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3.11 3.11 NON-SIGNIFICANCE\Consent to DEC as Lead Agent—Fort Miller-Rezoning of Mineral Extraction Pit—4-3-17 RESOLUTION AUTHORIZING CONSENT TO NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION BEING DESIGNATED AS LEAD AGENCY FOR SEQRA REVIEW OF PROPOSED REZONING APPLICATION OF THE FORT MILLER COMPANY, INC. RESOLUTION NO.: ,2017 INTRODUCED BY: WHO MOVED ITS ADOPTION SECONDED BY: WHEREAS, in accordance with the State Environmental Quality Review Act (SEQRA), the New York State Department of Environmental Conservation (DEC) has notified the Queensbury Town Board that DEC is seeking Lead Agency status for the purposes of fulfilling the SEQRA requirements relative to its review of the proposed rezoning application of The Fort Miller Company, Inc., concerning a parcel of land identified as tax map parcel no.: 279.-1-48 located at 1359 Ridge Road in the Town of Queensbury to permit sand and gravel extraction (the "Project") as set forth in DEC's April 20, 2015 email to the Town of Queensbury Planning Department presented at this meeting, and WHEREAS, DEC has requested that the Town Board consent to DEC being designated as Lead Agency, and the Town Board has concluded that DEC is the most involved agency and should be Lead Agency for the purposes of SEQRA review relating to the Project, and WHEREAS, the Town Board wishes to therefore provide such consent, NOW, THEREFORE, BE IT RESOLVED, that the Queensbury Town Board hereby authorizes, directs and consents to the New York State Department of Environmental Conservation as Lead Agency for SEQRA review relative to DEC's review of the proposed rezoning application of The Fort Miller Company, Inc., concerning a parcel of land identified as tax map parcel no.: 279.-1-48 located at 1359 Ridge Road in the Town of Queensbury to permit sand and gravel extraction and authorizes and directs the Town Supervisor to execute any needed consent and/or other documentation and take any other necessary actions to effectuate the terms of this Resolution. Duly adopted this 3rd day of April, 2017,by the following vote: AYES NOES ABSENT: C 12 1 - cos— --c4 i'\ 1'Q, i 2 LI—Z.L l (r.; •Laura Moore From: Bliss, Kevin (DEC) <kevin.bliss@dec.ny.gov> Sent: Monday,April 20, 2015 4:57 PM To: Laura Moore Cc: Bain,Jeremy D (DEC) Subject: Fort Miller Mine Expansion (SEQRA) Hi Laura, Thank you for your letter of March 26, with which you forwarded application materials received by the Town Planning Office relative to the above-referenced proposed mine expansion. (Likewise for your patience with me concerning follow up phone calls.) The Department of Environmental Conservation has not yet received an official permit application for permit modification from the Fort Miller Company for this proposed mine expansion. But we have met with their representatives here at my office and on site. So we are familiar with their intentions. As is Department custom, we shall seek Lead Agency status with respect to the State Environmental Quality Review Act (SEQRA) process for this application review. The Town of Queensbury is recognized as an Involved Party. It is my understanding that the Adirondack Park Agency will not exert jurisdiction. Though our official request to the Town for Lead Agency status would have awaited our receipt of an application, in light of the fact that the Town currently has an application before it, now would be an appropriate time to address the matter. As noted in Citizens Concerned for the Harlem Valley Environment v. Town Board of the Town of Amenia, 264 AD2d 394 (2d Dept 1999),the Court found that in an instance where rezoning was an integral part of a mining proposal,the impacts of the mining had to be considered at the same time as the environmental review of the rezoning. Consequently, one may argue by extension that the Town would be improperly segmenting their SEQRA review for site plan and special use permit approval if a coordinated approach for this SEQRA Type I Action with DEC were not taken. If the Town is prepared to consent to DEC as Lead Agency, please let me know and we'll record that outcome in our file. Though as a practical matter, we'll not be in a position to make a SEQRA Determination of Significance until such time as we have an application before us. I will of course let you know