Board of Trustees

Village of Millbrook- Board of Trustees Business Meeting Minutes Millbrook Village Hall- 35 Merritt Ave Date: 10/08/2025 Time: 6:00 PM Video Link Presentation Roll Call: Mayor Doro, Deputy Mayor Murphy, Trustee Bucklin, Call to Order: Mayor Doro opened Trustee Mawson, Trustee Socci, FD Chief Boscardin, FD President the meeting with the Pledge of Rochfort, Police Chief Dworkin, Scott Osborn (VRI), and Clerk Witt. Allegiance Administrative Minutes Approval: September Minutes approved by Deputy Mayor Murphy seconded by Trustee Bucklin- Business All voted in favor. Voucher Approval: October Vouchers approved by Deputy Mayor Murphy seconded by Trustee Socci- All voted in favor. Announcements: Mayor Doro announced the Village of Millbrook has been Bronze Certified for Climate Smart Communities and thanked former Mayor Collopy and former Trustee Herzog for all the work they did on the application. Departmental Reports Located in the presentation. Read by Department Head for the record. Fire & Rescue: The fire department reports an increase in volunteer numbers from 35 to about 55, addressing prior shortages. Chief B said they’ve issued all the turnout gear they own to the new members- and if necessary- may reach out to other Fire Departments for loner gear to outfit more volunteers. Police: Motion to accept the Police Policies as presented made by Mayor Doro, seconded by Trustee Mawson- All voted in favor. Public Works (HWY): No additional comments. Water & Sewer: Smoke tests we completed and showed issues in the sewer mains at Bennett. Mayor Doro presented the attached WWTP Upgrade update- with a plan to use the “Alternative 1” design (see presentation). More updates to follow. Building & Planning: No additional comments. Treasurer & Clerks: Board to review proposed Procurement Policy and adopt in November meeting. Reported she submitted CHIPS reimbursement for Washington Ave paving. Resolutions (Recorded by Roll Call Vote- Aye/Nay/Abstain/Absent) Motion Resolution Subject Doro Murphy Bucklin Mawson Socci Carried 2025-004.1 Recognizing Certain Streets in the Village as Aye Aye Aye Aye Aye Streets by Prescription Open to Use by the Public Motion Second Yes (Amended to add Front-Dead end on Resolution 2025-004 passed June 11, 2025) 2025-009 That the Village of Millbrook hereby calls for a Aye Aye Aye Aye Aye public hearing 11/12/2025 at 6PM for all interested persons to be heard in favor of or in Yes Motion Second opposition to the proposed renewal of the Cablevision Systems Dutchess Corporation LL0032025.2 Enacting Local Law No. 3 of 2025 Amending Aye Aye Aye Aye Aye &LL002025.3- Section 220-56 of the Village Code Entitled SEQR “Vehicles and Traffic Schedule XXIV: Handicap Yes (Voted on and Motion Second Parking” to add one (1) additional Handicap approved after public hearing) Parking space (Clerk to file with NYS) & SEQR New and Unfinished Business Public Public Hearing: Motion to Open Public Hearing made by Mayor Doro, seconded by Deputy Mayor Murphy- all were in Hearing favor. Public Comment from resident Tim Collopy- said his name is listed on the SEQR docs (as he was former Local Law mayor) and he asked about cutting the curb where the handicap spot was meant to be. Mayor Doro responded he #3 of 2025 will have the SEQR docs corrected and said legal never advised needing to cut the curb and thanked Mr. Collopy for his input. Motion to Close Public Hearing made by Mayor Doro, seconded by Deputy Mayor Murphy- all were in favor.  Board Member Updates Reported the Shade Tree Committee held a recent meeting and is finalizing plans and budget allocations for fall tree Bucklin plantings at various locations including near the tennis courts and by the schools. Mawson Nothing additional to report. Murphy Nothing additional to report. Socci Nothing additional to report. • Received a complaint regarding gas powered leaf blowers. Concerns were raised on the environmental impact and noise pollution from gas-powered leaf blowers. He said some municipalities have banned gas leaf blowers; with battery-operated alternatives being quieter and more environmentally friendly. • Potential Pickleball Programming at Village Hall Gym. He is considering a proposal to collaborate with the Town of Doro Washington REC to reopen village hall gym for pickleball, a popular senior activity that had previously been offered. Liability concerns were noted due to the high injury rate of pickleball, especially among seniors. Scheduling, supervision, and responsibility for gym use would need to be clearly defined to avoid issues experienced in the past (e.g., unsupervised use, open windows in winter). Public Comment • Mr. Herzog suggested the Climate Smart bronze certification plaques be added to the “Welcome to Millbrook” signs. Mayor Doro said he would talk to DPW about it. • A resident made a comment concerning the restaurant “Millbrook Continental” on Alden Place saying they think they should be allowed to have outdoor dining. Mayor Doro directed him to contact the Planning Board. Adjournment Time: 7:04 PM Motion made by Mayor Doro to adjourn the meeting, seconded by Trustee Bucklin