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20220943 106 Church Demolition Application
106 Church Street Saratoga Springs, N.Y I have owned this property since 2000.The three buildings on the property are in poor to terrible condition. In 2021 the City Code Department determined that the out buildings should be demolished. In May of 2022 the main building, suffered a " catastrophic " fire. Due to fact that the main building has no significant historical or architectural value and the condition of it due previous work and the amount of damage caused by the fire in May I am requesting permission to demolish these buildings. I am concerned that delay may cause further damage which might cause injury. Your consideration is appreciated. I spoke with Samantha Bosshart of the Historical Preservation Society. She stated that she does not have any information about the property other than age, but she would consider it a "contributing property". spoke with a long time Saratoga Springs resident, Mr. Fred McNeary Sr. would grew up at 62 Church St. Mr. McNeary stated that as far back as the early forties, the building was occupied by the Fay Family. As illustrated by the photographs,the buildings are in very poor condition.The main building has no special features. The ceiling height is 8 foot at best. There is no special interior trim. In fact it appears that average "modern" materials were used in remodeling over the buildings life. The windows were older double hung windows. The storm windows are triple tracks. The exterior siding is now mostly painted cedar shingles. I am not sure what the original siding was, The roofing is a mix of metal, very old slate, and some rolled roofing.The foundation is a mixture of stone, and cement with some additions that appear to be trying to support and or protect the original foundation from failing. As illustrated by the photographs, 106 Church St (subject property) is one of the few with such a large yard. Most adjoining and nearby buildings are much larger, consuming much more of the lot and much more in keeping with this area of downtown Saratoga. Many are brick. I would like to see a much nicer building or buildings on this property as the City continues to improve and as I have owned and improved property in the area since 1983 when this area was not as popular as it is today. Res ectfully Yours. Freder k W. Scheidt **HANDWRITTEN APPLICATIONS WILL NOT BE ACCEPTED" FOR OFF IC USE hPL `5r' CITY OF SARATOGA SPRINGS (Application#) DESIGN REVIEW COMMISSION Date received f, CITY HALL-474 BROADWAY t y SARATOGA SPRINGS, NEW YORK 12866-2296 (,RATEfl �9 5 TEL:518-587-3550 X2533 www.saratoga-,sprfngs.org (Project Title) APPLICATION FOR: ARCHITECTURAL/HISTORIC REVIEW staff Review APPLICANT(s) OWNERS(Ifnotlicantl ATTORNEY/AGENT Name Frederick Scheldt Address 106 Church St Saratoga Springs, NY Phone 518-378-6226 / 1 1 Email fwscheidt@nycap.rr.com Identify primary contact person: ®Applicant ❑ Owner ❑Attorney/Agent *An applicant must be the property owner,lessee, or one with an option to lease or purchase the property in question. Applicant's interest in premises: ®Owner © Lessee ❑ Under option to lease or purchase PROPERTY INFORMATION Property Address/Location: 106 Church St. Tax Parcel#: 165 2 - 22 (for example,165.52-4-37) Date Acquired by Owner: 06/01/20 Current Zoning District: U R3 properly use: © Residential ❑ Non-residential/mixed-use Type of Review: 10 Architectural 111 Historic © Extension/modification(of current approval) Summary description of proposed action: Demolition of 2 out buildings in very poor condition as identified by the code department and one 2 family dwelling which experienced a catastrophic fire in May 2022. Has a previous application been filed with the DRC for this property? a No ❑Yes--date(s)? -App.No.(s)? Revised 01/2021 A "complete" application consists of >2 hard co on final and I electronic co of lication&Al.t.other ma rims as required below: New Construction 1 Additions ❑ Color photographs showing site/exterior details of existing structures and adjacent properties ❑ Site plan,drawn to scale,showing existing&proposed construction,property lines&dimensions,required&proposed setbacks&lot coverage,site features(fences,walks,trees,etc.);on no larger than 2'x3'sheet-smaller preferred if legible ❑ Elevation drawings showing design of all sides of existing&proposed construction-label dimensions,colors,materials,lighting(fixture &lamp type,wattage),etc.