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Application
Area Variance Revised June 2009 General Information RECEIVED Tax Parcel ID Number: 301.15-1-19 Zoning District: MDR JUL 1 t11Z Detailed Description of Project [includes current&proposed use]: TOWN ZONING QUEENSBURY CONSTRUCT A NEW 18 LOT RESIDENTIAL SUBDIVISION WITH LOTS RANGING FROM 0.58 ACRES TO 1.46 ACRES.AN AREA VARIANCE IS REQUIRED TO ALLOW RESIDENTIAL LOTS OF LESS THAN 2 ACRES WHERE PUBLIC SEWER IS NOT AVAILABLE. Location of project: SOUTH SIDE OF PEGGY ANN ROAD BETWEEN QUAIL RUN TO THE WEST AND FERRIS DRIVE TO THE EAST. I Applicant Name: Address 9 MOUNTAINSIDE DRIVE JOESPH LEUCI QUEENSBURY NY Home Phone Cell �, 796-3520 4:t N Work Phone i '_ (=a e– .L 745-5557 , 745-0028 0 N 0 E-Mail: •�' JLEUCI24 @HOTMAIL.COM co 2 o L > F, _ a — c . QVa Agent's Name (r'�es 169 HAVILAND ROAD = >' , NACE ENGINEERING g rr cn 0) 7P :, ,, <h QUEENSBURY,NY cn Home Phone ([4 •� a — ,�-., ∎—:- 796-2515 M o .. Work Phone ...-;;-•;:.-',4.:..-f.,.-..�` 745-4400 ,..,..1-;-0.,„. . : s �� 792-8511 •c N c cn CD " E-mail �� nix i � y o TCENTER36 YAHOO.COM 4 rO1r nee's Name 3 �"' o SAME AS APPLICANT , i h ` -; Home Phone K fqt Work Phone -P-7,:�: , E-mail Town of Queensbury•Zoning Office•742 Bay Road•Queensbury, NY 12804•518-761-8238 1 I ow. 4 .,. .filogA., TOWN OF QUEENSBURY IF Awl Neil lir 742 Bay Road, Queensbury, NY 12804-5902 518-761-8201 July 10,2014 Joseph Leuci 9 Mountainside Drive Queensbury,NY 12804 Re: 18 Lot Subdivision Tax Map Parcel: 301.15-1-19 Peggy Ann Road Dear Mr.Leuci: I am writing to you in order to document my review of your application materials submitted for an 18 Lot residential subdivision of the above-referenced property. I have reviewed your proposal and find that an Area Variance and Subdivision approval are necessary in order for you to proceed with your project. Specifically, the proposed subdivision calls for the creation of lots with less than the minimum area of 2 acres as required within the Moderate Density Residential; (MDR) district so, density and lot size relief are necessary. Additionally, relief is necessary from the 100 ft. minimum lot width requirement(Lot 1 does not appear to have an average width of 100 feet). Subdivision review is necessary for the creation of the lots and future Town road. I understand that you and your agent; Tom Center are in the process of completing the necessary application materials. PIease note our established submittal deadlines and the need for a pre- submission meeting prior to submitting your application materials. Should you have any further questions or comments,please do not hesitate to contact me. Sincerely, Town of Queensbury C}LD Craig Brown Zoning Administrator CB/sh Cc: Tom Center L:\Craig Brown\2014 Letters\Denial Leuci 7_10_14.doc "HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE" Sh 1 PLED 1763 Area Variance Revised June 2009 Pre-Submission Conference Form 1179-4-0401 1. Tax Map ID 301.15-1-15 2. Zoning Classification MDR Co k (eSS ` c it ��l`eS (;�.� LC ( *363 e c 3. Reason for Review: r� ti 4. Zoning Section#: M ir'( 040 Co`ec, c tecvle k 9( MU. 5. Pre-Submission Meeting Notes; Outstanding Items To Be Addressed Include: Deed Yes No General Information complete ,'Yes o Site Development Data Complete Yes t/fjlo�p,��'tY CcA�, C�� Setback Requirements Complete Yes No Additional Project Information Complete ✓Yes No FAR addressed ,VI-Yes No Compliance with Zoning Ordinance ✓Yes No Checklist items addressed Yes ✓No Environmental Form completed 1/ Yes Not. -1 j E,4F Signature Page completed Yes -7No A 11 C c/-\* pr e5 n 1 04 SL.- fvj do e,r c, 1 `--‘. `--/- c,c \-e pc cc-e( _ Q cam._ 6, ■915, ;�(9•Ac__I (,_W9U') L t_.,_DucvL {.`eC CA,t Q - St4L cG,,tCux(TLJAS a n See(-b�cl IA.-11c r �.�+€0.4 c.1c kC%+ t k-2(-1-> Gk 17-it c "-SPtIL-e,-i- �� • Staff Representative: (i (1 l(ft, Applicant I Agent: /' N Date: 7 t ' -` Town of Queensbury•Zoning Office•742 Bay Road •Queensbury,NY 12804•518-761-8238 6 Area Variance Revised June 2009 Site Development Data A 0,90 .1:40,749,5S,1147:1;:f 1.9:FVCija A. Building footprint NA NA NA B. Detached Garage NA NA NA C. Accessory Structure(s) NA NA NA D. Paved, gravel or other hard surfaced area NA NA NA E. Porches / Decks NA NA NA F. Other NA NA NA G. Total Non-Permeable [Add A-F] NA NA NA H. Parcel Area [43,560 sq. ft. /acre] 14.8 ACRES 14.8 ACRES 14.8 ACRES - I. Percentage of Impermeable Area of Site [I=G/H] NA NA NA Setback Requirements Area Required Existing Proposed Front [1] 30 30+ Front [2] Shoreline Side Yard [1] 25 25+ Side Yard [2] 25 Rear Yard [1] 30 30+ Rear Yard [2] Travel Corridor Height [max] 40 LESS THAN 40 Permeability NA No. of parking spaces 2 MIN.2 SPACES PER LOT Minimum lot size 2 acres 14.8 acres 0.58- 1.46 acres Town of Queensbury•Zoning Office•742 Bay Road•Queensbury,NY 12804•518-761-8238 2 Area Variance Revised June 2009 Additional Project Information 1. Will the proposal require a Septic Variance from the Town Board of Health? NO 2. If the parcel has previous approvals, list application number(s): NO 3. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Program? YES 4. Estimated project duration: Start Date FALL,2014 End Date WINTER,2016 5. Estimated total cost of project: 6. Total area of land disturbance for project: 7.24 ACRES Floor Area Ratio Worksheet FLOOR AREA RATIO (FAR) --The relationship of building size to lot size, derived by dividing the total building floor area by the lot size in square feet, yielding a percentage. Zoning District ' Symbol Floor Area Ratio�FARl Waterfront Residential WR 0.22 Commercial Moderate CM 0.3 Commercial Intensive CI 0.3 A. The combined area of all square footage, as measure from exterior walls of all structures on the property, including all floors of the structures, garages, basements and attics with more than five (5) feet of ceiling height and covered porches. Building square footage does not include: Open deck, docks and that portion of covered docks extending over water and one storage shed of one hundred twenty (120) square feet or less. Any additional sheds will be included. (See"FLOOR AREA RATIO"). B. Commercial or industrial: the total area in square feet as measured from the exterior of the outside walls of a building or structure, and when applicable, the sum total of all floor areas of the principal and accessory buildings or structures on the project site. Parcel Area NA sq. ft. Existing Floor Area NA sq. ft. [see above definition] Proposed Additional Floor Area NA sq. ft. Proposed Total Floor Area NA sq. ft. Total Allowable Floor Area NA (Area x ) [see above table] Town of Queensbury•Zoning Office •742 Bay Road•Queensbury,NY 12804•518-761-8238 3 Area Variance Revised June 2009 Compliance with Zoning Ordinance Requesting relief from SECTION: 179-3-04 Area requirments for MDR Need relief from the requirement(s) listed below which can not be met by the project as proposed. [Check all that apply] LtSetback D Buffer Die El Lot Width ©0 the r MINIMUM LOT SIZE The following questions reflect the criteria for granting this type of variance. Please complete them; use additional sheets if needed. 1. Whether an undesirable change will be produced in the character of the neighborhood or a detriment to nearby property will be created by the granting of this area variance? NO. THE SUBDIVISION IS IN HARMONY WITH THE EXISTING RESIDENTIAL SUBDIVISIONS LOCATED WITHIN THE NEIGHBORING AREAS.THE NEIGHBOORING JUNK YARD TO THE SOUTH WOULD BE A DETERENT TO 2 ACRE ESTATE LOTS. 2. Whether the benefit sought by the applicant can be achieved by some method, feasible for the applicant to pursue, other than an area variance? THE APPLICANT COULD CONSTRUCT 6 RESIDENTIAL LOTS FRONTING ON PEGGY ANN ROAD BUT ALL LOTS WOULD HAVE DRIVEWAYS ACCESSING PEGGY ANN ROAD WHILE THE PROPOSED LAYOUT WOULD ONLY HAVE A SINGLE CONTROLLED ACCESS POINT ONTO PEGGY ANN ROAD. 3. Whether the requested area variance is substantial? THE REQUEST MAY BE CONSIDERED SUBSTANTIAL TO THE REGULATION BUT IS WITHIN CHARACTER OF THE EXISTING NEIGHBOORING SUBDIVISIONS. 4. Whether the proposed variance will have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district? NO. THE VARIANCE WOULD NOT HAVE AN ADVERSE OR NEGATIVE IMPACT IN THE NEIGHBOORHOOD AS IT IS IN HARMONY WITH THE EXISTING SUBDIVISIONS WITHIN THE NEIGHBOORHOOD. 5. Whether the alleged difficulty was self-created? YES. THE VARIANCE COULD BE CONSIDERED SELF CREATED. Town of Queensbury•Zoning Office•742 Bay Road• Queensbury, NY 12804•518-761-8238 4 Area Variance Revised June 2009 Submittal of a stamped and signed SURVEY MAP depicting existing and proposed conditions shall include the items as noted below. A.. GENERAL .,SHOWN ON . SHEET# 1 Title, Name,Address of applicant&person responsible for preparation of drawing COVER 2 Deed ATTACHED 3 North arrow,Tax Map ID,date prepared and scale[minimum 1In.=40 ft.] S-1 4 Boundaries of the property plotted to scale,zoning boundary S-1 5 Principal structures,accessory structures with exterior dimensions S-2 6 Site improvements incl.outdoor storage areas,driveways,parking areas,etc.: existing&proposed S-2,3, 7 Setbacks for all structures and improvements: existing&proposed S-1,2,3 8 Elevations and floor plans of all proposed and affected structures NA B. WATER&SEWER 'SHOWN'ON SHEET# 1 Project sewage disposal facilities,design details,construction details,flow rates,and number of bedrooms proposed S-2,3&5 2 Water supply[i.e.well]&septic on adjoining lots with separation distances to existing or proposed on-site water supply and S-2 septic 3 Separation distances for proposed sewage disposal system to well and water bodies S-2,3,&5 4 Existing public or private water supply [well, lake, etc.]