BROWNFIELDCLEANUPPROGRAM(BCP) APPLICATIONFORM DECrequiresanapplicationtorequestmajorchangestothedescriptionofthepropertysetforthina BrownfieldCleanupAgreement,or"BCA"(e.g.,addingasignificantamountofnewproperty,oradding propertythatcouldaffectaneligibilitydeterminationduetocontaminationlevelsorintendedlanduse). Suchapplicationmustbesubmittedandprocessedinthesamemannerastheoriginalapplication, includingtherequiredpubliccommentperiod.IsthisanapplicationtoamendanexistingBCA? Yes No Ifyes,provideexistingsitenumber: PARTA(note:applicationisseparatedintoPartsAandBforDECreviewpurposes) BCPAppRev10 DECUSEONLY SectionI.RequestorInformation-SeeInstructionsforFurtherGuidance BCPSITE#:________________ NAME MD45 Developers LLC ADDRESS48-02 25th Avenue, Suite 400 CITY/TOWN Astoria ZIPCODE11103 PHONE718-932-6342 FAX718-545-5983 E-MAILekokinakis@megagroup.nyc IstherequestorauthorizedtoconductbusinessinNewYorkState(NYS)? Yes No • IftherequestorisaCorporation,LLC,LLPorotherentityrequiringauthorizationfromtheNYS DepartmentofStatetoconductbusinessinNYS,therequestor'snamemustappear,exactlyasgiven above,intheNYSDepartmentofState'sCorporation&BusinessEntityDatabase.Aprint-outof entityinformationfromthedatabasemustbesubmittedtotheNewYorkStateDepartmentof EnvironmentalConservation(DEC)withtheapplicationtodocumentthattherequestorisauthorized todobusinessinNYS.Pleasenote:IftherequestorisanLLC,themembers/ownersnamesneedto beprovidedonaseparateattachment. Doallindividualsthatwillbecertifyingdocumentsmeettherequirementsdetailedbelow?Yes No • IndividualsthatwillbecertifyingBCPdocuments,aswellastheiremployers,meettherequirements ofSection1.5ofDER-10:TechnicalGuidanceforSiteInvestigationandRemediationandArticle145 ofNewYorkStateEducationLaw.Documentsthatarenotproperlycertifiedwillbenot approvedundertheBCP. SectionII.ProjectDescription 1. Whatstageistheprojectstartingat? Investigation Remediation NOTE:Iftheprojectisproposedtostartattheremediationstage,aRemedialInvestigationReport(RIR) ataminimumisrequiredtobeattached,resultingina30-daypubliccommentperiod.IfanAlternatives AnalysisandRemedialWorkPlanarealsoattached(seeDER-10/TechnicalGuidanceforSite InvestigationandRemediationforfurtherguidance)thena45-daypubliccommentperiodisrequired. 2. IfafinalRIRisincluded,pleaseverifyitmeetstherequirementsofEnvironmentalConservationLaw (ECL)Article27-1415(2): Yes No 3. Pleaseattachashortdescriptionoftheoveralldevelopmentproject,including: • thedatethattheremedialprogramistostart;and • thedatetheCertificateofCompletionisanticipated. 1 SectionIII.Property’sEnvironmentalHistory AllapplicationsmustincludeanInvestigationReport(perECL27-1407(1)).Thereportmustbesufficientto establishcontaminationofenvironmentalmediaonthesiteaboveapplicableStandards,Criteriaand Guidance(SCGs)basedonthereasonablyanticipateduseoftheproperty. Totheextentthatexistinginformation/studies/reportsareavailabletotherequestor,pleaseattachthe following(pleasesubmittheinformationrequestedinthissectioninelectronicformatonly): 1. Reports:anexampleofanInvestigationReportisaPhaseIIEnvironmentalSiteAssessmentreport preparedinaccordancewiththelatestAmericanSocietyforTestingandMaterialsstandard(ASTM E1903).PleasesubmitaseparateelectroniccopyofeachreportinPortableDocumentFormat (PDF). 