when that happens, and follow up then with additional information, including a request for additional input from the Town on specific areas of concern. Copied on this email is Jeremy Bain, our mine land reclamation specialist. Should you have any questions, please feel free to contact either myself or Jeremy. Thank you for this opportunity to comment. Kind Regards, Kevin Kevin R. Bliss, PhD 1 Deputy Regional Permit Administrator Division of Environmental Permits New York State Department of Environmental Conservation 232 Golf Course Road, Warrensburg, NY 12885 Ph: 518-623-1286 I kevin.bliss(c�dec.nv.gov http://www.dec.nv.00v 2 PAUL E.PONTIFFBARTLETT, PONTIFF, STEWART & RHODES,P.C. James R.BURKETT ALAN R.RHODES STEFANIE DILALLO BITTER ROBERT S.MCMILLEN ATTORNEYS AT LAW KARLA WILLIAMS BUETTNER PHILIP C.MCINTIRE P.O.BOX 2168 ELISABETH B.MAHONEY MARK A.LEBOWITZ ONE WASHINGTON STREET JOHN D.WRIGHT J.LAWRENCE PALTROWITZ JESSICA HUGABONE VINSON MALCOLM B.O'HARA GLENS FALLS, NEW YORK 12801-2168 PATRICIA E.WATKINS RICHARD J.BARTLETT MARK E.CERASANO 1926-2015 BRUCE O.LIPINSKI TELEPHONE(518)792-2117 FAX(518)792-3309 ROBERT S.STEWART PAULA NADEAU BERUBE 1932-2001 JONATHAN C.LAPPER EMAIL infotiebpsriaw.com BERTRAM J.DUBE BENJAMIN R.PRATT.JR. WEBSITE www.bpsrIaw.com 1916-1999 EILEEN M.HAYNES SERVICE BY FACSIMILE NOT ACCEPTED March 29, 2017 3 !_ i ; _! John Strough, Supervisor and Members of the Town Board _,l �'I-CEIVIP Y-9 Town of Queensbury -I MAR 2 9 Zit 17 742 Bay Road --\ Q11EENSBURY Queensbury,NY 12804 �'-,„-\ CLERK'S OFFICE %,. /\,q, Re: The Fort Miller Company, Inc. Old 6 Dear Supervisor Strough and Members: Per our prior workshop meeting, enclosed please find ten copies of an Application for Petition for Change of Zone and the revised Full Environmental Assessment form on behalf of my client, The Fort Miller Company, Inc. Also enclosed is a check in the amount of $250 for the application fee. Please place this on your agenda for the purpose of consenting to the NYS DEC being lead agency for the SEQR review. Once the SEQR is completed the Town review can proceed. Very truly yours, BARTLETT, PONTIFF, STEWART & RHODES, P.C. I By: ': 6"-t-- Jon thaA C. Lapper, Esq. Dir ct (518)832-6434 Dirdct ax i: (518)824-1034 Direc E-Mail:jcl@bpsrlaw.conn JCL: Cc: Craig Brown Butch Marcelle Revised Oct.2008 TOWN OF QUEENSBURY TOWN BOARD APPLICATION PETITION FOR CHANGE OF ZONE Petition No. (Office Use Only): Applicant's Name: The Fort Miller Company, Inc Address: PO Box 98 Schuylerville, NY12870 To the Applicant: Parcel to be ReZoned:Tax Map#279.-1-48 1359 Ridge Road The Queensbury Planning Board will review this Petition and make recommendations to the Town Board. As part of this review, the Planning Board will consider the following questions and submit answers to the Town Board. As the applicant, you will have the option to provide answers for the Boards to consider. 1. What need is being met by the proposed change in zone or new zone? To change to zone from MDR to RR-5 to permit Sand and Gravel Extraction which is the historical use of the parcel 2. What existing zones, if any, can meet the stated need? RR-5 3. How is the proposed zone compatible with adjacent zones? yes, RR-5 is the adjacent zone 4. What physical characteristics of the site are suitable to the proposed zone? Existing Sand and Gravel pit and existing mining road with access to NYS Route 91,(Ridge Road) 5. How will the proposed zone affect public facilities? It will improve public facilities by removing mining traffic from Dream Lake Road 6. Why is the current zone classification not appropriate for the property in question? Sand and Gravel Extraction is not a permitted use in MDR zone. 7. What are the environmental impacts of the proposed change? Positive impacts due to avoidance of traffic on residential portion of Dream Lake Road. 1 Revised Oct 2008 8. How is the proposal compatible with the relevant portions of the Comprehensive Land Use Master Plan? The rural character of Dream Lake Road will be restored by the elimination of mining traffic and its relocation directly to NYS Route 9L near the Town Transfer Station. 9. How are the wider interests of the Community being served by this proposal? The adjacent Fort Miller Company Sand and Gravel Extraction operation will be benefited which provides jobs and materials for the construction industry. These questions are based on criteria used to review all zoning amendments. 