-include compass bearing&scale;no larger than 2'x3'sheet-smaller permitted if legible ❑ Floor plans for proposed structure;on sheet no larger than 2'x3'-smaller permitted if legible ❑ Product literature,specifications and samples of proposed materials and colors Change in exterior building materials(windows,doors, roof, siding,etc.),or color(in non-residential districts only) ❑ Color photographs showing site/exterior details of existing structures and that illustrate affected features ❑ Elevation drawings showing all sides of existing&proposed construction-label dimensions,colors,materials,lighting(fixture&lamp type,wattage),etc.-include compass bearing&scale;no larger than 2'x3'sheet-smaller permitted if legible ❑ Product literature,specifications and samples of proposed materials and colors Within front)card setbacks in Historic_Districts only (Front setbacks:UR-1&INST-HTP=30;UR-4=25;UR 2,UP-3&NCUD-1=I0') -Installation, removal or change in material of drive-and walkways -Installation or removal of architectural,sculptural or vegetative screening over 3'in height - Installation of accessory utility structures or radio/satellite transmissionlreception devices(more than 2'diameter) For any of above: ❑Color photographs showing site/exterior details of existing structures,and of adjacent properties ❑ Site plan showing existing&proposed construction: include property lines&dimensions,required&proposed setbacks&lot coverage,site features(fences,walks,trees,etc.) street names,compass bearing&scale;no larger than 2'x3'sheet-smaller preferred If legible ❑ Product literature,specifications and samples of proposed materials and colors 5ignage 1 Awnings ©Color photographs showing site/exterior details of existing structures,and adjacent properties ❑ Plan showing location of proposed sign/awning structure on building/premises:no larger than I I"x 17" ❑Scaled Illustration of proposed sign/awning structure and lettering(front view&profile): include all dimensions of structure;type, dimensions and style of lettering or logo;description of colors,materials,mounting method and hardware ❑ Descriptions,specifications of proposed lighting including fixture&lamp type,wattage,mounting method,and location ❑ Product literature,specifications and samples of proposed materials and colors Demolition ® Color photographs showing sitelexterior details of existing structures,and of adjacent properties ®Site plan showing existing and any proposed structures-include dimensions,setbacks,street names,compass bearing,and scale ®Written description of reasons for demolition and,In addition: ® For structures of"architectural/historical significance",demonstrate"good cause"why structure cannot be preserved ❑ For structures in an architectural district that might be eligible for listing on National Register of Historic Places,or for a "contributing"structure in a National Register district(contact City staff),provide plans for site development following demolition- include a timetable and letter of credit for project completion Telecommunication facilities ❑Color photographs showing site/existing structures,and of adjacent properties ❑Site plan showing existing and proposed structures:include dimensions,setbacks,street names,compass bearing,and scale ❑Scaled illustration of proposed structures:include all dimensions;colors,materials,lighting,mounting details ❑Consult Article 240-12.22 of the City's Zoning Ordinance and City staff to ensure compliance with requirements for visual impact assessment and existing and proposed vegetative screening Revised 0112021 Request for extension of current approval ❑ Identify date of original DRC approval Current expiration date: Org.App. No. ©Describe why this extension is necessary and whether any significant changes have occurred either on the site or in the neighborhood. SEAR Environmental Assessment Form ®Applicants proposing the following must complete"Part I"of the SEQR Short Environmental Assessment Form(available here: httR://www.dec.ny.go—vLdoc-s/Rermits ej_ooRerationsrRdf/seafpartone.odo, -Construction or expansion of a multi-family residential structure(4 units+) -Construction or expansion(exceeding 4,000 sq.ft.gross floor area)of a principal or accessory non-residential structure -Telecommunications facility,radio antennae,satellite dishes -Demolition Disclosure Does any City officer, employee or family member thereof have a financial interest(as defined by General Municipal Law Section 809) in this application? W No ❑Yes-If yes, a statement disclosing the name, residence, nature,and extent of this interest must be filed with this application. Certification I/we,the property owner(s),or purchaser(s)/Iessee(s) under contract,of the land in question,hereby request an appearance before the Design Review Commission. By the signature(s)attached hereto, I/we certify that the information provided within this application and accompanying documentation is,to the best of my/our knowledge,true and accurate. I/we further