Fillable Planning-Board-Site-PlanSpecial-Permit-Application-and-ARB-Application-PDF PLANNING BOARD

Fill Online, Printable, Fillable, Blank Planning-Board-Site-PlanSpecial-Permit-Application-and-ARB-Application-PDF PLANNING BOARD Form

Use Fill to complete blank online TOWN OF EAST HAMPTON (NY) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Planning-Board-Site-PlanSpecial-Permit-Application-and-ARB-Application-PDF PLANNING BOARD

On average this form takes 48 minutes to complete

The Planning-Board-Site-PlanSpecial-Permit-Application-and-ARB-Application-PDF PLANNING BOARD form is 7 pages long and contains:

  • 0 signatures
  • 28 check-boxes
  • 178 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Town of East Hampton

BROWSE TOWN OF EAST HAMPTON (NY) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Page 1 of 7
Rev. Jan. 7, 2020
TOWN OF EAST HAMPTON
PLANNING BOARD
SITE PLAN/SPECIAL PERMIT APPLICATION
AND
ARCHITECTURAL REVIEW BOARD
APPLICATION
Type of Application:(Please check one or more)
Site Plan
Special Permit
Architectural
Review Board
SEQRA form attached:(Please check one)
Short EAF Part I
Full EAF Part I
Reason for Application: (Please check one or more)
New Structure Alteration of Structure or Site
Expansion of Structure or Use Change of Use Clearing of Land
Name of application (Project Title):
Describe the use being requested:
List the Special Permit use being requested (if applicable):
I.
APPLICANT INFORMATION:
A.
Landowner:
Address:
Telephone: Facsimile:
B.
Applicant (if other than landowner):
Address:
Telephone: Facsimile:
C.
Name of Business: __________________________________________________________________
D.
Attorney:
Address:
Telephone: Facsimile:
E.
Agent:
Address:
Telephone: Facsimile:
CORRESPONDENCE TO BE SENT TO: (Please check one) A B C D E
Contact Email (not required):
Complete Fee Calculation Worksheet on page 8
APPLICATION TYPE:
ARB FEE:
SPECIAL PERMIT FEE:
SITE PLAN FEE:________________________________
$100/500⎅ = $125/500⎅ =
TOTAL AMOUNT SUBMITTED:
Page 2 of 7
Rev. Jan. 7, 2020
II.
PROPERTY INFORMATION:
A.
Suffolk County Tax Map Number(s): 300-
B.
Street Address:
C.
Zoning District:
D.
School District: E. Fire District:
F.
Filed Map Identification: Lots Block
Filed Map Name Map Number
G.
Are there any encumbrances of record affecting the property, particularly right-of-way easements,
deed restrictions or covenants? YES NO
If YES, attach copies of the easements or covenants.
H.
Are there any open code violations on the property? YES NO
If yes, please explain the nature of the
violation:__________________________________________________________________________
__________________________________________________________________________________
I.
Does applicant own the property subject to the application? YES NO
If NO, please provide written permission of the property owner to allow application to proceed.
J.
Does applicant or predecessor in title own adjacent property? YES NO
If YES, give description and state when this parcel came into separate ownership:
K.
Please list below the names, addresses and tax map numbers of owners of the adjacent properties,
including those directly across any public or private streets on which your property fronts. This
information is available in person at the Town’s Assessor’s Office.
IMPORTANT: You will have to notify the owners of these properties by certified mail, before there is
a Public Hearing. The names and addresses below must be updated at the time you give this notice.
1. NAME: ______________________________ 5. NAME:
______________________________
ADDRESS: _____________________________ ADDRESS: _____________________________
TAX MAP NO.: _________________________ TAX MAP NO.: _________________________
2. NAME: ______________________________ 6. NAME:
______________________________
ADDRESS: _____________________________ ADDRESS: _____________________________
TAX MAP NO.: _________________________ TAX MAP NO.: _________________________
3. NAME: ______________________________ 7. NAME:
______________________________
ADDRESS: _____________________________ ADDRESS: _____________________________
TAX MAP NO.: _________________________ TAX MAP NO.: _________________________
4. NAME: ______________________________ 8. NAME:
______________________________
ADDRESS: _____________________________ ADDRESS: _____________________________
TAX MAP NO.: _________________________ TAX MAP NO.: _________________________
Page 3 of 7
Rev. Jan. 7, 2020
III.
PROJECT INFORMATION
A.
Description of Project (state purpose and give brief description):
B.
Description of proposed exterior changes:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
C.
Total Site Area (Square feet and Acres):
D.
List each structure or activity proposed including dimensions, heights, and total square footage
Structure/Use Dimensions Height (in feet) Total Square Feet
1.
2.
3.
4.
5.
E.