and all were in favor. Respectfully Submitted by: Village Clerk Village of Millbrook  RESOLUTION No. 2025-004.1 Originally passed 06.11.2025 (2025.004)- Amended 10.08.2025(2025.004.1) Recognizing Certain Streets in the Village as Streets by Prescription Open to Use by the Public At a meeting of the Village Board of Trustees of the Village of Millbrook (“Village Board”), held at the Village Hall, 35 Merritt Ave., Millbrook, New York on the 08th October, 2025 at 6:00 p.m., Mayor Doro Village Mayor, Peter Doro called the meeting to order, and _____________________________, Murphy seconded by Trustee ___________________________________, moved the following resolution: WHEREAS, Section 6-626 of the New York State Village Law provides that “all lands within the village which have been used by the public as a street for ten years or more continuously, shall be a street with the same force and effect as if it had been duly laid out and recorded as such”; and WHEREAS, the following streets, or portions of streets, located in the Village of Millbrook have not been laid out and recorded as public streets but nevertheless Village records indicate such streets have been continuously used by the public, and maintained by the Village, since at least 2005. Street Name Location Russell Knolls: Washington Ave.-Russell Knolls-Front St. (789ft) Russell Knolls: Front St.- Russell Knolls. (cul-de- sac) (392ft) West Pilgrim Ln: Church St.-W. Pilgrim Lane (cul-de-sac) (265ft) Cullen Ln: Maple Ave.-Cullen Lane (cul-de-sac) (372ft) Pilgrim Ln: Maple Ave.-Pilgrim Lane-Friendly Lane (415ft) Velletri Way: Maple Ave.-Velletri Way (cul-de-sac) (270ft) Firemans Way: Front St.-Dead End (162ft) ; and WHEREAS, the Village Board now wishes to officially recognize that the above named streets within the Village have been continuously used by the public, and maintained by the Village, for a period of well in excess of ten (10) years and therefore, pursuant to Section 6-626 of the New York State Village Law such streets are considered Streets by prescription open to use by the public, subject to maintenance by the Village and included in the official Inventory of Village Roads; and NOW THEREFORE, BE IT RESOLVED, the Board of Trustees of the Village of Millbrook (“Village Board”) hereby recognizes the following streets, or portions of streets, within the Village as having been used by the public as a street, and maintained by the Village as a Village street, for a {00139044 1} 1 period in excess of ten (10) years and therefore such streets shall be considered Streets by prescription pursuant to Section 6-626 of the New York State Village Law and therefore open to use by the public and required to be maintained by the Village, Street Name Location Russell Knolls: Washington Ave.-Russell Knolls-Front St. (789ft) Russell Knolls: Front St.- Russell Knolls. (cul-de- sac) (392ft) West Pilgrim Ln: Church St.-W. Pilgrim Lane (cul-de-sac) (265ft) Cullen Ln: Maple Ave.-Cullen Lane (cul-de-sac) (372ft) Pilgrim Ln: Maple Ave.-Pilgrim Lane-Friendly Lane (415ft) Velletri Way: Maple Ave.-Velletri Way (cul-de-sac) (270ft) Firemans Way: Front St.-Dead End (162ft) ;and BE IT FURTHER RESOLVED, the Village Highway Supervisor is hereby directed to include the streets listed above on the official Inventory of Village Streets maintained by the Village. The foregoing resolution was duly put to a vote which resulted as follows: Mayor Doro Aye Trustee Murphy Aye Trustee Mawson Aye Trustee Bucklin Aye Trustee Socci Aye DATED: Millbrook, New York October 8, 2025 ________________________________ SARAH J. WITT, VILLAGE CLERK {00139044 1} 2  Village of Millbrook Board of Trustees 35 Merritt Ave, Millbrook, NY 12545 October 8, 2025 Resolution 2025-009 BE IT RESOLVED, That the Village of Millbrook hereby calls for a public hearing at 6 PM, prevailing time, on the 12 day of November, 2025, in the Village Hall (35 Merritt Ave) of the Village of Millbrook, New York, for all interested persons to be heard in favor of or in opposition to the proposed renewal of the Cablevision Systems Dutchess Corporation. Franchise for a period of 10 years. MOTION TO ADOPT: The foregoing resolution was moved for adoption by Mayor Doro _______________________ and seconded Deputy Mayor Murphy by ___________________________ VOTE: Member Yea Nay Absent Mayor Doro [ X] [ ] [ ] Deputy Mayor Murphy [X ] [ ] [ ] Trustee Bucklin [ X] [ ] [ ] Trustee Mawson [X ] [ ] [ ] Trustee Socci [ X] [ ] [ ] The resolution was thereupon declared adopted. Certified by: Sarah J. Witt Village Clerk 10.08.2025  RESOLUTION No. LL0032025.2 Enacting Local Law No. 3 of 2025 Amending Section 220-56 of the Village Code Entitled “Vehicles and Traffic Schedule XXIV: Handicap Parking” to add one (1) additional Handicap Parking space At a meeting of the Village Board of Trustees of the Village of Millbrook (“Village Board”), held at the Village Hall, 35 Merritt Ave, Millbrook, New York on the 8th day of October, 2025, at 6:00 p.m., Village Mayor, Peter Doro called the meeting to order, and Mayor Doro, seconded by Trustee Murphy, moved the following resolution, to enact the following local