understand that intentionally providing false or misleading information is grounds for immediate denial of this application. I/we hereby authorize the members of the Design Review Commission and designated City staff to enter the property associated with this application for purposes of conducting any necessary site inspections relating to this application. Furthermore, I/we agree to meet all requirements under Article VII for Historic Review or Article Vill for Architectural Review of the Zoning Code of the City of Saratoga Springs. Date: (applicant signature) Date: (applicant signature) If applicant is not the currently the owner of the property,the current owner must also sign. Owner Signature: Date: Owner Signature: Date: Revised 01/2021 CITY OF SARATOGA SPRINGS DESIGN REVIEW COMMISSION r, City Flail-474 Broadway Saratoga Springs,New York 12866 RPaRnr�o '9� Tel:518-587-3550 x2533 www.saratoga-springs.org INSTRUCTIONS ARCHITECTURAL/HISTORIC REVIEWAPPLICATION I. ELIGIBILITY:An applicant to the Design Review Commission for Architectural Review or Historic Review must be the property owner(s) or lessee, or have an option to lease or purchase the property in question. 2. COMPLETE SUBMISSIONS:Applicants are encouraged to work with City staff to ensure that an application is complete. The DRC will pl7/y consider properly completed applications that contain 1 original and 1 diaital versiQn of the_Wlication and ALL other required materials as indicated on the application. HANDWRITTEN APPLICATIONS WILL NOT BE ACCEPTEW 3. ACTIONS REQUIRING_REVIEW: Architectural Review District Historic Review District • any exterior changes that require a building permit • Installation or exterior change to a structure requiring a • any change in exterior building materials building or demolition permit • a new,or change to an existing, sign or sign structure •any material change to exterior of a structure including: • demolition of a structure -addition or removal of exterior architectural features -installation, removal or material changes to exterior Within a non-residential zoning district: building elements such as roof,siding,windows,doors, • a change in exterior building color porches,etc. • installation of an awning -enclosure or screening or buildings openings such as windows,doors, porches,etc. -installation of utility, mechanical or mist.accessory structures to the exterior of a building such as HVAC equipment,solar panels,wind turbines,radio/satellite transmission/reception devices, etc. ■Within a front yard setback: installation, removal or material changes to drive-or walkways -installation or removal of architectural,sculptural or vegetative screening that exceeds 3'in height -installation of accessory utility structures or radio/satellite transmission/reception devices over 2'in diameter •a change in exterior building color within a non- residential zoning district •a new,or change to an existing,sign or awning • installation of telecommunications facilities Lote—Ordinary maintenance or repair that does not involve a change in material,design or outer appearance exempt from Historic or Architectural Review. Revised 0112021 2021 LAND USE BOARD FEE WORKSWEET OPED Fees Type 2022 Fee Application to Zoning Board ofAppeals[11121 TOTAL #VARIANCE UseVarlance $1100+$50/app Area Variance-Residential $275/var+$501app+$125 each add`I variance Area Variance-Multi-Family,Comm,Mixed-Use $660/var+$501app+$200 each add'I variance Interpretations $550+$50/app Post-WorkApplicatlon Fee Add 50%Appfee+$50/app Varlanceextensions 50%ofAppfee+$50/app Application to Design Review Commission[11 TOTAL #STRUCTURE Demolition $385 Residential Structures Principal $55 Accessory 2 $55 Extension $35 Modification $55 Multi-Famfly,Comm,Mixed-Use Structures Sketch $165 Principal $550 Extension $ZOD Modification $330 Multi-Farelly,Comm,Mixed-Use Accessory,Signs,Awnings Principal $14D Extension $75 Modification $14D Post-Work Application Fee Add 50%Appfee Application to Planning Board[1) TOTAL #STRUCTURE Special UsePermlt[21 $990+$50/app Special UsePermit-extension $330 Special Use Permit-modification 12] $45D+$50/app Site Plan Review-Incl.PUD: Sketch Plan $330 Residential $330+$200/unit Residential-extension $200 Residential-modification $400 Non-residential $660+$130/1000sf Non-Residential-extension $300 Non-Residential-modification $650 Subdiv€sion-€ncl.PUO: TOTAL #LOTS Sketch Plan $330 Preliminary Approval(21 Residential:1-5 lots $660+$50/app Residential:640lots $990+$50/app Residential:11-20 lots $1320+$50/app Residential:21+lots $1650+50/app Residential-extension $330 Final Approval 121 Residential $1320+$175/lot+$50/app Non-Residential $2000/lot+$50/app Final Approval Modification[21 $330+$50/app Residential