INC. 18 Hrse Hill Rad Brkville, NY 11545 These prcedures relate t Sectin 218-87 f Chapter 218, "Zning" f the Cde f the Incrprated Village f Brkville adpted by Lcal Law 5 f 2016 fr purpses f establishing guidelines fr site plan review and apprval befre the Planning Bard fr new land use, reuse, develpment, redevelpment and ther cnstructin activities. PRE-SUBMISSION REQUIREMENTS: The Applicant shall submit ne (1) cmpleted riginal Applicatin (as set frth belw) t the Building Department fr review f cmpliance with the applicatin requirements. After the submissin is deemed cmplete by the Building Inspectr, ten (10) additinal applicatin sets must be submitted t the Building Department and Applicant will be scheduled fr a hearing befre the Planning Bard. Deliver all ten (10) sets f the applicatin t the Village Hall. All cpies must be prvided in cllated frm with all surveys, maps, drawings, plans, etc. flded and made part f each set. Each set shall be enclsed in a separate envelpe suitable fr mailing. Partial r incmplete submissins will result in the rejectin f the applicatin. APPLICATION REQUIREMENTS: The cmplete frmal applicatin fr site plan review must be received at least 30 days prir t the Planning Bard meeting at which the site plan is t be cnsidered and, except as therwise prvided herein, and as nted abve, shall include eleven (11) sets ne (1) riginal and ten (10) cpies) f each f the fllwing items. EACH COMPLETE SET MUST BE SUBMITTED IN ENVELOPES: Applicatin frm fr site plan review, in frm and substance satisfactry t the Building Department. The applicatin frm must be signed by the wner(s) f the premises r be accmpanied by the written cnsent f the wner(s) f the premises. Disclsure affidavits must be signed by the wner(s) f the premises and representatives f the wner(s). Site survey, shwing all existing structures, prepared, signed and sealed by a licensed land surveyr and dated within six (6) mnths frm the date the applicatin is filed with the Village. Site plan fr the prpsed land use, drawn at a scale f nt less than ne inch equals 20 feet, signed and sealed by a licensed architect r engineer, and which shall include the fllwing infrmatin: (i) A title blck lcated in the lwer right-hand crner f the site plan and shall include the name and address f the applicant and recrd wner f the prperty, the prperty's designatin n the Nassau Cunty Land and Tax Map and the title f 1
the prject. If the applicant r prperty wner is a crpratin, the name and address f the president and secretary shall be submitted with the applicatin. (ii) A date blck f the site plan adjacent t the title blck cntaining the date f preparatin and dates f all revisins. (iii) A key map shwing the lcatin f the prperty with reference t surrunding areas and existing street intersectins within 1,000 feet f the bundaries f the subject premises. (iv) A written and graphic scale, as well as a Nrth arrw. (v) Zning district bundaries shall be shwn n the site plan as they affect the parcel. (vi) Tpgraphical infrmatin. (vii) Survey data shwing bundaries f the prperty, required building and setback lines and lines f existing and prpsed streets, lts, reservatins, easements and areas dedicated t public use, including grants, restrictins and rights-f-way. (viii) Reference t any existing cvenants, restrictins, easements r exceptins that are in effect r are intended t cver all r any f the prperty. A cpy f such cvenant, restrictin, easement r exceptin shall be submitted with the applicatin. If there are n knwn cvenants, deed restrictins, easements r exceptins affecting the site, a ntatin t the effect shall be indicated n the site plan map. (ix) Lcatin f existing structures n the site. The plan shall cntain a ntatin indicating any structures that are t be remved. (x) All distances, as measured alng the right-f-way lines f existing streets abutting the prperty, t the