Suffolk County, NY · Suffolk County
Application for Variance or Waiver from Regulations or Specifications
This application lets residents, businesses, or developers request a variance or waiver from regulations or specifications from the Suffolk County Department of Health Services Board of Review.
At a glance
- Issued by
- City of Suffolk County · Suffolk County, Suffolk County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- suffolkcountyny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this application to request a variance or waiver from a specified article and section of the New York State or Suffolk County Sanitary Code. It asks for the applicant’s address, the relevant health services reference number and development details, and an explanation of the request. Include the required project documents and pertinent paperwork, and pay the listed fee; the county will notify applicants in writing about a hearing.
Who needs it
Residents, businesses, and developers seeking a variance or waiver from regulations or specifications must complete this application for Board of Review consideration.
How to submit it
Type or print legibly and submit the completed form to the Suffolk County Department of Health Services Board of Review, 360 Yaphank Avenue, Suite 2C, Yaphank, NY 11980. Enclose the required project documents and paperwork, and submit the listed fee by check or money order; Visa and MasterCard are also accepted online.
About notarization
This application is signed and dated without a notary; the form lists no sworn statement or notarized attachment, so the applicant just signs and dates it.
How to submit this form
- 1
Download the Application
Download the variance or waiver application from the Suffolk County directory.
- 2
Complete the Application
Type or print legibly, provide the requested applicant and project details, explain the request, and sign and date the form.
- 3
Gather Required Attachments
Include the applicable survey, site plan, or development map, along with pertinent paperwork.
- 4
Submit to the County
Send the completed application and attachments to the Board of Review at the address shown on the form, with the listed fee.
Frequently asked questions
- Do I need a notary for the variance or waiver application?
- No. The application asks for a signature and date, not notarization. It lists no sworn statement or notarized attachment.
- How do I submit the variance or waiver application?
- Type or print legibly and submit it to the Board of Review at the address at the top of the form. Include the required project documents and paperwork, along with the fee.
- What attachments are required with this application?
- Enclose a survey for residential construction, a site plan for commercial construction, or a map of the proposed subdivision or development, plus pertinent paperwork.
- How will I learn about the hearing?
- The form says applicants will be notified in writing of the hearing’s date, time, and place.