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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