What is the Short Environmental Assessment Form for?

It collects project and sponsor information and responses about potential environmental effects. The completed Part 1 becomes part of an application for approval or funding and may be publicly reviewed or further verified.

Who completes Part 1 of the form?

The applicant or project sponsor is responsible for completing Part 1. The form asks for project location and description, sponsor contact details, and information about the site and proposed action.

Do I need a notary for the Short Environmental Assessment Form?

No. The applicant signs and dates this form without a notary. The form does not identify any attachment or related step that must be notarized or sworn.

How do I submit the Short Environmental Assessment Form?

Submit it to the city department named on the form; check the city website for current contact details. The form itself does not provide a submission address or other submission instructions.

Matinecock, NY · Nassau County

No notary required

Short Environmental Assessment Form

Applicants or project sponsors complete this form to provide project information and environmental details for an application for approval or funding.

At a glance

Issued by: City of Matinecock · Matinecock, Nassau County, New York
Notarization: Not required: file this form without a notary.
Official source: matinecockvillage.gov
Blank form: Download the PDF
Catalogued: Sep 28, 2026
Machine-readable: JSON record · about the forms index

What this form is

The applicant or project sponsor completes Part 1 with project and sponsor information and responses about the proposed action and its potential environmental effects. Responses become part of an application for approval or funding and are subject to public review and possible verification. The form asks about land use, site conditions, utilities, natural resources, and other project impacts; attach a location map and any additional pages needed.

Who needs it

An applicant or project sponsor completes Part 1 when providing project information for an application for approval or funding.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This form is signed and dated by the applicant without a notary; it does not identify any attachment or related step that must be notarized or sworn.

How to submit this form

1
Download The Form
Download the Short Environmental Assessment Form PDF.
2
Complete Part 1
The applicant or project sponsor completes all items using information currently available.
3
Gather Attachments
Attach a location map and any additional pages needed to supplement an item.
4
Sign And Date
The applicant or sponsor provides a name, date, and signature.
5
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.

Frequently asked questions

What is the Short Environmental Assessment Form for?: It collects project and sponsor information and responses about potential environmental effects. The completed Part 1 becomes part of an application for approval or funding and may be publicly reviewed or further verified.
Who completes Part 1 of the form?: The applicant or project sponsor is responsible for completing Part 1. The form asks for project location and description, sponsor contact details, and information about the site and proposed action.
Do I need a notary for the Short Environmental Assessment Form?: No. The applicant signs and dates this form without a notary. The form does not identify any attachment or related step that must be notarized or sworn.
How do I submit the Short Environmental Assessment Form?: Submit it to the city department named on the form; check the city website for current contact details. The form itself does not provide a submission address or other submission instructions.

Need something notarized?

This Short Environmental Assessment Form doesn’t need a notary, but if you have another Matinecock form that does, a commissioned online notary can help.