Fillable Informational Request Informational Request (City of Newburgh)

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Informational Request Informational Request (City of Newburgh)

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The Informational Request Informational Request (City of Newburgh) form is 3 pages long and contains:

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  • 10 check-boxes
  • 74 other fields

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File type: PDF

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City of Newburgh Building Inspector’s Office
Request for Informational Report
Form Update: 7/1/2017
REQUEST FOR INFORMATIONAL REPORT
Building Inspector’s Office
William Horton
Zoning Enforcement Officer
City of Newburgh, New York
Phone: (845) 569-7400
123 Grand Street, Newburgh, New York 12550 Fax: (845) 569-0096
www.cityofnewburgh-ny.gov
Applicant Name:
Property Owner Name*:
Property Address:
SBL:
Section:
Block:
Lot:
City:
State:
NY
Zip:
12550
Contact Phone:
Email:
*You must attach an Owner Proxy Statement if Applicant Name is different than Property Owner Name.
The City of Newburgh’s Code is available online for review at: http://ecode360.com/NE1082
Proposal is for (brief description):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Is the property currently subject to any existing area variance, use variance, or special permits? If
known, please provide the date the variance or special permit was approved, and a brief description
of what the approval permitted.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Does the property have residential dwellings? Yes ( ) No ( )
If yes, how many dwelling units exist currently? ________
If yes, are one of the dwellings owner-occupied? ________
Is the property vacant? Yes ( ) No ( )
If yes, for how long has property been vacant (best estimate)? __________________
City of Newburgh Building Inspector’s Office
Request for Informational Report
Form Update: 7/1/2017
What was the last known use of the property (see City Code §300-6(B) for “use” definitions and
City Code §300-31 for the list of “uses”)?
__________________________________________
Is the property still being used for that purpose? If not, how long has property not been used for
that purpose (best estimate)?
__________________________________________
Does the property have parking spaces? Yes ( ) No ( )
If yes, how many parking spaces? ________
What is the total square footage of the building? ________
Bulk Regulations by District:
*See City Code §300-32 or §§300-136 through 139 for applicable bulk table requirements.
Required by Code: Provided: Requested:
Lot Area: _________ ________ ________
Lot Width: _________ ________ ________
Lot Depth: _________ ________ ________
Front Yard: _________ ________ ________
Side Yard: _________ ________ ________
Rear Yard: _________ ________ ________
Building Height: _________ ________ ________
Lot Coverage: _________ ________ ________
Parking: _________ ________ ________
**PLEASE ATTACH A SURVEY OR SKETCH PLAN WITH THIS APPLICATION**
This application is hereby made to the Building Inspector of the City of Newburgh for an
Informational Inspection Report (Note: Incomplete submissions could result delays for
Informational Reports and/or determinations by Land Use Boards, if applicable).
______________________________________
Signature of Applicant
Print Name: ___________________________
Date: _________________________________
Fee: $50.00 Receipt No.: __________________________
Check/Cash: __________________________
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Department of Code Compliance
Owner’s Proxy Statement
City of Newburgh, New York,
123 Grand Street, Newburgh, New York 12550
Phone: (845) 569-7400 Fax: (845) 569-0096
www.cityofnewburgh-ny.gov
To Be Completed By the Owner If Different than Applicant.
A. Property Information:
Street Address:
City:
Newburgh
State:
NY
Zip:
12550
Tax Map
Designation:
Section:
Block:
Lot(s):
B. Property Owner:
Name:
Address:
City:
State:
Zip:
Phone:
C. Applicant: (Party making application on owner’s behalf)
Name:
Address:
City:
State:
Zip:
Phone:
D. Owner Proxy Statement:
I, swear that I am the owner of the subject
property, and, , the – Agent /Corporate Officer
/Contractor / Other _______________ of said owner or owners is duly
authorized to perform said work and to make and file this application; that all statements
contained in the application are true to the best of his/her knowledge and belief; that work
will be performed in the manner set forth in the application and in the plans and
specifications filed therewith.
Owner Signature: Date:
Subscribed and sworn to before me this day of , 20 .
____________________________
Signature of Notary Public
______________________
Printed Name of Notary
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Informational Request Informational Request (City of Newburgh)

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Completed 14 July 2020

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