Non-Residential $550+$50/app Final Approval Extension Residential 1 1$135 Non-Resldential $330 Other: TOTAL #LOT/ACRE Post-Work Applicatlon Fee IAdd 50%App fee Lot LlneAdjustment $350 Letter ofCredlt•modification or extension $440 Letter ofCredlt-collection upto 1%ofLaC Recreation Fee $2000/19torunit Land Disturbance $660+$55/acre SEORA EIS Review(Draft&Final) I TBD Legal NotlOng If PB requires Public Nearing $50/app [1] Feesarebasedon per structure,except where noted. $3.00 TOTALDUE (21 Legal adrectuired;includes City processingandpublishing ForAdmfnistratfveUse Total Paid at intake Revised Fee Balance Due ��/ Balance Paid Staffapproval Full Environmental Assessment Form Part 1 w 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 applicant or project sponsor to verify that the information contained in Part 1 is accurate and complete. A.Project and Applicant/Sponsor Information. Name of Action or Project: Project Location(describe,and attach a general location map): 106 Church St.Saratoga Springs,NY 12866 Brief Description of Proposed Action(include purpose or need): Demolish 2 small outbuildings in very poor condition s identified by the City of Saratoga Springs code department as well as a 2 family dwelling that suffered a catastrophic fire in May 2022. Name of Applicant/Sponsor: Telephone:618-583-9115 Frederick Scheidt E-Mail:fwscheidt@nycap.rr.com Address:106 Church St City/PO:Saratoga Springs State:my Zip Code:12866 Project Contact(if not same as sponsor;give name and title/role): Telephone: &Mail: Address: City/PO: State: Zip Code: Property Owner (if not same as sponsor): Telephone: E-Mail: Address.- City/PO., State: Zip Code: Page 1 of 13 FEAF 2019 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, ❑Yes❑No or Village Board of Trustees b.City,Town or Village ❑Yes❑No Planning Board or Commission c.City,Town or ❑Yes❑No Village Zoning Board of Appeals d.Other local agencies ❑Yes❑No e.County agencies ❑Yes❑No f.Regional agencies ❑Yes❑No g.State agencies DYes❑No 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? ❑Yesmo U. Is the project site located in a community with an approved Local Waterfront Revitalization Program? 0Yc80No tii. Is the project site within a Coastal Erosion Hazard Area? ❑YesONo C.Planning and Zoning C.I.Planning and zoning actions. Will administrative or legislative adoption,or amendment of a plan,local law,ordinance,rule or regulation be the ®Yes❑No only approval(s)which must be granted to enable the proposed action to proceed? • If Yes,complete sections C,F and G. • H No,proceed to question C2 and complete all remaining sections and questions in Part 1 C.2.Adopted land use plans. a.Do any municipally-adopted (city,town,village or county)comprehensive land use plan(s)include the site ❑Yes Na where the proposed action would be located? If Yes,does the comprehensive plan include specific recommendations for the site where the proposed action ❑Yeslr7No would be located? b.Is the site of the proposed action within any local or regional special planning district(for example:Greenway; ❑Yes®No 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, ❑Yes®No 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. O Yes❑No If Yes,what is the zoning classification(s)including any applicable overlay district? UR 3 b. Is the use permitted or allowed by a special or conditional use permit? ❑YesONo c.Is a zoning change requested as part of the proposed action? ❑YesONo If Yes, i. What is the proposed new zoning for the site? CA.Existing community services. a.In what school district is the project site located? Saratoga Springs b.What police or other public protection forces serve the project site? Saratoga Springs PD c.Which lire protection and emergency medical services serve the project site? Saratoga Springs FD d.What parks serve the project site? All parks in Saratoga Springs 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)? residential b.a.Total acreage of the site of the proposed action? .30 acres b.Total acreage to be physically disturbed? .001 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? .30 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)? % Units: d.Is the proposed action a subdivision,or does it include a subdivision? Oyes Oia If Yes, i.Purpose or type of subdivision?