. Method of securing public or private water, location, design and S-2,3,&4 construction of water supply including daily water usage 5 Percolation test location and results S-2&3 C. PARKING/PERMEAELE AREAS `SHOWN ON . -SHEET# 1 Number of spaces required for project including calculations and justification: existing&proposed NA 2 No.of existing parking spaces,number to be removed,number to maintain and type of surfacing material[e.g.,gravel,paved] NA 3 Provision for pedestrian and handicap access and parking: existing&proposed NA 4 Design details of ingress,egress,loading areas and cutting: existing&proposed S-2&S-3 5 Location and character of green areas[existing and proposed],modification to green area,buffer zone to remain undisturbed S-1,2,3&6 6 Lighting,location and design of all existing and proposed outdoor lighting WAIVER D. ADDITIONAL SITE-DEVELOPMENT:AND MISCELEANEOUS � .ON i^hr' 1 On-site&adjacent watercourses,streams,rivers,lake and wetlands NA 2 Utility/energy distribution system[gas,electric,solar,telephone]: existing&proposed S-2&S-3 3 Location,design and construction details of all existing and proposed site improvements including: drains,culverts, retaining walls,fences,fire&emergency zones and hydrants,etc. S-2,3,4,7 4 Square footage of bldg. area proposed for office, manufacturing, retail sales or other commercial activities: existing & NA proposed e Signage: Location,size,type,design and setback: existing 8,proposed NA f Waiver Request: provide letter with application requesting any waivers: please reference specific items ATTACHED g Commercial/Industrial Development requires submission of Landscaping,Stormwater Management,Grading&Lighting Plans NA h Identification of Federal,State or County permits required for the project together with a record of application for all necessary ATTACHED permits Town of Queensbury•Zoning Office•742 Bay Road•Queensbury,NY 12804 •518-761-8238 5 Area Variance Revised June 2009 Signature Page This page includes the 1.) Authorization to Act as Agent Form: 2.) Engineering Fee Disclosure; 3.) Authorization for Site Visits; 4.) Other Permit Responsibilities; 5.) Official Meeting Disclosure and 6.) Agreement to provide documentation required. OWNER'S AGENT FORM: Complete the following if the OWNER of the property is not the same as the applicant Owner: JOESPH LEUCI Designates: NACE ENGINEERING&BARTLETT.PONTIFF STEWART&RHODES As agent regarding: x Variance Site Plan x Subdivision For Tax Map N .: 301.15 Secti.n 1 Block 19 Lot Deed Refgeric lot,/ Page Date OWNER SIGNATURE: e-e�r DATE: 7-14-14 APPLICANT'S AGENT FORM: Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party: Owner: JOESPH LEUCI Designates: NACE ENGINEERING&BARTLETT PONTIFF STWEART&RHODES As agent regarding: x Variance Site Plan X Subdivision For Tax Map No.: 301.15 Section 1 Block 19 Lot Deed Refer e: ok Page Date OWNER SIGNATURE: )C erg(/ DATE: 7-14-14 2.) ENGINEERING FEE ISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design, storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be charged directly to the applicant. Fees for engineering review will not exceed$ 1,000 without notification to the applicant. 3.) AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein, the Owner, Applicant, and his/her/their agent(s) hereby authorize the Zoning Board or Planning Board and Town Staff to enter the subject properties for the purpose of reviewing the application submitted. 4.) OTHER PERMIT RESPONSIBILITIES: Other permits may be required for construction or alteration activity subsequent to approval by the Zoning Board or Planning Board. It is the applicant's responsibility to obtain any additional permits. 5.) OFFICIAL MEETING MINUTES DISCLOSURE: It is the practice of the Community Development Department to have a designated stenographer tape record the proceedings of meetings resulting from application, and minutes transcribed from those tapes constitutes the official record of all proceedings. 6.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I, the undersigned, have thoroughly read and understand the instructions for submission and agree to the submission requirements, I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application, plans and supporting materials are a true and complete statement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the approved plans and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents,will obtain a certificate of occupancy as necessary. I also understand that I/we may be required to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy I have ad and agree to the above. /10 / JOESPH LEUCI 7-14-14 -ture [Ap.licant] Print Name[Applicant] Date signed : .`� NACE ENGINEERING THOMAS CENTER 7-14-14 Si. ature [Agent] Print Name [Agent] Date signed Town of Queensbury•Zoning Office•742 Bay Road •Queensbury,NY 12804•518-761-8238 9 • • '" = WARREN COUNTY— STATE OF NEW YORK NR►•RWI �� " `"r•�� PAMELA J.VOGEL, COUNTY CLERK 1340 STATE ROUTE 9, - � * �� Q! LAKE GEORGE, NEW YORK 12845 `. j �a Ussafirn COUNTY CLERK'S RECORDING PAGE --THIS PAGE IS PART OF THE DOCUMENT—DO NOT DETACH`" Recording : Cover Page 5 .00 Recording Fee 30.00 Cultural Ed 14. 25 Records Management - Coun 1.00 Records Management - Stat 4. 75 TP584 5 .00 BOOK/PAGE: 4947 / 267 RP5217 - county 9.00 INSTRUMENT #: 2014-1220 RP5217 All others - State 241.00 Receipt#: 2014326199 Sub Total : 310.00 -- clerk: LB Rec Date: 02/28/2014 03 : 43 : 24 PM Transfer Tax Doc Grp: RP Transfer Tax - State 840 .00 Descrip: DEED Num Pgs : 3 Sub Total : 840.00 Recd Frm: MEYER & FULLER PLLC Partyl: GLENS FALLS CITY OF Total : 1150.00 Party2 : FOOTHILLS BUILDERS LLC **** NOTICE: THIS IS NOT A BILL **** Town: QUEENSBURY ***** Transfer Tax ***** Transfer Tax #: 1470 Transfer Tax consideration: 210000.00 Transfer Tax - State 840.00 Total : 840.00 W ARN'ING*** I hereby certify that the within and foregoing was recorded in the Warren County Clerk's Office, State of New York. This sheet constitutes the Clerks endorsement Record and Return To: required by Section 316 of the Real Property Law of the State of New York. JEFFREY R MEYER ESQ Pamela J. Vogel 161 OTTAWA STREET Warren County Clerk LAKE GEORGE NY 12845 stewart title Bargain and Sale Deed,without Covenants against Grantor's Acts—Individual or Corporation. CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY. THIS INDENTURE, made the 28'" day of February, 2014 6 BETWEEN City of Glens Falls, A Municipal Corporation with its principal place of business located at 42 Ridge Street, Glens Falls, New York, 12801, party of the first part, and Foothills Builders, LLC, a New York Limited Liability Company, with its principal place of business located at 9 Mountainside Drive, Queensbury, New York 12804, parties of the second part, WITNESSETH, that the party of the first part, in consideration of one dollars and other valuable consideration paid by the parties of the second part, do hereby grant and release unto the parties of the second part, the heirs or successors and assigns of the parties of the second part forever, ALL that certain tract or parcel of land situate in the Town of Queensbury, County of Warren, and State of New York being more fully described as follows: BEGINNING at a point in the southerly boundary of Peggy Ann Road, said point being the northwesterly corner of the Queensbury Forest Subdivision, running thence from the point of Beginning southerly along the westerly boundary of Queensbury Forest Subdivision South 06°39'25"West a distance of 926.13' to a point in the northerly boundary of the lands now or formerly of Carol Mosher, as recorded in the office of the Warren County Clerk in book 714 at page 258, running thence westerly along the northerly boundary of said lands now or formerly of Carol Mosher, as recorded in the office of the Warren County Clerk in book 714 at page 258 North 84°44'01"West a distance of 624.04' to a point in the easterly boundary of Phase Two of the Oakwoods Subdivision, running thence northerly along the easterly boundary of Phase Two of the Oakwoods Subdivision North 05°37'59" East a distance of 61.60' to a point at the southeasterly corner of Section Two Pheasant Walk Subdivision, running thence northerly along the easterly boundary of said Section Two Pheasant Walk Subdivision North 06°36'59" East a distance of 1074.17' to a point in the southerly boundary of Peggy Ann Road, running thence easterly along the southerly boundary of Peggy Ann Road South 66°04'35" East a distance of 655.25' to the point or place of Beginning. BEING part of the premises conveyed by Charity Deuel and Bertha W. Gifford as widow and only heir- at-law of Henry B. Wilkie dated April 18, 1923 and recorded in the Warren County Clerk's Office on July 14, 1924 at Book 160 of Deeds at Page 558. Subject to any covenants, restrictions, or easements of record. This conveyance is being made pursuant to the terms and conditions of Resolution No. 491 made by the City of Glens Falls Common Council on December 23, 2013 and reaffirmed by Resolution No. 68 made by the City of Glens Falls Common Council on February 25, 2014. TOGETHER with all right, title and interest, if any, of the party of the first part, in and to any streets and roads abutting the above-described premises to the center lines thereof; TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises; TO HAVE AND TO HOLD the premises herein granted unto the parties of the second part, the heirs or successors and assigns of the parties of the second part forever. AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. stewart title The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires. IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF r of Glens Falls • Diamon., Mayor STATE OF NEW YORK : ss.: COUNTY OF WARREN On the 27"day of February, 2014 before me, the undersigned, personally appeared JOHN DIAMOND, personally known to me or proved to me on the basis of satisfactory evidence to be the individual, whose name is subscribed to within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the individual. or the person upon behalf of which the individual acted executed the instrument. Notary Public MARK C.REJiM NOTARY PUBLIC.STATE OF NEW YORK WARREN COUNTY NO.02RE6066348 Record and Return: COMMISSION EXPIRES NOV.13,20 ►I' Jeffrey R. Meyer, Esq. 161 Ottawa Street Lake George, NY 12845 Full Environmental Assessment Form R C , Part 1-Project and Setting `C Instructions for Completing Part 1 JUL. 15 7'3:4 Part 1 is to be completed by the applicant or project