nearest intersectin with any ther street. (xi) Lcatin plans and elevatins f all prpsed structures. (xii) Lcatin f all existing and prpsed driveways, walkways and impervius surfaces lcated n the prperty. (xiii) Lcatin f all existing strm drainage structures, sil ersin and sediment cntrl devices and utility facilities, including electric, water, telephne and cable televisin, which are lcated within the prperty lines. (xiv) Existing and prpsed cnturs accrding t United States Gedetic Survey Datum NAD88 at intervals nt t exceed tw feet. Existing cnturs are t be indicated by slid lines; prpsed cnturs are t be indicated by dashed lines. 2
(xv) Existing elevatins f the rad r right-f-way cntiguus t the site. (xvi) The lcatin f all existing significant natural features such as bulders, rck utcrps, watercurses, depressins, pnds, marshes and ther wetlands, whether r nt fficially mapped. (xvii) All prpsed streets, with prfiles indicating grading and crss sectins shwing width f radway, lcatin and width f sidewalk, if any, and lcatin and size f utility lines. (xviii) All means f vehicular ingress and egress t and frm the site nt public r private streets, shwing the size and lcatin f driveways and curb cuts and sidewalks, if any. (xix) All prvisins fr pedestrian access t the site and internal pedestrian circulatin. (xx) The lcatin and design f any ff-street parking areas, lading r utdr strage areas. (xxi) The lcatin f all prpsed water lines, valves and hydrants and all sewer lines r alternative means f water supply r sewage dispsal and treatment. (xxii) The prpsed lcatin, directin f illuminatin, pwer and time f prpsed utdr lighting. (xxiii) The lcatin, design and type f cnstructin f all prpsed signs. (xxiv) The prpsed strmwater drainage system. (xxv) Structural elevatin calculatins. (xxvi) Zning Chart shwing all area requirements f the zning regulatins and all existing and prpsed zning area calculatins. (xxvii) Disturbance Limit Line shwing all areas f the site t be disturbed. (xxviii) Delineatin f tidal and freshwater wetland areas as designated by the New Yrk State Department f Envirnmental Cnservatin. (xxix) Signature lines fr bth the Planning Bard Chairman and the Village Engineer. Landscaping plan, drawn at a scale f nt less than ne inch equals 20 feet, and which cntains the fllwing infrmatin: 3
(i) Outlines f all existing and prpsed structures, driveways, walkways and impervius surfaces t be lcated n the prperty. (ii) The lcatin f all existing significant natural features such as bulders, rck utcrps, watercurses, depressins, pnds and marshes. (iii) The lcatin f all trees, identified by type r species and size, bearing a trunk circumference f eighteen (18 ) inches r greater measured at any pint between grund level and a height f fur (4 ) feet abve the base f the trunk. (iv) The lcatin f all trees, shrubs and/r any vegetatin, identified by type r species, which are t be remved. (v) The lcatin f all trees, shrubs and/r any vegetatin, identified by type r species, which are t be preserved. (vi) Lcatin f all trees, shrubs and/r ther vegetatin, identified by size, height and type r species, which are t be prvided. (vii) A separate list f all trees and shrubs, identified by size, height and type r species, that are t be remved and/r t be prvided. (viii) Ttal caliper f trees being remved and ttal caliper f trees t be installed. Phtgraphs (tw sets nly) f existing structures f the prperty and surrunding landscaping/screening. Envirnmental assessment frm cmpleted and signed by the Applicant. Identificatin f all required permits r apprvals frm the Village r any ther gvernmental bdy, and a recrd f applicatin fr and status f such permits r apprvals. Radius map, drawn t scale, shwing the size and lcatin f all parcels within a radius f three hundred (300) feet f the subject premises measured frm all pints f the subject premises