2 Revised Oct.2008 Application - Petition for Change of Zone The applicant must submit a fee of $250 with the original & seventeen (17) copies of all documentation requested in this application to the Town Clerk's office. [Copies are distributed as follows: Town Board (5), Town Clerk(1),Town Counsel (1), Planning Board (9), File Copy (1), and Planning Staff(1). Petition No. (Office Use Only): Date Received by Town Clerk: Date Received by Planning Office: 1. Application For: (check where applicable) Amendment of Zoning Map X Amendment of Zoning Ordinance X 2. Current Zoning: MDR Proposed Zoning: RR-5 3. Project Location: 1359 Ridge Road 4. Tax Map ID: 279.-1-48 5. Applicant: The Fort Miller Company,Inc Address: PO Box 98 Srhn lerville.NY12870 Phone: 695-5000 6. Applicant's Agent: Jon Lapper,Esq. Address: I3PSR 1 Washington Street Glens Falls,N Phone: 792-2117 7. Property Owner: Kubricky Construction Corp. Inc Address: 269 Ballard Road Wilton NY 12831 Phone: 8. Directions to Site: West side of Ridge Road,South of Town Transfer Station 9. Statistics and Data on Property: a. Total Area: sq. ft. or 9.23 acres b. Dimensions: Minimum Width: Average Width: Minimum Depth: Average Depth: 3 Revised Oct.2008 Physical Irregularities (describe): none c. Existing use(s): include structures, outdoor uses, rights of way, easements, deeds and limitations to use of property: Existing Sand and Gravel Pit, Existing mining road d. Adjacent uses within 400 feet: (state direction, location, use, zone & owner): Sand and Gravel Pit(east) undeveloped(north) Proposed Sand and Gravel Pit (west)Residential(south) e. State, County or Town property within 500 feet: NYS Route 9L and Town Transfer Station 10. A Map/Survey of the property to be rezoned must be submitted with the application; items A through H must be included on the plan and addressed in the submission A. Map of property at a scale of 1 inch =40 feet or less with scale, north arrow and topography. B. Boundaries of property with dimensions in feet, including zoning boundary. C. Identification of wetlands, watercourses or waterbodies on site. D. Location of any current structures on site, their exterior dimensions, use and setbacks. E. Location of any proposed easements and driveways. F. Location of existing public or private water and sewer facilities. G. Location of existing and proposed parking and loading facilities. H. Identification of uses (i.e. residential, commercial, industrial) on property within 500 feet. 11. If Petition is for an amendment to Zoning Ordinance, cite the section(s) to be changed, and wording to be substituted: See below* 12. In support of this petition, the following statement is made: In 2014 the Town Board amended the Zoning Code specifically to enable the project to proceed so that mining traffic will use Ridge Road rather than Dream I ake Riad. 13. The following documents are submitted herewith: * Zoning Code Section 179-10-070(a)(1) Commercial mineral extraction (defined as above the Department of Environmental Conservation Threshold) shall be allowed only within the Heavy Industrial(HI) or Rural Residential- five Acres (RR-5) Districts by Special Use Permits only in a substantially undeveloped area,with atleast a 1,000 foot(horizontal distance) buffer from any existing residence,which buffer may be modified by a waiver issued by the Town Planning Board. 4 Revised Oct.2008 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: Kubricky Construction Corp. Inc Designates: The Fort Miller Company Inc As agent regarding: Variance Site Plan Subdivision rezoning For Tax Map No.: 279 Section 1 Block 48 Lot Deed Refer nce: 583 Book 621 Page 8/15/74 Date OWNER SIGNATURE: DATE: 3-8-•17. 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: L , T 1`^-•11.E , C�Ma-y , •� Designates: -Jc;. ).-u���r- 6 pS 2- As agent regarding: Variance Site Plan Subdivision rL-z..•v,--r For Tax Map No.: Section Block Lot ?\rO. j- Deed Reference: Book Page Date OWNER SIGNATURE: DATE: 2.) ENGINEERING FEE DISCLOSURE: 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 applicants 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 read and agree to the above. (cc SIGNATURE OF APPLICANT: •• �( rM 1 " 1C DATE: 3� SIGNATURE OF AGENT: at, DATE: 3 17--') ! t 7 1 r 5 • Full Environmental Assessment Form Part 1 -Project and Setting Instructions for Completing Part 1 Part 1 is to be completed by the applicant or project sponsor. 