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Permit Process I Building Permit Application I Roof Replacement Application
Upload Application Documents I Applicant's Signature
Determination (To be filled by Code Officer) I
Submission Date
5/17/2023
Contact Information
Primary Contact*
Will receive emailed instructions after form submission
owner
Submitter's Email Address*
adamscornerscafe@gmail.com
Landowner Last Name* Landowner First Name*
Ciaschi
Landowner Phone Number*
607-279-3039
LAI 05 am],
Name of Contractor*
Enter name of landowner if landowner is doing the work themselves
Tim Ciaschi
Contractor Phone Number
607-279-3039
V
Project Address
Need help finding your Tax Map #?
Click this link to search for it:
Tape Map # of Project Property* htt 1/ ro ert .tom kins-
p� i? P Y P
10.-4-1.2 go.org/iMO/searc,h.aspx
Street Number
Street Number
903
please enter as a 4 digit number i.e. 1 would be 0001
Street Name
Street Name
Hanshaw Road
Address Line 2
city State
Ithaca NY
Is the Project Address the same as the Landowner's Address?
Yes
0 No
Type of Property Use
Commercial
v
v
Description ofWork
Expanding the seating i my caf6
Don't forget to upload the Workers Compensation form or signed CE-200 Exemption form at the end of this application!
https://www.wcb.ny.gov/icexempt/index.jsp
Your application can NOT be processed without this form!
Project Square Footage Cost Estimate
Building permit fees vary depending on the type Of construction (Residential, Commercial, New, Renovobono,
Accessory Building, etol To estimate the fee, you may view the new Village of Cayuga Heights Zoning Fee Schedule
atthe following link:
htbp:/hxxxowcayuga-heightsoy'ue/Text�/2OandY620PDFo/Fomne/Bui|ding_end Zonino Fae @chedu|e.pdf
The Code Enforcement Officer will review this application and you will be notified of the final fee.
Previous I
Comments 2000 characters left
Brent Gross
From: Adam.ciaschi@mail.com on behalf of Adam Ciaschi <adam.ciaschi@mail.com>
Sent: Monday, May 22, 2023 12:55 PM
To: Brent Cross
Subject: Seating
AdamsCorners cafe has a goal of expanding into the next empty space at community corners. The purpose, for this is to
have more room for my existing customers to sit, particularly during their lunch hour when we are at our busiest. Storage
is also motivating factor for this project as i am running out of space for dry storage items and other items.
Short Environmental Assessment Form
Part I - Project Information
Instructions for Comnletinng
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 Informati
N�tion or Project:
- 1 er,-1- �oUe_
Project Location (deserme, and a ch a location map):
Brief Description of Propo e Action:
Je'A" r/`_>_
e'K rid
Name of Applicant or Sponsor:
6 '.C."C
Address-
909 1 r, PVC't'xµ-ef rc)
l ^ -J"v eX. -►-ram
Telephone: Gv-�
E-Mail: C,,r
City/PO: stag: �✓ 1 L1 b
1. 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
be in
F1� ❑
t
may affected the municipality and proceed to Part 2. If no, continue to question 2.
I
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:
I I ❑
3. a. Total acreage of the site of the proposed action? l7 acres
b. Total acreage to be physically disturbed? ,., acres
c. Total acreage (project site and any contiguous properties) owned
or controlled by the applicant or project sponsor? 'IT acres
4. Check all land uses that occur on, are adjoining or near the proposed action:
0 Urban [] Rural (non -agriculture) ❑ Industrial Commercial ❑ Residential (suburban)
❑ Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify):
❑ Parkland
D ' c 1 of 3 SEAF 2019
5. Is the proposed action, I NO YES N/A
a. A permitted use under the zoning regulations? (❑ rfj ❑
b. Consistent with the adopted comprehensive plan? (❑ ( 1 ❑
NO YES
6. Is the proposed action consistent with the predominant character of the existing built or natural landscape?
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: ff ❑
8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES
b. Are public transportation services available at or near the site of the proposed action? ❑
c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed ❑
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:
❑ C_..1
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No, describe method for providing potable water:j(� �71`j�
11. Will the proposed action connect to existing wastewater utilities? NO YES
If No, describe method for providing wastewater treatment: C€�.5 t• ��
❑ l=J
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 Q ❑
archaeological sites on the NY State Historic Preservation Office (SHPO) 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:
'C 0 -
14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply:
❑Shoreline ❑ Forest ❑ Agricultural/grasslands ❑ Early mid -successional
❑ Wetland L!J Urban ❑ 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? 6 ❑
16. Is the project site located in the 100-year flood plan? NO YES
{
i' r ❑
17. Will the proposed action create storm water discharge, either from point or non -point sources? NO YES
If Yes, EI ❑
a. Will storm water discharges flow to adjacent properties? EJ ❑
b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? Er ❑
If Yes, briefly describe:
i
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:
I.9. 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 f
completed) for hazardous waste?
If Yes, describe: ❑
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF
MY KNOWLEDGE
Applicant/sponsor/name:Ado-.., t 6-(7 G V ` • Date: S �
� Signature: Title: Pw f
I PRINT FORM I Page 3 of 3
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