law, to be known as Local Law No. 3 of 2025, entitled “A Local Law Amending Section 220-56 of the Village Code Entitled “Vehicles and Traffic Schedule XXIV: Handicap Parking” to add one (1) additional Handicap Parking space” as follows: WHEREAS, the following Local Law was introduced as Proposed Local Law No. 3 of 2025, by Resolution adopted at a regular meeting of the Village Board held on September 10, 2025; and WHEREAS, a properly noticed public hearing was held before the Village Board during the meeting on October 8th, 2025, on Local Law No. 3 of 2025; and WHEREAS, the Village Board determined the enactment of this Local Law will have no adverse environmental impacts and issued a Negative Declaration pursuant to the New York State Environmental Quality Review Act; and BE IT ENACTED by the Board of Trustees of the Village of Millbrook (“Village Board”) as follows: Section 1. Legislative intent: Chapter 220 of the Village of Millbrook Village Code contains the Village’s regulations with respect to Vehicle and Traffic. The Village Board has determined it is in the best interest of the Village to update and amend Chapter 220 of the Village Code Entitled “Vehicles and Traffic” to add one (1) additional Handicap Parking space to “Schedule XXIV: Handicap Parking” contained in Section 220-56. {00377456 3 } 1 Section 2. Section 220-56 of the Village Code is hereby amended to add one (1) additional space in the “Schedule XXIV: Handicap Parking” to include the following language. “§ 220-56 Schedule XXIV: Handicap Parking. In accordance with the provisions of § 220-14.2, the following described locations are hereby designated as handicap parking: Name of Street Location Merritt Ave At 35 Merritt Ave (2 spaces) Merritt Ave At 15 Merritt Ave (2 spaces) Friendly Ln Friendly Ln -across from Library- (1 space) Section 3. This local law shall take effect as of the date of filing with the New York Secretary of State. DATED: Millbrook, New York October 8th, 2025 ________________________________ SARAH J. WITT, VILLAGE CLERK The foregoing resolution was duly put to a vote which resulted as follows: Mayor Doro Aye Trustee Murphy Aye Trustee Bucklin Aye Trustee Mawson Aye Trustee Socci Aye DATED: Millbrook, New York October 8th, 2025 ________________________________ SARAH J. WITT, VILLAGE CLERK Village of Millbrook {00377456 3 } 2  VILLAGE OF MILLBROOK, DUTCHESS COUNTY, NY Resolution No: LL0032025.3 October 8th, 2025 Intent to Declare Lead Agency and Determination of Significance in accordance with the State Environmental Quality Review Act (SEQRA) Local Law No. 3 of 2025 Amending Section 220-56 of the Village Code Entitled “Vehicles and Traffic Schedule XXIV: Handicap Parking” to add one (1) additional Handicap Parking space Unlisted Action WHEREAS, the Village of Millbrook Village Board (“Village Board”) has determined it is in the best interest of the Village to amend Section 220-56 of the Village Code Entitled “Vehicles and Traffic Schedule XXIV: Handicap Parking” to add one (1) additional Handicap Parking space (the “Project”); and WHEREAS, the action of amending Section 220-56 of the Village Code Entitled “Vehicles and Traffic Schedule XXIV: Handicap Parking” to add one (1) additional Handicap Parking space is an Unlisted Action under the State Environmental Quality Review Act (“SEQRA”); and WHEREAS, the Short Environmental Assessment Form (EAF) has been completed by the Village; and now, THEREFORE, BE IT RESOLVED: 1. The Village Board shall act as lead agency for the environmental review of the Project as there are no other involved agencies. 2. The Village Board finds that the Project will not have a significant adverse impact on the environment for reasons stated in Part 3 of the EAF and the attached determination of significance. 3. The Village Mayor is hereby authorized and directed to sign Part 3 of the EAF indicating thereon that an Environmental Impact Statement will not be prepared and that a Negative Declaration is issued. 4. This resolution shall take effect immediately. Motion offered by: Mayor Doro Motion seconded by: Trustee Murphy Mayor Doro Aye Trustee Murphy Aye Trustee Mawson Aye Trustee Bucklin Aye Trustee Socci Aye I certify that the above resolution adopted by the Village of Millbrook Village Board on October 8th, 2025 is a true and correct transcript of the original now on file in this office. Sarah Witt Village of Millbrook Village Clerk {00390897 1}  State Environmental Quality Review (SEQR) NEGATIVE DECLARATION NOTICE OF DETERMINATION OF NON-SIGNIFICANCE This notice is issued pursuant to part 617 of the implementing regulations pertaining to Article 8 of the Environmental Conservation Law (SEQR). The Village of Millbrook Village Board, as lead agency, has determined that the proposed action described below will not have a significant adverse effect on the environment and that an Environmental Impact Statement will not be prepared. DATE: October 8th, 2025 NAME OF ACTION: Local Law No. 3 of 2025 LOCATION: Village of Millbrook Dutchess County SEQR STATUS: Unlisted Action LEAD AGENCY: Village of Millbrook Village Board CONTACT PERSON: Peter Doro, Village