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;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 lis accurate and complete. A.Project and Sponsor Information. Name of Action or Project: - r, F. C o c,��a-=k-i. ( at & ..x412 6icc.L) F r_ s,:--t a y!C-u' --'I Project Location(describe,and attach a gen S ral location map): "`5--57-31— D d D 1 1- v`F 61,Am. l[L. -- .�- & (.v •6 , C fi,,:: !1, t'4 L t 1 LtAA-0 A (-C)(� :`t Brief Description of Proposed Action(include purpose or need): ; e t •r o, - i - i...�.. 1 C .-i i elk/(.`- CC e\f‘'.'; (C-L,C.C't_::= -.Q, C . i '':.%.•(-1...C. t,I t. 1 (C.!t' r i("(e,d,; , V I( C e k.0,. ..;.it(,r{.�{ i'-,A.' C"!.'.{— .•„-- � Name of Applicant/Sponsor: Telephone: 5 g _ .r s X060 z.-t.; 23\ ,- E-Mail: ! l \l_ { D t2:r. l'-k. i \ ';4^.G) (b • -.1.._ i'.c.. a.I..1 rA (Ll- tu.i-I'a out P!.6 A Address: r (( Q -, `C Ele \ti 11 V .! ,.. .',i Z. i (ji,s•: =.e:,t�t,,C V.: \\W. ( i. 4... City/1~O: - „ ' Mater r Zip Code: Y '1 II O , ,4,v � '� �r �^�r {� i,y. a �;\.i `�. � ��� L�i!L.._ � Project Contact(if not same as sponsor;give name and title/role): Telephone: 5 G g..-.444,(- 2((4:, �' Moi t , - J \• ' ”` -`; n c't 'r F'.. `.� : •- { -i E-Mail: 1J1 ...( 't , /, ' a n C•t�_ : r Ij l Gt<<C t� t ) , v! 0, ick.? ( !'.a.)1, Address: e,T, City/PO: \ ' State: Zip Code: Property Owner (if not same as sponsor): Telephone: ' T L / = -T 1,. \ I)tP. \s.\1`kV (_.D,. T:} 1 _ R - E-Mail: Address: .-t\ 0, �Q 1. a `1 's ZipCode: City/PO: \ State: Page 1 of 13 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, ❑Yes2INo or Village Board of Trustees b.City, or Village �Yes❑No Ta &L o 'LLLr • e. ''I Planning Board or Commission 4,1 _. c. City Council,Town or YesJNo '..- • . - • - Village Zoning Board of Appeals ' - d. Other local agencies ❑Yea:INo e. County agencies ❑Yes121No f.Regional agencies ❑YesQNo g. State agencies IYes❑No ` D�G h. Federal agencies ❑Yes( No i. Coastal Resources. i. Is the project site within a Coastal Area,or the waterfront area of a Designated Inland Waterway? ❑Yes 51No ii. Is the project site located in a community with an approved Local Waterfront Revitalization Program? 0 Yes❑No iii. Is the project site within a Coastal Erosion Hazard Area? ❑YesZNo 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 L]Yes❑No 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.Z.Adopted land use plans. a. Do any municipally-adopted (city,town,village or county)comprehensive land use plan(s) include the site f,8Yes❑No where the proposed action would be located? If Yes,does the comprehensive plan include specific recommendations for the site where the proposed action ( Yes❑No would be located? b. Is the site of the proposed action within any local or regional special planning district(for example: Greenway 0Yes14No 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, ❑YesrANo or an adopted municipal farmland protection plan? If Yes, identify the plan(s): Page 2 of 13 C.3. Zoning a. Is the site of the proposed action located in a municipality with an adopted zoning law or ordinance. Yes❑No If Yes,what's the zoning classification(s) including any applicable overlay district? b. Is the use permitted or allowed by a special or conditional use permit? 14Yes❑No c. Is a zoning change requested as part of the proposed action? ❑Yesl�?�-,No If Yes, i. What is the proposed new zoning for the site? C.4.Existing community services. a. In what school district is the project site located? t;`e e(h5,,t‘60 :_r! b. What police or other public protection forces serve the project nsite? VJovv- Ax.. Ca , S4t..ev :'= jt4YS " tG� c. Which fire protection and emergency medical services serve the project site? 7"LLV.?� d.What parks serve the project site? 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)? _ ; Cow�l�,te, '�_�'�: a? y:-;1 ac.• _. � �� c- w f � :�= . �_^ . b.a.Total acreage of the site of the proposed action? 412. t. acres b. Total acreage to be physically disturbed? 4- LLZ acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? s 3 61, acres c.Is the proposed action an expansion of an existing project or use? ,Yes❑No i. If Yes,what is the approximate percentage of the proposed expansion and identify the units(e.g.,acres,miles,housing units, square feet)? % I ' '{a cl +c+4\ act'arc Units: d.Is the proposed action a subdivision,or does it include a subdivision? ❑YesANo If Yes, 1. Purpose or type of subdivision?