(e.g.,residential,industrial,commercial;if mixed,specify types) ii. Is a cluster/conservation layout proposed? ❑Yes`J7 No iii.Number of lots proposed? iv. Minimum and maximum proposed lot sizes? Minimum Maximum e.Will the proposed action be constructed in multiple phases? ❑Yes ONo i. If No,anticipated period of construction: months U. If Yes; • Total number of phases anticipated • Anticipated commencement date of phase I (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 .. £Does the project include new residential uses? ❑yesONo .......... If Yes,show numbers of units proposed. One Family Two Family Thrcc Family Multiple Famd f(our or more Initial Phase At completion of all phases g.Does the proposed action include new iron-residential construction(including expansions)? ❑YesONo If Yes, i.Total number of structures ii.Dimensions(in feet)of largest proposed structure: height; width; and Iength 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 ❑YesONo liquids,such as creation of a water supply,reservoir,pond,lake,waste Iagoon or other storage? If Yes, i.Purpose of the impoundment: H. If a water impoundment,the principal source of the water: Ground water❑Surface water streams CFOther specify: iii.If other than water,identify the type of impounded/contained liquids and their source. iv.Approximate size of the proposed impoundment. Volume: million gallons;surface area: acres v. Dimensions of the proposed dam or impounding structure: height; length vi. Construction method/materials for the proposed dam or impounding structure(e.g.,earth fill,rock,wood,concrete): D.2. Project Operations a,Does the proposed action include any excavation,mining,or dredging,during construction,operations,or both? Yes No (Not including general site preparation,grading or installation of utilities or foundations where all excavated materials will remain onsite) If Yes: i.What is the purpose of the excavation or dredging? ii. How much material(including rock,earth,sediments,etc.)is proposed to be removed from the site? • Volume(specify tons or cubic yards): • over what duration of time? iii.Describe nature and characteristics of materials to be excavated or dredged,and plans to use,manage or dispose of them. iv. Will there be onsite dewatering or processing of excavated materials? EIYesENo If yes,describe. v.What is the total area to be dredged or excavated? acres vi.What is the maximum area to be worked at any one time? acres 0. What would be the maximum depth of excavation or dredging? feet viii. Will the excavation require blasting? ❑Yes®No ix. Summarize site reclamation goals and plan: b.Would the proposed action cause or result in alteration of,increase or decrease in size of,or encroachment ❑Yes 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 H. 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 the proposed action cause or result in disturbance to bottom sediments? ❑Yes o7 No If Yes,describe: iv.Will the 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 chemicaliherbicide treatment will be used,specify product(&): v.Describe any proposed reclamation/mitigation following disturbance: c.Will the proposed action use,or create a new demand for water? ❑Yes 0,10 If Yes: i. Total anticipated water usage/demand per day: gallons/day fi. Will the proposed action obtain water from an existing public water supply? ❑YesJ7JMo 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? ❑Yes❑No iii. Will line extension within an existing district be necessary to supply the project? ❑Yes❑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? ❑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),what is the maximum pumping capacity: gallons/minute. d.Will the proposed action generate liquid wastes? ❑Yes®No If Yes: f. Total anticipated liquid waste generation per day: gallons/day H.Nature of liquid wastes to be generated(e.g.,sanitary wastewater,industrial;if combination,describe all components and approximate volumes or proportions of each): iff.Will the proposed action use any existing public wastewater treatment facilities? ❑Yes Wo 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? ®Yes❑No • Is the project site in the existing district? ®Yes❑No • Is expansion of the district needed? ❑Yes®No Page 5 of 13 • Do existing sewer lines serve the project site? . ®Yes©No • Will a line extension within an existing district be necessary to serve the project? ❑Yes®No 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? ❑Yes®No If Yes: • Applicant/sponsor for new district: • Date application submitted or anticipated: • What is the receiving water for the wastewater discharge? v. 