Plandome, NY · Nassau County
Short Environmental Assessment Form
Applicants or project sponsors complete Part I of this form to provide project information for an environmental assessment of an unlisted action.
What this form is
This form is for unlisted actions and collects project and site details, land use information, and information about permits or approvals. The applicant or sponsor completes Part I; the lead agency completes the impact assessment in Part II and the determination of significance in Part III. The form also asks about potential environmental effects and may call for supporting attachments.
Who needs it
An applicant or project sponsor with an unlisted action completes Part I, while the lead agency completes the remaining assessment and determination sections.
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 without a notary; any supporting attachments mentioned are not described as requiring notarization.
How to submit this form
- 1
Download The Form
Download the Short Environmental Assessment Form PDF.
- 2
Complete Part I
The applicant or project sponsor fills in project, location, land use, and permit information, then signs and dates Part I.
- 3
Gather Supporting Materials
Add attachments or supporting materials if needed to explain the assessment.
- 4
Submit To The City
Submit the form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- What is the Short Environmental Assessment Form used for?
- It collects project information and assesses potential environmental effects for an unlisted action.
- Who completes the form?
- The applicant or project sponsor completes Part I. The lead agency completes the impact assessment in Part II and the determination in Part III.
- Do I need a notary for the Short Environmental Assessment Form?
- No. This form is signed and dated without a notary. Any supporting attachments mentioned are not described as requiring notarization.
- 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.
Need something notarized?
This Short Environmental Assessment Form doesn’t need a notary — but if you have another Plandome form that does, a commissioned online notary can help.