HomeMy WebLinkAbout20190417 ECS Psychological Medical Office Application ',FOR gEfijziEj_ia ,
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Cir'OF SARATOGA SPRINGS
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Saratoga Springs,New York I 2866
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,ufu,Tsnu Tel:5 I 8-587-3550 x.515 fax:518-580-9480 (Date received)
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ARCHITECTURAL/ HISTORIC REVIEW APPLICATION
APPLICANT(S) 'Ow applicant) ATTORNEY/AGENT
NameIVMINOL.00 CAL tz-s 4e 1°
Address ZiO CdUC4 Iiiir
iietecuz=469(2.tifkleTs ai Mk_ 6ter%6 Viai.fs.__ ___Iga
Phone 6I '569- 42E026 / se - 204 -OZ6t6
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Email .01 . - riSilirce% e -ticidslr-- - , , L. ,,....,,,*co. •Co afirictil&nectfinr. 6orri
Identify primary contact person: 'Applicant 0 Owner 0 Attorney/Agent
An applicant must be the property owner, lessee, or one with an option to lease or purchase the property in question.
Applicant's interest in premises: Erbwner 0 Lessee 0 Under option to lease or purchase
PROPERTY INFORMATION
Property Address/Location: et, C44(A) C(4 E5t- Tax Parcel #: 1(66` - 50 - 2;) - 0
(for example: /6552—4—37)
Current Zoning District:laiti Property use: 0 Residential lNon-residentialimixed-use
Type of Review: iArchitectural 0 Historic 0 Extension/modification (of current approval)
Summary description of proposed action: Ni Niel bitePli CL, CDFriCS
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Has a previous application been filed with the DRC for this property? Er(lo 0 Yes—date(s)?
-App. No.(s)?
R.vised 0U2019
APPLICATION FEE (payable to "Commissioner of Finance"):
Residential Structures (principal, accessory) $50 Non-residential I mixed-use structures (principal) $500
Residential approval—extension/mod $50 Non-residential signs, awnings, accessory structures $125
Non-residential mixed-use sketch $150 Non-residential approval—extension/mod $125
Demolition $350
A "complete" application consists of I hard co (original) ancm _ _ co of Hear° cation &ALL other
materials as required below:
New Construction Additions
'Color photographs showing site/exterior details of existing structures and adjacent properties
iiirSite plan.drawn to scale,showing existing&proposed construction,property lines&dimensions, required&proposed setbacks&lot
coverage,site features(fences,walks,trees,etc.); on no larger than 2.'xX sheet 7 smaller preferred if legibig
• releNiation'drawings showing design of all sides of existing&proposed corisiructi&—label dimerisins,colors,materials, lighting(fixture
&lamp type,wattage),etc.7 include compass bearing&scale; no larger than 2'x3'sheet—smaller permitted if legible
aFloor plans for proposed structure on sheet no larger than 2'x3'—smaller permitted if legible
0 Product literature specifications and samples of proposed materials and colors
•
= .• . •
Change in exterior building-materials (windows, doors, roof, siding, etc.), or color(in non-residential districts only)
o Color photographs showing site/exteriordetails,of existing structures and that illustrate,affected features'.
