1234 CENTER STREET (full text)

CASENO._ JS32 DATE OF HEARING 4 |20 26 Town of Aurora Zoning Board of Appeals 575 Oakwood Avenue, East Aurora, New York 14052 Zoning Board of Appeals Application Form l. TYPE OF REQUEST x AREA VARIANCE SPECIAL USE PERMIT ___USE VARIANCE INTERPRETATION ll. APPLICANT/PETITIONER Applicant's Name |Wee Kp Tic Address bay CONN Seer State Noy ZIP os? cily anit Boy (heli tho Taesus @ Cerin Com Phone Wie W324 S512 Fax Email Interest in the property (ex: owner/purchaser/developer) Poe it Ill. PROPERTY OWNER INFORMATION (f different from applicant information. ) Property Owner(s) Name(s) SDAeinns Kem ASicg Address. 23% Céovee. $7 City EAST A tots State AI7~ ZIP__ Jez Phone “Jite 435-S$54 Fax Email T Aiteotn eit @ Giansit. COs lll. PROPERTY INFORMATION Property Address _|234 (gutyr St SBL# (k7.00-\-4¢- | Property size in acres 2.0 Ae Property Frontage in feet_\43.55' Zoning District__ V1]A- Surrounding Zoning C2] Pr Current Use of Property Wo Sidewhal IV. REQUEST DETAIL (check all that apply) _& Variance from Ordinance Section(s) #2 \\ be XY, AMO ¢ \\UB4AUO)(») ____ Special Use Permit for: ____ Use Variance for: ___ Interpretation of

PETITIONER’S LETTER OF INTENT Please describe in detail the proposed project, reason the variance and/or special use permit is being requested and any additional information that may be helpful to the Zoning Board of Appeals in deciding this appeal: (attach additional pages if needed) Wt Meer BT Aw wtih Suite pa We CONEY oled. SME Kew i iw ite COATS tart a iCieS tae SHE WAS KAISED ie VOR? DAA. Sue BAS CAAT SET DEMEVT IG AWD CALLING, ole ESE eee Cats Mee A SOAs POSS BUITY. Wh Lives TMES frye ttS br Levis TeE Des PerSisitpr a (Anve fet Ty WE eee ME CRISP AD ta ee USE OL fiittAwWAY F665 D KOS AND webuhings AS we WE ee TA da OF SEU NIE (APPL CeBie™ | Ow CETL A Woe as He Psraqlaric “26 iden TO BE COMPLETED ONLY WHEN A USE VARIANCE IS BEING REQUESTED: A Use Variance is requested because the applicable regulations and restrictions in the Zoning Code of the Town of Aurora have caused unnecessary hardship as demonstrated by the following: 1) | cannot realize a reasonable return on my property for each and every permitted use allowed in the current zoning classification as demonstrated by the accompanying financial evidence (provide financial evidence to support your argument). Financial Evidence Provided Yes No__A___ (financial evidence is required per NYS Town Law) 2) Describe why your alleged hardship relating to the subject property is unique and does not apply to other properties in the zoning district or neighborhood: FAR DSA LP i3 GMT SMG Ve” ONL BHecavse AR RAALS Awe Bee AN KB OM CWear Meg, TWE AW rte ¢ Po {DOC ban NEA NerTAn EXERO SE AWD Kees ads WAP D 9 awd wed4eey , Www Areerer G iver VAS LiLees€ CAkwit fr Teese AW UNAS SAK UFO. 3) Describe why you believe that the essential character of the neighborhood/community will not change if the Zoning Board of Appeals grants you a use variance: W#i/emmons Kee AM ORES Awd Aden Ve NA AON AZEe TYUSeD Ade ee CKD NEIL MOES pool Chest £58 UMECES ANS ISSUES. 4) Is your need for a use variance a result of you own actions (is your difficulty self-created)? Please explain: Cuwensnsl ge CAN Res Ans Cows. (Attach additional pages if needed)

