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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: Project Location (describe, and attach a location map): Brief Description of Proposed Action: Name of Applicant or Sponsor:Telephone: E-Mail: Address: City/PO: State: Zip Code: 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: NO YES 3. a. Total acreage of the site of the proposed action? __________ acres b. Total acreage to be physically disturbed? __________ acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? __________ acres Check all land uses that occur on,DUHadjoining RU near the proposed actioQ 8UEDQRural (non-agriculture),ndustrial Commercial Residential (suburban) $TXDWLF2WKHU6SHFLI\ƑForest Agriculture ƑParkland Everts Avenue Self Storage Approved Site Plan Modifications 106 Everts Avenue, Queensbury NY 12804 Applicant proposes as-built site modifications for a previously approved site plan regarding site landscaping, lighting, and fencing. Everts Avenue Self Storage 518-636-3323 easelfstorage@gmail.com 106 Everts Avenue Queensbury NY 12804 ✔ ✔ 3.26 2.5+/- 3.26 ✔ ✔✔ ✔✔ 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 a. Will the proposed action result in a substantial increase in traffic above present levels? EAre public transportation services available at or near the site of the proposed action? FAre any pedestrian accommodations or bicycle routes available on or near WKHsite 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 ZDWHU: _________________________________________ _____________________________________________________________________________________________ NO YES 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: ______________________________________ _____________________________________________________________________________________________ NO YES D'RHVWKHSURMHFWVLWHFRQWDLQRULVLWVXEVWDQWLDOO\FRQWLJXRXVWRDEXLOGLQJDUFKDHRORJLFDOVLWHRUGLVWULFW ZKLFKLVOLVWHGRQWKH1DWLRQDORU6WDWH5HJLVWHURI+LVWRULF3ODFHVRUWKDWKDVEHHQGHWHUPLQHGE\WKH &RPPLVVLRQHURIWKH1<62IILFHRI3DUNV5HFUHDWLRQDQG+LVWRULF3UHVHUYDWLRQWREHHOLJLEOHIRUOLVWLQJRQWKH 6WDWH5HJLVWHURI+LVWRULF3ODFHV" DUFKDHRORJLFDOVLWHVRQWKH1<6WDWH+LVWRULF3UHVHUYDWLRQ2IILFH6+32DUFKDHRORJLFDOVLWHLQYHQWRU\" NO YES D. 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? EWould 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 E,VWKHSURMHFWVLWHRUDQ\SRUWLRQRILWORFDWHGLQRUDGMDFHQWWRDQDUHDGHVLJQDWHGDVVHQVLWLYHIRU ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Page 3 of 3 Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: ƑShoreline ƑForest Agricultural/grasslands Early mid-successional Wetland ƑUrban 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? NO YES 16. Is the project site located in the \HDUIlood 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 ZRXOGresult in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain WKHpurpose and sizeRIWKHLPSRXQGPHQWBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB ____________________________________________________________________________________________ _ NO YES 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe: _______________________________________________________________________________ _____________________________________________________________________________________________ NO YES 20.Has the site of the proposed action or an adjoining property been WKHsubject of remediation (ongoingRU completed)for hazardous waste? If Yes, describe: _______________________________________________________________________________ _____________________________________________________________________________________________ NO YES I &(57,)< THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Date: _____________________Applicant/sponsorname:BBBBBBBBBBBBBBBBBBBBB______________________BBBBBBBBB__________________________ Signature: _____________________________________________________7LWOHBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Drainage basins, pocket ponds, and associated storm waster conveyance components installed per approved plan. EAF mapper identifies a nearby closed spill for duck pond adjacent to Garrison Road (DEC IDs 557018/557007) Steven Scoville 5/12/22 Owner/Member PRINT FORM Page 1 of 2 $JHQF\8VH2QO\>,IDSSOLFDEOH@ 3URMHFW 'DWH 6KRUW(QYLURQPHQWDO$VVHVVPHQW)RUP 3DUW,PSDFW$VVHVVPHQW Part 2 LVWREHFRPSOHWHGE\WKH/HDG$JHQF\ 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 small impact may occur Moderate to large impact may 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? PRINT FORM Page 2 of 2 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) 4IPSU&OWJSPONFOUBM"TTFTTNFOU'PSN 1BSU%FUFSNJOBUJPOPG4JHOJGJDBODF "HFODZ6TF0OMZ<*GBQQMJDBCMF> 1SPKFDU %BUF PRINT FORM EEAF Mapper Summary Report Thursday, May 12, 2022 7:26 AM 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. 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] No 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] Yes 1Short Environmental Assessment Form - EAF Mapper Summary Report