O Elevationdrawings showing all Sides of existing&proposed construction—label dimensions,colors,materials,lighting(fixture&lamp
type,wattage), etc. -include compass bearing&scale; no larger than 2'x3' sheet—smaller permitted if legible
0 Product literature,specifications and samples of proposed materials and colors
Within front yard setbacks in Historic Districts onl (Front sotbacksi UR--I &INcr-NTR=30%UR-4=25';UR-2,UR-3&NCUD-1----10')
- Installation, removal or change in material of drive-and walkways
- Installation or removal of architectural, sculptural or vegetative screening over 3' in height
- Installation of accessory utility structures or radio/satellite transmission/reception devices (more than 2'diameter)
For any of above:
O Color photographs showing site/exterior details of existing structures,and of adjacent properties
CI Site plan showing existing&proposed construction: include property lines&dimensions, required&proposed setbacks&lot
coverage,site features(fences,walks,trees,etc.) street names,compass bearing&scale; no larger than 2'x3'sheet—smaller
preferred if legible
-
0 Product literature,specifications and samples of proposed materials and colors
CI Color photographs showing site/exterior details of existing structures,and adjacent properties
o Plan showing location of proposed sign/awning structure on building/premises: no larger than 11"x17"
0 Scaled illustration of proposed sign/awning structure and lettering(front-View&profile) include all dimensions of structure; type,
dimensions and style of lettering or logo; description of colors, materials,mounting method and hardware
0 Descriptions,specifications of proposed lighting including fixture klanip type,wattage, mounting method,and location -
o Product literature,specifications and samples of proposed materials and colors
•
•
Demolition
0 Color photographs showing sitefexterior details of existing structures, and of adjacent properties
O Site plan showing existing and any proposed structures-include dimensions,setbacks, street names,compass bearing,and scale
O Written description of reasons for demolition and,in addition:
O For structures of"architectural/historical significance",demonstrate"good cause"why structure cannot be preserved
El For structures in an architectural district that might be eligible for listing on National Register of Historic Places,or for a
contributing"structure in a National Register district(contact City staff), provide plans for site development following demolition-
include a timetable and letter of credit for project completion
Telecommunication facilities
0 Color photographs showing site/existing structures, and of adjacent properties
0 Site plan showing existing and proposed structures: include dimensions,setbacks,street names,compass bearing,and scale
O Scaled illustration of proposed structures: include all dimensions; colors, materials, lighting, mounting details
El Consult Article 240-12.22 of the City's Zoning Ordinance and City staff to ensure compliance with requirements for visual impact
assessment and existing and proposed vegetative screening
Revised 0112019
Request for extension of current approval
0 Identify date of original DRC approval: Current expiration date: Org.App. No.
0 Describe why this extension is necessary and whether any significant changes have occurred either on the site or in the neighborhood.
SE IR Environmental Assessment Form
Applicants proposing the following must complete "Part l"of the SEQR Short Environmental Assessment Form (available here:
ly_t_tpv.dec.n ov/docs e tions. c_p_i_f/sRgpra artone.pd0:
-Construction or expansion of a multi-family residential structure (4 units 4-)
-Construction or expansion (exceeding 4,000 sq. ft. gross floor area)of a principal or accessory non-residential structure
-Telecommunications facility, radio antennae,satellite dishes
- Demolition
Disclosure
Does any City officer, employee or family member thereof have a financial interest(as defined by General Municipal Law
Section 809) in this application?
(E/No 0 Yes- If yes, a statement disclosing the name, residence, nature, and extent of this interest must be filed with this
application.
Certification
liwe, the property owner(s), or purchaser(s)/lessee(s) under contract, of the land in question, hereby request an appearance
before the Design Review Commission.
By the signature(s)attached hereto, liwe certify that the information provided within this application and accompanying
documentation is,to the best of my/our knowledge, true and accurate. l/we further understand that intentionally providing
false or misleading information is grounds for immediate denial of this application.
I/we hereby authorize the members of the Design Review Commission and designated City staff to enter the property
associated with this application for purposes of conducting any necessary site inspections relating to this application.
Furthermore, liwe agree to meet all requirements under Article VII for Historic Review or Article VIII for Architectural
Review of the Zoning Code of the City of Saratoga Springs.
Date---46
(applicant signature)
Date:
(applicant signature)
If applicant is not the currently the owner of the property,the current owner must also sign.
Owner Signature: Date:
Owner Signature: Date:
RGvised 01/2019
- '
FOR OFFICE USE
This aphas been reviewed by the Zoning Enforcement Officer and is being forwarded to the Commission.Signature:
Date:
Additional Comments:
_. __ . _ . - _ _ _ _ _- '_ . _ _ - _ -_. - - .
.
.
n�w=d01/2019
Short Environmental Assessment Form
Part I -Project Information
Instructions for Completing
Part 1—Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the
application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on
information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as
thoroughly as possible based on current information.
Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the
lead agency;attach additional pages as necessary to supplement any item.
Part 1—Project and Sponsor Information
Name of Action or Project:
ECS Pshycological Services
Project Location(describe,and attach a location map):
210 Church Street,Saratoga Springs NY
Brief Description of Proposed Action:
Reconstruction and expansion of existing building that was damaged by fallen tree.
Name of Applicant or Sponsor:
Telephone: 518-580-0520
ji
ECS Psychological Services
dr.christopher-sisk@ecspshycological.corn
Address:
210 Church Street
City/PO: State: Zip Code:
Saratoga Springs New York 12866
. Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that Z El
may be affected in the municipality and proceed to Part 2. If no,continue to question 2.
