbury Planning Office. 742 Bay Road • Queensbury, NY 12804 • 518-761-8220 8
Site Plan Review Revised June 2009
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: See authorization attached as Exhibit Q.
Designates:
As agent regarding: Variance Site Plan Subdivision
For Tax Map No.: Section Block Lot
Deed Reference: Book Page Date
OWNER SIGNATURE: DATE:
APPLICANT'S AGENT FORM:
Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party:
Applicant: Cellco Partnership d/b/a Verizon Wireless
Designates: Nixon Peabody LLP
As agent regarding: X Variance X Site Plan Subdivision
*See cover letter.
For Tax Map No.: Section Block Lot
Deed Reference: Book Page Date
APPLICANT SIGNATURE: / DATE: 3
2.) ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design,
storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be charged
directly to the applicant. Fees for engineering review will not exceed$ 1,000 without notification to the applicant.
3.) AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein, the Owner,
Applicant, and his/her/their agent(s) hereby authorize the Zoning Board or Planning Board and Town Staff to enter the subject
properties for the purpose of reviewing the application submitted.
4.) OTHER PERMIT RESPONSIBILITIES: Other permits may be required for construction or alteration activity subsequent to approval
by the Zoning Board or Planning Board. It is the applicant's responsibility to obtain any additional permits.
5.) OFFICIAL MEETING MINUTES DISCLOSURE: It is the practice of the Community Development Department to have a designated
stenographer tape record the proceedings of meetings resulting from application, and minutes transcribed from those tapes constitutes
the official record of all proceedings.
6.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I, the undersigned, have thoroughly read and understand the
instructions for submission and agree to the submission requirements, I acknowledge no construction activities shall be commenced
prior to issuance of a valid permit. I certify that the application, plans and supporting materials are a true and complete
statement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the
approved plans and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my
agents,will obtain a certificate of occupancy as necessary. I also understand that I/we may be required to provide an as-built survey by
a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy
I have read and agree to the above. ,L 1�,t
Signat/' •• .nt Print Dame [ADDlicantl Dat si.n-d
... Calico Partnership dfi/a Verson Wireless.by its Attorney
Nixon Peabody LLP.Jared C Lusk.Eso.
Sig - re [Agent] Print Name [Agent] D. e s'•ned
Town of Queensbury Planning Office- 742 Bay Road Queensbury, NY 12804 • 518-761-8220 11