2. SAMPLINGDATA:INDICATEKNOWNCONTAMINANTSANDTHEMEDIAWHICHAREKNOWNTOHAVE BEENAFFECTED.LABORATORYREPORTSSHOULDBEREFERENCEDANDCOPIESINCLUDED. ContaminantCategory Soil Groundwater SoilGas Petroleum X ChlorinatedSolvents X OtherVOCs SVOCs X Metals X Pesticides PCBs X Other* *Pleasedescribe:______________________________________________________________ 3. FOREACHIMPACTEDMEDIUMINDICATEDABOVE,INCLUDEASITEDRAWINGINDICATING: • SAMPLELOCATION • DATEOFSAMPLINGEVENT • KEYCONTAMINANTSANDCONCENTRATIONDETECTED • FORSOIL,HIGHLIGHTIFABOVEREASONABLYANTICIPATEDUSE • FORGROUNDWATER,HIGHLIGHTEXCEEDANCESOF6NYCRRPART703.5 • FORSOILGAS/SOILVAPOR/INDOORAIR,HIGHLIGHTIFABOVEMITIGATELEVELSONTHENEW YORKSTATEDEPARTMENTOFHEALTHMATRIX THESEDRAWINGSARETOBEREPRESENTATIVEOFALLDATABEINGRELIEDUPONTOMAKETHECASE THATTHESITEISINNEEDOFREMEDIATIONUNDERTHEBCP.DRAWINGSSHOULDNOTBEBIGGERTHAN 11”X17”.THESEDRAWINGSSHOULDBEPREPAREDINACCORDANCEWITHANYGUIDANCEPROVIDED. ARETHEREQUIREDMAPSINCLUDEDWITHTHEAPPLICATION?* (*answeringNowillresultinanincompleteapplication) Yes No 4. INDICATEPASTLANDUSES(CHECKALLTHATAPPLY): CoalGasManufacturingManufacturing AgriculturalCo-op DryCleaner SalvageYard BulkPlant Pipeline ServiceStation Landfill Tannery Electroplating Unknown Other:________________________________________warehouse storage, knitting mill, electronics__________________________________ manufacturer 2 SectionIV.PropertyInformation-SeeInstructionsforFurtherGuidance PROPOSEDSITENAME 22-60 46th Street ADDRESS/LOCATION 22-60 46th Street CITY/TOWN Queens, New York ZIPCODE 11105 MUNICIPALITY(IFMORETHANONE,LISTALL): Borough of Queens, NYC COUNTY Queens County SITESIZE(ACRES)0.689 LATITUDE(degrees/minutes/seconds) LONGITUDE(degrees/minutes/seconds) N40 °46 ‘ 09.65 “ W73 °54 ‘ 16.01 “ Completetaxmapinformationforalltaxparcelsincludedwithintheproposedsiteboundary.Ifaportionofanylotis proposed,pleaseindicateassuchbyinserting“P/O”infrontofthelotnumberintheappropriateboxbelow,andonly includetheacreageforthatportionofthetaxparcelinthecorrespondingfarrightcolumn.ATTACHREQUIREDMAPS PERTHEAPPLICATIONINSTRUCTIONS. ParcelAddress SectionNo.BlockNo.LotNo. Acreage 22-60 46th Street, Queens, New York, NY 11105 400 769 25 0.689 1. Dotheproposedsiteboundariescorrespondtotaxmapmetesandbounds? Yes No Ifno,pleaseattachanaccuratemapofthepropsedsite. 2. Istherequiredpropertymapattachedtotheapplication? Yes No (applicationwillnotbeprocessedwithoutmap) 3. IsthepropertywithinadesignatedEnvironmentalZone(En-zone)pursuanttoTaxLaw21(b)(6)? (SeeDEC'swebsiteformoreinformation) Yes No Ifyes,identifycensustract:___________________________ PercentageofpropertyinEn-zone(checkone): 0-49% 50-99% 100% 4. Isthisapplicationoneofmultipleapplicationsforalargedevelopmentproject,wherethedevelopment projectspansmorethan25acres(seeadditionalcriteriainBCPapplicationinstructions)?Yes No Ifyes,identifynameofproperties(andsitenumbersifavailable)inrelatedBCP applications:________________________________________ 5. Isthecontaminationfromgroundwaterorsoilvaporsolelyemanatingfrompropertyotherthanthesite subjecttothepresentapplication?Yes No 6. HasthepropertypreviouslybeenremediatedpursuanttoTitles9,13,or14ofECLArticle27,Title5of ECLArticle56,orArticle12ofNavigationLaw?Yes No Ifyes,attachrelevantsupportingdocumentation. 