Do I need a notary for the residential referral application?

No. The form has no notary block; the authorized project representative signs and dates it. No notarized attachment or sworn step is specified.

How do I submit the residential referral application?

Email the application, submission checklist, and plan sets to 239f@nassaucountyny.gov. Hand deliver or mail fees with a copy of the form to the NCDPW Permits Office in Westbury.

What information does the application ask for?

It asks for property section, block, lot, and address; owner and representative details; a work description; and municipal referral information.

What fee information does the form provide?

It lists an initial submission fee of $1,500, describes a 0.75% approval fee for construction costs above $250,000, and gives a resubmittal fee of $740 when the estimate is under $250,000.

Bayville, NY · Nassau County

No notary required

NYS General Municipal Law 239-F Residential Municipal Referral Application

This residential referral application documents a project for Nassau County review and is completed by the property owner and authorized project representative.

What this form is

This application refers a residential project for Nassau County review under New York State General Municipal Law Section 239-f. The authorized project representative provides property and contact details, describes the work, and serves as the county’s single point of contact. The form also describes submission fees and requires a cost of construction affidavit; the referring municipality completes its section.

Who needs it

Property owners and their authorized project representatives use this form for residential projects referred to Nassau County for review.

How to submit it

Email the application, 239-f submission checklist, and plan sets to [email protected]. Hand deliver or mail fees with a copy of the form to NCDPW Permits Office – Room 102, 1194 Prospect Ave, Westbury, NY 11590.

About notarization

This document is signed without a notary; the authorized project representative signs and dates the form, and no notarized attachment or related sworn step is specified.

How to submit this form

1
Download The Application
Download the residential municipal referral application.
2
Complete The Form
Enter the property, owner, authorized representative, and scope of work details; the referring municipality completes its section.
3
Gather Submission Materials
Prepare the 239-f submission checklist and plan sets. Include the cost of construction affidavit described on the form.
4
Email And Deliver Fees
Email the application, checklist, and plan sets to [email protected]. Hand deliver or mail fees with a copy of the form to the listed NCDPW office.

Frequently asked questions

Do I need a notary for the residential referral application?: No. The form has no notary block; the authorized project representative signs and dates it. No notarized attachment or sworn step is specified.
How do I submit the residential referral application?: Email the application, submission checklist, and plan sets to [email protected]. Hand deliver or mail fees with a copy of the form to the NCDPW Permits Office in Westbury.
What information does the application ask for?: It asks for property section, block, lot, and address; owner and representative details; a work description; and municipal referral information.
What fee information does the form provide?: It lists an initial submission fee of $1,500, describes a 0.75% approval fee for construction costs above $250,000, and gives a resubmittal fee of $740 when the estimate is under $250,000.

Need something notarized?

This NYS General Municipal Law 239-F Residential Municipal Referral Application doesn’t need a notary — but if you have another Bayville form that does, a commissioned online notary can help.