Design Review Board (linked)

Town of Waterford
Department of Planning and Development
www.waterfordct.org 
 
 
 
 
 
Informal Staff Review
Site Plan/Design Review
Municipal Project (CGS§8-24)
Special Permit/Design Review1
Subdivision /Resubdivision
Lot line Adjustment
Zoning Map Change
Regulation Amendment(s)
New District
Multifamily Development
Coastal Area Management 2
Earth Excavation
Flood Hazard Area
Other: ___________________
Other: ___________________
Specify all uses and corresponding section for which this application applies3:
Use:  _______________________________________
Section: ____________________________________________
Use:  _______________________________________
Section: ____________________________________________
Use:  _______________________________________
Section: ____________________________________________
Name of proposed development/subdivision: ____________________________ If subdivision how many lots?: _______
If applicable, are roadways proposed to be private, public or both: 
Private
Public
Both4
Parcel 1
Parcel 2
Map/Block/Lot:   ____/____/____    ____/____/____
Map/Block/Lot:   ____/____/____    ____/____/____
Street No. & Name:
_______________________
Street No. & Name:
_______________________ 
Size SF/AC:  ___________/___________
Size SF/AC:  ___________/___________ 
Zoning District(s): __________________
Zoning District(s): __________________
                                                          
1 Include a completed list of property owners with Parcel ID, name, address and mailing address.  It is the applicant’s responsibility to distribute all 
notices certified return receipt.  Evidence of mailing shall be submitted prior to the start of the hearing.  Failure to do so will delay the opening of the 
hearing. 
2 Coastal Site Plan reviews under Coastal Area Management §25.4 must submit a completed PZC Form 2 in addition to this PZC Form 1. 
3 The use listed must correspond to the exact use term noted within the zoning district as a permitted use allowed through site plan or special permit.
4 A plan must accompany the application clearly delineating the limits of public and private roads. 
PZC Form 1
Planning and Zoning Application
1.
Type of Application(s), Use and Property Information (check all that apply)
Office Use Only
Date Submitted:___________
Processed By:_____________  
App. No.: ________________ 
Total Fee: $_______________
Electronic Submission 
Waived:  _____Yes  _____No
Multi-Family Residential
16.1.2 (C-MF)
Existing Office
8.1.3 (C-MF)
Waterford Central Apartments
N/A
140
9191A
140
5005
61 Myrock Avenue
61A Myrock Avenue
861,808 19.78
332,142 7.62
C-MF
C-MF

Name: 
____________________________________
Applicant’s Authority to File Application5
Title:
____________________________________
Legal Owner of Record
Company:
____________________________________
Power of Attorney
Address:
____________________________________
Contract to Purchase
City/State:
________________________
__________
Other ________________________________
Zip Code:
_______________
Telephone:
_________________
Fax:
___________________
Email: ________________________
Name: 
____________________________________
Specify Nature of Agent
Title:
____________________________________
Attorney
Company:
____________________________________
Civil Engineer
Address:
____________________________________
Land Surveyor
City/State:
________________________
__________
Design Professional; ____________________
Zip Code:
_______________
Other: _______________________________
Bar/License/Reg. No.:___________________
Telephone:
_________________
Fax:
___________________
Email: ________________________
Note: If landowner is an LLC, Corporation, Trust or other legal entity, attach the names, addresses and title of each 
member or officer, including agent(s). If same as applicant list ‘Same’.
Name: 
________________________________
Name: 
________________________________
Title:
________________________________
Title:
________________________________
Company:
________________________________
Company:
________________________________
Address:
________________________________
Address:
________________________________
City/State:
________________________
______
City/State:
________________________
______
Zip Code:
_______________
Zip Code:
_______________
Telephone:
_______________
Telephone:
_______________
Fax:
_______________
Fax:
_______________
Email:
_______________
Email:
_______________
                                                          
5 Applicant must submit evidence attesting to the authority to file application (i.e. deed, option for purchase, etc.) 
2.
Applicant Information
3.
Agent Information; if applicable
4.
Property Owner(s) and Parcel(s) Information
Is owner co-applicant?       Yes        No
Kevin Daley
Manager
Sig Con Associates, LLC
#606 Post Road East #320
Westport
CT
06880
(203) 846-2501
signaturekd@gmail.com
Brandon Handfield, PE
Civil Engineer
Yantic River Consultants, LLC
191 Norwich Avenue
Lebanon
CT
06249
(860) 367-7264
brandon@yrc-ne.com
 Kevin Daley
Manager
Kevin Daley
Manager
Waterford Central LLC
61A Myrock LLC
606 Post Road East #320
606 Post Road East #320
Westport
CT
Westport
CT
06880
06880
(203) 846-2501
(203) 846-2501
signaturekd@gmail.com
signaturekd@gmail.com

