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HomeMy WebLinkAbout20250165 131 Middle Ave Subdivision EAF Short Environmental Assessment Form Pall I - Project Information Instructions for Completing Part I—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 infornration 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 Pan 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 I—Project and Sponsor Information Name of Action or Project: Southern Residence Project Location(describe,and attach a location map): 131 Middle Avenue Saratoga Springs,NY 12866 Brief Description of Proposed Action: Construct a single-family residence on a vacant parcel. Name of Applicant or Sponsor: Telephone: {518}316-4759 Mike&Kim Southem E-Mail: mksouth@vefixon.net Address: 124 York Avenue City/PO: State; Zip Cade: Saratoga Springs NY 12866 1. Does the proposed action only involve the legislative adoption of a plan,local law,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. 1 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; ❑ ❑ Building Permit from ciiy of Saratoga Springs 3. a.Total acreage of the site of the proposed action? 0.12 acres b.Total acreage to be physically disturbed? 4.12 acres c.Total acreage(project site and arty contiguous properties)owned or controlled by the applicant or project sponsor? o,2a acres 4. Check all land uses that occur on,are adjoining or near the proposed action: ©Urban ❑ Rural(non-agriculntre) ❑ Industrial ❑ Commercial ® Residential(suburban) Forest ❑ Agriculture ❑ Aquatic 0 Other{Specify): []Parkland Page I ol'3 SERF 2019 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ ❑� ❑ b, Consistent with the adopted comprehensive plan? ❑ 21 ❑ b, Is the proposed action consistent with the predominant character of the existing built or natural landscape? NO YES 7. Is the site ofthe proposed action located in,or does it adjoin,a state listed Critical Environmental Area'? NO YES If Yes,identify: R] ❑ NO YES S. 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? RI 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. Will the proposed action connect to an existing public.private water supply? NO YES If No,describe method for providing potable water: M� ❑ LJ 11, Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment; El 12. a.Does the project site contain,or is it substantially contiguou_c to,a building,archaeological 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 NY5 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? 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: Page 2 of 3 14. Identify the typical habitat types that occur an,or are likely to be found on the project site.Check au that apply: ❑Shoreline [] Forest ❑AgriculturaUgrasslands ❑ Early mid-successional ❑Wetland ❑ Urban 0 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 1 N-year flood plan? NO YES R1 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes. ❑ a a. Will storm water discharges flow to adjacent properties? 21 El— b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? 21 If Yes;briefly describe: I& 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)? If Yes,explain the purpose and size of the impoundment: ❑ ❑ 19. 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? 1f Yes,describe: 20.1-Tas the site of the proposed action or an adjoining property been the subject of retnediation(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 KNOWL G C Applicantlsp s /na ( S V1 Date: � Signature: ti Tide' PRINT FORM Page 3 of 3