2. Does the proposed action require a permit,approval or funding from any other government Agency? NO YES
If Yes,list agency(s)name and permit or approval:City Planning&Zoning,City Building Permit 111
3. a.Total acreage of the site of the proposed action? 0.139 acres
b.Total acreage to be physically disturbed? 0.005 acres
c. Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 0.139 acres
_ . .
4. Check all land uses that occur on,are adjoining or near the proposed action:
5. Un Urban El Rural(non-agriculture) 0 Industrial Commercial Residential(suburban)
0 Forest El Agriculture Aquatic Other(Specify):
Parkland
Page 1 of 3
5. Is the proposed action, NO YES N/A
a. A permitted use under the zoning regulations? El El
b. Consistent with the adopted comprehensive plan? 11
El
NO YES
6. Is the proposed action consistent with the predominant character of the existing built or natural landscape?
El
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify: El El
NO YES
8. a. Will the proposed action result in a substantial increase in traffic above present levels?
PT
b. Are public transportation services available at or near the site of the proposed action?
17 :If
c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed 7 El
action?
9. Does the proposed action meet or exceed the state energy code requirements? NO YES
If the proposed action will exceed requirements,describe design features and technologies:
Fl
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water:
nn
11. Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment:
E El
12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district NO YES
which is listed on the National or State Register of Historic Places,or that has been determined by the
Commissioner of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the
State Register of Historic Places?
b.Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for El
archaeological sites on the NY State Historic Preservation Office(SHP0)archaeological site inventory?
13. a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES
wetlands or other waterbodies regulated by a federal,state or local agency?
b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody?
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:
Page 2 of 3
14. Identify the typical habitat types that occur on,or are likely to be found on the project site.Check all that apply:
El Shoreline Forest 0 Agricultural/grasslands El Early mid-successional
El Wetland 10 Urban 0 Suburban
15. Does the site of the proposed action contain any species of animal,or associated habitats,listed by the State or NO YES
Federal government as threatened or endangered?
16. Is the project site located in the 100-year flood plan'? NO gin
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17. Will the proposed action mate storm water discharge,either from point or non point sourNO YES
If Yes, El El
a. Will storm water discharges flow to adjacent properties? El
b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? 7117
If Yes,briefly describe:
18. Does the proposed action include construction or other activities that would result in the impoundment of water NO YES
or other liquids(e.g.,retention pond,waste lagoon,dam)?
If Yes,explain the purpose and size of the impoundment:
E1
19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES
management facility?
If Yes,describe:
20 Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES
completed) for hazardous waste?
If Yes,describe:
El El
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF
MY KNOWLEDGE
Applicant/sponsor/ e: Ethan Hall- itect\Agent for the Applicant Date: 5 April 2019
Signature: Title:ArchitectiAgent for the Applicant
PRINT FORM Page 3 of 3
EAF Mapper Summary Report Tuesday, April 16, 2019 12:38 PM
Disclaimer: The EAF Mapper is a screening tool intended to assist
k. :r•=2} project sponsors and reviewing agencies in preparing an environmental
x.. :- assessment form( AF).Not all questions asked in the EAF are
answered by the EAF Mapper,Additional information on any EAF
, - _ question can be obtained by consulting the EAF Workbooks. Although
the EAF Mapper provides the most up-to-date digital data available to
._ _ -- ��` -' `-1 DEC,you mayalso need to contact lc l or other data sources in order
— to obtain data not provided by the Mapper.Digital data is not a
substitute for agency determinations.
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Part 1 1 Question 7 [Critical Environmental No
Area]
Part 1 1 Question 12a [National or State ,Yes
Register of Historic Places or State Eligible
Sites]
Part 1 /Question 12b [Archeological Sites] Yes
Part 1 /Question 13a [Wetlands or Other No
Regulated 11 terbodies]
Part 1 /Question 15(Threatened or No
Endangered Animal]
Part 1 /Question 16 [100 Year Flood Plain] Digital mapping data are not available or are incomplete. Refer to EAF
Workbook.
Part 1 /Question 20 [Remediation Site] No
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Short Environmental Assessment Form - EAF Mapper Summary Report i