Project and Sponsor Information Short Environmental Assessment Form (SEAF)
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:
This section provides basic information about the applicant and the action. The purpose is to provide a common description of the project for easy communication between the various involved agencies, the public, and the applicant.
Name of Action or Project
Insert the common name or title of the project. Examples include:
- "Spaulding Subdivision"
- "Pine Hills Office Park"
- "Acme Plaza"
- "Adoption of Local Law #2 of 2012 (Telecommunication Towers)"
Project Location
Describe the location of the project. Include the actual address of the project site and add the county it is in. If the site does not have a street address, you can describe the location of the site using identifiable features found nearby (such as "200 feet south of the intersection of Maple Street and Main Street").
If required by the local municipality, also include the tax parcel identification number(s). Tax parcel ID numbers can be found on the official tax map of the community, and can be viewed at the local tax assessor's office.
Attach a map showing the location of the project. This map should be of sufficient size so the reviewing agency knows where the parcel is. This map can be from a tax map, a topographic map, an image from Google maps, or Bing maps, or another similar online mapping program. The map should show the project site boundaries at a scale large enough to display the relevant information about the site. A scale of one inch equals 24,000 feet is generally adequate. A small project site may need a more detailed map at a scale of one inch equals 40 or 100 feet. Select the scale that provides the reviewing agency with a good overview of the project site and the immediate surrounding area.
If the project requires subdivision, site plan, or special use permit approvals, a more detailed map will likely be required as part of the permit and review process. Check with the town, village or city clerk, building inspector, or code enforcement officer for information on permit and mapping requirements. The location map may be required as part of a more detailed site map, and the municipality may have other requirements that need to be incorporated into the location map.
Brief Description of Proposed Action
Describe and identify the major elements of the project including:
- The type of activity - such as: residential subdivision, commercial or industrial site plan or special use application, erection of a sign, adoption of a local law, adoption of a local plan, or land acquisition.
- Whether the project is a new structure, a modification of an existing structure or facility, or an expansion.
- The number of residential units planned, the square footage of the structure, the height of the structure, the number and size of lots being subdivided, the number of floors, the number of structures.
- If residential, whether the project includes attached, detached, condominium, townhouse, or single family units.
- For adoption or amendment of a plan, local law or ordinance, describe the basic elements of the law, ordinance, or plan.
Examples
- Description of a residential subdivision: "Subdivision of a vacant 20-acre parcel into four five-acre parcels. Each parcel will have 150 feet of road frontage. Four new two-story, single family homes will be built, each approximately 2000 square feet in size. Driveway access will be provided for all sites off of Maple Street. Individual wells and septic systems will be built for each house."
- Description of a commercial project: "Site plan approval for a 10,000 square foot structure for retail space will be built along with a 25-car parking lot, and two access drives (one off Maple Street, and the other off Downey Street). The area is zoned commercial. An exterior lighted, freestanding eight foot high, 24 square foot size sign will be placed outside the Maple Street right of way in a landscaped base. Lighting and landscaping within the parking lot and around the new building will be provided for. Cross-access into the neighboring parking lot will be provided. A fenced in dumpster area will be sited."
- Description of adoption of a local law: "Adoption of a local law regulating placement of telecommunication towers within the city. The law regulates tower height, setbacks, co-location, inspections and maintenance, and removal. It also includes tower application submittal requirements and review procedures."
Name of Applicant/Sponsor
Provide the name of the applicant or the project sponsor, and accurate contact information so the agency can efficiently communicate with the applicant.
Back to Part 1 - Project Information || Continue to Question 1 (SEAF)
