Town of Big Flats
Department of Planning
476 Maple Street
Big Flats, NY 14814
T: 607-562-8443
http://www.bigflatsny.gov
This application form is required as part of any request to process a planning action involving the
review of a proposed Site Plan. In addition, the Town of Big Flats Municipal Code requires specific
material to be submitted with this form. A copy of the applicable sections of the code are available
upon request. It is the applicants responsibility to ensure that application package are complete and
accurate.
Site Plan
Application
NOTE: AN INCOMPLETE APPLICATION CANNOT BE SCHEDULED FOR REVIEW
Preliminary Acceptance Date:_______________
Final Approval Date:______________ Conditions Yes No
Name of Proposed Development: __________________________
Applicant: Plans Prepared by:
Name Name
Address Address
Telephone Telephone
Owner (If Different):
Name
Address
Telephone
Ownership Intentions: Purchase Lease Other: ______________________________
Project Location: Other Permits Needed: Dept. of Health Water/Septic
Parcel ID: _______________________
(all may not be applicable) Town of Big Flats DPW- Water
Address: ________________________ Chemung County Sewer District
________________________________ NYSDEC- SPDES
NYS/ACOE-Wetlands
Current Zoning: _________________ FAA
NYSDOT
Variance(s) Requested: ______________________________ Chemung County DPW-Driveway
______________________________ Town of Big Flats DPW-Driveway
Town of Big Flats Building Permit
Proposed Use(s) of Site: ______________________________ Other: ________________________
Anticipated Construction Start Date: ______________________
Anticipated Completion Date: ___________________Will Construction be Phased: ___________________
Current Land Use of Site (agricultural, commercial, residential, etc.): _________________________________
Character of Surrounding Lands (agricultural, residential, wetlands, etc.): ____________________________
Actions Requested
Site Plan Review
Site Plan Amendment
Area/Use Variance Requested (Additional Fees Apply)
Special Use/RLO Permit Required (Additional Fees Apply)
Department Use Only:
Site Plan Application (8/2010)
1
Estimated Cost of Proposed Improvement: $____________________
Estimated/Projected number of daily customers, employees, residents, etc.:
__________________________________________________________________________________________
__________________________________________________________________________________________
Estimate/Projected Hours of Operation: _______________________________________________________
Describe proposed use, including primary and secondary uses; ground floor area; height; and number of
stories for each building:
- for residential buildings include number of dwelling units by size (efficiency, one-bedroom, two-bedroom,
three- or more bedrooms) and number of parking spaces to be provided.
- for non-residential buildings, include total floor area and total sales area; number of automobile and truck
parking spaces.
- other proposal structures.
(Use separate sheet if needed)
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
APPLICATIONS WILL NOT BE ACCEPTED WITHOUT SIGNATURE OF LEGAL OWNER OR OFFICIAL AGENT
Check one:
Owner
Power of Attorney*
Contract to Purchase*
Official Agent*
Other: ____________________
*Attach evidence
I hereby certify that the above information and
accompanying documents are truthful ad accurate to
the best of my knowledge and acknowledge that the
processing of this application may require additional
fees and expenses, at my expense, for preparation of
necessary environmental, engineering and planning
studies.
________________________ ________________
Legal Owner/Official Agent Date
________________________ ________________
Legal Owner/Official Agent Date
________________________ ________________
Applicant (If Different) Date
Department Use (only)
Lead Agency: ___________________ Environmental Determination: _________
Type I Type II Unlisted
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Final Plans Signed and Filed: ________________ _______ Application Closeout Date: _________
Director of Planning Date
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Public Hearing: Yes No Date Advertised: __________ Date Conducted: __________
FEE SCHEDULE
Residential: $250.00*
Non-Residential: $500.00**
Concept: $200.00 (Fee goes toward full review)
*add $50.00 per 1,000 Sq. Ft. Gross Floor Area
**add $150.00 per 2,500 Sq. Ft. Gross Floor Area
Site Plan Application (8/2010)
2