Attached a typed statement of use in conformance with the Zoning Regulations as described in Section 22.4.2.  In addition 
include all hours and days of operation, size of buildings and number of stories, utilities servicing the parcel, variances 
received, number of employee and structures to be demolished. 
Attach a statement describing how the building and site design is compatible with the neighborhood, character of 
Waterford and Zoning Regulations. 
Attach a statement attesting to how the proposed use, zone change, amendment or design is consistent with the most 
recent adopted Plan of Preservation, Conservation and Development (the Plan).  Note relevant Plan section numbers and 
pages. 
Yes
No 
 
 
 
 
 
 
 
 
 
 
 
 % of Property
a.  Are inland wetlands present on site?   Total SF/AC
_____________/___________      _________ 
b.  Are tidal wetlands present on site? 
  Total SF/AC
_____________/___________      _________ 
c.  Are their known or suspected vernal pools on the property? 
 
d. CT DEEP NDDB: Are endangered, threatened or species of special concern suspected to be located on 
the property? Applicant must attach an 8 ½ x 11 map of the most current CT DEEP Natural Diversity 
Database with site clearly identified regardless of response provided. If you answered yes to item d.,
attach a letter from CT DEEP stating the name of the specie(s) that are suspected to be on the 
property. See Section 22 of the Zoning Regulations for additional information.
e.  Are floodplains or flood hazard areas on the property? 
 
Identify: ___________________________________________________________________________ 
f.  Is the property located within a local, state of national historic district?   
If yes identify district name:  ___________________________________________________________ 
g.  Does the site possess any structures or sites listed on the local, state or national register of historic 
landmarks?
If yes, identify: ______________________________________________________________________ 
8.
Natural and Cultural Resources
5.
Statement of Use
6.
Statement of Design Compatibility (Site Plans and Special Permits only)
7.
Consistency with Adopted Plan of Preservation, Conservation and Development (all 
applications) 
X
236,450
5.43
X
20
X
X
X
ZONE A
X
X

Yes 
No
a.
Is any part of the site within 500' of the Town line?  Which town: _________________________ 
b.
Will any egress or ingress for the property use streets within an adjoining municipality?
c.
Is any work proposed in wetlands or watercourses?  Explain in Statement of Use
d.
Is any work proposed within 100 feet of a wetlands or watercourse? Explain in Statement of Use
e.
Is any work proposed within a floodplain or flood hazard area? Explain in Statement of Use  
f.
Is public water available or proposed to the site?  Identify: ________________________________ 
g.
Are public sanitary sewers available or proposed to the site?  Identify: _______________________ 
h.
Is there a utility, drainage or other easement(s) on the site? Specify:_________________________ 
i.
Is open space proposed on the property?   
How much open space is proposed (SF/AC)? _________/_________    Percent of property(s)_____ 
Use and purpose of open space: ______________________________________________________ 
Have previous permits been issued for the Property:
     Yes             No
(List singularly; attached additional pages if necessary)
Date Issued  
 
Issuing Agency  
 
Approved Use/Activity 
__________ 
 
___________________  
___________________________________________________ 
__________ 
 
___________________  
___________________________________________________ 
__________ 
 
___________________  
___________________________________________________ 
__________ 
 
___________________  
___________________________________________________ 
__________ 
 
___________________  
___________________________________________________ 
9.
Additional Information
10.
Previous Land Use Permits Associated with the Property(s)
X
X
X
X
X
X
X
X
X
Willetts Ave. Ext. & 394 Willetts Ave.
Private 8" on Site
Sanitary Easement
243,500 5.59
20.2
Conservation
07/08/21
8/9/22
4/27/23
CC
C-21-06 Private Sewer Main
PZC
PL-22-11 Zone Change
CC
Determination of no Regulated Activity

