Town of Mount Pleasant, NY
One Town Hall Plaza Valhalla, NY 10595
ph: 914-742-2300
fx: 914-769-3155
Mount Pleasant Forms

Assessor Forms
Name
Description/Use
STAR Application
School Tax Assessment Reduction - if you own a cooperative unit, a statement of shares owned must be provided.
http://www.mtpleasantny.comhttp://www.orps.state.ny.us/ref/forms/pdf/rp425.pdf
Aged All Exemption
Senior citizen low income application.
http://www.mtpleasantny.comhttp://www.orps.state.ny.us/ref/forms/pdf/rp467.pdf
Veterans Exemption
Application
 
http://www.mtpleasantny.comhttp://www.orps.state.ny.us/ref/forms/pdf/rp458.pdf
Grievance Application
Instructions on filing a grievance
http://www.mtpleasantny.comhttp://www.orps.state.ny.us/ref/forms/pdf/rp524.pdf
Building Department Forms
Name
Description/Use
Application for Zoning & Building Permit
This is for reference only. Original must be obtained from the Building Department.
http://www.mtpleasantny.com/Pages/MountPleasantNY_Building/AppZoningBuildingPermit.pdf
Application for Plumbing Permit
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Building/PlumbingApp.pdf
Zoning Spec Sheet
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Building/Zoningspecsheet.pdf
Engineering Department
Name
Description/Use
Application for Wetlands Permit (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Engineering/EngineeringWetlandsPermit.pdf
SEQR Short Environmental Assessment Form (PDF Format)
http://www.mtpleasantny.com/Pages/MountPleasantNY_Engineering/EngineeringShortForm.pdf
SEQR Full Environmental Assessment Form (PDF Format)
http://www.mtpleasantny.com/Pages/MountPleasantNY_Engineering/EngineeringFullForm.pdf
Steep Slope Application (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Engineering/steepslope.pdf
Receiver of Taxes
Name
Description/Use
Change of Address/No Longer Escrowing Form (PDF Format)
http://www.mtpleasantny.com/Pages/MountPleasantNY_Taxes/TaxChangeofAddress.pdf
Recreation & Parks Department
Name
Description/Use
Registration Form for Rec Programs
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Recreation/Forms/RegForm.pdf
Parks and Rec Facilities
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Recreation/Forms/Facilities.pdf
Senior Citizen Trip Registration and Bus Seating Procedures (PDF)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Recreation/Forms/WinterBrochurePart2,pdf

 
Individual Insurance Waiver and Eligibility Certificate-Basketball (PDF)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Recreation/Forms/InsuranceBasketball.pdf
Individual Insurance Waiver and Eligibility Certificate-Softball (PDF)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Recreation/Forms/InsuranceSoftball.pdf
Alcohol Beverage Permit
http://www.mtpleasantny.com/Pages/MountPleasantNY_Recreation/Forms/Alcohol.pdf
Application for Mt. Pleasant Community Center
 
http://www.mtpleasantny.comCommunityCenter09.pdf
Application for Bradhurst Community Center
 
http://www.mtpleasantny.combradhurstcenter09.pdf
Picnic-Permit Application - Broadway Field
 
http://www.mtpleasantny.comPicnicBroadway09.pdf
Picnic-Permit Application Bradhurst Park
http://www.mtpleasantny.comPicnicBradhurstpark09.pdf
Town Clerk
Name
Description/Use
Application for Copy of Birth Certificate (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Clerk/BirthCertApp.pdf
Application for Copy of Death Certificate (PDF Format)
http://www.mtpleasantny.com/Pages/MountPleasantNY_Clerk/DeathCertApp.pdf
Application for Copy of Marriage License (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Clerk/MarriageLicApp.pdf
Water/Sewer Department
Name
Description/Use
Application for Water Service (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/WaterApp.pdf
Architectural Review Board
Name
Description/Use
Architectural Review Board Application (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_BComm/ARBApplication.pdf
Planning Board
Name
Description/Use
Application for Site Approval (PDF Format)
This is for reference only. Original must be obtained from the Planning Department.
http://www.mtpleasantny.com/Pages/MountPleasantNY_BComm/SiteApproval.pdf
Application for Subdivision Approval (PDF Format)
This is for reference only. Original must be obtained from the Planning Department.
http://www.mtpleasantny.com/Pages/MountPleasantNY_BComm/SubdivisionApp.pdf
Short Environmental Assessment Form - SEQR (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_BComm/ShortEnviron.pdf
Full Environmental Assessment Form - SEQR (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_BComm/LongEnviron.pdf



http://www.mtpleasantny.com/Pages/MountPleasantNY_Recreation/Forms/SpringCover.pdf
Water/Sewer Department Reports
Name
Description/Use
WATER SUBSYSTEM IMPROVEMENT STUDY-Feb 2004
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/WaterSubStudy.doc
COST EVALUATION FOR ROLLING HILLS AREA WATER MAIN EXTENSION
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/CostEvaluation.pdf
WATER SUBSYSTEM IMPROVEMENT STUDY-Feb 2004-Table 1
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Table1WaterSub.pdf
WATER SUBSYSTEM IMPROVEMENT STUDY-Feb 2004-Table 2
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Table2.pdf
Information on Lead in the Water (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Lead.pdf
Filtration Notice - All Water Districts (PDF Format)
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Filtration.pdf
Notice to Consumers_Consolidated Kensico Water District
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Consumers.doc
Apple Hill Farm WD
Report - 2007
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Apple Hill Farm WD Report - 2007.pdf
Bear Ridge Lake WD \Report - 2007
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Bear Ridge Lake WD Report - 2007.pdf
Kensico WD
Report - 2007
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Kensico WD Report - 2007.pdf
Meadowbrook WD
Report - 2007
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Meadowbrook WD Report - 2007.pdf
Old Farm Hill WD
Report - 2007
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Old Farm Hill WD Report - 2007.pdf
Pleasant Ridge WD
Report - 2007
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Pleasant Ridge WD Report - 2007.pdf
Pleasantville WD
Report - 2007
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Pleasantville WD Report - 2007.pdf
Pocantico WD
Report - 2007
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Pocantico WD Report - 2007.pdf
Mill River WD Report - 2007
 
http://www.mtpleasantny.com/Pages/MountPleasantNY_Water/Forms/Mill River WD Report - 2007.pdf