HomeMy WebLinkAbout1.8.2024 408 E. Upland SEQRShort Environmental Assessment Form
Part 1 - Project Information
Instructions for Comnletinl;
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 I 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 bclievc will be needed by or useful to the
lead agency; attach additional pages as necessary to supplement any item.
Part l — Project and Sponsor Information
Name of Action or Project:
Project Location (describe, and attach a location map): J. 11
Brief Description of Propose tion: t Y
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Name of Applicant or Sponsor:
1 P' Cst�, rs
Address: '
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Telephone: [00 T I 0-L. -5 5z Zj
E-Mail:
City/P I I State f I Zip Code:
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1. Does the proposed action only involve the legislative adoption of a plan, local law, ordin ce, NO
administrative rule, or regulation?
If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that
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
If Yes, list agency(s) name and permit or approval:
3. a. Total acreage of the site of the proposed action? 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? acres
4. Check all land uses that occur on, are adjoining or near the proposed action:
❑ Urban ❑ Rural (non -agriculture) ❑ Industrials Commercial Residential (suburban)
❑ Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify):
❑ Parkland
Nee e I o f 3
SEAF 2019
YES
0
YES
5. Is the proposed action,
a. A permitted use under the zoning regulations?
b. Consistent with the adopted comprehensive plan?
6. Is the proposed action consistent with the predominant character of the existing built or natural landscape?
NO YES
NIA
NO
YES
❑
0
7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? NO YES I
If Yes, identify:
1�1
❑
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
❑
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action?
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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:
10. Will the proposed action connect to an existing public/private water su ply?
NO
YES
If No, describe method for providing potable water-
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11. Will the proposed action connect to existing wastewater utilities? j
NO
YES
If No, describe method for providing wastewater treatment: t "�
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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 I listoric 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 it, located in
❑
project site, or any portion of or adjacent to an area designated as sensitive for
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, identity the wetland or waterbody and extent of alterations in square feet or acres:
gage' of3
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 Urban P6uburban
15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or
Federal government as threatened or endangered?
16. Is the project site located in the 100-year flood plan?
17. Will the proposed action create storm water discharge, either from point or non -point sources?
If Yes,
a. Will storm water discharges flow to adjacent properties?
b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)?
If Yes, briefly describe:
18. Does the proposed action include construction or other activities that would result in the impoundment of water
or other liquids (e.g., retention pond, waste lagoon, dam)?
If Yes, explain the purpose and size of the impoundment:
NO YES
0D
NO YES
0 ❑1
NO YES
19
M
YES
r: ■
.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: � ❑
1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF
MY KNOWLEDGE` r /
Applicant/sponsor/name: �r rslL l / Date:
Signature: 1 Title:
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