716-699-2005

CCIDA Environmental Assessment Form – Short

Complete & Submit Online CCIDA Environmental Assessment Form – Short (SEQR)  Below or download form to print and return by mail.

(PDF online version also available – See below.)

See all applications

Downloadable Form

PDF Online

This Application is needed for the CCIDA to consider a project for inducement. When completed, please mail the Sale Leaseback Application, the Cost Benefit Analysis form and the Full EAF Form, along with a check for $1,500.00 made payable to CCIDA to the following address:

County of Cattaraugus IDA
P.O. Box 1749
Ellicottville, New York 14731

Environmental Assessment Form – Short

Short Environmental Assessment Form

Part 1: Project and Sponsor 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 additional pages as necessary to supplement any item.

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, 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 governmental Agency?
Acres
Acres
Acres
4. Check all land uses that occur on, adjoining and near the proposed action.
5. a. Is the proposed action a permitted use under the zoning regulations?
5. b. Is the proposed action consistent with the adopted comprehensive plan?
6. Is the proposed action consistent with the predominant character of the existing built or natural landscape?
7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area?
8. a. Will the proposed action result in a substantial increase in traffic above present levels?
8. b. Are public transportation service(s) available at or near the site of the proposed action?
8. c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action?
9. Does the proposed action meet or exceed the state energy code requirements?
10. Will the proposed action connect to an existing public/private water supply?
11. Will the proposed action connect to existing wastewater utilities?
12. a. Does the site contain a structure that is listed on either the State or National Register of Historic Places?
12. b. Is the proposed action located in an archeological sensitive area?
13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain wetlands or other waterbodies regulated by a federal, state or local agency?
13. b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody?
14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply:
15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered?
16. Is the project site located in the 100 year flood plain?
17. Will the proposed action create storm water discharge, either from point or non-point sources?
17. a. If yes, Will storm water discharges flow to adjacent properties?
17. b. If yes, Will storm water discharges be directed to established conveyance systems (runoff and storm drains)?
18. Does the proposed action include construction or other activities that result in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)?
19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility?
20. Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste?

I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.

Applicant/sponsor name:
Applicant/sponsor name:
First
Last

Part 2 Impact Assessment

Part 3

Maximum file size: 20MB

If you an any questions with regards to what application is to be filled out and submitted for your proposed project, please feel free contact our office at 716-699-2005, as we will be happy to assist you.

The Applications listed above along with the N.Y. State Environmental Assessment Forms (SEQR) forms are designed to be filled in on your computer, printed on your printer, signed and mailed/e-mailed to our offices.

Please Note: All applications are to be submitted to our office NO LATER than seven (7) business days prior to the next Board of Director’s Meeting. Please see the Meeting schedule that is located on our website for meetings, dates and times. If you have any questions or concerns, please feel free to contact our office directly at 716-699-2005. Thank you.

These forms are in Adobe Acrobat Reader (PDF) format. A free copy of Acrobat Reader may be downloaded by clicking on the following image:

adobe acrobat reader

Cattaraugus County Industrial Development Agency

P.O. Box 1749, 9 East Washington Street
Ellicottville, New York 14731
Phone: (716) 699-2005
Fax: (716) 699-2942

Application Forms
Contact Us

© Copyright 2021 Cattaraugus County IDA. All rights reserved.

Cattaraugus County Industrial Development Agency

P.O. Box 1749, 9 East Washington Street
Ellicottville, New York 14731
Phone: (716) 699-2005
Fax: (716) 699-2942

Application Forms
Contact Us

© Copyright 2021 Cattaraugus County IDA. All rights reserved.