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2.2A 2.2(A) NON-SIGNIHCANCE'Alater District Extension#50-Exit 18 Overlay—9-14-15 RESOLUTION ADOPTING DETERMINATION OF NON-SIGNIFICANCE REGARDING EXIT 18 OVERLAY WATER DISTRICT EXTENSION NO. 50 TO QUEENSBURY CONSOLIDATED WATER DISTRICT RESOLUTION NO.: ,2015 INTRODUCED BY: WHO MOVED ITS ADOPTION SECONDED BY: WHEREAS, the Town of Queensbury wishes to extend the Queensbury Consolidated Water District to form the Exit 18 Overlay Water District Extension No. 50 to serve three (3) parcels not within the Water District or wholly within such District, but where Town water service currently exists to serve or benefit such properties in accordance with New York Town Law Article 12-A, and WHEREAS, no comments have been received from any potentially involved agencies, the New York State Department of Environmental Conservation and the New York State Department of Health, and WHEREAS, the Town's Water Department has not identified any environmental impacts, and WHEREAS, the Town Board is duly qualified to act as Lead Agency for compliance with the State Environmental Quality Review Act (SEQRA) which requires environmental review of certain actions undertaken by local governments, and WHEREAS, the proposed action is an unlisted action in accordance with the rules and regulations of SEQRA, NOW, THEREFORE, BE IT RESOLVED, that the Town Board, after considering the proposed action, reviewing the Environmental Assessment Form and thoroughly analyzing the action for potential environmental concerns, determines that the action will not have a significant effect on the environment, and BE IT FURTHER, RESOLVED, that the Town Board hereby authorizes and directs the Town Supervisor to complete the Environmental Assessment Form by checking the box indicating that the proposed action will not result in any significant adverse impacts, and BE IT FURTHER, RESOLVED, that the Town Board approves of a Negative Declaration and authorizes and directs the Town Clerk's Office to file any necessary documents in accordance with the provisions of the general regulations of the Department of Environmental Conservation. Duly adopted this 14'h day of September, 2015, by the following vote: AYES NOES ABSENT: Short Environmental Assessment Form Part 1 -Project Information 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 Name of Action or Project: Town of Queensbury Exit 18 Overlay Water District Extension#50 Project Location(describe,and attach a location map): Big Boom Road and Main Street,Town of Queensbury,New York.Please see attached location map. Brief Description of Proposed Action: Formation of Town of Queensbury Exit 18 Overlay Water District Extension#50. Name of Applicant or Sponsor: Telephone: 518-761-8200 Town of Queensbury E-Mail: johns @queensbury.net Address: 742 Bay Road City/PO: State: Zip Code: Queensbury New York 12804 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that 0 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? NO YES If Yes,list agency(s)name and permit or approval: ❑ 3.a.Total acreage of the site of the proposed action? 18.7 acres b.Total acreage to be physically disturbed? 0 acres c. Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ['Rural(non-agriculture) ❑Industrial m Commercial ❑Residential(suburban) ❑Forest ['Agriculture El Aquatic ['Other(specify): ['Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ a ❑ b.Consistent with the adopted comprehensive plan? ri CI 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES P P P g landscape? n 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: tgi El 8. a.Will the proposed action r esult in a substantial increase in traffic above present levels? NO YES on b. Are public transportation service(s)available at or near the site of the proposed action? O N - c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? O 0 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: no 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 0 ❑ Action is the formation of a water district extension. 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: Action is the formation of a water district extension. 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 0 ❑ b.Is the proposed action located in an archeological sensitive area? O 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? n g b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? 0 ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 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 0 Urban 0Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 0 16.Is the project site located in the 100 year flood plain? NO YES L✓1 l 1 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? O NO OYES 51 n b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: NO OYES Page 2 of 3 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES_ 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 NO YES solid waste management facility? If Yes,describe: 0 1-1 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: 5 ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: Signature: PRINT FORM Page 3 of 3 Agency Use Only[If applicable] Project: l Date: Short Environmental Assessment Form Part 2 -Impact Assessment Part 2 is to be completed by the Lead Agency. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a. public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ ❑ waterbodies,groundwater, air quality,flora and fauna)? 