and, if the subject premises is adjacent t a private rad, all ther parcels adjacent t the private rad, tgether with sectin, blck and lt numbers and names and mailing addresses f the prperty wner(s) f such prperties. The prperty wner(s) are t be the last wner(s) f recrd f the prperty as shwn by the recrds f the Cunty Clerk f Nassau Cunty n the date the applicatin is filed. The radius map must be signed by the applicant. (Only if the premises has r requires a cnditinal use permit in additin t site plan review) Certificate f title and deed(s) fr the existing lt(s). Letter frm the water district regarding availability f water t the site (fr new structures nly). 4
Any ther infrmatin fund by the Planning Bard r Building Department t be necessary t reasnably determine cmpliance f the site plan with this sectin and Village Law 7-725-a. If ne (1) acre r mre f land is t be disturbed, a strmwater pllutin preventin plan cnsistent with the requirements f Chapter 175 shall be required fr site plan apprval. The SWPPP shall meet the perfrmance and design criteria and standards in Chapter 175. The apprved site plan shall be cnsistent with the prvisins f this Chapter 175. Payment fr all required fees and escrws in the fllwing amunts: a) Filing fee in the amunt f $750; b) Public Hearing fee in the amunt f $2000; c) Escrw depsit in the amunt f $3500; all t be made payable t the "Incrprated Village f Brkville". The escrw depsit is t ensure reimbursement by the Applicant fr expenses assciated with the applicatin including engineering, legal and ther fees. Any balance remaining f this depsit will be returned t the Applicant prvided that the Applicant files with the Village Clerk a demand fr such refund. All unclaimed depsits shall becme prperty f the Village tw years after the date f the filing f the decisin, reslutin r ther final determinatin with the Village Clerk, as prvided in Chapter A224-7 f the Village Cde, Fee Schedule. PUBLIC NOTICE: Public Ntice f such hearing shall be given by publicatin in the Village's fficial newspaper at least five (5) days prir t the date theref. If any matter hereunder pertains t review f a site plan fr a prperty perating under a cnditinal use permit, the applicant must send ntice f the public hearing t all neighbring prperty wners lcated within three hundred (300) feet f the subject parcel, and if the prperty is lcated adjacent t a private rad, t all prperty wners adjacent t such private rad, by certified mail, return receipt requested, at least ten (10) days, but nt mre than twenty (20) days prir t the hearing. An affidavit f mailing shall be prepared, executed, and delivered t the Village Attrney s ffice alng with cpies f the certified mail receipts and receipt cards n later than three (3) days prir t the hearing. The Planning Bard may require that the applicant prvide additinal ntice t the adjining prperty wners as determined by the Planning Bard n a case by case basis and within its sle discretin. * * * * * * THE BUILDING DEPARTMENT MAY WAIVE ANY OF THE ABOVE REQUIREMENTS FOR WHICH IT DETERMINES TO BE UNNECESSARY FOR THE APPROPRIATE REVIEW OF A PARTICULAR APPLICATION, BUT SUCH WAIVER SHALL NOT BE BINDING UPON THE PLANNING BOARD. ADDITIONAL INFORMATION MAY BE REQUESTED BY THE PLANNING BOARD DURING THE COURSE OF THE HEARING PROCESS. THESE RULES AND REGULATIONS AS HEREIN SET FORTH MAY FROM TIME TO 5
TIME BE AMENDED BY THE PLANNING BOARD. APPLICANT SHALL BE REQUIRED TO PAY ALL EXISTING CHARGES ARISING FROM HIS/HER APPLICATION AND SIGN AN AFFIDAVIT ACKNOWLEDGING PROBABLE ADDITIONAL INCURRED CHARGES. ANY APPLICATION SUBMITTED WHICH DOES NOT CONFORM TO THE RULES CONTAINED HEREIN WILL NOT BE ACCEPTED BY THE VILLAGE AND THE PLANNING BOARD WILL NOT HEAR THE MATTER. ALL COMPLETE APPLICATIONS PROVIDED TO THE VILLAGE HALL MUST BE SUBMITTED IN PERSON MONDAY THROUGH FRIDAY BETWEEN THE HOURS OF 9:00 AM AND 4:00 PM ONLY. NO APPLICATIONS WILL BE ACCEPTED BY MAIL. 6