Mayor, Village of Millbrook DESCRIPTION OF ACTION: Amending Section 220-56 of the Village Code Entitled “Vehicles and Traffic Schedule XXIV: Handicap Parking” to add one (1) additional Handicap Parking space (the “Project”). REASONS SUPPORTING THIS DETERMINATION: The Village Board has reviewed the Short Environmental Assessment Form (EAF) and the criteria contained in 6 NYCRR §617.7 and has determined that the Action will not have a significant adverse impact on the environment for the following reasons: A. As required by §617.7(a)(2), the Village Board has determined that an Environmental Impact Statement is not required because any identified adverse impacts on the environment will not be significant. B. As required by §617.7(b), the Village Board has: 1. Considered the action as defined in subdivisions 617.2(b) and 617.3(g). 2. Reviewed the EAF, the criteria identified in 617.7(c) and other supporting information to identify relevant areas of environmental concern. 3. Analyzed the identified relevant areas of environmental concern to determine whether the action will have a significant adverse impact. 4. Set forth herein is its written Finding of No Significant Adverse Environmental Impact. C. The Village Board has compared the impacts reasonably expected to result from the proposed action to the criteria listed in 617.7(c)(1) as indicators of significant adverse impacts: 1. Air quality, ground or surface water quality or quantity, traffic or noise levels, solid waste production, erosion potential, flooding, leaching or drainage problems; {00390897 1}  2. Removal or destruction of large quantities of vegetation or fauna, interference with migration fish or wildlife, impacts to special habitats, impacts to threatened or endangered species, or any other impacts to natural resources; 3. Impairment of Critical Environmental Areas; 4. Conflicts with currently adopted community plans and goals; 5. Impairment of important historical, archeological, or aesthetic resources or community character; 6. Major change in use or type of energy; 7. Creation of a human health hazard; 8. Substantial change in use or intensity of use of land including agricultural land, open space or recreational resources; 9. Encouraging a population increase; 10. Creation of a material demand for other actions resulting in above consequences; 11. Changes in two or more elements of the environment that combined have a substantial adverse impact on the environment; 12. Two or more related actions undertaken, funded or approved by an agency that combined have a significant effect on the environment. D. 617.7(c)(2) – For the purpose of determining significant adverse impacts on the environment of those factors listed above, the long-term, short-term, direct, indirect and cumulative impacts, including simultaneous or subsequent actions, to the extent reasonable, as included in any long-range plan for the action, any action that is a result of the reviewed action or is dependent on the action were reviewed. E. 617.7(c)(3) – The significance of any likely consequences was assessed in connection with the setting of the action, the likelihood of occurrence, duration, irreversibility, geographic scope, magnitude and the number of people affected as a consequence of the action. Based on this review, the Village of Millbrook Village Board has determined that no significant adverse environmental impacts would result from this Action. {00390897 1}  Agency Use Only [If applicable] Project: LL Amending Sec 220-56 of V. Code Date: October 8th, 2025 Short Environmental Assessment Form Part 2 - Impact Assessment Part 2 is to be completed by the Lead Agency. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept “Have my responses been reasonable considering the scale and context of the proposed action?” No, or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? ✔ 2. Will the proposed action result in a change in the use or intensity of use of land? ✔ 3. Will the proposed action impair the character or quality of the existing community? ✔ 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area (CEA)? ✔ 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit, biking or walkway? ✔ 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? ✔ 7. Will the proposed action impact existing: ✔ a. public / private water supplies? b. public / private wastewater treatment utilities? ✔ 8. Will the proposed action impair the character or quality of important historic, archaeological, ✔ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, waterbodies, groundwater, air quality, flora and fauna)? ✔ 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage problems? ✔ 11. Will the proposed action create a hazard to environmental resources or human health? ✔ PRINT FORM Page 1 of 2  Agency Use Only [If applicable] Project: LL Amend Sec. 220-56 Date: October 8th, 2025 Short Environmental Assessment Form Part 3 Determination of Significance For every question in Part 2 that was answered “moderate to large impact may occur”, or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact, please complete Part 3. Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting, probability of occurring, duration, irreversibility, geographic scope and magnitude. Also consider the potential for short- term, long-term and cumulative impacts. The proposed action involves amending Section 220-56 of the Village Code Entitled “Vehicles and Traffic Schedule XXIV: Handicap Parking” to add one (1) additional Handicap Parking space. Such action will provide one (1) additional handicap parking space in front of the Village Library and is not expected to result in any significant adverse environmental impact. Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. ✔ Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Village of Millbrook Board of Trustees _________________________________________________ September 11, 2024 _______________________________________________ Name of Lead Agency Date Peter Doro _________________________________________________ Mayor _______________________________________________ Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer _________________________________________________ _______________________________________________ Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from Responsible Officer) PRINT FORM Page 2 of 2  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 Village of Millbrook Village Board Name of Action or Project: Enactment of Local Law Amending Section 220-56 of the Village Code to add one (1) additional Handicap Parking space. Project Location (describe, and attach a location map): Village of Millbrook Brief Description of Proposed Action: The Village Board of the Village of Millbrook intends to enact a Local Law amending Section 220-56 of the Village Code Entitled “Vehicles and Traffic Schedule XXIV: Handicap Parking” to add one (1) additional Handicap Parking space Name of Applicant or Sponsor: Telephone: (845) 677-3939 Village of Millbrook Village Board E-Mail: clerk@villageofmillbrookny.com Address: 35 Merritt Avenue City/PO: State: Zip Code: Millbrook New York 12545 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. 2. Does the proposed action require a permit, approval or funding from any other governmental Agency? NO YES If Yes, list agency(s) name and permit or approval: 3.a. Total acreage of the site of the proposed action? ___________ acres b. Total acreage to be physically disturbed? ___________ acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? ___________acres 4. Check all land uses that occur on, adjoining and near the proposed action. 9 Urban 9 Rural (non-agriculture) 9 Industrial 9 Commercial 9 Residential (suburban) 9 Forest 9 Agriculture 9 Aquatic 9 Other (specify): _________________________ 9 Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? NO YES If Yes, identify: __________________________________________________________________________ _______________________________________________________________________________________ 8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES b. Are public transportation service(s) available at or near the site of the proposed action? 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? 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: ______________________________________ _______________________________________________________________________________________ 11. Will the proposed action connect to existing wastewater utilities? NO YES If No, describe method for providing wastewater treatment: ________________________________ _______________________________________________________________________________________ 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 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 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: _______________ _______________________________________________________________________________________ _______________________________________________________________________________________ 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 † Urban † Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed NO YES by the State or Federal government as threatened or endangered? 16. Is the project site located in the 100 year flood plain? NO YES 17. Will the proposed action create storm water discharge, either from point or non-point sources? NO YES If Yes, a. Will storm water discharges flow to adjacent properties? † NO † YES b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: † NO † YES _______________________________________________________________________________________ _______________________________________________________________________________________ Page 2 of 3 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain purpose and size: ____________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes, describe: _________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ 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 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Village of Millbrook Village Board ___________________________________________ Date: October 8th, 2025 ___________________________ Signature: _______________________________________________________ PRINT FORM Page 3 of 3