sponsor. Responses become part of the aN ` fft►> tep�funding, are subject to public review,and may be subject to further verification. ONING OFFICE 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;indicate whether missing information does not exist, or is not reasonably available to the sponsor;and,when possible,generally describe work or studies which would be necessary to update or fully develop that information. Applicants/sponsors must complete all items in Sections A&B. In Sections C,D&E,most items contain an initial question that must be answered either"Yes"or"No". If the answer to the initial question is"Yes",complete the sub-questions that follow. If the answer to the initial question is"No",proceed to the next question. Section F allows the project sponsor to identify and attach any additional information. Section G requires the name and signature of the project sponsor to verify that the information contained in Part 1is accurate and complete. A.Project and Sponsor Information. Name of Action or Project: LEUCI PEGGY ANN ROAD SUBDIVISION Project Location(describe, and attach a general location map): PEGGY ANN ROAD,SOUTH SIDE BETWEEN QUAIL RUN AND FERRIS DRIVE Brief Description of Proposed Action(include purpose or need): CONSTRUCT AN 18 LOT RESIDENTIAL SUBDIVISION. Name of Applicant/Sponsor: Telephone:518-796-3520 JOESPH LEUCI E-Mail:JLEUCI24QHOTMAIL.COM Address:9 MOUNTAINSIDE DRIVE City/PO:QUEENBSURY State:NY Zip Code:12804 Project Contact(if not same as sponsor;give name and title/role): Telephone:518-796-2515 THOMAS CENTER,NACE ENGINEERING,P.C. E-Mail:TCENTER36@YAHOO.COM Address: 169 HAVILAND ROAD City/PO: State: Zip Code: QUEENSBURY NY 12804 Property Owner (if not same as sponsor): Telephone: E-Mail: Address: City/PO: State: Zip Code: Page 1 of 13 Joseph Leuci AV 61-2014 18-lot residential subdivision south side of Peggy Ann Road between Quail Run and Ferris Drive B.Government Approvals B.Government Approvals,Funding,or Sponsorship. ("Funding"includes grants,loans,tax relief,and any other forms of financial assistance.) Government Entity If Yes:Identify Agency and Approval(s) Application Date Required (Actual or projected) a. City Council,Town Board, DYesDNo or Village Board of Trustees b.City,Town or Village 0YYes0No QSBY PLANNING BOARD-SUBDIVISION 7-15-14 Planning Board or Commission APPROVAL c.City Council,Town or OYesDNo QSBY ZBA-AREA VARIANCE 7-15-14 Village Zoning Board of Appeals d.Other local agencies DYes0No e.County agencies DYesDNo f.Regional agencies DYes❑No g.State agencies OYesDNo NYS DOH-REALTY SUBDIVISION 9-30-14 NYS DEC NOI h.Federal agencies DYesDNo i. Coastal Resources. i. Is the project site within a Coastal Area,or the waterfront area of a Designated Inland Waterway? DYes IZINo ii. Is the project site located in a community with an approved Local Waterfront Revitalization Program? ❑YesONo iii. Is the project site within a Coastal Erosion Hazard Area? D YesONo C.Planning and Zoning C.1.Planning and zoning actions. Will administrative or legislative adoption,or amendment of a plan,local law,ordinance,rule or regulation be the DYesIallo only approval(s)which must be granted to enable the proposed action to proceed? • If Yes,complete sections C,F and G. • If No,proceed to question C.2 and complete all remaining sections and questions in Part 1 C.2.Adopted land use plans. a.Do any municipally-adopted (city,town,village or county)comprehensive land use plan(s)include the site OYes❑No where the proposed action would be located? If Yes,does the comprehensive plan include specific recommendations for the site where the proposed action LaYes❑No would be located? b.Is the site of the proposed action within any local or regional special planning district(for example: Greenway ❑YesONo Brownfield Opportunity Area(BOA);designated State or Federal heritage area;watershed management plan; or other?) If Yes,identify the plan(s): c. Is the proposed action located wholly or partially within an area listed in an adopted municipal open space plan, ❑YesONo or an adopted municipal farmland protection plan? If Yes,identify the plan(s): Page 2 of 13 C3. Zoning a. Is the site of the proposed action located in a municipality with an adopted zoning law or ordinance. OYes❑No If Yes,what is the zoning classification(s)including any applicable overlay district? MDR-RESIDENTIAL b. Is the use permitted or allowed by a special or conditional use permit? OYes❑No c.Is a zoning change requested as part of the proposed action? OYes❑No If Yes, i. What is the proposed new zoning for the site?AV REQUESTED FOR LOTS LESS THAN 2 ACRES WITH ONSITE WASTEWATER SYSTEMS C.4.Existing community services. a.In what school district is the project site located?QUEEBSURY SCHOOL DISTRICT b.What police or other public protection forces serve the project site? WARREN COUNTY SHERRIF c.Which fire otection and emergency medical services serve the project site? QUEENSBURY CENTRAL FIRE AND WEST GLENS FALLS EMS d.What parks serve the project site? NONE D.Project Details D.1.Proposed and Potential Development a.What is the general nature of the proposed action(e.g.,residential,industrial,commercial,recreational;if mixed,include all components)?RESIDENTIAL b.a.Total acreage of the site of the proposed action? 14.8 acres b.Total acreage to be physically disturbed? 7.24 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 14.8 acres c.Is the proposed action an expansion of an existing project or use? ❑YesO No 1. If Yes,what is the approximate percentage of the proposed expansion and identify the units(e.g.,acres,miles,housing units, square feet)? % Units: d.Is the proposed action a subdivision,or does it include a subdivision? PJYes❑No If Yes, i. Purpose or type of subdivision?(e.g.,residential,industrial,commercial;if mixed,specify types) RESIDENTIAL ii. Is a cluster/conservation layout proposed? ❑Yes 0No iii. Number of lots proposed? 18 iv. Minimum and maximum proposed lot sizes? Minimum 1.46 Maximum 0.58 e.Will proposed action be constructed in multiple phases? JYes❑No i. If No,anticipated period of construction: months ii. If Yes: • Total number of phases anticipated 2 • Anticipated commencement date of phase 1 (including demolition) 10 month 2014 year • Anticipated completion date of final phase 12 month 2017year • Generally describe connections or relationships among phases,including any contingencies where progress of one phase may determine timing or duration of future phases: INITIAL PHASE WILL BE CONSTRUCTION OF THE SUBDIVISION ROAD AND UTILITIES AND FINAL PHASE WILL BE CONSTRUCTION OF INDIVIDUAL HOMES Page 3of13 f.Does the project include new residential uses? ❑Yes❑No If Yes,show numbers of units proposed. One Family Two Family Three Family Multiple Family(four or more) Initial Phase 18 At completion of all phases 18 g.Does the proposed action include new non-residential construction(including expansions)? ❑YesONo If Yes, i.Total number of structures ii. Dimensions(in feet)of largest proposed structure: _ height; width; and length iii. Approximate extent of building space to be heated or cooled: square feet h.Does the proposed action include construction or other activities that will result in the impoundment of any ❑YesONo liquids,such as creation of a water supply,reservoir,pond,lake,waste lagoon or other storage? If Yes, i. Purpose of the impoundment: ii. If a water impoundment,the principal source of the water: ❑Ground water❑Surface water streams❑Other specify: iii. If other than water,identify the type of impounded/contained liquids and their source. iv. Approximate size of the proposed impoundment. Volume: million gallons;surface area: acres v. Dimensions of the proposed dam or impounding structure: height; length vi. Construction method/materials for the proposed dam or impounding structure(e.g.,earth fill,rock,wood,concrete): D.2. Project Operations a.Does the proposed action include any excavation,mining,or dredging,during construction,operations,or both? ❑Yes No (Not including general site preparation,grading or installation of utilities or foundations where all excavated materials will remain onsite) If Yes: i.What is the purpose of the excavation or dredging? ii. How much material(including rock,earth,sediments,etc.)is proposed to be removed from the site? • Volume(specify tons or cubic yards): • Over what duration of time? iii. Describe nature and characteristics of materials to be excavated or dredged,and plans to use,manage or dispose of them. iv. Will there be onsite dewatering or processing of excavated materials? ❑Yes❑No If yes,describe. v. What is the total area to be dredged or excavated? acres vi. What is the maximum area to be worked at any one time? acres vii. What would be the maximum depth of excavation or dredging? feet viii. Will the excavation require blasting? ❑Yes❑No ix. Summarize site reclamation goals and plan: b.Would the proposed action cause or result in alteration of,increase or decrease in size of,or encroachment ❑Yes r❑/No into any existing wetland,waterbody,shoreline,beach or adjacent area? If Yes: i. Identify the wetland or waterbody which would be affected(by name,water index number,wetland map number or geographic description): Page 4 of 13 ' ii. Describe how the proposed action would affect that waterbody or wetland,e.g. excavation,fill,placement of structures,or alteration of channels,banks and shorelines. Indicate extent of activities,alterations and additions in square feet or acres: iii. Will proposed action cause or result in disturbance to bottom sediments? ❑Yes❑No If Yes,describe: iv. Will proposed action cause or result in the destruction or removal of aquatic vegetation? ❑Yes❑No If Yes: • acres of aquatic vegetation proposed to be removed: • expected acreage of aquatic vegetation remaining after project completion: • purpose of proposed removal(e.g.beach clearing,invasive species control,boat access): • proposed method of plant removal: • if chemical/herbicide treatment will be used,specify product(s): v. Describe any proposed reclamation/mitigation following disturbance: c.Will the proposed action use,or create a new demand for water? 