I, (as applicant) d hereby certify that I have submitted all f the required infrmatin and dcumentatin requested n pages 1 6 f this applicatin. I als certify that I am knwledgeable f The Cde f the Village f Brkville and f all rules and regulatins and will build in accrdance with the apprved Bard plans. Dated: Swrn t befre me this day f 20 Applicant s Signature Ntary Public I, (as architect f recrd) d hereby certify that I am knwledgeable f the Cde f the Village f Brkville and f all rules & regulatins pertaining t this cnstructin. Signature Print Name Date I, (as a licensed cntractr) d hereby certify that I am knwledgeable f The Cde f the Village f Brkville, f all rules and regulatins pertaining t this cnstructin. I further certify that I will build in accrdance with the Bard and Building Department apprved drawings. Any changes t the apprved cnstructin will be brught t the attentin f the Building Inspectr prir t cnstructin. Signature Print Name Date 7
FOR OFFICIAL USE ONLY Applicatin Fee: $750.00 Receipt # Date Received: Hearing Fee: $2,000.00 Receipt # Date Received: Depsit: $3,500.00 Receipt # Date Received: APPLICANT PLEASE COMPLETE THE FOLLOWING: LOCATION OF SITE: SECTION: BLOCK: LOT: OWNER S NAME: EMAIL: ADDRESS: PHONE NUMBER: FAX: ADD'L OWNER ADDRESS: TELEPHONE: FAX/EMAIL: ADD'L OWNER ADDRESS: TELEPHONE: FAX/EMAIL: ATTORNEY'S NAME: EMAIL: ADDRESS: TELEPHONE: FAX: SURVEYOR'S NAME: EMAIL: ADDRESS: TELEPHONE: FAX: ENGINEER'S NAME: EMAIL: ADDRESS: TELEPHONE: FAX: ARCHITECT'S NAME: EMAIL: ADDRESS: TELEPHONE: FAX: 8
LAND IS HELD BY OWNER UNDER DEED DATED (ATTACH COPY): RECORDED IN NASSAU COUNTY'S CLERK'S OFFICE ON: IN LIBER: OF DEED'S PAGE: IS THERE A STRUCTURE CURRENTLY ON THE PARCEL? IF YES, ARE YOU INCREASING THE SIZE OF THE STRUCTURE BY 50% OR MORE? DESCRIBE THE PROPOSED PROJECT AND CHANGES TO THE PROPERTY REQUIRING SITE PLAN APPROVAL: ANTICIPATED CONSTRUCTION TIME: TOTAL ACREAGE OF PARCEL: NET LOT AREA OF PARCEL (as defined in Cde): ZONING DISTRICT: WILL DEVELOPMENT BE STAGED? EXPLAIN: IF FILL IS REQUIRED TO BE BROUGHT TO THE SITE, ANTICIPATED AMOUNT IN CUBIC YARDS: DOES YOUR PROJECT DISTURB ONE OR MORE ACRES OF LAND? IF SO, A SWPPP MUST BE FILED WITH THE DEC AND A COPY TO THE VILLAGE. IS PROPERTY LOCATED WITHIN 500 FEET OF THE FOLLOWING: THE BOUNDARY OF ANY CITY, VILLAGE OR TOWN THE BOUNDARY OF ANY EXISTING OR PROPOSED COUNTY OR STATE PARK OR ANY OTHER RECREATION AREA THE RIGHT- OF- WAY OF ANY EXISTING OR PROPOSED COUNTY OR STATE PARKWAY, THRUWAY, EXPRESSWAY, ROAD OR HIGHWAY THE EXISTING OR PROPOSED RIGHT-OF-WAY OF ANY STREAM OR DRAINAGE CHANNEL OWNED BY THE COUNTY OR FOR WHICH THE COUNTY HAS ESTABLISHED CHANNEL LINES THE EXISTING OR PROPOSED BOUNDARY OF ANY COUNTY OR STATE OWNED LAND ON WHICH A PUBLIC BUILDING OR INSTITUTION IS SITUATED THE BOUNDARY OF A FARM OPERATION LOCATED IN AN AGRICULTURAL DISTRICT, AS DEFINED BY ARTICLE TWENTY-FIVE -AA OF THE AGRICULTURE AND MARKETS LAW 9
STATE AND FEDERAL PERMITS NEEDED: LIST TYPE: APPROPRIATE AGENCY: DEPARTMENT: PROPOSED PROVISIONS FOR COLLECTING AND DISPOSING OF STORM WATER WITH THE SUBJECT PLOT: ARE ANY EASEMENTS NECESSARY OUTSIDE OF PROPOSED SITE: 10
IF THERE ARE ANY EXISTING STRUCTURES ON THE PROPERTY, WILL THE STRUCTURE(S) BE DEMOLISHED? FOR STRUCTURES WHICH ARE TO REMAIN, PROVIDE THE FOLLOWING INFORMATION AND CALCULATIONS FOR EACH STRUCTURE: FLOOR AREA (SQUARE FEET): BUILDING COVERAGE (SQUARE FEET): TOTAL LOT COVERAGE OF ALL STRUCTURES (SQUARE FEET) (as defined in Cde): HEIGHT OF BUILDINGS AND DETERMINATION OF DISTANCES REQUIRED FROM ALL PROPERTY LINES: 11
Fr prperties under site plan review als requiring cnditinal use permits: Please list the names, addresses and sectin, blck and lts fr all neighbring prperty wners within three hundred (300) feet n the subject parcel r adjacent t the same private rad. (Attach additinal pages if necessary) 12