(e.g.,residential,industrial,commercial; if mixed,specify types) ii. Is a cluster/conservation layout proposed? ❑Yes 0No iii. Number of lots proposed? iv. Minimum and maximum proposed lot sizes? Minimum Maximum e.Will proposed action be constructed in multiple phases? 121Yes❑No i. If No,anticipated period of construction: months ii. If Yes: • Total number of phases anticipated .;,=4.4%'�=�L�� .� "''' �� c o�i�c� (A t. Zo-3✓ V2 'rte � r • Anticipated commencement date of phase 1 (including demolition) month year • Anticipated completion date of final phase month year • Generally describe connections or relationships among phases,including any contingencies where progress of one phase may determine timing or duration of future phases: Page 3 of 13 f.Does the project include new residential uses? ❑YessNo If Yes,show numbers of units proposed. One Family Two Family Three Family Multiple Family(four or more) Initial Phase At completion of all phases g.Does the proposed action include new non-residential construction(including expansions)? ❑Yes©No If Yes, I► 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 POYes❑No liquids,such as creation of a water supply,reservoir,pond, lake,waste lagoon or other storage? -F Ifi.Pu Purpose of the impoundment: W�. IM.O. 1 PF-.„-E,c.(�l':.O s cjl R.. c.We), , 'r?Se v KR. + .9-11-w.,')&tie's 1 k 6 L'�Z-64 rP P �:S1v-4' ii. If a water impoundment,the principal sour of the water: Ground water❑Surface water streams ❑Other specify: t,J I4 Ct r t,t. iii. If other than water,identify the type of impounded/contained liquids and their source. 04 rte. iv. Approximate size of the proposed impoundment. Volume: million gallons; surface area: l/z R; ( ) acre3l•-•''''' v. Dimensions of the proposed dam or impounding structure: height;_ length ` ' '.<-=e. 'rl`. vi. Construction method/materials for the proposed dam or impounding structure(e.g.,earth fill,rock,wood,concrete): Eats,kct_ -A14 ) 20,AA -el. Vitct'1e--z . ^ . D.2. Project Operations a. Does the proposed action include any excavation,mining,or dredging,during construction,operations,or both? ElYes❑No (Not including general site preparation,grading or installation of utilities or foundations where all excavated materials will remain onsite) If Yes: • r i.What is the purpose of the excavation or dredging? 4o •2�-�,rec.t: S JJ z C(c0 '.'E..- --nV !' rI)Cess 1 v 4 ii. How much material(including rock,earth, sediments,etc.)is proposed to be removedTki'm the site? • Volume(specify tons or cubic yards): 7 (?a(. ' • Over what duration of time? 7'B iii. Describe natureandcharacteristics of materials to be excavated or dredged,and plans to use, manage or dispose of them. Satr\ OJC'cA erVO_(.,eQ. 40 a.(N .,:C`-Lt C_ ck4 61 r'g 1,-t'':-:" -i-TA , Le.).tC 'J _•'-t:-6.:., , GOccs.t N ,:1 i' iv. Will there be onsite dewatering or processing of excavated materials? , If yes,describe. C v r a_c��t tna S 'r•in,i?ti'.t a.Cr h.)0.S‘�`t a a-'0.4}4 5`.. C t- = •s.' v. What is the total area to be dredged or excavated? "Tk acres vi. What is the maximum area to be worked at any one time? i £ acres vii. What would be the maximum depth of excavation or dredging? TLS`i.) feet viii. Will the excavation require blasting? ❑YesgiNo Lt Summarize site reclamation goals an4 plan: 1/tl.e UJ tV c.:..'..4+. ,-_. -1 -'/`. P `' ("t /. f et:C-Ct),(41,CA-a-- , Lt,t�'�-- <<P r.L,1).1 d\ . ,, ryA.t.]\_ ..,- >... Q� . r 0,434(,-,c( i. J \v... Out {t _ t sit i.�.; l�'1:.0 c.. •C�"' 1\A C..f \ t-)'!��1, (1..( - C'k. . \ ..'r•, . , - '• _ %L. • .. Cr:-:=1IGr G•.:. b.Would the proposed action cause or result in alteration of, increase or decrease in size of,or encroachment ❑Yes X❑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? El YesEnNo 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? ❑Yes10 If Yes: i. Total anticipated water usage/demand per day: gallons/day ii. Will the proposed action obtain water from an existing public water supply? EYes❑No If Yes: • Name of district or service area: • Does the existing public water supply have capacity to serve the proposal? ❑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? E Yes❑No iii. Will line extension within an existing district be necessary to supply the project? EYes❑No If Yes: • Describe extensions or capacity expansions proposed to serve this project: • Source(s)of supply for the district: iv. Is a new water supply district or service area proposed to be formed to serve the project site? 0 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? 