What are the setbacks of structures from the property lines and natural features?
Structure Front Yard Rear Yard Side Yard Natural Feature
1.
2.
3.
4.
5.
F.
Will project affect existing parking requirements? YES NO
Existing Number of Parking Spaces:
Proposed Number of Parking Spaces:
G.
Indicate the maximum vehicular trips generated per hour upon completion of the project:
H.
Coverage, Building (Lot Coverage): As defined in §255-1-20 of the Town Code
Existing: sq. ft. % of Lot Area
Proposed: sq. ft. % of Lot Area
I.
Coverage, Total: As defined in §255-1-20 of the Town Code
Existing: sq. ft. % of Lot Area
Proposed: sq. ft. % of Lot Area
J.
Is the project ADA compatible? Yes No
Page 4 of 7
Rev. Jan. 7, 2020
IMPORTANT NOTICES:
THE SUBMISSION OF AN ACCURATE, THOROUGH APPLICATION WITH ALL NECESSARY
INFORMATION SUPPLIED IS A PREREQUESITE TO THE PROCESSING OF THE
APPLICATION AND THE TIMELY SCHEDULING OF A PUBLIC HEARING. AN INCOMPLETE
APPLICATION WILL BE RETURNED TO THE APPLICANT FOR COMPLETION.
WHEN A PUBLIC HEARING HAS BEEN SCHEDULED, THE APPLICANT WILL BE NOTIFIED.
THE APPLICANT IS THEN REQUIRED TO PROVIDE NOTICE TO THE PUBLIC IN
ACCORDANCE WITH §255-9-23 OF THE TOWN CODE:
1.
Notify by certified mail, return receipt requested, the owners of record of every property which
abuts, and every property which is directly across any public or private street from the property
which is the subject of the application. This notice must be given at least ten (10) days in
advance of the forthcoming public hearing.
2.
Post the property with the sign provided by the Planning Board at least ten (10) days in advance
of the public hearing (in accordance with the provisions of §255-9-23 (2) of the Zoning Code).
3.
Submit proof, prior to or at the hearing, in the form of an affidavit with copies of the postal
return receipts attached, that the notification requirements 1 and 2 above have been complied
with.
FOLLOWING SITE PLAN APPROVAL, THE FINAL BUILDING PLANS MUST BE
SUBMITTED TO AND APPROVED BY THE TOWN BUILDING INSPECTOR, AND ALL
CONDITIONS OF SITE PLAN APPROVAL MUST BE MET, BEFORE A BUILDING PERMIT
CAN BE OBTAINED.
STATE OF )
COUNTY OF )
SS.:
, being duly sworn, deposes and says that he/she is the
Owner of the Property
Contract Purchaser of the Property
Agent for Owner/Contract Purchaser of the Property
and that all statements made in this application are true to the best of his/her knowledge and belief; and
that he/she has read the notices contained in this application and understands the same and agrees to
abide thereby; and that the project which is the subject of this application, if approved, will be carried
out in accordance with the terms and conditions set forth by the Planning Board and the Architectural
Review Board in their decision and in accordance with all applicable laws.
Signature of Applicant
Sworn to before me this
day of , _20 .
NOTARY PUBLIC
Page 5 of 7
Rev. Jan. 7, 2020
STATEMENT OF DISCLOSURE OF INTEREST
Officers or Employees of State, County, or Town Government
Required by § 809 of the New York General Municipal Law
The following Statement must be signed by the following:
(1)
Every individual owner of any real property which is a subject of this application
(hereafter, the "subject property");
(2)
An authorized representative of every corporation, partnership, company, trust,
association, or other legal entity which has an ownership interest in the subject property;
(3)
Every individual who has a contract to purchase an interest in the subject property; and
(4)
An authorized representative of every corporation, partnership, company, trust,
association, or other legal entity which has a contract to purchase an interest in the
subject property.
NOTICE: A KNOWINGLY FALSE STATEMENT UNDER § 809 OF THE GENERAL MUNICIPAL
LAW IS PUNISHABLE AS A MISDEMEANOR.
I make the following statements about interests in the real property which is the subject of this
application (the "subject property"):
PART I: Except as otherwise set forth in Part II below –
A.
Individuals with an ownership interest in the property.
1.
No person having an ownership interest in the subject property is an officer or employee of New
York State, Suffolk County, or the Town of East Hampton.
2.
No person having an ownership interest in the subject property is a spouse, a brother, a sister, a
parent, a child, or a grandchild of any individual who is an officer or employee of New York State,
Suffolk County, or the Town of East Hampton.
3.
No person having an ownership interest in the subject property is the spouse of a brother, a sister,
a parent, a child, or a grandchild of any individual who is an officer or employee of New York State,
Suffolk County, or the Town of East Hampton.
B.
Individuals with an interest in a contract to purchase the property.
1.
No person having an interest in a contract to purchase the subject property is an officer or