V. SIGNATURES (This application must be signed by the applicant/petitioner. If the applicant is not the owner of the property, a separate owner authorization form must be submitted — see pg. 5) Signature of Applicant/Petitioner “Thom AS KeAscict Print name of Applicant/Petitioner State of New York; County of Erie On the Alpday of Sept in the year ZOZhefore me, the above individual appeared, personally known to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and DOROTHY BAILEY Reg #01BA0023544 Notary Ntéarypjublic, State of New York ( Qualified in Erie County ze Commission Expires April 15, 20_4© Office Use Only: Date received: 4 // [20/; 2925 Receipt #:,_ 7/3 YSF Application reviewed by: ALL ECDP ZR-1 form sent to EC: Hearing publication date: PREVIOUS APPEAL(S): A previous appeal to the Zoning Board of Appeals ( ) has ( ) has not been made with respect to this property. Previous appeals: Date: Type of Appeal: Granted Denied Date: Type of Appeal: Granted Denied

SUPERVISOR TOWN CLERK Charles D. Snyder Martha L. Librock (716) 652-7590 (716) 652-3280 csnyder(@townofaurora.com [email protected] TOWN OF AURORA Aurora Municipal Center 575 Oakwood Avenue, East Aurora, NY 14052 www.townofaurora.gov November 26, 2025 TOWN COUNCIL MEMBERS Luke Wochensky [email protected] Thomas Kotarski 1234 Center Street Joseph M. McCann East Aurora, NY 14052 [email protected] Raymond M. Wrazen rwrazen(@townofaurora.com Thomas, The Building Department has reviewed your request for chickens and domestic animals SUPT. OF HIGHWAYS David M. Gunner (goats) at 1234 Center Street (SBL 187.00-1-48.1). The request has been denied because it (716) 652-4050 fails to meet the allowable amounts based on the two-acre lot in the Rural Residential and highway(@townofaurora.com Agriculture (RR/A) zoning districts in which the property is located. CODE ENFORCEMENT OFFICER Elizabeth Cassidy Sections 116-8.4A(10)(a) (716) 652-7591 Required: Six chickens or other poultry per acre, no roosters, confined to lot boundaries [email protected] and housed in the rear yard at least 25 feet from any lot line. Requested: 17 chickens (property is two acres for a code allotment of 12 chickens). ASSESSOR Stephen R. Pigeon Variance: 5 chickens assessor(@townotaurora.com (716) 652-0011 Sections 116-8.4A(10)(b)[1] DIR. OF RECREATION Required: The keeping of large domestic animals, including but not limited to horses, Christopher Musshafen (716) 652-8866 goats, sheep, etc., shall have a minimum of one-acre undeveloped land per animal. [email protected] Requested: 2 goats (property has less than two acres of undeveloped land for a code allotment of one goat). TOWN ATTORNEY Variance: I goat Brigid M. Maloney TOWN JUSTICE Jeffrey P. Markello James Granville This letter serves as notice that we have received the application and fee for the Zoning Board of Appeals. You will receive notification from the Town Clerk with the date and HISTORIAN Robert L. Goller time of the next available hearing. If you have any questions, please contact our office at (716) 652-7944 652-7591. [email protected] Sincerely, FAX: (716) 652-3507 This institution is an equal opportunity provider and employer. Assistant Cod¢ Enforcement Officer

November 17, 2025 Richard Miga Assistant Code Enforcement Officer Town of Aurora Dear Mr. Miga, I am writing to formally request a zoning variance for my property in the Town of Aurora regarding the number of animals currently in my care. At present, I have 17 chickens, which exceeds the town’s limit of 12. Of these, five are older hens that no longer produce eggs. They have been part of our flock for years, and while they are no longer productive, they remain healthy and well cared for. We do not have the heart to cull them, as they are part of the therapeutic environment we've created for my mother, who is in the early stages of dementia. Additionally, I am requesting permission to keep two goats, where the current code allows for only one. Goats are highly social animals and thrive when living with companions. We currently have two, and I would like to keep the second to ensure their well-being and maintain a stable herd dynamic. All of these animals are housed in a dedicated shed structure that includes a built-in coop for the chickens and secure space for the goats. The shed is located near the south property line, and while I am unsure of the exact measurement, the fence is built with eight-foot sections mounted on 4x4 posts spaced approximately 8.5 feet apart. From the last post to what I believe is the property line, there is an estimated 28.5 feet of clearance. Importantly, my mother is the primary caregiver for these animals. Her daily interaction with them provides her with a sense of purpose, routine, and emotional engagement. I have submitted a letter from her mental health provider supporting the therapeutic value of this arrangement. Our neighbors have been very supportive. In particular, our neighbor to the south frequently brings her grandchildren to visit the animals, and I can provide a letter of support from her if needed. I appreciate your time and consideration of this request. Please let me know if any

