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Short EAFPage 1 of 3 □ □ 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: Brandy Tennyson PV Installation Project Location (describe, and attach a location map): 1631 Ridge Road, Queensbury, New York 12804 Brief Description of Proposed Action: Installation of a 20.16 kW (42 panels) ground-mounted PV array. Name of Applicant or Sponsor: Loreen Harvey Telephone: (518) 478 - 3906 E-Mail: Address: 279 Broadway Bldg 2 City/PO: Menands State: New York Zip Code: 12204 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no, continue to question 2. NO YES ✔ 2. Does the proposed action require a permit, approval or funding from any other government Agency? If Yes, list agency(s) name and permit or approval: Town of Queensbury Site Plan Approval, Town of Queensbury Building Permit NO YES ✔ 3. a. Total acreage of the site of the proposed action? 9.47 acres b. Total acreage to be physically disturbed? .25 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, are adjoining or near the proposed action: 5. Urban Rural (non-agriculture) Industrial Commercial ✔ Residential (suburban) Forest Agriculture Aquatic Other(Specify): Parkland Page 2 of 3 5. Is the proposed action, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A ✔ ✔ 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? NO YES ✔ 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? If Yes, identify: NO YES ✔ 8. a. Will the proposed action result in a substantial increase in traffic above present levels? b. Are public transportation services available at or near the site of the proposed action? c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed action? NO YES ✔ ✔ ✔ 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features and technologies: NO YES ✔ 10. Will the proposed action connect to an existing public/private water supply? If No, describe method for providing potable water: NO YES ✔ 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: NO YES ✔ 12. a. Does the project site contain, or is it substantially contiguous to, a building, archaeological site, or district which is listed on the National or State Register of Historic Places, or that has been determined by the Commissioner of the NYS Office of Parks, Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b. Is the project site, or any portion of it, located in or adjacent to an area designated as sensitive for archaeological sites on the NY State Historic Preservation Office (SHPO) archaeological site inventory? NO YES ✔ ✔ 13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain wetlands or other waterbodies regulated by a federal, state or local agency? b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody? If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: NO YES ✔ ✔ □ □ □ 14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: Shoreline Forest Agricultural/grasslands Early mid-successional Wetland Urban ✔ Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered? Northern Long-eared Bat NO YES ✔ 16. Is the project site located in the 100-year flood plan? NO YES ✔ 17. Will the proposed action create storm water discharge, either from point or non-point sources? If Yes, a. Will storm water discharges flow to adjacent properties? b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: NO YES ✔ ✔ ✔ 18. Does the proposed action include construction or other activities that would result in the impoundment of water or other liquids (e.g., retention pond, waste lagoon, dam)? If Yes, explain the purpose and size of the impoundment: NO YES ✔ 1_9. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe: NO YES ✔ 20.Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste? If Yes, describe: NO YES ✔ I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor/name: Loreen Harvey Date: 2.25.22 Signature: Title: Permit Coordinator Page 3 of 3 PRINT FORM EAF Mapper Summary Report Friday, February 4, 2022 2:11 PM Part 1 / Question 7 [Critical Environmental Area] No Part 1 / Question 12a [National or State Register of Historic Places or State Eligible Sites] No Part 1 / Question 12b [Archeological Sites] Yes Part 1 / Question 13a [Wetlands or Other Regulated Waterbodies] Yes - Digital mapping information on local and federal wetlands and waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 / Question 15 [Threatened or Endangered Animal] Yes Part 1 / Question 15 [Threatened or Endangered Animal - Name] Northern Long-eared Bat Part 1 / Question 16 [100 Year Flood Plain] Digital mapping data are not available or are incomplete. Refer to EAF Workbook. Part 1 / Question 20 [Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report 1 Disclaimer: The EAF Mapper is a screening tool intended to assist project sponsors and reviewing agencies in preparing an environmental assessment form (EAF). Not all questions asked in the EAF are answered by the EAF Mapper. Additional information on any EAF question can be obtained by consulting the EAF Workbooks. Although the EAF Mapper provides the most up-to-date digital data available to DEC, you may also need to contact local or other data sources in order to obtain data not provided by the Mapper. Digital data is not a substitute for agency determinations.