employee of New York State, Suffolk County, or the Town of East Hampton.
2.
No person having an interest in a contract to purchase the subject property is a spouse, a brother,
a sister, a parent, a child, or a grandchild of any individual who is an officer or employee of New York
State, Suffolk County, or the Town of East Hampton.
3.
No person having an interest in a contract to purchase the subject property is the spouse of a
brother, a sister, a parent, a child, or a grandchild of any individual who is an officer or employee of
New York State, Suffolk County, or the Town of East Hampton.
C.
Corporations or other entities with an ownership interest in the property.
1.
No officer, director, partner, or employee of any corporation, partnership, company, trust,
association, or other legal entity which has an ownership interest in the subject property is an officer or
employee of New York State, Suffolk County, or the Town of East Hampton.
Page 6 of 7
Rev. Jan. 7, 2020
2.
No officer, director, partner, or employee of any corporation, partnership, company, trust,
association, or other legal entity which has an ownership interest in the subject property is a spouse, a
brother, a sister, a parent, a child, or a grandchild of any individual who is an officer or employee of
New York State, Suffolk County, or the Town of East Hampton.
3.
No officer, director, partner, or employee of any corporation, partnership, company, trust,
association, or other legal entity which has an ownership interest in the subject property is the spouse of
a brother, a sister, a parent, a child, or a grandchild of any individual who is an officer or employee of
New York State, Suffolk County, or the Town of East Hampton.
D.
Corporations or other entities with an interest in a contract to purchase the property.
1.
No officer, director, partner, or employee of any corporation, partnership, company, trust,
association, or other legal entity having an interest in a contract to purchase the subject property is an
officer or employee of New York State, Suffolk County, or the Town of East Hampton.
2.
No officer, director, partner, or employee of any corporation, partnership, company, trust,
association, or other legal entity having an interest in a contract to purchase the subject property is a
spouse, a brother, a sister, a parent, a child, or a grandchild of any individual who is an officer or
employee of New York State, Suffolk County, or the Town of East Hampton.
3.
No officer, director, partner, or employee of any corporation, partnership, company, trust,
association, or other legal entity having an interest in a contract to purchase the subject property is the
spouse of a brother, a sister, a parent, a child, or a grandchild of any individual who is an officer or
employee of New York State, Suffolk County, or the Town of East Hampton.
PART II: If any of the statements made under A through D above are not true, please set forth
the names of any individuals or persons involved and explain their relationship to the subject property:
AUTHORIZATION
I, the owner, hereby authorize the Planning Department, the Architectural Review Board and the
Planning Board to enter the subject parcel to review the pending application for site plan/site plan-
special permit.
(Note – Each person required to sign this statement must have his/her signature separately
attested before a Notary Public. Use additional pages if necessary.)
ATTEST:
STATE OF )
COUNTY OF )
SS.:
, being duly sworn, deposes and says that the
foregoing Statement of Disclosure of Interest is true and accurate to the best of his/her knowledge and
belief; that all statements set forth in Part I of this Statement of Disclosure of Interest are true and
accurate, except and to the extent that any contrary statements are set forth in Part II of this Statement;
and that any such statements made in Part II of this Statement of Disclosure of Interest are true and
accurate to the best of his/her knowledge and belief.
Signature:
Name & Capacity:
Sworn to before me this
day of , 20 .
NOTARY PUBLIC
Page 7 of 7
Rev. Jan. 7, 2020
Fee Calculation Worksheet
Application Type
Calculation
Fees Owed
☐ Preliminary Site
Plan
☐ Minor Site Plan
☐ Site Plan –
Commercial Use
(Proposed)
Total area =
÷ 500 =
x 100 =
+ 875 =
☐ Site Plan –
Commercial Use
(Existing)
Total area =
÷ 500 =
x 125 =
+ 975 =
☐ Site Plan –
Residential Use in
Commercial Zoning
District
Total area =
÷ 500 =
x 100 =
+ 450 =
☐ Special Permit
☐ Change of Use
(Existing)
☐ Change of Use
(Proposed)
☐ Architectural
Review Board
☐ Architectural
Review Board for
work that has
commenced prior to
obtaining approval
TOTAL FEES PAID
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Planning-Board-Site-PlanSpecial-Permit-Application-and-ARB-Application-PDF PLANNING BOARD

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 12 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document