Thomas Kotarski 1234 Center Street East Aurora, NY 14052 October 15, 2025 Town of Aurora Zoning Board of Appeals 575 Oakwood Avenue East Aurora, NY 14052 Dear Members of the Zoning Board, I am writing to respectfully request a variance from the current zoning regulations regarding the number of domestic animals permitted on residential properties in the Town of Aurora. My family currently keeps two goats and twelve chickens at our home on Center Street, which exceeds the town’s limit of one goat and six chickens. I would like to present two key reasons for this request: 1. Community Support and Positive Impact: Our neighbors are fully aware of and supportive of our animals. Many of them regularly visit to interact with our goats and enjoy spending time near the chickens. While our chickens are not currently producing eggs, they are expected to begin laying in the near future, and we plan to share the eggs with our neighbors once they do. The animals have become a cherished part of our neighborhood, fostering a sense of community and connection among residents. We have taken care to ensure that the animals are well-maintained, quiet, and kept in a secure, fenced area that does not interfere with neighboring properties. 2. Therapeutic Benefit for My Mother: My mother, who resides with us, is in the early stages of dementia. She spent her childhood as a World War II refugee in Venezuela, where she was raised on a small farm and cared for chickens. These animals provide her with a sense of purpose and comfort, connecting her to cherished memories from her youth. Caring for them has become her daily routine and offers her meaningful engagement while we are at work. Her mental health provider, Dr. Kristin McKenzie, supports this therapeutic activity and will be providing a letter to affirm its positive impact on her well-being. We understand and respect the town’s regulations, but we believe that our situation merits special consideration. The animals are not only a source of joy and community engagement but also play a vital role in supporting my mother’s mental health. We are committed to maintaining a clean, safe, and respectful environment for both our animals and our neighbors.

Thank you for your time and consideration of our request. We would be happy to provide any additional documentation or answer any questions you may have. Sincerely, Thomas Kotarski

Nhaninate NP Psuichia tvy, PLLC 3595 Eggert Rd., Orchard Park, NY 14127 (716) 903-6036 October 21st, 2025 Attn: Town of East Aurora Re: Christine Bruni DOB: 5/10/1947 To whom it may concern, Ms. Christine Bruni is a client under my care who has been diagnosed with more than one mental health condition that is recognized as a disability under the Americans with Disabilities Act (ADA Amendments Act of 2008). My client's mental health disorder substantially limits one or more major life activities and disrupts her functioning at unpredictable times. During a recent assessment it was determined that Christine’s new caretaking role of the animals on her property has had a profound positive effect on her cognitive and emotional health. Due to the severity of her mental health symptoms, and the substantial improvement in quality of life that she gets from her animals, | am ordering her an emotional support animal. In Ms. Bruni’s case the animals that bring her the most benefit are farm animals like chickens and goats. | am requesting that Ms. Christine Bruni be allowed to continue raising her current chickens on her property. Please allow for an increase per acre of the amount of chickens she is allowed to keep, as raising them is an important part of emotional and cognitive rehabilitation for her. Sincerely, Reahis Makings Mw? DP Kristin D. McKenzie DNP, PMHNP-BC Psychiatric Provider NPI 1053752626 NY License 401631 [email protected] (716) 903-6036

‘ aye prea an Re Ni a s ; f = wwe HAN BBDNE, $B fy, ecmoinananeners er SI7't MEAS. 825'¢ DEED a ee oe ceo oa Re ee =< FRAME HOLADE NO a4 oh. eee) parte | 8 Lat ONE oe wy ay a fi Lute WR gd we aoe NERET BG ERD vie Be oy wee Lon OR La rE ke saponin apoenonanypanninncnnnanannnnnnoeny NNR ja3.55! C Gate’ Wal STREET