12I Yes❑No If Yes: i. Total anticipated water usage/demand per day: 7,920 gallons/day ii. Will the proposed action obtain water from an existing public water supply? OYesON° If Yes: • Name of district or service area: QUEENBBURY WATER DISTRICT • Does the existing public water supply have capacity to serve the proposal? 0 Yes❑No • Is the project site in the existing district? ®Yes❑No • Is expansion of the district needed? ❑Yes No • Do existing lines serve the project site? • 0 Yes❑No iii. Will line extension within an existing district be necessary to supply the project? OYes[io If Yes: • Describe extensions or capacity expansions proposed to serve this project: NEW 8 INCH WATER MAIN • Source(s)of supply for the district: QUEENBSURY WATER DISTRICT iv. Is a new water supply district or service area proposed to be formed to serve the project site? ❑Yes No If,Yes: • Applicant/sponsor for new district: • Date application submitted or anticipated: • Proposed source(s)of supply for new district: v. If a public water supply will not be used,describe plans to provide water supply for the project: vi.If water supply will be from wells(public or private),maximum pumping capacity: gallons/minute. d.Will the proposed action generate liquid wastes? El Yes❑No If Yes: i. Total anticipated liquid waste generation per day: 7.920 gallons/day ii. Nature of liquid wastes to be generated(e.g.,sanitary wastewater,industrial;if combination,describe all components and approximate volumes or proportions of each): SANITARY WASTE iii. Will the proposed action use any existing public wastewater treatment facilities? ['Yes ION° If Yes: • Name of wastewater treatment plant to be used: • Name of district: • Does the existing wastewater treatment plant have capacity to serve the project? ❑YesONo • Is the project site in the existing district? El yes❑No • Is expansion of the district needed? ❑Yes❑No Page 5 of 13 • Do existing sewer lines serve the project site? ❑Yes❑No • Will line extension within an existing district be necessary to serve the project? ❑Yes❑No If Yes: • Describe extensions or capacity expansions proposed to serve this project: iv. Will a new wastewater(sewage)treatment district be formed to serve the project site? ❑YesmNo If Yes: • Applicant/sponsor for new district: • Date application submitted or anticipated: • What is the receiving water for the wastewater discharge?_ v. If public facilities will not be used,describe plans to provide wastewater treatment for the project,including specifying proposed receiving water(name and classification if surface discharge,or describe subsurface disposal plans): vi. Describe any plans or designs to capture,recycle or reuse liquid waste: e.Will the proposed action disturb more than one acre and create stormwater runoff,either from new point ®Yes❑`o sources(i.e.ditches,pipes,swales,curbs,gutters or other concentrated flows of stormwater)or non-point source(i.e.sheet flow)during construction or post construction? If Yes: i.How much impervious surface will the project create in relation to total size of project parcel? Square feet or 1.481 acres(impervious surface) Square feet or 14.8 acres(parcel size) ii. Describe types of new point sources.Roof&road runoff. iii. Where will the stormwater runoff be directed(i.e.on-site stormwater management facility/structures,adjacent properties, groundwater,on-site surface water or off-site surface waters)? Yes,the stormwater will be directed to infiltration drywells and grassed lawn areas. • If to surface waters,identify receiving water bodies or wetlands: • Will stormwater runoff flow to adjacent properties? ❑Yes1 No iv. Does proposed plan minimize impervious surfaces,use pervious materials or collect and re-use stormwater? I Yes❑No E Does the proposed action include,or will it use on-site,one or more sources of air emissions,including fuel ❑Yes ON° combustion,waste incineration,or other processes or operations? If Yes,identify: i.Mobile sources during project operations(e.g.,heavy equipment,fleet or delivery vehicles) ii. Stationary sources during construction(e.g.,power generation,structural heating,batch plant,crushers) iii. Stationary sources during operations(e.g.,process emissions,large boilers,electric generation) g.Will any air emission sources named in D.2.f(above),require a NY State Air Registration,Air Facility Permit, 0Yes0No or Federal Clean Air Act Title IV or Title V Permit? If Yes: i. Is the project site located in an Air quality non-attainment area? (Area routinely or periodically fails to meet ❑Yes❑No ambient air quality standards for all or some parts of the year) ii In addition to emissions as calculated in the application,the project will generate: • Tons/year(short tons)of Carbon Dioxide(CO2) • Tons/year(short tons)of Nitrous Oxide(N20) • Tons/year(short tons)of Perfluorocarbons(PFCs) • Tons/year(short tons)of Sulfur Hexafluoride(SF6) • Tons/year(short tons)of Carbon Dioxide equivalent of Hydroflourocarbons(HFCs) • Tons/year(short tons)of Hazardous Air Pollutants(HAPs) Page 6 of 13 h.Will the proposed action generate or emit methane(including,but not limited to,sewage treatment plants, ❑Yes®No landfills,composting facilities)? If Yes: i. Estimate methane generation in tons/year(metric): ii. Describe any methane capture,control or elimination measures included in project design(e.g.,combustion to generate heat or electricity,flaring): i.Will the proposed action result in the release of air pollutants from open-air operations or processes,such as ❑Yes®No quarry or landfill operations? If Yes: Describe operations and nature of emissions(e.g.,diesel exhaust,rock particulates/dust): j.Will the proposed action result in a substantial increase in traffic above present levels or generate substantial ❑Yes®No new demand for transportation facilities or services? If Yes: i. When is the peak traffic expected(Check all that apply): ❑Morning ❑Evening ❑Weekend ❑Randomly between hours of to ii. For commercial activities only,projected number of semi-trailer truck trips/day: iii. Parking spaces: Existing Proposed Net increase/decrease iv. Does the proposed action include any shared use parking? ❑Yes❑No v. If the proposed action includes any modification of existing roads,creation of new roads or change in existing access,describe: vi. Are public/private transportation service(s)or facilities available within`/z mile of the proposed site? ❑Yes❑No vii Will the proposed action include access to public transportation or accommodations for use of hybrid,electric ❑Yes❑No or other alternative fueled vehicles? viii. Will the proposed action include plans for pedestrian or bicycle accommodations for connections to existing ❑Yes❑No pedestrian or bicycle routes? k.Will the proposed action(for commercial or industrial projects only)generate new or additional demand ❑Yes®No for energy? If Yes: i. Estimate annual electricity demand during operation of the proposed action: ii. Anticipated sources/suppliers of electricity for the project(e.g.,on-site combustion,on-site renewable,via grid/local utility,or other): iii. Will the proposed action require a new,or an upgrade to,an existing substation? ❑Yes❑No 1.Hours of operation. Answer all items which apply. i. During Construction: ii. During Operations: • Monday-Friday: 0700-2000 • Monday-Friday: NA • Saturday: • Saturday: • Sunday: • Sunday: • Holidays: • Holidays: Page 7 of 13 m. Will the proposed action produce noise that will exceed existing ambient noise levels during construction, ❑Yes 0No operation,or both? If yes: i. Provide details including sources,time of day and duration: ii. Will proposed action remove existing natural barriers that could act as a noise barrier or screen? ❑Yes❑No Describe: n.. Will the proposed action have outdoor lighting? ❑Yes ONo If yes: i. Describe source(s),location(s),height of fixture(s),direction/aim,and proximity to nearest occupied structures: ii. Will proposed action remove existing natural barriers that could act as a light barrier or screen? ❑Yes❑No Describe: o. Does the proposed action have the potential to produce odors for more than one hour per day? ❑Yes 0No If Yes,describe possible sources,potential frequency and duration of odor emissions,and proximity to nearest occupied structures: p. Will the proposed action include any bulk storage of petroleum(combined capacity of over 1,100 gallons) ❑Yes RI No or chemical products 185 gallons in above ground storage or any amount in underground storage? If Yes: i. Product(s)to be stored ii. Volume(s) per unit time (e.g.,month,year) iii. Generally describe proposed storage facilities: q.Will the proposed action(commercial, industrial and recreational projects only)use pesticides(i.e.,herbicides, ❑Yes El No insecticides)during construction or operation? If Yes: i. Describe proposed treatment(s): ii. Will the proposed action use Integrated Pest Management Practices? ❑ Yes ❑No r.Will the proposed action(commercial or industrial projects only)involve or require the management or disposal ❑ Yes 12I No of solid waste(excluding hazardous materials)? If Yes: i. Describe any solid waste(s)to be generated during construction or operation of the facility: • Construction: tons per (unit of time) • Operation: tons per (unit of time) ii. Describe any proposals for on-site minimization,recycling or reuse of materials to avoid disposal as solid waste: • Construction: • Operation: iii. Proposed disposal methods/facilities for solid waste generated on-site: • Construction: • Operation: Page 8 of 13 s. Does the proposed action include construction or modification of a solid waste management facility? ❑ Yes® No If Yes: i. Type of management or handling of waste proposed for the site(e.g.,recycling or transfer station,composting,landfill,or other disposal activities): ii. Anticipated rate of disposal/processing: • Tons/month,if transfer or other non-combustion/thermal treatment,or • Tons/hour,if combustion or thermal treatment iii. If landfill,anticipated site life: years t.Will proposed action at the site involve the commercial generation,treatment,storage,or disposal of hazardous ❑Yes®No