Yes
No
a.
Is this application for a new zoning district and/or regulation not presently established within the 
Zoning Regulations?  If a new zoning district, distinguish type of zone proposed:
Fixed Zone
Floating Zone
Overlay Zone
Identify proposed zone name: ____________________________________________________ 
For new regulations, list proposed section number(s) and titles(s): 
i.
______________________________________________________________________ 
ii.
______________________________________________________________________ 
iii.
______________________________________________________________________ 
b.
Is this application an amendment to an existing regulation?  Attach proposed amendments, clearly 
noting any deletions, modifications or additions.  List sections proposed to be modified:
i.
______________________________________________________________________ 
ii.
______________________________________________________________________ 
iii.
______________________________________________________________________ 
c.
Is this application for a change to a district already established within the regulations?  Identify:
________________________________________________________________________________  
Supporting materials: 
For new zoning districts or a change in zone provide a legal description of the land involved in the zone district change
including the following:
x
Location map at 1”=1000’ 
x
Accurate description and acreage of tract(s) to be changed with existing buildings and uses 
x
Show existing features including but not limited to contours at two-foot intervals, wetlands and watercourses,
flood plains, all improvements and structures,   
x
All lots or parts of lots contained in an area within 500 feet in all directions of the zone change tract
x
All lots shown in this area and within the zone change tract shall contain the name and address of owners as 
recorded in the Assessor’s records and shall show the nature of use 
x
North point, and distance along road from nearest road intersection. 
x
Scale of map(s)
11.
Change of Zone, Regulation Amendment or New Zoning District, if applicable
X

Complete the following table, which must also be included on applicable drawings:
Zoning District(s): ____________
Item
Required
Proposed
Minimum Lot Size
Frontage
Front Yard
Side Yard
Rear Yard
Building Line
Building Coverage
Parking6
Landscaping
Impermeable Coverage
                                                          
6 Attach method used to determine the number of parking spaces required. 
12.
Bulk Zoning Requirements Table
C-MF
60,000
1,202,585
150
411.56
75
75.97
50
54.24
75
180.01
N/A
N/A
25%
8.2%
324
325
10% Parking Area
> 10%
N/A
23.4% (6.465 AC)

Provide a list of all professionals responsible for the project.  Additional pages attached, if necessary:
Yes             No
Discipline:
_______________________________  
Telephone:
_______________________________ 
Name:   
_______________________________  
Fax: 
 
_______________________________ 
Company:
_______________________________  
Email:  
_______________________________ 
License(s)/ 
 
 
 
 
 
 
License(s)/ 
Accreditations: _______________________________  
Accreditation No(s): ___________________________ 
Discipline:
_______________________________  
Telephone:
_______________________________ 
Name:   
_______________________________  
Fax: 
 
_______________________________ 
Company:
_______________________________  
Email:  
_______________________________ 
Licenses and/or  
 
 
 
 
 
License/
Accreditations: _______________________________  
Accreditation No(s): ___________________________ 
Discipline:
_______________________________  
Telephone:
_______________________________ 
Name:   
_______________________________  
Fax: 
 
_______________________________ 
Company:
_______________________________  
Email:  
_______________________________ 
Licenses and/or  
 
 
 
 
 
License/
Accreditations: _______________________________  
Accreditation No(s): ___________________________ 
Discipline:
_______________________________  
Telephone:
_______________________________ 
Name:   
_______________________________  
Fax: 
 
_______________________________ 
Company:
_______________________________  
Email:  
_______________________________ 
Licenses and/or  
 
 
 
 
 
License/
Accreditations: _______________________________  
Accreditation No(s): ___________________________ 
Discipline:
_______________________________  
Telephone:
_______________________________ 
Name:   
_______________________________  
Fax: 
 
_______________________________ 
Company:
_______________________________  
Email:  
_______________________________ 
Licenses and/or  
 
 
 
 
 
License/
Accreditations: _______________________________  
Accreditation No(s): ___________________________ 
13.
Planning, Design and Engineering Team
Civil Engineering
Brandon Handfield, PE
(860) 367-7264
Yantic River Consultants, LLC
brandon@yrc-ne.com
Ct Professional Engineer
24564
Architecture
John Wicko
(203) 876-0200
(203) 876-0005
John A. Wicko Architect LLC
johnwicko@jwickoarchitect.com
CT Professional Architect
04547
Land Surveying
Kevin Franklin, MS, PLS
(860) 748-6183
Franklin Surveys
kevin@franklinsurveys.com
Professional Land Surveyor
70381
Traffic Engineering
Joseph Balskus, PE, PTOE
(860) 807-4405
VHB
jbalskus@vhb.com
CT Professional Engineer
19481