7. Arethereanylandsunderwater? Yes No Ifyes,theselandsshouldbeclearlydelineatedonthesitemap. 3 SectionIV.PropertyInformation(continued) 8. Arethereanyeasementsorexistingrightsofwaythatwouldprecluderemediationintheseareas? Ifyes,identifyhereandattachappropriateinformation.Yes No Easement/Right-of-wayHolderDescription Not Applicable 9. ListofPermitsissuedbytheDECorUSEPARelatingtotheProposedSite(typehereorattach information) TypeIssuingAgencyDescription N/A 10. PropertyDescriptionandEnvironmentalAssessment–pleaserefertoapplicationinstructionsfor theproperformatofeachnarrativerequested. ArethePropertyDescriptionandEnvironmentalAssessmentnarrativesincluded Yes No intheprescribedformat? Note:Questions11through13onlypertaintositeslocatedwithinthefivecountiescomprisingNewYorkCity 11. Istherequestorseekingadeterminationthatthesiteiseligiblefortangiblepropertytax Yes No credits? Ifyes,requestormustanswerquestionsonthesupplementattheendofthisform. 12. IstheRequestornow,orwilltheRequestorinthefuture,seekadetermination Yes No thatthepropertyisUpsideDown? 13. IfyouhaveansweredYestoQuestion12,above,isanindependentappraisal Yes No ofthevalueoftheproperty,asofthedateofapplication,preparedunderthe N/A hypotheticalconditionthatthepropertyisnotcontaminated,includedwiththe application? NOTE:Ifatangiblepropertytaxcreditdeterminationisnotbeingrequestedintheapplicationto participateintheBCP,theapplicantmayseekthisdeterminationatanytimebeforeissuanceof acertificateofcompletionbyusingtheBCPAmendmentApplication,exceptforsitesseeking eligibilityundertheunderutilizedcategory. IfanychangestoSectionIVarerequiredpriortoapplicationapproval,anewpage,initialedbyeachrequestor, mustbesubmitted. InitialsofeachRequestor:_______________________________________________ 4 BCPapplication-PARTB(note:applicationisseparatedintoPartsAandBforDECreviewpurposes) DECUSEONLY SectionV.AdditionalRequestorInformation BCPSITENAME:______________________________________________ SeeInstructionsforFurtherGuidance BCPSITE#:_______________________ NAMEOFREQUESTOR’SAUTHORIZEDREPRESENTATIVE Emanuel Kokinakis ADDRESS 48-02 25th Avenue, Suite 400 CITY/TOWN Astoria, NY ZIPCODE 11103 PHONE718-932-6342 FAX718-545-5983 E-MAILekokinakis@megagroup.nyc NAMEOFREQUESTOR’SCONSULTANTDeborah Shapiro, QEP; AKRF, Inc. ADDRESS440 Park Ave South, 7th Floor CITY/TOWN New York, NY ZIPCODE 10016 PHONE646-388-9544 FAX 212-726-0942 E-MAILdshapiro@akrf.com NAMEOFREQUESTOR’SATTORNEYGeorge Duke, Esq., P.G.; Brown Duke & Fogel, P.C. ADDRESS350 5th Avenue, Suite 4640 CITY/TOWN New York, NY ZIPCODE10118 PHONE646-915-0236 FAX646-219-2601 E-MAILgduke@bdflegal.com SectionVI.CurrentPropertyOwner/OperatorInformation–ifnotaRequestor CURRENTOWNER’SNAMESee attached. OWNERSHIPSTARTDATE: ADDRESS CITY/TOWN ZIPCODE PHONE FAX E-MAIL CURRENTOPERATOR’SNAMESee attached. ADDRESS CITY/TOWN ZIPCODE PHONE FAX E-MAIL PROVIDEALISTOFPREVIOUSPROPERTYOWNERSANDOPERATORSWITHNAMES,LASTKNOWN ADDRESSESANDTELEPHONENUMBERSASANATTACHMENT.DESCRIBEREQUESTOR’SRELATIONSHIP, TOEACHPREVIOUSOWNERANDOPERATOR,INCLUDINGANYRELATIONSHIPBETWEENREQUESTOR’S CORPORATEMEMBERSANDPREVIOUSOWNERANDOPERATOR.IFNORELATIONSHIP,PUT“NONE”.
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