Fillable Site Plan/ Subdivision Application (Village of Cold Spring)

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Site Plan/ Subdivision Application (Village of Cold Spring)

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U.S.A. forms for Village of Cold Spring

BROWSE VILLAGE OF COLD SPRING (NY) FORMS

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Village of Cold Spring Planning Board
85 Main Street Cold Spring, NY 10516
Application for Site Plan or Subdivision Approval
Date of Application: Date of Attached Building Inspector Referral:
Application is for: Site Plan Review/Amendment Subdivision
Project Name
Address:
Description of Project (attach additional page if needed)
Applicant Name:
Address:
Phone Number Fax Number
e-mail:
Name of Property Owner (if Other Than Applicant Attach Notarized Owner's Endorsement)
Address:
Phone Number Fax Number
e-mail:
Page 1 of 3
Village of Cold Spring Planning Board Application
Application for Site Plan or Subdivision Approval
Applicant's Primary Representative
Applicant Architect Engineer Lawyer Other
Name of Representative :
Address:
Phone Number Fax Number:
e-mail:
Land is recorded by Deed(s) in the County Clerk's Office as Follows:
Date: Liber: Page:
Town and Village Tax and Zoning Information:
Tax Map No(s) Block No(s) Parcel No(s)
Acres: Number of Parcels
Zoning District
Is this project currently being reviewed by any other Village board? If "Yes" please indicate which Board(s):
Zoning Board of Appeals Historic District Review Board
Is the Property Located Within a Historic District?
No Local District National District
Are there any waivers of Village of Cold Spring regulations required for this project.? If "Yes" , attach your request here in
writing referencing the specific section of code in your request.
Yes No
Has State Environmental Quality Review (SEQR) been conducted by any other Board(s)? If "Yes" attach Declaration of
Significance and all supporting forms and documents.
Yes No
Page 2 of 3
Village of Cold Spring Planning Board Application
Application for Site Plan or Subdivision Approval
Disclosure Statement
(Pursuant to Section 809 of the General Municipal Law)
A. Nature and Extent of Interest of any State Official or Municipal Officer or Employee in this Application, Petition, or
Request (set forth in detail):
B. Statement that no State Official or Municipal Officer or Employee in this Application, Petition, or Request:
The undersigned Applicant, Petitioner or Person (Firm) making this request certifies by signature on this Disclosure Statement
that, in accordance with the Provisions of §809 of the General Municipal Law, except as stated in A above, no State Officer, or
any officer or employee of the Village of Cold Spring or any municipality of which the Village is a part has any interest in the
person or firm (partnership or association) making the above application, petition, or request.
Signed: (Applicant, Petitioner or Authorized Representative)
By: (Name, Title and Date)
The above information is complete and factually correct to the best of my knowledge:
Applicant's Signature and Date
PLEASE PROVIDE EIGHT COPIES OF THIS APPLICATION AND ALL SUPPORTING MATERIALS
TO COMPLETE YOUR APPLICATION PACKET SO THAT IT CAN BE PLACED ON THE AGENDA
APPLICATIONS WHERE THE APPLICANT IS NOT THE PROPERTY OWNER WILL NOT BE
ACCEPTED WITHOUT THE AFFIDAVIT OF OWNERSHIP FULLY EXECUTED BY THE
PROPERTY OWNER
Page 3 of 3
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Site Plan Subdivision Application (Village of Cold Spring)

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Completed 14 July 2020

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