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 ❑YcsONo 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? If Yes: i.How much impervious surface will the project create in relation to total size of project parcel? Square feet or acres(impervious surface) Square feet or acres(parcel size) ii.Describe types of new point sources. iii. Where will the stormwater runoff be directed(i.e.on-site stormwater management faoility/structures,adjacent properties, groundwater,on-site surface water or off-site surface waters)? • If to surface waters,identify receiving water bodies or wetlands: • Will stormwater runoff flow to adjacent properties? ❑YesO No iv.Does the proposed plan minimize impervious surfaces,use pervious materials or collect and re-use stormwater? ❑YesO No f. Does the proposed action include,or will it use on-site,one or more sources of air emissions,including fuel ❑Yes ONo 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) g.Will any air emission sources named in D.2.f(above),require a NY State Air Registration,Air Facility Permit, []YesONo or Federal Clean Air Act Title IV or Title V Permit? If Yes: i. Is the project site located in an Air quality non-attainment area? (Area routinely or periodically fails to meet ❑Yes0No ambient air quality standards for all or some parts of the year) U. In addition to emissions as calculated in the application,the project will generate: Tons/year(short tons)of Carbon Dioxide(COA • Tons/year(short tons)of Nitrous Oxide(N20) • Tons/year(short tons)of Perfluorocarbons(PFCs) • Tons/year(short tons)of Sulfur Hexaf'luoride(SF6) • Tons/year(short tons)of Carbon Dioxide equivalent of Hydrollourocarbons(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); U.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 ❑Yes®No quarry or landfill operations? If Yes:Describe operations and nature of emissions(e.g.,diesel exhaust,rock particulates/dust): j.Will the proposed action result in a substantial increase in traffic above present levels or generate substantial ❑Yes®No new demand for transportation facilities or services? If Yes: i. When is the peak traffic expected(Check all that apply): ❑Morning ❑Evening []Weekend ❑Randomly between hours of to R. For commercial activities only,projected number of truck trips/day and type(e.g.,semi trailers and dump trucks): iii. Parking spaces: Existing Proposed Net increase/decrease iv.Does the proposed action include any shared use parking? []Yes[]No u 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%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 ❑Yes❑No 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 1.Hours of operation. Answer all items which apply. t. During Construction: ii. During Operations: • Monday Friday: • Monday-Friday: • Saturday: • Saturday:T • Sunday: • Sunday: • Holidays: • Holidays: Page 7 of 13 m.Will the proposed action produce noise that will exceed existing ambient noise levels during construction, [I Yes ONo operation,or both? If yes: i. Provide details including sources,time of day and duration: U. Will the proposed action remove existing natural barriers that could act as a noise barrier or screen? MYes ONo Describe: n.Will the proposed action have outdoor lighting? ❑Yes ONo If yes: 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? Yes❑No Describe: o. Does the proposed action have the potential to produce odors for more than one hour per day? ❑Yes❑/No 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 bulls storage of petroleum(combined capacity of over 1,100 gallons) ❑Yes ONo 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 the proposed storage facilities: q.Will the proposed action(commercial,industrial and recreational projects only)use pesticides(i.e.,herbicides, ❑Yes ONo insecticides)during construction or operation? If Yes: t. Describe proposed treatment(s): r ii.Will the ro osed action use Integrated Pest Management Practices? ❑ Yes ❑No r.Will the proposed action(commercial or industrial projects only)involve or require the management or disposal ❑ Yes []No 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) H. Describe any proposals for on-site minimization,recycling or reuse of materials to avoid disposal as solid waste: • Construction: • Operation: fii. 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? ❑Yes0-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 the proposed action at the site involve the commercial generation,treatment,storage,or disposal of hazardous❑Yes®No waste? If Yes: i.Name(s)of all hazardous wastes or constituents to be generated,handled or managed at facility: H. 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? Yes No 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 ❑ Industrial ❑ Commercial ® Residential(suburban) ❑ Rural(non-farm) ❑ Forest ❑ Agriculture ❑ Aquatic ❑ Other(specify): ii. if mix of uses,generally describe: b.Land uses and coverlypes on the project site. Land use or Current Acreage After Change Covertype Acreage Project Completion (Acres+/-) • Roads,buildings,and other paved or impervious 10 0 _10 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) .20 .30 +.10 • Other Describe: Page 9 of 13 c.Is the project site presently used by members of the community for public recreation? ❑Yes@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? ❑Yes®No If Yes: i.Dimensions of the dam and impoundment: • Dam height: feet • Dam length: -- ...._. ,.,....._.,,.. .,,,..,_, feet • Surface area: acres • Volume impounded: gallons OR acre-feet U. Dam's existing hazard classification: iii, Provide date and summarize results of last inspection: £Has the project site ever been used as a municipal,commercial or industrial solid waste management facility, ❑Yes®No 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: U.Describe the location of the project site relative to the boundaries of the solid waste management facility: W.