HomeMy WebLinkAbout20220267 688 N. Broadway Area Variance Short EAF-Part 1 PROJECT ID NUMBER 617.20 SEQR
APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor)
1.APPLICANT/SPONSOR 2.PROJECT NAME
George and Tamie Ehinger New detached garage
3.PROJECT LOCATION:
City of Saratoga Springs Saratoga
Municipality County
4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map
688 North Broadway
Saratoga Springs, NY 12866
5.IS PROPOSED ACTION: � New �Expansion ❑Modification/alteration
6.DESCRIBE PROJECT BRIEFLY:
Applicant desires to construct a new two-car garage on their property. The garage and the primary house structure would
be the only two structures on the property.
7.AMOUNT OF LAND AFFECTED:
Initially .013 acres Ultimately .013 acres
8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
❑Yes ❑� No If no,describe briefly:
A front yard setback variance will be required.
9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.)
�Residential �Industrial �Commercial �Agriculture �Park/Forest/Open Space �Other (describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or Local)
�Yes �No If yes, list agency name and permit / approval:
Action will require approval of local Design Review Commission as well as a Building Permit.
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
�Yes �No If yes, list agency name and permit / approval:
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION?
❑Yes �No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant i sponsor Name Tamie Ehinger Date:
Signature ����f�'� 03/30/22
If the action is a Costal Area, and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment Reset
PART II - IMPACT ASSESSMENT(To be completed by Lead Agency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes,coordinate the review process and use the FULL EAF.
� Yes � No
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No,a negative
declaration may be superseded by another involved agency.
� Yes � No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,if legible)
C1. Existing air quality,surface or groundwater quality or quantity,noise levels,existing traffic pattern,solid waste production or disposal,
potential for erosion,drainage or flooding problems? Explain briefly:
C2. Aesthetic,agricultural,archaeological, historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly:
C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered species?Explain briefly:
C4. A community's existing plans or goals as officially adopted,or a change in use or intensity of use of land or other natural resources?Explain briefly:
C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly:
C6. Long term,short term,cumulative,or other effects not identified in C1-05? Explain briefly:
C7. Other impacts(including changes in use of either quantity or type of energy? Explain briefly:
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA CEA? If es,ex lain briefl :
� Yes �No
E. IS THERE,OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex lain:
� Yes �No
PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency)
INSTRUCTIONS: Foreach adverse effect identified above,determine whether it is substantial,large,important orotherwise significant. Each
effect should be assessed in connection with its(a)setting (i.e. urban or rural); (b) probability of occurring; (c)duration; (d) irreversibility; (e)
geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain
sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked
yes,the determination ofsignificance mustevaluate the potential impactofthe proposed action on the environmental characteristics ofthe CEA.
Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL
EAF and/or prepare a positive declaration.
Check this box if you have determined,based on the information and analysis above and any supporting documentation,that the proposed actio
WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi
determination.
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)
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