e INSTRUCTIONS(RP-5217-PDF-INS): www.orps.state.ny.us FOR COUNTY USE ONLY New York State Department of C1. SWIS Code Ly q i it | Taxation and Finance f ‘ iPS cay C2. Date Deed Recordes L ] [Ly L 5 / a er Dicer eat rsopety tax Seneca womens nae EA 1) RP- 5217 -PDF C3. Book ALL f Oy ca. page Page L 5.0, 4] Real property Transfer Report (8/10) PROPERTY INFORMATION | 1. Property 3 wee S iyi ie Location 1234 Center Street * STREET NUMBER * STREET NAME Aurora 14052 “CITY OR TOWN VILLAGE * ZIP CODE “ pnd Kotarski Thomas * LAST NAME/COMPANY FIRST NAME Kotarski Amy * LAST NAME/COMPANY FIRST NAME 3. Tax Billing Indictate where future Tax Bills are to be sant Address if other than buyer address (at bottom of form) LAST NAME/COMPANY FIRST NAME STREET NUMBER AND NAME CITY OR TOWN STATE 4, indicate the number of Assessment 1 gO purciatena {Only If part of a Parcel) Check as they apply: Rolt parcels transfered on the deed # of Parcels OR art of a a Parce 4A. Planning Board with Subdivision Authority Exists aye ; {] 6. Deed xX OR 2.02 4B. Subdivisi . : . Subdivision Approval was Required for Transfer ow * FRONT FEET * DEPTH “ACRES P "s CJ Size 4C. Parcel Approved for Subdivision with Map Provided [| Lillis Edward M. &. Seller * LAST NAME/COMPANY FIRST NAME Name Lillis Kathleen A. LAST NAME/COMPANY FIRST NAME Check the boxes below as they apply: *7. Select the descripticon which most accurately describes the - ; ; use of the property at the time of sale: 8. Ownership Type is Condominium [| : . 9. New tructi ni A. One Family Dwelling Construction on Vacant Land L 410A. Property Located within an Agricultural District [] 108. Buyer received a disclosure notice indicating that the property is in an [] Agricultural District | SALE INFORMATION / 45. Check one or more of these conditions as applicable to transfer: ] A, Sale Between Relatives or Former Relatives +1 Rate Conpece ate 08/03/22 |__| B. Sale Between Related Companies or Partners in Business . D |_| C. One of the Buyers is also a Seller * 42, Date of Sale/Transfer rah wors / 2 22 |__| D. Buyer or Seller is Government Agency or Lending Institution |__| &. Deed Type not Warranty or Bargain and Sale (Specify Below) * 43, Full Sate Price 510,000 990 |__| F. Sale of Fractional or Less than Fee Interest (Specify Below) |__| G. Significant Change in Property Between Taxable Status and Sale Dates (Full Sale Price is the Total amount paid for the property including personal property. |__| H. Sale of Business Is included in Sale P ice This payment may be in the form of cash, other property or goods, or the assumption of |_| 1. Other Unusual Factors Affecting Sale Price (Specify Below) mortgages or other obligations.) Please round to the nearest whole dollar amount. [XJ J. None * Comment(s) on Condition: 14, Indicate the value of personal property Included in the sale 0 .00 | ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill | 16. Year of Assessment Roil from which information taken(YY) 22 * 17. Total Assessed Value la, bo. % * 18. Property Class A\O * 20. Tax Map identifier(s)/Roil identifler(s) (If more than four, attach sheet with additional Identifler(s)) * 49. Schoo District Name 6 Aurore 187.00-3-61 | CERTIFICATION | certify that all of the Items of information entered on this form are true le correct (to the best of my knowledge and bellef) and | understand thet the making of any willful false statement of material fact herein subject me to the provisions of relative to the making and filing of faise instruments. IGNATURE BUYER CONTACT INFORMATION Xdarec Dn Lol Loe lo /zolez. (Ermer for the buyer, Note: If buyer is LLC, society, association, corporation, joint son company, estate or SELLER SIGNATURE entity that is not an individual agent or fiduciary, then a name and contact of an | party who can answer questions regarding the transfer must be entered, Type or print clearfy.) Kotarski Thomas C2EY * LAST NAME FIRST NAME BUYER S| o RE t “AREA CODE * TELEPHONE NUMBER (Ex: 6000999) ‘‘ LUIS 1234 Center Street * STREET NUMBER * STREET NAME sr ann il East Aurora NY 14052 i * CITY OR TOWN * STATE * ZIP CODE B R'S ATTORNEY Scott Karen Gaughan LAST NAME FIRST NAME 716 6491571 | AREA CODE TELEPHONE NUMBER (Ex: 9006908) Book11410/Page5049 Extra Page 2