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 ❑Yes®No 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 ❑Yes®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 fi.If site has been subject of RCRA corrective activities,describe control measures: W.Is the project within 2000 feet of any site in the NYSDEC Environmental Site Remediation database? ❑Yes®No 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. ❑YesORO • Explain: E.2. Natural Resources On or Near Project Site a.What is the average depth to bedrock on the project site? 10 feet b.Are there bedrock outcroppings on the project site? ❑Yes®No If Yes,what proportion of the site is comprised of bedrock outcroppings? % c.Predominant soil type(s)present on project site: % d.What is the average depth to the water table on the project site? Average: 10 feet e.Drainage status of project site soils:❑ Well Drained: 100%of site ❑ Moderately Well Drained: %of site ❑ Poorly Drained %of site f.Approximate proportion of proposed action site with slopes: ® 0-10%: 0%of site ❑ 10-15%: %of site ❑ 15%or greater: %of site g.Are there any unique geologic features on the project site? Yes®No If Yes,describe: b.Surface water features. i.Does any portion of the project site contain wetlands or other waterbodies(including streams,rivers, ❑Yes®No ponds or lakes)? ii. Do any wetlands or other waterbodies adjoin the project site? ❑Yes®No If Yes to either i or ii,continue. If No,skip to E.21 Hi. Are any of the wetlands or waterbodies within or adjoining the project site regulated by any federal, ❑YesO10 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 ofNYS water quality-impaired ❑Yes®No waterbodies? If yes,name of impaired water body/bodies and basis for listing as impaired: i.Is the project site in a designated Floodway? ❑YesoNo J.Is the project site in the 100-year Floodplain? []Yes JZNo k.Is the project site in the 500-year Floodplain? ❑Yes®No 1.Is the project site located over,or immediately adjoining,a primary,principal or sole source aquifer? ❑Yes®No 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? ❑YesONo If Yes: i. Describe the habitat/community(composition,function,and basis for designation): H. Source(s)of description or evaluation: W.Extent of cotnmunitylhabitat: • Currently: 0 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? If Yes: i. Species and listing(endangered or threatened): 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? If Yes: i. Species and listing: q.Is the project site or adjoining area currently used for hunting,trapping,Fishing-or shell fishing? []Yes®No If yes,give a brief description of how the proposed action may affect that use: 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 ❑Yes®No 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? ❑Yes®No W i. If Yes:acreage(s)on project site? U. 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 ❑Yes®No Natural Landmark? If Yes: i. Nature of the natural landmark: ❑Biological Community ❑ Geological Feature H. 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? ❑Yes®No If Yes: i. CEA name: ii. Basis for designation: W.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 ❑Yes®No 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? If Yes: i. Nature of historic/archaeological resource: ❑Archaeological Site ❑Historic Building or District ii.Name: M. Brief description of attributes on which listing is based: £Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for ❑Yes®No 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? ❑Yes®No If Yes: i.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: L Identify resource: ii.Nature of,or basis for,designation(e.g.,established highway overlook,state or local park,state historic trail or scenic byway, etc.): M.Distance between projcct and resource: miles. i. is the project site located within a designated river corridor under the Wild,Scenic and Recreational Rivers ❑Yes®No Program 6 NYCRR 666? If Yes: i. Identify the name of the river and its designation: U, 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/SponsorNarne C' � Date q/ l2 Signature Titte_0 ��, PRINT FORM Page 13 of 13