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Home My WebLink About20190417 ECS Psychological Services Office EAF 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 addational pages as necessary to supplement any item. Part 1—Project aud Spoosor Informatioo Name of Action or Project: ECS Pshycological Services Project Location(describe,and attach a location map): 210 Church Street,Saratoga Springs NY Brief Description of Proposed Action: Reconstruction and expansion of existing buiiding that was damaged by fallen tree. Name of Applicant or Sponsor: Telephone: 518-580-0520 ECS Psychological Services E-Mail: dr.christopher-sisk@ecspshycological.com Address: 290 Church Street City/PO: State: Zip Code: iSaratoga Springs New York 12866 I 1. Does the proposed action only involve the legisiative adoption of a plan,local(aw,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 � ❑ 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 government Agency? NO YES If Yes,list agency(s)name and permit or approval:City P�anning&Zoning,City Build;ng Permit ❑ � 3. a.Total acreage of the site of the proposed action? 0•139 acres b.Total acreage to be physically disturbed? 0.005 acres a Total acreage(project site and any contiguous properties)owned or controlled by the appticant or project sponsor? 0.139 acres 4. Check all land uses that occur on,are adjoining or near the proposed action: 5. m Urban ❑ Rural(non-agriculture) ❑ Industria( ❑ Commercial m Residential(suburban) ❑Forest ❑ Agriculture � Aquatic ❑ Other(Specify): ❑Parkland I'��pe 1 c�f 3 5. Is the proposed action, NO YES N/A � a. A permitted use under the zoning regulations? ❑ � ❑ il b. Consistent with the adopted comprehensive plan? � � � � NO YES 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? ❑ �✓ � 7. ls the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: � ❑ NO YES 8. a. Wiil the proposed action result in a substantial increase in traffic above present levels? � ❑ b. Are public transportaxion 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? 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: ❑ ❑✓ 10. Wi(I the proposed action connect to an existing public/private water supply? NO YES Tf No,describe method for providing potable water: ❑ ❑✓ 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ �❑ 12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeolagical site,or district NO YES 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)archaeologica) site inventory? 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? � ❑ 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: _ Pa��e � 01�3 f d on the ro'ect site.Check all that a 1 : I 14. Identify the typical habrtat types that occur on,or are hkely to be oun p � pp y ❑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 NO YES Federal government as threatened or endangered? � ❑ 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? NO YES If Yes, � � a. Will storm water discharges flow to adjacent properties? � � b. Will storm water discharges be directed to established conveyance systems(runoffand storm drains}? � � If Yes,briefly describe: I 8. Does the proposed action include construction or other activities that would result in the impoundment of water NO YES or other liquids(e.g.,retention pond,waste lagoon,dam)? 1f Yes,explain the purpose and size of the impoundment: ❑ ❑ �9. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES management facility? If Yes,describe: ❑ ❑ 20.Has the site ofthe proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed} for hazardous waste? If Yes,describe: ❑ ❑ I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor/ e: Ethan Hafl- hitectWgent for the Applicant Date:5 April 2019 Signakure: Title:Architect�Agent for the Applicant PRINT FORM �-�f<<r� _; �,� ; EAF Mapper Summary Report Tuesday, ap��i �s, 2o�g �2:ss PM , DiSClalmel': The EAF Mapper is a screening tool intended to assist �,<�_�-�,_,�" project sponsors and reviewing agencies in preparing an environmental i ' :�PI'; +-F�L�`` �� . assessment form(EAF).Not all questions asked in the EAF are answered by the EAF Mapper.Additional information on any EAF I .;;t question can be obtained by consulting the EAF Workbooks. Although ,: t,� '`i' ___--- - the EAF Mapper provides the most up-to-date digifal data available to ' ___- ---' " i 4��t r,,,_<_j,; DEC,you may also need to contact local or other data sources in order ' --...- ' to obtain data n�t provided by the Mappec Digital data is not a substitute for agency determinations. ---- - , t�ftH� ;A1tr�ttteal �t � �� ,-'-1 t_�5.5�:: �-�1��2'; � � ~...__--__.. .._ �_�� t��Spr,i gs ��i�5.5a-s-�� , - � , .,, -� �rt��a�-�� `, t , �r��,ta � _, , �,-, --- - :.� �,� -__--- -_. = i � � s�� r�un� r,r��r,G�:�z �, �° r� tu�E��r�r �:��oMti ' �,B�xon 1 � �;r�5;, � _ �i��i�a! Frra+teEalcr.a '".r. _ ��rmir, :rG�G' - � � - . � ��^ ^ f �TE E i h'� °= �k i �r• f, i � S} ; _ . -- - =ti E T F s4 .�.arr E�t� __ — _ i,s F�n K ESri � ` . . ' �^�-r� ��ri.�-;EPE .:s r^i^. �c1} d,G3L� E �"#`�sal�n6',tfv'ICi�"r � I i, �,�t��rYr�ra� ,F+3i�bca5�fr LoC�ila�rrl� I�v"REf?F�;T ( r � - i . � ,_.+,_, I �5.54-3-�; � C�rtStr�tf�la�'i�h�ri�ute3s.sr�Er_�E� F.,:?;:�r,�ri.,a�ar.t�.9ET1. � � I i�s��cmfhunit?I '� 4i;��ai�� sr °'�ira i��eg iCer,g.�,��;ri '4Ya,,,��.�q�''tE3�, Part 1 /Question 7 [Critical Environmental No Area] Part 1 I Question 12a (National or State Yes Register of His#oric Places or State Eligible Sites] Part 1 /Question 12b [Archeological Sites] Yes Part 1 /Question 13a [Wetlands or Other No Regulated Waterbodies) Part 1 I Question 15[Threatened or No Endangered Animal] Part 1 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 