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HomeMy WebLinkAboutShort Environmental Assessmant Short Environmental Assessment Form Part 1-Project Information Instructions for Comnletinv Part I—Project Information.The applicant or project sponsor is responsible for the completion of Part 1.Responses become part ofthe 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 Pan I.You may also provide any additional information you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part i—Project and Sponsor Information Name of Action or Project: Project Location(describe,and attach a location map): oV5-1 $ Brief Description ufProposed Action: SpCtk 14-3 acres 'tom 3 Se�TaYa�t Qo�ce i s Name ofAppllicant/or�Sponso_dr. Telephone: &67- i• tell I 1 E-Mail: Address: as /< City/PO: Slate: Zip Code: f488 1. Does the p used action only involve the legislative adoption ofa plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description ofthe intent ofthe 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. Dom 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: Rr ❑ 3. a.Total acreage ofthe site ofthe proposed action? ILI. '7t acres It.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: M Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial Residential(suburban) ❑ Forest ® Agriculture ❑ Aquatic ❑ Other(Speeify): ❑Parkland Page 1 of 3 SEPF 2M 5. Is the proposed action, NO YES N/A 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 ❑ JR 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: z ❑ YES R. a. Will the proposed action result in a substantial increase in traffic above present levels? © Elb. Are public transportation services available at or near the site of the proposed action? ® ❑ c. Arc 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 requirenieniO NO YES If the proposed action will exceed requirements,describe design features and technologies: s� 1-112SI 10,Will the proposed action connect to anexisting public/private water supply? NO YES If No,describe method for providing potable water: ❑ Ef 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 12,a.hoes the project site counts,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 die project site,or any portion of it,located in or adjacent to an area designated as sensitive for ❑ archaeological sites on the NY State I Iistoric 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,sure or local agency? ❑ IZI b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? Pull ❑ If Yes,identify the wetland or waterbody and extent ofalterations in square feet or acres: LV Page 2 of 3 SERF 2026 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 ❑ Suburban 15.Does the site ofthe proposed action contain any species ofanimal,or associated habitats,listed by the State or NO YES Federal government a threatened or endangered? In/ ❑ 16. Is the projoct site located in the 100-year or 500-year Rood plain? NO YES 0 ❑ 17. Will the proposed action create storm waterdischarge,either from point or non-point NO YES sources?IfYes, [0 ❑ a. Will storm water discharges Row to adjacent properties? ❑ ❑ b. Will storm water discharges be directed to established conveyance systems(mnoffand storm drains)? ❑ IfYes,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 sin of the impoundment: ❑ 19.1las 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 remedietion(ongoing or NO YES completed)for hazardous waste? I fYes.describe: GD ❑ NO YES 21.Is the project located within,or within''/a mile of,a disadvantaged community? ❑ If No,could impacts from the project affect a disadvantaged community? —_I If Yes to either question in 21,answer the tollowing question. a. Identify the potential pollution impacts ofthe project,either direct or indirect,that may occur within the disadvantaged earn munity(e.g.,wastewater discharges,air emissions,noise,odors,solid or ba2nrdous waste generation or management): I CERTIFVTHAT THE INFORMATION PROVIDED ABOVE ISTRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE n t I Applicam/sponsor/mom -(�IYI f� Date, Sigma Title: ��P.Y' Page 3 of 3 SW 2026