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Home My WebLink AboutShort Environmental Assessment Form (SEAF) Part 1, October 1, 2017Short Environmental Assessment Form Part 1 -Project ln/ormation 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 Project Location ( describe, and fttach a location map): Brief Description of Proposed Action: Telephone: ?., 7 ?-.)_/(I~ State: ii , Zip Code: l.i'. roposecl action only involve the legislative adoption of a plan, local law, ordinance, 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 governmental Agency? If Yes, list agency(s) name and permit or approval: 3.a. Total acreage of the site of the proposed action? b . Total acreage to be physically disturbed? c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? ~--:.,_ __ acres _ __,c,::;__ __ acres ~·=3_6~:k.,~· ~-acres 4. Check all land uses that occur on, adjoining and near the proposed action. D Urban ljil Rural (non-agriculture) D Industrial o Commercial Kl Residential (suburban) NO NO y: 1jil Forest ~ Agriculture o Aquatic o Other (specify): _________ _ o Parkland Page I of3 YES )< YES \ 5. Is the proposed action , NO YES NIA . a. A permitted use under the zoning regulations ? '1, b . Consistent with the adopted comprehensive plan ? >< 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ·x 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Enviro,imental Area ? NO YES If Yes , identify: X 8 . a . Will the proposed action result in a substantial increase in traffic above present levels ? NO YES )( b. Are public transportation service(s ) available at or near the site of the proposed action? X c . Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action ? !x 9 . Does the proposed action meet or exceed the state energy code requirements ? NO YES If the proposed action will ex ceed requirements , describe design features and technologies : A'A 10. Will the proposed action connect to an existing public /private water supply? NO YES If No , describe method for providing potable w ater : >q 11. Will the proposed action connect to existing wastewater utilities ? NO YES If No , describe method for providing wastewater treatment : ;x 12. a . Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? --X b . Is the proposed action located in an archeological sensiti ve area? X. 13. a. Does any portion of the site of the proposed action , or lands adjoining the proposed action, contain NO YES wetlands or other w aterbodies 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 : Y. 14. Identify the typical habitat types that occur on , or are likely to be found on the project site . Check all that apply : D Shoreline IE Forest M Agricultural/grasslands D Early mid-successional D Wetlan·d D U rban D Suburban 15. Does the site of the proposed a ction contain any species of animal, or associated h abitats, listed NO YES by the State or Federal government a s threatened or endangered ? ?< 16. Is the project site located in the 100 year flood plain? ' NO YES ! ~ 17. Will the proposed act ion create storm water discharge , either from point or non-point source s? If Yes , NO YES a. Will storm water discharges flow to adjacent properties? ONO DYES )( b . Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes , briefly describe : ONO DYES I Page 2 of3 .. ;i. 18. Does the proposed action include construction or other activities that re~lt in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain purpose and size: ________________________ _ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe : _____________________________ _ 20 . Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste? If Yes, describe:------------------------------- NO YES NO YES NO YES I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spon Signature: ---lle.:i--.!!.:.ct.-..-JJ..<rc2o1~.:.._------------- ~ ..... . . ' Page 3 of3 EAF Mapper Summary Report ,, , .. ) Danby .. ,.. , ....... Wednesday , Sept'i'J'lber 20, 2017 4:39 PM .f .... ~-- Dlsclalmer: The EAF Mapper is a screening too l intended to assist . , ..:,;:: · ·a.:Qi~nsors and reviewing agencies in preparing an en vironmental assessment form (EAF). Not all questions a sked in the EAF are answered by the EAF-,,Mapper. Additional information on any EAF question can be obtafed by consu lting the EAF Workbooks . Although -the EAF .Mapl)!3r prc;,,-ies the most up-to-date d igital data avai lable to DEC , you may alstttl8ed-to eontact loc al or other data sources in order · to obtain data not provided by the Mapper . Digital data is not a substitute for agency determinations . Ol l:W, .i r.t on ll eal To 1o t1tQ . }. .ll .. 1t¢l l S=ir:::es . C;-i , :-:=E , C:L =-:-ri~. t.,. SG S , lrterl'f':C . l>,!:?EU E:, T F. h?.Gsr>, Es r i ~-=c=", f..~E:TI , E:!"i Crir ,: ;-:-rg K~ng i , E ~ri J<:: .. :.:. E:;r i , T"sils~'i ~. tJ s crr;.lr=i::, r,GCC . ~ Sr;:rSt-=:t t·.1.si= oc,t -·i="to-.=, =r.:. tr : 31S ~: €!" C ~:""1'il.t.rit !J· ,~ _ <.olum b u !:. ..:immt p c,:.tan ;,,r-.111,,w " s~.rces .. ~'i.~~=E ~:L~~.d.it ~ZS Irr:-:~:~. 1~,C~E f.~E\T ;=, t,,?C :r . E;ri _W:)·:,F,fflf[o !\1E TI , :i r i 1>ir.s -e rg Part 1 / Question 7 [Critical Environmental Area] Part 1 / Question 12a [National Register of Historic Places] Part 1 / Question 12b [Archeological Sites] Part 1 / Question 13a [Wetlands or Other Regulated Waterbodies] Part 1 / Question 15 [Threatened or Endangered Animal] Part 1 / Question 16 [100 Year Flood Plain] Part 1 / Quest ion 20 [Remediation Site] No No No Yes -Digital mapping information on local and federal wetlands and waterbodies is known to be incomplete. Refer to EAF Workbook . Yes Digital mapping data are not available or are incomplete. Refer to EAF Workbook. No \_ . -~fA ::• ·--._,.,._ ••.•• ,• . ... .. .. ·.• . -: "' .. ~-!"' ... ---~"'~:::'- Short Environmental Assessment Form -EAF Mapper Summary Report 1