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INCORPORATED VILLAGE OF SAG HARBOR FREEDOM OF INFORMATION (Incorporated Village of Sag Harbor)

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U.S.A. forms for Incorporated Village of Sag Harbor

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\\sagvillage-dc\USERS\czaino\Desktop\CivicPlus\Building Dept. Forms\New folder\FOIA4.doc
INCORPORATED VILLAGE OF SAG HARBOR FREEDOM OF INFORMATION ACT
APPLICATION FOR ACCESS TO PUBLIC RECORDS
VERSION 4.0
I HEREBY APPLY TO INSPECT COPY THE RECORD(S) DESCRIBED BELOW:
Send to: Village of Sag Harbor
P.O. Box 660
Sag Harbor, N.Y. 11963
Email:
Name of Applicant:
First Middle Last
Date of Application:
(mm / dd / yyyy)
Telephone:
Mailing Address:
Name of Business Firm (if applicable):
Street Address (if PO Box above):
Name of Property Owner:
City/State/Zip:
Signature of Applicant:
Department:
Village Clerk
Building Department
Fire Marshal/Code
________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
_______ ______ _____ _______
DISTRICT SECTION BLOCK LOT
ROUTINE SEARCHES:
OPEN VIOLATIONS
OPEN BUILDING PERMITS
CERTIFICATE OF OCCUPANCY
Receipt of this request is acknowledged.
PLEASE NOTE: The Public Officer’s Law requires that a response to this request occur within five (5) business days.
The Village is required to provide documents, not information. There is no specific time limit in which to produce the
documents.
The reproduction costs for the records requested is $___________ plus postage $__________ Total $__________
Records cannot be found after diligent search.
Records not possessed or maintained by this Agency.
Records denied:
Specifically exempt by state or federal statute
Unwarranted invasion of personal privacy
Would impair current or imminent contract
awards or collective bargaining agreements
Are trade secrets
Documents are not reasonably described
Would endanger the life of a person
Are computer access codes
Are for law enforcement purposes, which if disclosed would:
-interfere with law enforcement investigations or judicial proceedings
-deprive a person of the right to a fair trial or impartial adjudication
-identify a confidential source or disclose confidential information relating to
a criminal investigation
-reveal criminal investigative techniques or procedures except routine
techniques and procedures
Are inter-agency or intra-agency materials that are not:
-statistical or factual tabulations of data
-instruction to staff that affect the public
-final agency policy or determinations
-external audits
You have the right to appeal a denial of this application by writing to the Clerk of the Village of Sag Harbor within thirty days of the denial.
FOIA OFFICER’S SIGNATURE:
TITLE:
DATE:
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INCORPORATED VILLAGE OF SAG HARBOR FREEDOM OF INFORMATION (Incorporated Village of Sag Harbor)

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Completed 16 July 2020

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