Qadiani | ro vra s Sud AMY, Ro Teaser : XY : \2S4 Cee Sree | DEED - Warranty with lien covenant (individual) FORM WD-1s Brat AYALA NY 14 2 SL Eastern Abstract of N.Y. tne. Chis Indenture Made the a G Hh ay of October Two Thousand and TWENTY Tud Between Grantor(s): EDWARD M. LILLIS and KATHLEENA. LILLIS, residing at 1234 Center Street, East Aurora, NY 14052 Grantee(s): THOMAS KOTARSKI and AMY KOTARSKI as Husband and Wife, residing at 12 Rose Street, Lancaster, NY 14086 CGitnes g eth that the grantor(s) in consideration of -—----- ONE AND MORE -------- Dollar(s) ( $1.00 & More ) lawful money of the United States, paid by the grantee(s) does hereby grant and release unto the grantee(s) Their Heirs and assigns forever, All That Tract or Parcel of Land Situate in the Town of Aurora, County of Erie and State of New York being more particularly described in Schedule A attached hereto and made a part hereof. Together with the appurtenances and all the estate and rights of the Grantor(s) in and to the said premises. the above granted Premises unto the said Grantee(s). Co Fave and To Holt, Their Heirs and assigns forever. And the said Grantor(s) does (do) covenant with the said Grantee(s) as follows: First. ---- That the Grantee(s) shall quietly enjoy the said premises. Second. — ---- That the Grantor(s) will forever WARRANT the title to said premises. Third. ---- Subject to the trust fund provisions of section thirteen of the lien law. Jn Witness CAthereof, The said Grantor(s) have (has) set their (his), (her) hand(s) and seal(s) the day and year first above written. Jn a of L Le [L.S.] Hosen Bde) [L.S.] Edward M. Fi KathleenA. Lillis [L.S.] [L. SJ State of New Bork ) ss. Onthe 2G7™” day of October County of Erie ) in the year 2022 before me, the undersigned, personally appeared Edward M. Lillis and Kathleen A. Lillis personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. ny Piedn Eton SA Edel 0 we 8 ’ Son ExpedCony My Comma: No, inte oy on 26 Notary Public 50007 AVA Book11410/Page5048

SCHEDULE “A” ALL THAT TRACT OR PARCEL OF LAND, situate in the Town of Aurora, County of Erie and State of New York, being part of Lot No. 20, Township 9, Range 6 of the Holland Land Company’s Survey, bounded and _ described as follows: BEGINNING at a point in the Center Street, being also the west line of Lot No. 20 distant 590 feet northerly from the southwest comer of Lot No. 20 as Measured along the center line of Center Street which point of beginning is also the northwest corner of lands conveyed to American Traditions Homes, Inc. by Deed recorded in Erie County Clerk’s Office in Liber 10582 of Deeds at Page 849; running thence easterly along the north line of said lands conveyed to American Traditions Homes, Inc. and parallel with the south line of Lot No. 20, being also the center line of Blakeley Road a distance of 477 feet, more or less to a point in the center line of a stream, which center line of steam is also the west line of lands conveyed to David Waples and Barbara A. Waples, his wife by Deed recorded in Erie County Clerk’s Office in Liber 9997 of Deeds at Page 153; thence northerly along the center line of stream and the west line of said lands conveyed to Waples a distance of 197 feet more or less to the southeast corner of lands conveyed to Michael S. Dudek and Elaine A. Dudek, his wife by Deed recorded in Erie County Clerk’s Office in Liber 10896 of Deeds at Page 1671; thence westerly along the south line of lands conveyed to Dudek and parallel with the south line of Lot No. 20, 525 feet more or less to the center line of Center Street; thence southerly along the center line of Center Street 193.55 feet to the point or place of beginning. Policy No. 3 Book11410/Page5049

ERIE COUNTY CLERK'S OFFICE County Clerk's Recording Page Return to: Book Type: D Book: 11410 Page: 5047 THOMAS&AMY KOTARSKI Page Count: 3 1234 CENTER ST Doc Type: DEED EAST AURORA, NY 14052 Rec Date: 11/15/2022 Rec Time: 09:40:31 AM Control #: 2022215016 Party 1: UserID: Molly LILLIS EDWARD M Trans #: 22175092 Document Sequence Number Party 2: TT2022008071 KOTARSKI THOMAS Consideration Amount: 510000.00 Recording Fees: BASIC MT $0.00 RECORDING $35.00 SONYMA MT $0.00 COE CO $1 RET $1.00 ADDL MT/NFTA $0.00 COE STATE $14.25 GEN $14.25 SP MT/M-RAIL $0.00 COE STATE $4.75 RM $4.75 NY STATE TT $2,040.00 RP5217 CNTY $9 $9.00 ROAD FUND TT $0.00 RP5217 ST-RES $116 $116.00 TP584 $10.00 Total: $2,230.00 STATE OF NEW YORK ERIE COUNTY CLERK’S OFFICE WARNING — THIS SHEET CONSTITUTES THE CLERK’S ENDORSEMENT REQUIRED BY SECTION 319&316-a (5) OF THE REAL PROPERTY LAW OF THE STATE OF NEW YORK. DO NOT DETACH. THIS IS NOT A BILL. Michael P. Kearns Erie County Clerk ~ Book11410/Page5047

