Fillable Application For Single Family Home Planning Board (Town of Brookhaven)

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Application For Single Family Home Planning Board (Town of Brookhaven)

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U.S.A. forms for Town of Brookhaven

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Application for Planning Board
Builders Job No:
Applicant to complete information in this box only.
Typewritten or printed P.B. No.
Applicant:
Mailing Address
Phone No.
Responsible Person
Email:
DATE:
TO: APPLICANT
FROM: PLANNING BOARD
application.
DATED: Per:
Approval expires within one (1) year.
NOTICE:
Grading Plan.
HOUSE No.
Enclosed please find approved copiees of your survey wit assigned house number (approved on reverse side of survey).
Retain only one (1) copy (stamped "Applicants Copy") for your records and submit a copy of survey stamped "Building
topographical information to determine compliance to the grading ordinance.
An application for planning board final approval will require the submission of three (3) final surveys showing sufficient
The final survey shall show in detail those structures (i.e. Driveway Drywells, Retaining Walls, etc.) as shown on Approved
Town of Brookhaven Planning Board
HAMLET:
Department Copy" along with one (1) additional copy of the survey to the Building Department to obtain a building permit
Application for Planning Board
Builders Job No:
Applicant to complete information in this box only.
Typewritten or printed P.B. No.
Applicant:
Mailing Address
Phone No.
Responsible Person
Email:
DATE:
TO: APPLICANT
FROM: PLANNING BOARD
A review of your survey for a building permit application indicated non-compliance. If necessary, please contact
the appropriate department as indicated below:
Access: Section 28A of N.Y.S. Town law
( ) Application does not demonstrate access to a suitably improved highway
( ) Access not suitabley improved.
( ) Request_____________widening. Per:
GRADING ORDINANCE: Chapter 35 Town of Brookhaven Ordinance
( ) Submit site grading plan to the Planning Divison for review. Per:
MUNICIPAL ACQUISITION:
( ) To be acquired. Per:
( ) Area being studied for acquisition Per:
SUBDIVISION REGULATIONS:
( ) Submit Land Division application. Per:
OTHER: (specify)
Per:
WETLANDS: Chapter 81 Town of Brookhaven Ordinance
( ) Requires further review and/or application.
OTHER: (specify)
Per:
( ) Maintained
( ) Inproved - jurisdiction other than Town
( )Paper Street - should be inproved to Town Specifications.
( ) Non-existing or dirt road.
( ) Pending Development
( ) Work Permit not required
( ) Work permit required for apron, curb cut, continuation of curb, sidewalk (circle requirement)
( ) No apparent grade problem
( ) Property lower than road.
( ) Property higher than road.
( ) Request topo map.
( )No apparent street drainage problem.
( ) Highway Department will install catch basin at this location.
( ) Overall drainage problem - Planning Board review.
( ) Existing basin.
Date of Inspection: Highway Inspector:
Remarks:
Town of Brookhaven Planning Board
HAMLET:
PLANNING DEPARTMENT USE ONLY
DEPARTMENT OF ENVIRONMENTAL PROTECTION
HIGHWAY DEPARTMENT USE ONLY
HOUSE No.
Application for Planning Board
Builders Job No:
Applicant to complete information in this box only.
Typewritten or printed P.B. No.
Applicant:
Mailing Address
Phone No.
Responsible Person
Email:
DATE:
TO: APPLICANT
FROM: PLANNING BOARD
A review of your survey for a building permit application indicated non-compliance. If necessary, please contact
the appropriate department as indicated below:
Access: Section 28A of N.Y.S. Town law
( ) Application does not demonstrate access to a suitably improved highway
( ) Access not suitabley improved.
( ) Request_____________widening. Per:
GRADING ORDINANCE: Chapter 35 Town of Brookhaven Ordinance
( ) Submit site grading plan to the Planning Divison for review. Per:
MUNICIPAL ACQUISITION:
( ) To be acquired. Per:
( ) Area being studied for acquisition Per:
SUBDIVISION REGULATIONS:
( ) Submit Land Division application. Per:
OTHER: (specify)
Per:
WETLANDS: Chapter 81 Town of Brookhaven Ordinance
( ) Requires further review and/or application.
OTHER: (specify)
Per:
( ) Maintained
( ) Inproved - jurisdiction other than Town
( )Paper Street - should be inproved to Town Specifications.
( ) Non-existing or dirt road.
( ) Pending Development
( ) Work Permit not required
( ) Work permit required for apron, curb cut, continuation of curb, sidewalk (circle requirement)
( ) No apparent grade problem
( ) Property lower than road.
( ) Property higher than road.
( ) Request topo map.
( )No apparent street drainage problem.
( ) Highway Department will install catch basin at this location.
( ) Overall drainage problem - Planning Board review.
( ) Existing basin.
Date of Inspection: Highway Inspector:
Remarks:
Town of Brookhaven Planning Board
HAMLET:
PLANNING DEPARTMENT USE ONLY
DEPARTMENT OF ENVIRONMENTAL PROTECTION
HIGHWAY DEPARTMENT USE ONLY
HOUSE No.
Application for Planning Board
Builders Job No:
Applicant to complete information in this box only.
Typewritten or printed P.B. No.
Applicant:
Mailing Address
Phone No.
Responsible Person
Email:
DATE:
TO: APPLICANT
FROM: PLANNING BOARD
A review of your survey for a building permit application indicated non-compliance. If necessary, please contact
the appropriate department as indicated below:
Access: Section 28A of N.Y.S. Town law
( ) Application does not demonstrate access to a suitably improved highway
( ) Access not suitabley improved.
( ) Request_____________widening. Per:
GRADING ORDINANCE: Chapter 35 Town of Brookhaven Ordinance
( ) Submit site grading plan to the Planning Divison for review. Per:
MUNICIPAL ACQUISITION:
( ) To be acquired. Per:
( ) Area being studied for acquisition Per:
SUBDIVISION REGULATIONS:
( ) Submit Land Division application. Per:
OTHER: (specify)
Per:
WETLANDS: Chapter 81 Town of Brookhaven Ordinance
( ) Requires further review and/or application.
OTHER: (specify)
Per:
( ) Maintained
( ) Inproved - jurisdiction other than Town
( )Paper Street - should be inproved to Town Specifications.
( ) Non-existing or dirt road.
( ) Pending Development
( ) Work Permit not required
( ) Work permit required for apron, curb cut, continuation of curb, sidewalk (circle requirement)
( ) No apparent grade problem
( ) Property lower than road.
( ) Property higher than road.
( ) Request topo map.
( )No apparent street drainage problem.
( ) Highway Department will install catch basin at this location.
( ) Overall drainage problem - Planning Board review.
( ) Existing basin.
Date of Inspection: Highway Inspector:
Remarks:
Town of Brookhaven Planning Board
HAMLET:
PLANNING DEPARTMENT USE ONLY
DEPARTMENT OF ENVIRONMENTAL PROTECTION
HIGHWAY DEPARTMENT USE ONLY
HOUSE No.
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Application For Single Family Home Planning Board (Town of Brookhaven)

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Completed 16 July 2020

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