Itemize, including additional attachments, all information provided in support of the application.  Titles, dates and 
sheet/map numbers shall correspond exactly with the corresponding information provided.  
Additional pages attached, if necessary:         Yes             No
____________________________________________  
____________________________________________ 
____________________________________________  
____________________________________________ 
____________________________________________  
____________________________________________ 
____________________________________________  
____________________________________________ 
____________________________________________  
____________________________________________ 
Sec. 7-159b – Pre-application review of use of property. Notwithstanding any other provision of the general statutes, 
prior to the submission of an application for use of property under chapters 124, 126, 440 and 541 or any other provision 
of the general statutes authorizing an authority, commission, department or agency of a municipality to issue a permit or 
approval for use of such property, such authority, commission, department or agency or authorized agent thereof may 
separately, jointly, or in any combination, conduct a pre-application review of a proposed project with the applicant at 
the applicant's request. Such pre-application review and any results or information obtained from it may not be appealed 
under any provision of the general statutes, and shall not be binding on the applicant or any authority, commission, 
department, agency or other official having jurisdiction to review the proposed project.  
I have read and understand the above provision of the Connecticut General Statutes and understand and agree that 
whatever discussion, comments and/or recommendations are made through this review are non-binding upon the parties.  
Further, I acknowledge and agree that this pre-application review meeting is being conducted prior to and in anticipation 
of a formal application to the Waterford Planning and Zoning Commission or Conservation Commission to obtain 
feedback and response to the proposal or design, as it exists on this date, in the interest of preparing an application 
consistent with the Subdivision, Zoning or Wetlands regulations of the Town of Waterford as the case may be.
Signature 
 
 
 
 
Printed Name  
 
 
 
Date
_______________________________  
_______________________________  
________________ 
Applicant
_______________________________  
_______________________________  
________________ 
Agent
_______________________________  
_______________________________  
________________ 
Land Owner
_______________________________  
_______________________________  
________________ 
Land Owner 
14.
Supporting Documentation
15.
For Informal Staff Review Use Only
(e) Abutter Map & List
(a) Application form
(b) Sig Con Associated Filing
(c) Application Supplement
(d) NDDB Map December 2022
(f) Traffic Impact Study
(g) Stormwater Managment Report
(h) Site Plan
(i) Architectural Elevations
Kevin Daley
Brandon Handfield, PE
5/3/23
Kevin Daley
Kevin Daley
Kevin Daley (May 3, 2023 17:16 EDT)
Kevin Daley (May 3, 2023 17:16 EDT)
Kevin Daley (May 3, 2023 17:16 EDT)
May 3, 2023
May 3, 2023
May 3, 2023

In accordance with the Waterford Code of Ordinance Chapter 16.08, the Commission may require third party technical 
assistance review for the evaluation of applications associated with but not limited to site plans, special permits, zone 
change and regulation amendments and may collect payment for costs associated with the review.  This includes but is not 
limited to civil engineering, architecture, legal assistance, traffic engineering and environmental protection.
Application Content 
The undersigned herby acknowledges that this application and statements submitted herewith are true to the best of my 
knowledge and approval of the application is contingent upon compliance with all requirements of said regulations.   
Right of Entry and Inspection
The undersigned hereby authorizes the Waterford Planning and Zoning Commission or its agents, to enter the subject 
property for the purposes of inspection and enforcement for the said Zoning Regulations until receipt of final Certificate 
of Occupancy and Certificate of Zoning Compliance. 
Electronic Data Accuracy and Transmission
If applicable, the undersigned hereby acknowledges that all electronic data submitted as part of this application is an 
accurate and true representation of all paper transmissions provided as part of this application and may be transmitted 
publically when requested and all applicable fees are paid in full by the requesting party. 
Signature 
 
 
 
 
Printed Name  
 
 
 
Date
_______________________________  
_______________________________  
________________ 
Applicant 
_______________________________  
_______________________________  
________________ 
Agent
_______________________________  
_______________________________  
________________ 
Land Owner 
_______________________________  
_______________________________  
________________ 
Land Owner 
17.
Acknowledgements; All applications
16.
Technical Assistance Review Fee
Kevin Daley
Brandon Handfield, PE
Kevin Daley
Kevin Daley
5/3/23
Kevin Daley (May 3, 2023 17:16 EDT)
Kevin Daley (May 3, 2023 17:16 EDT)
Kevin Daley (May 3, 2023 17:16 EDT)
May 3, 2023
May 3, 2023
May 3, 2023