AFFIDAVIT OF INDIVIDUAL APPLICANT STATE OF NEW YORK ) : SS. COUNTY OF NASSAU ), being duly swrn, depses and says that Applicant resides at, and is the wner in fee f the prperty hereinbefre described and is the Applicant herein; that the statements cntained in the freging Applicatin and in any papers submitted herewith are in all respects true. Swrn t befre me this day f, 20 Ntary Public Applicant s Signature AFFIDAVIT OF OFFICER OF CORPORATE APPLICANT STATE OF NEW YORK ) :SS. COUNTY OF NASSAU ), being duly swrn, depses and says that Applicant resides at (Applicant), and that Applicant is (Title) f (Crpratin), which is the wner f the prperty hereinbefre described and is the Applicant herein; that the statements cntained in the freging Applicatin and in any papers submitted herewith are in all respects true. Swrn t befre me this day f, 20 Ntary Public Applicant s Signature 13
OWNER'S AUTHORIZATION I/we d hereby certify that I/we, wner(s) f premises lcated at and knwn f the Nassau Cunty Land and Tax Map as Sectin, Blck, and Lt(s) d hereby authrize having a place f business at t file an applicatin fr Site Plan Review f the subject premises. Name f Prperty Owner(s).(If a crpratin, name and addresses f fficers and wner's agents) : Signatures f Prperty: Owners: Address: Hme Phne: Business Phne: Fax: Swrn t befre me this day f, 20 Ntary Public 14
STATE OF NEW YORK) ) COUNTY OF NASSAU ) DISCLOSURE AFFIDAVIT being swrn, depses and says: 1. This affidavit is submitted in cnnectin with the applicatin f t the Village f Brkville fr a 2. I am the president, fficer, directr, member, attrney, engineer, builder, representative fr (delete unnecessary wrds)the applicant. 3. I have read Sectin 809 f the General Municipal Law added by Chapter 646 f the Laws f 1969 which states: " 809, Disclsure in certain applicatins 1. Every applicatin, petitin r request submitted fr a variance, amendment, change f zning, apprval f a plat, exemptin frm a plat r fficial map, license r permit, and planning regulatins f a municipality shall state the name, residence and the nature and extent f the interest r any state fficer r any fficer r emplyee f such municipality r f a municipality f which such municipality is a part, in the persn, partnership r assciatin making such applicatin, petitin r request (hereinafter called the applicant) t the extent knwn t such applicant. 2. Fr the purpse f this sectin an fficer r emplyee shall be deemed t have an interest in the applicant when he, his spuse, their brthers, sisters, parents, children, grandchildren, r the spuse f any f them (a) is the applicant, r (b) is an fficer, directr, partner r emplyee f the applicant, r (c) legally r beneficially wns r cntrls stck f a crprate applicant r is a member f a partnership r assciatin applicant, r 15
(d) is a party t an agreement with such an applicant, express r implied, whereby he may receive any payment r ther benefit, whether r nt fr services rendered, dependent r cntingent upn the favrable apprval f such applicatin, petitin r request. 3. Ownership f less than five percent f the stck f a crpratin whse stck is listed n the New Yrk, American Stck r Nasdaq Exchanges shall nt cnstitute an interest fr the purpses f this Sectin. 4. A persn wh knwingly and intentinally vilates this sectin shall be guilty f a misdemeanr. 4. I am familiar with all persns having an interest in the persn, partnership r assciatin making this applicatin as defined in Subdivisin 2 f Sectin 809 and hereby state that n fficer r emplyee f the State f New Yrk, the Cunty f Nassau, the Twn f Oyster Bay, r the Village f Brkville has such an interest in the applicant except thse whse name, residence and extent f interest are stated n Schedule A which is annexed t this affidavit and signed by me. Swrn t befre me this day f, 20 Ntary Public 16