What is the Short Environmental Assessment Form Part 1?

It collects project and sponsor information, site details, and responses about environmental conditions and potential impacts for an application for approval or funding.

Who completes Part 1?

The applicant or project sponsor is responsible for completing Part 1, answering all items based on information currently available and adding pages if needed.

Do I need a notary for the Short Environmental Assessment Form Part 1?

No. The applicant or sponsor signs and dates this form and certifies the information is true and accurate; no notary is required.

How do I submit the Short Environmental Assessment Form Part 1?

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

North Salem, NY · Westchester County

No notary required

Short Environmental Assessment Form Part 1

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

At a glance

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

What this form is

Part 1 collects project and sponsor details, the proposed action, site acreage, nearby land uses, and information about environmental conditions and potential impacts. The applicant or project sponsor completes it based on currently available information as part of an application for approval or funding. The form says to answer every item and allows additional pages to supplement responses.

Who needs it

An applicant or project sponsor seeking approval or funding for a proposed action completes Part 1 using currently available information.

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 document is signed and dated without a notary; the applicant or sponsor certifies the information is true and accurate and provides a signature and title.

How to submit this form

1
Download The Form
Download the Short Environmental Assessment Form Part 1 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 responses.
4
Submit To The City
Submit the completed form 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 Part 1?: It collects project and sponsor information, site details, and responses about environmental conditions and potential impacts for an application for approval or funding.
Who completes Part 1?: The applicant or project sponsor is responsible for completing Part 1, answering all items based on information currently available and adding pages if needed.
Do I need a notary for the Short Environmental Assessment Form Part 1?: No. The applicant or sponsor signs and dates this form and certifies the information is true and accurate; no notary is required.
How do I submit the Short Environmental Assessment Form Part 1?: The form does not specify a submission address or method. 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 Part 1 doesn’t need a notary, but if you have another North Salem form that does, a commissioned online notary can help.