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? LI PRINT FORM Page 1 of 2 Agency use Only[If applicable] Project:I Date: I Short Environmental Assessment Form Part 3 Determination of Significance For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting, probability of occurring,duration,irreversibility,geographic scope and magnitude. Also consider the potential for short- term,long-term and cumulative impacts. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT FORM Page 2 of 2 I= `20 'Qs _.,,10.1,,,,A,175.,,, y 309 10- �-3 ai 3e •`f '309;10-1-33.1,1.,,!,, ,,- 09 att 3:49.faf-Y o raf 133, faz• iiLegend 32: 10. fa 6" a1a1 " for r¢2 0`1 a we 10.24 • . 9 1 3oa.i�1a1 f ..'/4-1 �°9.fai-16 s� 9 fS 1 Existing Queensbury Consolidated Water District boa f4f a f4t 2 z •tb 15 (tl• ' Proposed Exit 18 Overlay Water District, Extension#50 °1`i f4 1h l° 3091'1�0 1 �®T' �? 41 30x.141-so -309 �Y'�,... r,,�i 26 ,`® r ,F" 'y.' 3DD1 f29 y4- of ...P7�r 6 _"-:- -Y-58.81 �,�» i 13 .y4'OL 30 • i 1;=80 ' :\odd y A,, , ` * I 141-52 /: ,'', --,11:,3.':..1,-7;1,:::: tdf- a •° f }„ * � " x iF t 1r1 Parcels to be included In proposed Exit .1,,,,,,::,.,1,,,,.,,., .6 '4t 6' 30914 y' 30D,14,148., f 4 18 Overlay Water District,Extension#50 •/ " c , � it 4 - sa a- r 14:14.1:::,:-,„,,,,,,,4r:: 14.1 3 .309 i41-61-- r• 309:15.140 508.14-1-60 3o9t°� 873 974 faI 30. 3oD.14-1.48.22 508.14.1 82 30Cfh1-02`" 3o9.fhf e2 3' 0 1 509 14 1 88.1 ,'14 1.6 ••f4-16.2 T'T dx 'G.13.2• Y°9141•j • MI j• ih1. 'alhid 309.14.1.48.21 30D.13.2- 309,14-146.11 77 309.14-f-56 ` 30a.1S1fif "d•:141-7• Town of 30°13.2 2 County 30x151.62 a_ "a?. �,9.f3-2.2 ty '06'13-2-• ;309 14,14 3 •.141-86 '� ' 09..13.2-1 ,9r-'86.12 _ =30D.14d-08 2 30D.f1-1+17. 30915143 , .13.2-1• , � 3 30 13- 27 30D.14f-80.1 30x.141.2 r w 309141691 0 30a 15164 309 13-2-19 _ � '',,,'-.:,;,;.1;'", s.. 369:y3.2;14' `n` < �3% yi!4 x.Aa ,4 R/Ytl�'/tl 13 JO 30D 14'1 1 ,ev 754A.^s: t-: - . 0. - 1 _ _ ". _.L:, :,1'4 r- x.151 7�': 9.1322 : 309141x1 � ,t a $�' 30x.14.1-/3 30D.f1.114.1 30913211 fat .y. °.;-z .• y�. ° a, " t v '�, 309.14.1-46 30x.141.442 309.18.148 ,aes�*�i°r 1414"49-14. , 4.` �••R m _ 3oa.1a-1r.'. . - >0 309 n Y z3 zf +7 fz3 30017'1-21* 3091r-r-fa 1 �-� '••181 16.3 s Town of Sarel ! * ,} x Tea ,,_ �]J8-1J Moroeu Coo° ae oro ,.am r _ '"'+a?-'r",. `3091781,23 5� 1 }.tt �;, 309.18-1-2 ... ..� - .',' .� .,.. _ ,.. .,__. 309V: � 316.51.10 C�THE Water District Extension Map,Plan and Report °" O21 CHAZEN ENOINEERINO,LAND SURVEYING a LANDS ARCHITECTURE CO.,D.P.C. xrt V�[ W4 Dmchaee county ol8ee: capital a.tr1�1 oMOe: North country oMee: oerzom,s COMPANIES• 21 Fox Street 547 River Street 375 Bay Road Exit 18 Overlay Water District Extension#50 'Me ^+,+•••u.o0 - Pou9hkeapsie,NV.12601 Troy,NV.12160 Oueenebury,NY.12604 tnen.xxrt«t •"""', Phone:(845)4543960 Phone:(516)237-°055 Phone:(516)812-0513 w•1•' nsoo to lix,,•°I„°••Y•n....•°r,•,n.∎••"' ,o,„,,,,,,....7,,;;;;........"ew�•Y,°MY�Mr,n•Mbrn•YMww..YMKmM TM Grr,fr,•rb,rr,M'4,•Y•r°•wr•Mbr MlYnhw M.r °M U.,.bbbnwr Town of Cueensbury,Warren County,New York n«b. App.* 12-12-79(3/99)-9c SEQR State Environmental Quality Review NEGATIVE DECLARATION Notice of Determination of Non-Significance Project Number Date 1-5-15 This notice is issued pursuant to Part 617 of the implementing regulations pertaining to Article 8(State Environmental Quality Review Act)of the Environmental Conservation Law. The Queensbury Town Board as lead agency, has determined that the proposed action described below will not have a significant environmental impact and a Draft Impact Statement will not be prepared. Name of Action: Exit 18 Overlay Water District Extension No.50 SEQR Status: Type 1 Unlisted Conditioned Negative Declaration: Yes No Description of Action: Formation of Town of Queensbury Exit 18 Overlay Water District Extension No.50 to establish an extension to the Queensbury Consolidated Water District to serve three(3) parcels not wihtin the Water District or wholly within such District, but where Town water service currently exists to serve or benefit such properties as more specifically shown on the Map, Plan and Report submitted and filed in the Queensbury Town Clerk's Office. Location: (Include street address and the name of the municipality/county.A location map of appropriate scale is also recommended.) Big Boom Road and Main Street in the Town of Queensbury, as more specifically shown on the Map, Plan and Report submitted and filed in the Queensbury Town Clerk's Office,Town of Queensbury,Warren County, New York SEQR Negative Declaration Page 2 of 2 Reasons Supporting This Determination: (See 617.7(a)-(c)for requirements of this determination ;see 617.7(d)for Conditioned Negative Declaration) If Conditioned Negative Declaration, provide on attachment the specific mitigation measures imposed,and identify comment period(not less than 30 days from date of pubication In the ENB) For Further Information: Contact Person: John Si-rough,Town Supervisor Address: `14Z Gay Road 0kw-4'6 y fly 121304 Telephone Number: 5 i$°7(o I ZZ9 For Type 1 Actions and Conditioned Negative Declarations, a Copy o f this Notice is sent to: Chief Executive Officer,Town/City/Village of Other involved agencies(If any) Applicant(If any) Environmental Notice Bulletin, Room 538, 50 Wolf Road,Albany NY, 12233-1750(Type One Actions only)