waste? If Yes: i. Name(s)of all hazardous wastes or constituents to be generated,handled or managed at facility: ii. Generally describe processes or activities involving hazardous wastes or constituents: iii. Specify amount to be handled or generated tons/month iv. Describe any proposals for on-site minimization,recycling or reuse of hazardous constituents: v. Will any hazardous wastes be disposed at an existing offsite hazardous waste facility? ❑Yes❑No If Yes:provide name and location of facility: If No:describe proposed management of any hazardous wastes which will not be sent to a hazardous waste facility: E. Site and Setting of Proposed Action E.1.Land uses on and surrounding the project site a. Existing land uses. i. Check all uses that occur on,adjoining and near the project site. ❑ Urban ❑ Industrial ❑ Commercial ® Residential(suburban) ❑ Rural(non-farm) ❑ Forest ❑ Agriculture ❑ Aquatic ❑ Other(specify): ii. If mix of uses,generally describe: b. Land uses and covertypes on the project site. Land use or Current Acreage After Change Covertype Acreage Project Completion (Acres+/-) • Roads,buildings,and other paved or impervious surfaces 0 1.491 +1.491 • Forested 14.8 7.012 +7.788 • Meadows,grasslands or brushlands(non- 0 6.297 +6.297 agricultural, including abandoned agricultural) • Agricultural (includes active orchards,field,greenhouse etc.) • Surface water features (lakes,ponds,streams,rivers,etc.) • Wetlands(freshwater or tidal) • Non-vegetated(bare rock,earth or fill) • Other Describe: • Page 9 of 13 c.Is the project site presently used by members of the community for public recreation? ❑YesONo i. If Yes:explain: d.Are there any facilities serving children,the elderly,people with disabilities(e.g.,schools,hospitals,licensed ❑YesONo day care centers,or group homes)within 1500 feet of the project site? If Yes, i. Identify Facilities: e.Does the project site contain an existing dam? ❑YesONo If Yes: i. Dimensions of the dam and impoundment: • Dam height: feet • Dam length: feet • Surface area: acres • Volume impounded: gallons OR acre-feet ii. Dam's existing hazard classification: iii. Provide date and summarize results of last inspection: f. Has the project site ever been used as a municipal,commercial or industrial solid waste management facility, ❑YesONo or does the project site adjoin property which is now,or was at one time,used as a solid waste management facility? If Yes: i. Has the facility been formally closed? ❑Yes❑ No • If yes,cite sources/documentation: ii. Describe the location of the project site relative to the boundaries of the solid waste management facility: iii. Describe any development constraints due to the prior solid waste activities: g.Have hazardous wastes been generated,treated and/or disposed of at the site,or does the project site adjoin ❑YesONo property which is now or was at one time used to commercially treat,store and/or dispose of hazardous waste? If Yes: i. Describe waste(s)handled and waste management activities,including approximate time when activities occurred: h. Potential contamination history. Has there been a reported spill at the proposed project site,or have any ❑YesO No remedial actions been conducted at or adjacent to the proposed site? If Yes: i. Is any portion of the site listed on the NYSDEC Spills Incidents database or Environmental Site ❑Yes❑No Remediation database? Check all that apply: ❑ Yes—Spills Incidents database Provide DEC ID number(s): ❑ Yes—Environmental Site Remediation database Provide DEC ID number(s): ❑ Neither database ! ii. If site has been subject of RCRA corrective activities,describe control measures: iii. Is the project within 2000 feet of any site in the NYSDEC Environmental Site Remediation database? ❑Yes❑No If yes,provide DEC ID number(s): iv. If yes to(i),(ii)or(iii)above,describe current status of site(s): Page 10 of 13 v. Is the project site subject to an institutional control limiting property uses? ❑Yes❑No • If yes,DEC site ID number: • Describe the type of institutional control(e.g.,deed restriction or easement): • Describe any use limitations: • Describe any engineering controls: • Will the project affect the institutional or engineering controls in place? ❑Yes❑No • Explain: E.2. Natural Resources On or Near Project Site a.What is the average depth to bedrock on the project site? GREATER THAN 15 feet b.Are there bedrock outcroppings on the project site? ❑Yes®No If Yes,what proportion of the site is comprised of bedrock outcroppings? % c.Predominant soil type(s)present on project site: LOAMY SAND 100% d.What is the average depth to the water table on the project site? Average: 15+ feet e.Drainage status of project site soils:0 Well Drained: 100_%of site ❑ Moderately Well Drained: %of site ❑ Poorly Drained %of site f.Approximate proportion of proposed action site with slopes: ® 0-10%: 100%of site ❑ 10-15%: %of site El 15%or greater: %of site g.Are there any unique geologic features on the project site? ❑Yes®No If Yes,describe: h.Surface water features. i. Does any portion of the project site contain wetlands or other waterbodies(including streams,rivers, ❑Yes®No ponds or lakes)? ii. Do any wetlands or other waterbodies adjoin the project site? ❑Yes®No If Yes to either i or ii,continue. If No,skip to E.2.i. Are any of the wetlands or waterbodies within or adjoining the project site regulated by any federal, ❑Yes❑No state or local agency? iv, For each identified regulated wetland and waterbody on the project site,provide the following information: • Streams: Name Classification • Lakes or Ponds: Name Classification • Wetlands: Name Approximate Size • Wetland No.(if regulated by DEC) v. Are any of the above water bodies listed in the most recent compilation of NYS water quality-impaired ['Yes❑l'o waterbodies? If yes,name of impaired water body/bodies and basis for listing as impaired: i. Is the project site in a designated Floodway? ['Yes ON° j.Is the project site in the 100 year Floodplain? ❑Yes®No k.Is the project site in the 500 year Floodplain? ['Yes ONO 1.Is the project site located over,or immediately adjoining,a primary,principal or sole source aquifer? ❑Yes EINo If Yes: i. Name of aquifer: Page 11 of 13 m. Identify the predominant wildlife species that occupy or use the project site: NONE n. Does the project site contain a designated significant natural community? YesEINo If Yes: i. Describe the habitat/community(composition,function,and basis for designation): ii. Source(s)of description or evaluation: iii. Extent of community/habitat: • Currently: acres • Following completion of project as proposed: acres • Gain or loss(indicate+or-): acres o.Does project site contain any species of plant or animal that is listed by the federal government or NYS as ❑Yes®No endangered or threatened,or does it contain any areas identified as habitat for an endangered or threatened species? SEE LETTER FROM NYS DEC p. Does the project site contain any species of plant or animal that is listed by NYS as rare,or as a species of ❑Yes®No special concern? SEE LETTER FROM NYS DEC q. Is the project site or adjoining area currently used for hunting,trapping,fishing or shell fishing? ❑Yes No If yes,give a brief description of how the proposed action may affect that use: E.3. Designated Public Resources On or Near Project Site a. Is the project site,or any portion of it,located in a designated agricultural district certified pursuant to ❑Yes®No Agriculture and Markets Law,Article 25-AA,Section 303 and 304? If Yes, provide county plus district name/number: b.Are agricultural lands consisting of highly productive soils present? ❑Yes EiNo i. If Yes: acreage(s)on project site? ii. Source(s)of soil rating(s): c. Does the project site contain all or part of,or is it substantially contiguous to,a registered National 0YesIONo Natural Landmark? If Yes: i. Nature of the natural Iandmark: ❑Biological Community ❑ Geological Feature ii. Provide brief description of landmark,including values behind designation and approximate size/extent: SEE ATTACHED PRINT OUT FROM NYS SPRHP WEBSITE d.Is the project site located in or does it adjoin a state listed Critical Environmental Area? ❑Yes®No If Yes: i. CEA name: ii. Basis for designation: iii. Designating agency and date: Page 12 of 13 e.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district ❑Yes No which is listed on,or has been nominated by the NYS Board of Historic Preservation for inclusion on,the State or National Register of Historic Places? If Yes: i. Nature of historic/archaeological resource: ['Archaeological Site ❑Historic Building or District ii. Name: iii. Brief description of attributes on which listing is based: f.Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for ❑YesONo archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory? g.Have additional archaeological or historic site(s)or resources been identified on the project site? ❑YesONo If Yes: i.Describe possible resource(s): ii. Basis for identification: h. Is the project site within fives miles of any officially designated and publicly accessible federal,state,or local ❑YesONo scenic or aesthetic resource? If Yes: 1. Identify resource: ii.Nature of,or basis for,designation(e.g.,established highway overlook,state or local park,state historic trail or scenic byway, etc.): iii. Distance between project and resource: miles. i. Is the project site located within a designated river corridor under the Wild,Scenic and Recreational Rivers ❑YesONo Program 6 NYCRR 666? If Yes: i. Identify the name of the river and its designation: ii. Is the activity consistent with development restrictions contained in 6NYCRR Part 666? ❑Yes❑No F.Additional Information Attach any additional information which may be needed to clarify your project. If you have identified any adverse impacts which could be associated with your proposal,please describe those impacts plus any measures which you propose to avoid or minimize them. G. Verification I certify that the information provided is true to the best of my knowledge. fY P Y g Applicant/Sponsor Name NACE ENGINEERING,P.C.