Michael P. Kearns Erie County Clerk 92 Franklin Street Buffalo, New York 14202 ,, Kathleen A. Lilli “42 ba AbboTt Pkwy ~ NOTICE - Hamburg NY 14219 From County Clerk Michael P. Kearns regarding a change in ownership of your property NOTICE OF SALE OR TRANSFER OF OWNERSHIP OF YOUR RESIDENTIAL PROPERTY To: Edward M. Lillis, Kathleen A. Lillis (name of owner of record) Our records show that you are listed as the current owner of record for residential property: Section: 187.00 Biock: 3 Lot: 61 Located At: 1234 Center Street East Aurora , County of Erie, New York (street address) (city/town) On NOW| 5 Documents were filed at this office to change ownership and transfer title of your property. (date To: Thomas Kotarski and Amy Kotarski (name of new owner) If you have any questions regarding the validity of the documents, and wish to dispute the recording of the transfer, you should obtain legal counsel. If you believe you are a victim of a crime related to this recording, contact your local law enforcement agency or, if In the City of New York, the office of the sheriff. Book11410/Page5049 Extra Page 1

Short Environmental Assessment Form Part 1 - Project 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. Part 1 — Project and Sponsor Information Name of Action or Project: HeehwE Caic@ers Awd OAKS Project Location (describe, and attach a location map): 1234 Fs Cen Me TEn. > VEER Qe - tasy re] Audet AGT ‘ail’ Wes if ZL Brief Description of Proposed Action: (Fp ae _ . x fang . Far 4 7 eee aft po LO’ OSA TD hee? 2 GOATS Ars > 1S CW ReS OA SAY Phebertr Name of Applicant or Sponsor: Telephone: “JI 73% SSY¥Z “Pets TUS HY E-Mail: TH Keaesk © Giri. coe Address: (234 Cente Ser City/PO: State: Zip Code: East , - Au em Aud y/ ao eS 2 Fy mx 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. Ifno, continue to question 2. LI 2. 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: - 3. a. Total acreage of the site of the proposed action? 2 acres b. Total acreage to be physically disturbed? e acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? sy) acres 4. Check all land uses that occur on, are adjoining or near the proposed action: [-] Urban (J Rural (non-agriculture) [J Industrial [] Commercial J Residential (suburban) [J Forest Agriculture [] Aquatic [7] Other(Specify): [__] Parkland Page | of 3 SEAF 2019

5. Is the proposed action, [||] é LIL) = 0 )a/00) & a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? Gs) EB WN < 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? E NM < If Yes, identify: [ E ~< NM 8. a. Will the proposed action result in a substantial increase in traffic above present levels? 4/4 b. Are public transportation services available at or near the site of the proposed action? HOO c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed action? 9. Does the proposed action meet or exceed the state energy code requirements? re tm n 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: = [“] 11. Will the proposed action connect to existing wastewater utilities? NO | YES 7 If No, describe method for providing wastewater treatment: 12. a. Does the project site contain, or is it substantially contiguous to, a building, archaeological site, or district YES 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? 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 YES wetlands or other waterbodies regulated by a federal, state or local agency? j00 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: rs

14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: [Shoreline [_] Forest Agricultural/grasslands [_] Early mid-successional []Wetland [2] Urban Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or ies! [Vs N Federal government as threatened or endangered? (eles elelerale 16. Is the project site located in the 100-year flood plan? E —N < jao00 [| 17. Will the proposed action create storm water discharge, either from point or non-point sources? ES re If Yes, a. Will storm water discharges flow to adjacent properties? b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: 18. 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? If Yes, describe: EJ) Ld 20.Has the site of the proposed action or an adjoining property been the subject of remediation (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 KNOWLEDGE (ev PNR S TEN Date: 4-26-15 See) TAG we ‘ C= | s ; TL Peete Pye CU Signature: ZA Title: PERM IO Cow VA PRINT FORM Page 3 of 3