7 y` G SA c,,c44 �� , �2 �� �;�, , ❑Yes No If Yes: '; !,r �c3 �: , ` �::'Ye,. :i ; s 1 i. Total anticipated liquid waste generation per day: gallons/day v L 'k 'Ju ct E;c 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): iii. Will the proposed action use any existing public wastewater treatment facilities? ['Yes No 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? DYes❑No • Is the project site in the existing district? EYes❑No • Is expansion of the district needed? ['Yes DNo 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? ❑Yes121S10 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? ❑YesgNo If Yes: • Applicant/sponsor for new district: • Date application submitted or anticipated: • What is the receiving water for the wastewater discharge? 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❑No 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? L ;C.1;\ ',,/,' If Yes: Su.4-:; 'w::',J,.c, ,l\ c- ,v .' i. How much impervious surface will the project create in relation to total size of project parcel?; _ � t . - ct �. Square feet or acres(impervious surface) Square feet or acres(parcel size) -, r u_; ii. Describe types of new point sources. �v t 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)? '. ' f'•.:C.: c;�r�5���b e U `e,,,fc. g V a.u,- gA v.,^.t. 44 t \ . n r) • Itto surface waters,identify receiving water bodies or wetlands: • Will stormwater runoff flow to adjacent properties? ❑YesINo iv. Does proposed plan minimize impervious surfaces,use pervious materials or collect and re-use stormwater? ❑YesigNo f. Does the proposed action include,or will it use on-site,one or more sources of air emissions, including fuel (Yes❑No 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) c. Lam' 4``.U 021: t iC. — g. Will any air emission sources named in D.2.f(above),require a NY State Air Registration,Air Facility Permit, tElYesDNo or Federal Clean Air Act Title IV or Title V Permit. p 1,, �R �, .� 1.r ;1, ,L ,_-,,r - If Yes: .-. i. Is the project site located in an Air quality non-attainment area? (Area>'outinely 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(N2O) • 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 21YesONo quarry or landfill operations? If Yes: Describe operations and nature of emissions(e.g.,diesel exhaust,rock particulates/dust): a ,•o,,p.\ -e vi\r�r's tc,``:-1 roc*_ ?c tr-.:r.t�. c..k c: ci f-3... . j. Will the proposed action result in a substantial increase in traffic above present levels or generate substantial 12Yes0No new demand for transportation facilities or services? If Yes: i.When is the peak traffic expected(Check all that apply): 0 Morning 0 Evening OWeekend 0 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`h 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 ❑YesONo 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 I. Hours of operation. Answer all items which apply. i.During Construction: \ ii. During Operations: • Monday-Friday: 3 Rue P.s .0 U. • Monday-Friday: ( AK -4-a 5\3D PIA • Saturday: I, i-, ..•�)- ,. . p • Saturday: e, A,t,1 -• 2'.G ' , • Sunday: ' • Sunday: 14o o p a.+.ON.s • Holidays: • Holidays: islo ar>nra.A-0t..5 k Page 7 of 13 m. Will the proposed action produce noise that will exceed existing ambient noise levels during construction, ❑YesJNo operation,or both? If yes: i. Provide details including sources,time of day and duration: ii. Will proposed action removejexisting natural barriers that could act as a noise barrier or screen? ❑Yes kNo Describe: `) e. s (k(( 1CG•4 to t '. ^".SNA,. 5 ))e. Ud cclV4Ec 5 a J f=4e.r0. `, 't)A ou ek: 1,7N( .,s_ ,, ?SA,YpAS,Ate,.