-TOM CENTER, Date 7-1514 Signature La_ Title PROJECT ENGINEER PRINT FORM Page 13 of 13 Agency Use Only[If applicable] Full Environmental Assessment Form project: Part 2-Identification of Potential Project Impacts Date: Part 2 is to be completed by the lead agency. Part 2 is designed to help the lead agency inventory all potential resources that could be affected by a proposed project or action. We recognize that the lead agency's reviewer(s)will not necessarily be environmental professionals. So,the questions are designed to walk a reviewer through the assessment process by providing a series of questions that can be answered using the information found in Part 1. To further assist the lead agency in completing Part 2,the form identifies the most relevant questions in Part 1 that will provide the information needed to answer the Part 2 question. When Part 2 is completed,the lead agency will have identified the relevant environmental areas that may be impacted by the proposed activity. If the lead agency is a state agency and the action is in any Coastal Area,complete the Coastal Assessment Form before proceeding with this assessment. Tips for completing Part 2: • Review all of the information provided in Part 1. • Review any application,maps,supporting materials and the Full EAF Workbook. • Answer each of the 18 questions in Part 2. • If you answer"Yes"to a numbered question,please complete all the questions that follow in that section. • If you answer"No"to a numbered question,move on to the next numbered question. • Check appropriate column to indicate the anticipated size of the impact. • Proposed projects that would exceed a numeric threshold contained in a question should result in the reviewing agency checking the box"Moderate to large impact may occur." • The reviewer is not expected to be an expert in environmental analysis. • If you are not sure or undecided about the size of an impact,it may help to review the sub-questions for the general question and consult the workbook. • When answering a question consider all components of the proposed activity,that is,the"whole action". • Consider the possibility for long-term and cumulative impacts as well as direct impacts. • Answer the question in a reasonable manner considering the scale and context of the project. 1. Impact on Land Proposed action may involve construction on,or physical alteration of, ❑NO ❑YES the land surface of the proposed site. (See Part 1. D.1) If"Yes", answer questions a -j. If"No", move on to Section 2. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may involve construction on land where depth to water table is E2d ❑ ❑ less than 3 feet. b.The proposed action may involve construction on slopes of 15%or greater. E2f ❑ ❑ c.The proposed action may involve construction on land where bedrock is exposed,or Eta ❑ ❑ generally within 5 feet of existing ground surface. d.The proposed action may involve the excavation and removal of more than 1,000 tons D2a ❑ ❑ of natural material. e.The proposed action may involve construction that continues for more than one year Dle ❑ ❑ or in multiple phases. f.The proposed action may result in increased erosion,whether from physical D2e,D2q ❑ ❑ disturbance or vegetation removal(including from treatment by herbicides). g.The proposed action is,or may be,located within a Coastal Erosion hazard area. B1 i ❑ ❑ h.Other impacts: ❑ ❑ Page 1 of 10 2. Impact on Geological Features The proposed action may result in the modification or destruction of,or inhibit access to, any unique or unusual land forms on the site(e.g.,cliffs,dunes, ❑NO DYES minerals, fossils, caves). (See Part 1.E.2.g) If"Yes", answer questions a-c. If"No", move on to Section 3. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.Identify the specific land form(s)attached: Egg ❑ ❑ b.The proposed action may affect or is adjacent to a geological feature listed as a E3c ❑ ❑ registered National Natural Landmark. Specific feature: c. Other impacts: ❑ ❑ 3. Impacts on Surface Water The proposed action may affect one or more wetlands or other surface water ❑NO DYES bodies(e.g.,streams,rivers,ponds or lakes). (See Part 1.D.2, E.2.h) If"Yes", answer questions a-1. If'No', move on to Section 4. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may create a new water body. D2b,D 1 h ❑ ❑ b.The proposed action may result in an increase or decrease of over 10%or more than a D2b ❑ ❑ 10 acre increase or decrease in the surface area of any body of water. c.The proposed action may involve dredging more than 100 cubic yards of material D2a ❑ ❑ from a wetland or water body. d.The proposed action may involve construction within or adjoining a freshwater or E2h ❑ ❑ tidal wetland,or in the bed or banks of any other water body. e.The proposed action may create turbidity in a waterbody,either from upland erosion, D2a,D2h ❑ ❑ runoff or by disturbing bottom sediments. f.The proposed action may include construction of one or more intake(s)for withdrawal D2c ❑ ❑ of water from surface water. g.The proposed action may include construction of one or more outfall(s)for discharge D2d ❑ ❑ of wastewater to surface water(s). h.The proposed action may cause soil erosion,or otherwise create a source of D2e ❑ ❑ stormwater discharge that may lead to siltation or other degradation of receiving water bodies. i.The proposed action may affect the water quality of any water bodies within or E2h ❑ ❑ downstream of the site of the proposed action. j.The proposed action may involve the application of pesticides or herbicides in or D2q,E2h ❑ ❑ around any water body. k. The proposed action may require the construction of new,or expansion of existing, D I a,D2d ❑ ❑ wastewater treatment facilities. Page 2 of 10 1.Other impacts: ❑ ❑ 4. Impact on groundwater The proposed action may result in new or additional use of ground water,or LINO ❑YES may have the potential to introduce contaminants to ground water or an aquifer. (See Part 1. D.2.a, D.2.c,D.2.d,D.2.p,D.2.q,D.2.t) If"Yes", answer questions a-h. If"No", move on to Section 5. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may require new water supply wells,or create additional demand D2c ❑ ❑ on supplies from existing water supply wells. b.Water supply demand from the proposed action may exceed safe and sustainable D2c ❑ ❑ withdrawal capacity rate of the local supply or aquifer. Cite Source: c.The proposed action may allow or result in residential uses in areas without water and Dla,D2c ❑ ❑ sewer services. d.The proposed action may include or require wastewater discharged to groundwater. D2d,E21 ❑ ❑ e.The proposed action may result in the construction of water supply wells in locations D2c,Elf, ❑ ❑ where groundwater is,or is suspected to be,contaminated. Elg,Elh f.The proposed action may require the bulk storage of petroleum or chemical products D2p,E21 ❑ ❑ over ground water or an aquifer. g.The proposed action may involve the commercial application of pesticides within 100 E2h,D2q, ❑ ❑ feet of potable drinking water or irrigation sources. E21,D2c h. Other impacts: ❑ ❑ 5. Impact on Flooding The proposed action may result in development on lands subject to flooding. El NO DYES (See Part 1. E.2) If"Yes", answer questions a-g. If"No", move on to Section 6. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may result in development in a designated floodway. E2i ❑ ❑ b.The proposed action may result in development within a 100 year floodplain. E2j ❑ ❑ c.The proposed action may result in development within a 500 year floodplain. E2k ❑ ❑ d.The proposed action may result in,or require,modification of existing drainage D2b,D2e ❑ ❑ patterns. e.The proposed action may change flood water flows that contribute to flooding. D2b,E2i, ❑ ❑ E2j,E2k f.If there is a dam located on the site of the proposed action,is the dam in need of repair, E l e ❑ ❑ or upgrade? Page 3 of 10 g. Other impacts: ❑ ❑ 6. Impacts on Air The proposed action may include a state regulated air emission source. ENO Ei YES (See Part 1. D.2.f.,D,2,h,D.2.g) If"Yes", answer questions a-f. If"No", move on to Section 7. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.If the proposed action requires federal or state air emission permits,the action may also emit one or more greenhouse gases at or above the following levels: i. More than 1000 tons/year of carbon dioxide(CO2) D2g ❑ ❑ ii. More than 3.5 tons/year of nitrous oxide(N20) D2g ❑ ❑ iii.More than 1000 tons/year of carbon equivalent of perfluorocarbons(PFCs) D2g ❑ ❑ iv.More than.045 tons/year of sulfur hexafluoride(SF6) D2g ❑ ❑ v. More than 1000 tons/year of carbon dioxide equivalent of D2g ❑ ❑ hydrochloroflourocarbons(I{'Cs)emissions vi.43 tons/year or more of methane D2h ❑ ❑ b.The proposed action may generate 10 tons/year or more of any one designated D2g ❑ ❑ hazardous air pollutant,or 25 tons/year or more of any combination of such hazardous air pollutants. c.The proposed action may require a state air registration,or may produce an emissions D2f,D2g ❑ ❑ rate of total contaminants that may exceed 5 lbs.per hour,or may include a heat source capable of producing more than 10 million BTU's per hour. d.The proposed action may reach 50%of any of the thresholds in"a"through"c", D2g ❑ ❑ above. e.The proposed action may result in the combustion or thermal treatment of more than 1 D2s ❑ ❑ ton of refuse per hour. f.Other impacts: ❑ ❑ 7. Impact on Plants and Animals The proposed action may result in a loss of flora or fauna. (See Part 1.E.2.m.-q.) ONO DYES If"Yes", answer questions a-j. If"No", move on to Section 8. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may cause reduction in population or loss of individuals of any E2o ❑ ❑ threatened or endangered species,as listed by New York State or the Federal government,that use the site,or are found on,over,or near the site. b.The proposed action may result in a reduction or degradation of any habitat used by E2o ❑ ❑ any rare,threatened or endangered species,as Isted by New York State or the federal government. c.The proposed action may cause reduction in population,or loss of individuals,of any E2p ❑ ❑ species of special concern or conservation need,as listed by New York State or the Federal government,that use the site,or are found on,over,or near the site. d.The proposed action may result in a reduction or degradation of any habitat used by E2p ❑ ❑ any species of special concern and conservation need,as listed by New York State or the Federal government. Page 4 of 10 e. The proposed action may diminish the capacity of a registered National Natural E3c ❑ ❑ Landmark to support the biological community it was established to protect. f.The proposed action may result in the removal of,or ground disturbance in,any E2n ❑ ❑ portion of a designated significant natural community. Source: g.The proposed action may substantially interfere with nesting/breeding,foraging,or E2m ❑ ❑ over-wintering habitat for the predominant species that occupy or use the project site. h.The proposed action requires the conversion of more than 10 acres of forest, Elb ❑ ❑ grassland or any other regionally or locally important habitat. Habitat type&information source: i.Proposed action(commercial,industrial or recreational projects,only)involves use of D2q ❑ ❑ herbicides or pesticides. j.Other impacts: ❑ ❑ 8. Impact on Agricultural Resources The proposed action may impact agricultural resources. (See Part 1. E.3.a. and b.) ONO DYES If"Yes", answer questions a-h. If"No", move on to Section 9. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a. The proposed action may impact soil classified within soil group 1 through 4 of the Etc,E3b ❑ ❑ NYS Land Classification System. b. The proposed action may sever,cross or otherwise limit access to agricultural land Ela,Elb ❑ ❑ (includes cropland,hayfields,pasture,vineyard,orchard,etc). c.The proposed action may result in the excavation or compaction of the soil profile of E3b ❑ ❑ active agricultural land. d.The proposed action may irreversibly convert agricultural land to non-agricultural Elb,E3a ❑ ❑ uses,either more than 2.5 acres if located in an Agricultural District,or more than 10 acres if not within an Agricultural District. e.The proposed action may disrupt or prevent installation of an agricultural land El a,Elb ❑ ❑ management system. f.The proposed action may result,directly or indirectly,in increased development C2c,C3, ❑ ❑ potential or pressure on farmland. D2c,D2d g.The proposed project is not consistent with the adopted municipal Farmland C2c ❑ ❑ Protection Plan. h.Other impacts: ❑ ❑ Page 5 of 10 • 9. Impact on Aesthetic Resources The land use of the proposed action are obviously different from,or are in ONO OYES sharp contrast to,current land use patterns between the proposed project and a scenic or aesthetic resource. (Part 1. E.l.a,E.1.b,E.3.h.) If"Yes", answer questions a-g. If"No",go to Section 10. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.Proposed action may be visible from any officially designated federal,state,or local E3h ❑ ❑ scenic or aesthetic resource. b.The proposed action may result in the obstruction,elimination or significant E3h,C2b ❑ ❑ screening of one or more officially designated scenic views. c.The proposed action may be visible from publicly accessible vantage points: E3h i.Seasonally(e.g., screened by summer foliage,but visible during other seasons) ❑ ❑ ii.Year round ❑ ❑ d.The situation or activity in which viewers are engaged while viewing the proposed E3h action is: E2q, i. Routine travel by residents,including travel to and from work ❑ ❑ ii.Recreational or tourism based activities Elc ❑ ❑ e.The proposed action may cause a diminishment of the public enjoyment and E3h ❑ ❑ appreciation of the designated aesthetic resource. f. There are similar projects visible within the following distance of the proposed Dla,Ela, ❑ ❑ project: Dlf,Dlg 0-1/2 mile V2-3 mile 3-5 mile 5+ mile g.Other impacts: ❑ ❑ 10. Impact on Historic and Archeological Resources The proposed action may occur in or adjacent to a historic or archaeological ENO ❑YES resource. (Part 1.E.3.e, f. and g.) If"Yes", answer questions a-e. If"No", go to Section 11. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may occur wholly or partially within,or substantially contiguous E3e ❑ El to,any buildings,archaeological site or district which is listed on or has been nominated by the NYS Board of Historic Preservation for inclusion on the State or National Reeister of Historic Places. b.The proposed action may occur wholly or partially within,or substantially contiguous E3f ❑ ❑ to,an area designated as sensitive for archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory. c.The proposed action may occur wholly or partially within,or substantially contiguous E3g ❑ ❑ to,an archaeological site not included on the NY SHPO inventory. Source: Page 6 of 10 d.Other impacts: ❑ ❑ e.If any of the above(a-d)are answered"Yes",continue with the following questions to help support conclusions in Part 3: i. The proposed action may result in the destruction or alteration of all or part E3e,E3g, ❑ ❑ of the site or property. E3f ii. The proposed action may result in the alteration of the property's setting or E3e,E3f, ❑ ❑ integrity. E3g,El a, Elb iii. The proposed action may result in the introduction of visual elements which E3e,E3f, ❑ ❑ are out of character with the site or property,or may alter its setting. E3g,E3h, C2,C3 11. Impact on Open Space and Recreation The proposed action may result in a loss of recreational opportunities or a ENO ❑YES reduction of an open space resource as designated in any adopted municipal open space plan. (See Part 1. C.2.c, E.l.c., E.2.q.) If"Yes", answer questions a-e. If"No", go to Section 12. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may result in an impairment of natural functions,or"ecosystem D2e,Elb ❑ ❑ services",provided by an undeveloped area,including but not limited to stormwater E2h, storage,nutrient cycling,wildlife habitat. E2m,E2o, E2n,E2p b.The proposed action may result in the loss of a current or future recreational resource. C2a,Elc, ❑ ❑ C2c,E2q c.The proposed action may eliminate open space or recreational resource in an area C2a,C2c ❑ ❑ with few such resources. E1c,E2q d.The proposed action may result in loss of an area now used informally by the C2c,Elc ❑ ❑ community as an open space resource. e. Other impacts: ❑ ❑ 12. Impact on Critical Environmental Areas The proposed action may be located within or adjacent to a critical n NO n YES environmental area(CEA). (See Part 1. E.3.d) If"Yes", answer questions a-c. If'No", go to Section 13. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur - a.The proposed action may result in a reduction in the quantity of the resource or E3d ❑ ❑ characteristic which was the basis for designation of the CEA. b.The proposed action may result in a reduction in the quality of the resource or E3d ❑ ❑ characteristic which was the basis for designation of the CEA. c.Other impacts: ❑ ❑ Page 7 of 10 13. Impact on Transportation The proposed action may result in a change to existing transportation systems. LINO El YES (See Part 1. D.2 j) If"Yes", answer questions a-g. If"No",go to Section 14. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.Projected traffic increase may exceed capacity of existing road network. D2j ❑ ❑ b.The proposed action may result in the construction of paved parking area for 500 or D2j ❑ ❑ more vehicles. c. The proposed action will degrade existing transit access. D2j ❑ ❑ d.The proposed action will degrade existing pedestrian or bicycle accommodations. D2j ❑ ❑ e.The proposed action may alter the present pattern of movement of people or goods. D2j ❑ ❑ f. Other impacts: ❑ ❑ 14. Impact on Energy The proposed action may cause an increase in the use of any form of energy. ONO DYES (See Part 1. D.2.k) If"Yes", answer questions a-e. If"No", go to Section 15. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a. The proposed action will require a new,or an upgrade to an existing,substation. D2k ❑ ❑ b.The proposed action will require the creation or extension of an energy transmission Dl f, ❑ ❑ or supply system to serve more than 50 single or two-family residences or to serve a D lq,D2k commercial or industrial use. c.The proposed action may utilize more than 2,500 MWhrs per year of electricity. D2k ❑ ❑ d.The proposed action may involve heating and/or cooling of more than 100,000 square D 1g ❑ ❑ feet of building area when completed. e.Other Impacts: ❑ ❑ 15. Impact on Noise,Odor, and Light The proposed action may result in an increase in noise,odors,or outdoor lighting. ONO DYES (See Part 1. D.2.m.,n.,and o.) If I "Yes answer'', saver questions a -f. If"No",go to Section 16. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may produce sound above noise levels established by local D2m ❑ ❑ regulation. b.The proposed action may result in blasting within 1,500 feet of any residence, D2m,Eld ❑ ❑ hospital,school,licensed day care center,or nursing home. c.The proposed action may result in routine odors for more than one hour per day. D2o ❑ ❑ Page 8 of 10 d.The proposed action may result in li ght shining onto adjoining pro erties. D2n ❑ ❑ e.The proposed action may result in lighting creating sky-glow brighter than existing D2n,Ela ❑ ❑ area conditions. f.Other impacts: ❑ ❑ 16. Impact on Human Health The proposed action may have an impact on human health from exposure ❑NO EYES to new or existing sources of contaminants. (See Part 1.D.2.q.,E.1. d. f. g. and h.) If"Yes", answer questions a-rn. If"No",go to Section 17. Relevant No,or Moderate Part I small to large Question(s) impact impact may may cccur occur a.The proposed action is located within 1500 feet of a school,hospital,licensed day Eld ❑ ❑ care center,group home,nursing home or retirement community. b.The site of the proposed action is currently undergoing remediation. Elg,Elh ❑ ❑ c. There is a completed emergency spill remediation,or a completed environmental site Elg,Elh ❑ ❑ remediation on,or adjacent to,the site of the proposed action. d.The site of the action is subject to an institutional control limiting the use of the Elg,Elh ❑ ❑ property(e.g.,easement or deed restriction). e.The proposed action may affect institutional control measures that were put in place Elg,Elh ❑ ❑ to ensure that the site remains protective of the environment and human health. f.The proposed action has adequate control measures in place to ensure that future D2t ❑ ❑ generation,treatment and/or disposal of hazardous wastes will be protective of the environment and human health. g.The proposed action involves construction or modification of a solid waste D2q,Elf ❑ ❑ management facility. h.The proposed action may result in the unearthing of solid or hazardous waste. D2q,Elf ❑ ❑ i. The proposed action may result in an increase in the rate of disposal,or processing,of D2r,D2s ❑ ❑ solid waste. j.The proposed action may result in excavation or other disturbance within 2000 feet of Elf,Elg ❑ ❑ a site used for the disposal of solid or hazardous waste. Elh k.The proposed action may result in the migration of explosive gases from a landfill Elf,Elg ❑ ❑ site to adjacent off site structures. I. The proposed action may result in the release of contaminated leachate from the D2s,E1f, ❑ ❑ project site. D2r m.Other impacts: ❑ ❑ Page 9 of 10 17. Consistency with Community Plans The proposed action is not consistent with adopted land use plans. ENO EYES (See Part 1. C.1,C.2. and C.3.) If"Yes", answer questions a-h. If"No",go to Section 18. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a. The proposed action's land use components may be different from,or in sharp C2,C3,Dla ❑ ❑ contrast to,current surrounding land use pattern(s). Ela,Elb b.The proposed action will cause the permanent population of the city,town or village C2 ❑ ❑ in which the project is located to grow by more than 5%. c.The proposed action is inconsistent with local land use plans or zoning regulations. C2,C2,C3 ❑ ❑ d.The proposed action is inconsistent with any County plans,or other regional land use C2,C2 ❑ ❑ plans. e.The proposed action may cause a change in the density of development that is not C3,Dlc, ❑ ❑ supported by existing infrastructure or is distant from existing infrastructure. Dld,Dlf, Dld,Elb f.The proposed action is located in an area characterized by low density development C4,D2c,D2d ❑ ❑ that will require new or expanded public infrastructure. D2j g. The proposed action may induce secondary development impacts(e.g.,residential or C2a ❑ ❑ commercial development not included in the proposed action) h. Other: ❑ ❑ 18. Consistency with Community Character The proposed project is inconsistent with the existing community character. ONO DYES (See Part 1. C.2, C.3,D.2,E.3) If"Yes", answer questions a-g. If"No",proceed to Part 3. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may replace or eliminate existing facilities,structures,or areas E3e,E3f,E3g ❑ ❑ of historic importance to the community. b.The proposed action may create a demand for additional community services(e.g. C4 ❑ ❑ schools,police and fire) c. The proposed action may displace affordable or low-income housing in an area where C2,C3,D 1 f ❑ ❑ there is a shortage of such housing. Dig,Ela d.The proposed action may interfere with the use or enjoyment of officially recognized C2,E3 ❑ ❑ or designated public resources. e.The proposed action is inconsistent with the predominant architectural scale and C2,C3 ❑ ❑ character. f.Proposed action is inconsistent with the character of the existing natural landscape. C2,C3 ❑ ❑ Ela,Elb E2g,E2h g. Other impacts: ❑ ❑ PRINT FULL FORM Page 10 of 10 Agency Use Only [IfApplicable] Project: Date: Full Environmental Assessment Form Part 3-Evaluation of the Magnitude and Importance of Project Impacts and Determination of Significance Part 3 provides the reasons in support of the determination of significance. The lead agency must complete Part 3 for every question in Part 2 where the impact has been identified as potentially moderate to large or where there is a need to explain why a particular element of the proposed action will not,or may,result in a significant adverse environmental impact. Based on the analysis in Part 3,the lead agency must decide whether to require an environmental impact statement to further assess the proposed action or whether available information is sufficient for the lead agency to conclude that the proposed action will not have a significant adverse environmental impact. By completing the certification on the next page,the lead agency can complete its determination of significance. Reasons Supporting This Determination: To complete this section: • Identify the impact based on the Part 2 responses and describe its magnitude. Magnitude considers factors such as severity, size or extent of an impact. • Assess the importance of the impact. Importance relates to the geographic scope,duration,probability of the impact occurring,number of people affected by the impact and any additional environmental consequences if the impact were to occur. • The assessment should take into consideration any design element or project changes. • Repeat this process for each Part 2 question where the impact has been identified as potentially moderate to large or where there is a need to explain why a particular element of the proposed action will not,or may,result in a significant adverse environmental impact. • Provide the reason(s)why the impact may,or will not,result in a significant adverse environmental impact • For Conditional Negative Declarations identify the specific condition(s)imposed that will modify the proposed action so that no significant adverse environmental impacts will result. • Attach additional sheets,as needed. Determination of Significance-Type 1 and Unlisted Actions SEQR Status: ❑ Type 1 ❑Unlisted Identify portions of EAF completed for this Project: ❑Part 1 ❑Part 2 ❑Part 3 Upon review of the information recorded on this EAF,as noted,plus this additional support information and considering both the magnitude and importance of each identified potential impact,it is the conclusion of the as lead agency that: ❑ A. This project will result in no significant adverse impacts on the environment,and,therefore,an environmental impact statement need not be prepared. Accordingly,this negative declaration is issued. ❑ B. Although this project could have a significant adverse impact on the environment,that impact will be avoided or substantially mitigated because of the following conditions which will be required by the lead agency: There will,therefore,be no significant adverse impacts from the project as conditioned,and,therefore,this conditioned negative declaration is issued. A conditioned negative declaration may be used only for UNLISTED actions(see 6 NYCRR 617.d). ❑ C. This Project may result in one or more significant adverse impacts on the environment,and an environmental impact statement must be prepared to further assess the impact(s)and possible mitigation and to explore alternatives to avoid or reduce those impacts. Accordingly,this positive declaration is issued. Name of Action: Name of Lead Agency: Name of Responsible Officer in Lead Agency: Title of Responsible Officer: Signature of Responsible Officer in Lead Agency: Date: Signature of Preparer(if different from Responsible Officer) Date: For Further Information: Contact Person: Address: Telephone Number: E-mail: For Type 1 Actions and Conditioned Negative Declarations,a copy of this Notice is sent to: Chief Executive Officer of the political subdivision in which the action will be principally located(e.g.,Town/City/Village of) Other involved agencies(if any) Applicant(if any) Environmental Notice Bulletin: http://www.dec.ny.govlenb/enb.html PRINT FULL FORM Page 2 of 2 • New York State Department of Environmental Conservation Division of Environmental Permits, Region 5 232 Golf Course Road, Warrensburg, NY 12885 Phone: (518) 623-1240 • Fax: (518) 623-3603 Website: www.dec.ny.gov Joe Martens LETTER OF NO JURISDICTION Commissioner ENDANGERED SPECIES ACT July 7, 2014 Tom Center Nace Engineering 169 Haviland Road Queensury, NY 12804 Re: Leuci Subdivision, Peggy Ann Road SBL#: 301 .15-1-19 Town of Queensbury, Saratoga County Dear Mr. Center: The Department of Environmental Conservation (DEC) has determined that your proposal to develop a parcel located on Peggy Ann Road in the town of Queensbury is not likely to result in the take of threatened or endangered species. This determination is based on the information submitted by Nace Engineering on June 28, 2014 and reviewed by staff from the Division of Fish, Wildlife, and Marine Resources. Though Karner blue butterflies (Lycaeides melissa samuelis) are known to occur near your project location, based on a site visit performed on July 3, 2014 the DEC does not anticipate your proposed action to result in a take. Therefore, no permit is required at this time pursuant to the implementing regulations (6NYCRR Part 182) of the New York State Endangered Species Act (Article 11-0535). Be advised that any changes in location, expansion of the footprint of the project, modifications of the scope, or changes in the timing of proposed actions that are not identified in the submission referenced above may trigger DEC authorization. Please reinitiate contact with this office if such activities are contemplated. Please note that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies or local municipalities. Si ': ely, Marc S. Mig iore Deputy Regional Permit Administrator LEUCI SUBDIVISION- PEGGYANN ROAD Page 1 of 1 LEUCI SUBDIVISION - PEGGY ANN ROAD --.,, ,.. . ii 'ir •, '.-.---,---, ic c --,..,,,...,"; _,.... 4,..-q 4,7:7. ‘S.,71111, .44-# i -I , , .,. ±, 1, • • .f 5 1 i 1 I J11...4 .%.".... ■ -."-'''''''y .r"valk_ Legend Background Maps l •.1-'...r.T. .. • 1 t 40, 111.-1cf, i. 4"/ ----'''C'..Z -f-....i17-4.--.7[:Z‘aCk- .■.1)%lft - .4.,.•I (Scanned Quads) 7, I, •••,. 'i• *. 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Disclaimer:This map was prepared by the New York State Parks,Recreation and Historic Preservation National Register Listing Internet Application.The :uly 11,2014 information was compiled using the most current data available.It is deemed accurate,but is not guaranteed. • http://pwa.parks.ny.gov/nr/print/print display.asp?title=LEUCI+SUBDIVISION+-+PEGG... 7/11/2014 _