TOWN OF CHATHAM, NEW YORK - Town of Germantown, NY



TOWN OF GERMANTOWN, NEW YORK

APPLICATON TO THE ZONING BOARD OF APPEALS

Appeal No.:_________________ Appeal Date: ______________

TO THE ZONING BOARD OF APPEALS, TOWN OF GERMANTOWN, NEW YORK:

I) (We) __________________(owner or agent) of ___________________________

(mailing address and telephone)

Hereby appeal to the Zoning Board of Appeals from the decision of ________________

(Bldg. Inspector, Planning Board, etc.) on application No. _________date______________

for ___________________(Bldg. Permit, Use Permit, Subdivision, etc). Attach copy of above application and action being appealed.

1. Location of property:_______________ Zoning District:________

Tax map Number _________

2. Description of proposed project: ____________________________________________________________________________________________________________________________________

3. Provision(s) of the Zoning Local Law Appealed: _____________________

(Indicate the article, Section and paragraph of the Zoning Local Law being appealed by number)

4. Type of Appeal:

( ) An Interpretation of the Zoning Local Law or Zoning Map, including decision of ZEO/CEO

( ) A Special Permit under the Zoning Local Law

( ) A Variance to the Zoning Local Law

5. Previous Appeal: A Previous appeal (has) (has not) been made with respect to this decision of the Zoning Officer or with respect to the property. Such appeal was in the form of:

( ) A Request for Interpretation ( ) A Request for a Variance

( ) A Request for Special Permit

and was (were) made in Appeal Number _____ dated ____________, 20____

Reason for Appeal: (complete relevant section);

A. Interpretation of the Zoning Local Law is requested because: _______________________________________________________________________________________________________________________________________________

B. A Special Permit under the Zoning Local Law is requested pursuant to Article_____, Section_____, Paragraph ______ of the Zoning Local Law because: ______________________________________________

__________________________________________________________

C. A Variance to the Zoning Local Law is requested for these reasons:

1) Strict application of the Local Law would produce undue hardship because: __________________________________________________________________________________________________________________

2) The hardship created is unique and is not shared by all properties alike in the immediate vicinity of this property and in this use district because:

_______________________________________________________________________________________________________________________

3) The Variance would observe the spirit of the Local Law and would not change the character of the district because:

________________________________________________________________________________________________________________________

Enclosures: _________________________________________________________

(list attached documents)

Notary Public:

STATE OF NEW YORK

COUNTY OF COLUMBIA

______________________ Sworn to me before this __________ day of ______________, 20____

Notary Public: Applicant’s Signature:

_____________________

Full Name

Address

Phone/fax numbers

Email or other contact Information

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