*'• „qv 44 eF+LE r:+r•S t''. c [�D t,4 L CI U.D L ds l 4�o `... �;rd41 taw kA n.. Will the proposed action have outdoor lighting? ❑Yes WNo If yes: ,L. J 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? ❑YesJNo Describe: o. Does the proposed action have the potential to produce odors for more than one hour per day? ❑Yes tgiNo 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®,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, 0 Yes IKNo insecticides)during construction or operation? If Yes: i. Describe proposed treatment(s): ii. Will the proposed action use Integrated Pest Management Practices? ❑ Yes E,No r.Will the proposed action(commercial or industrial projects only)involve or require the management or disposal ❑ Yes IZINo 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? 0 Yes I1 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 0 YesiZiNo 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? ❑YcsjNo 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 0 Industrial Commercial l:iti Residential(suburban) 0 Rural(non-farm). Forest 0 Agriculture ❑ Aquatic 0 Other(specify): c& 1-vttu S t'�at 1 i'7` =f? 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 • Forested • Meadows,grasslands or brushlands(non- 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? ❑YesE.No i. If Yes:explain: d.Are there any facilities serving children,the elderly,people with disabilities (e.g.,schools,hospitals,licensed ❑Yes!No 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? ❑YestgNo If Yes: 1. 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, ❑Yeslo 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 0 Yes2iNo 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 ❑Yesr 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? 0 YessZINo 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? ❑YesONo • 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? vtti�l;a �' feet b. Are there bedrock outcroppings on the project site? ❑YesONo If Yes,what proportion of the site is comprised of bedrock outcroppings? c. Predominant soil type(s)present on project site: �A;t n 1r `:'t__`•� d. What is the average depth to the water table on the project site? Average: 260 -1 feet e. Drainage status of project site soils:®,Well Drained: 1 t %of site ❑ Moderately Well Drained: %of site ❑ Poorly Drained %of site f.Approximate proportion of proposed action site with slopes: 0 0-10%: %of site ❑ 10-15%: %of site V( 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. 1. Does any portion of the project site contain wetlands or other waterbodies(including streams,rivers, ❑YesigNo ponds or lakes)? ii. Do any wetlands or other waterbodies adjoin the project site? ❑t Yes❑No If Yes to either i or ii,continue. If No, skip to E.2.i. iii. 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❑too 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 Vklo j.Is the project site in the 100 year Floodplain? ❑YesINo k.Is the project site in the 500 year Floodplain? ['Yes to I.Is the project site located over,or immediately adjoining,a primary,principal or sole source aquifer? ❑Yes0No If Yes: i.Name of aquifer: Page 11 of 13 m. Identify the predominant wildlife species that occupy or use the project site: n. Does the project site contain a designated significant natural community? Yes0N0 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? 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? q. Is the project site or adjoining area currently used for hunting,trapping,fishing or shell fishing? pgYesElNo If yes,give a brief description of how the proposed action may affect that use: \(\143 ,�, t;.r=,' ^ :-•A �`f.. It t Cis Cc. 0.-rt...: r 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 ❑YesNo 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? ❑YesNo 1. 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 ElYesiZiNo Natural Landmark? If Yes: i. Nature of the natural landmark: ❑Biological Community ❑ Geological Feature ii. Provide brief description of landmark, including values behind designation and approximate size/extent: d. Is the project site located in or does it adjoin a state listed Critical Environmental Area? 1:1 Yes al 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 0 YesigNo 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 ❑Yes ONo 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? ❑Ycs❑No If Yes: 1.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 Yes❑No scenic or aesthetic resource? If Yes: i. Identify resource: La _`: w 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 0 Yes❑No 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. Applicant/Sponsor Name Date Signature Title PRINT FORM Page 13 of 13