NYS HOUSING TRUST FUND CORPORATION
ACCESS TO HOME PROGRAM
Environmental Compliance Checklist
LOCAL PROGRAM ADMINISTRATOR (LPA):
PROGRAM NAME:
SHARS ID:
BUILDING ADDRESS:
PROGRAM MUNICIPALITY:
PROGRAM COUNTY:
For Programmatic: Describe compliance
procedures (B) or reason why “Not Applicable to
this Program” (A)
Area of Statutory – Regulatory
Compliance
A*
B**
For Site Specific: Describe particular site
compliance
Additional material may be attached.
Historic/Cultural Resources:
Section 14.09 of the Parks, Recreation and
Historic Preservation Law.
Flood Plains:
6 NYCRR Part 502, Floodplain
Management Criteria for State Projects.
Zoning change/special use permit:
Projects must conform to the relevant local
land use plans and must receive all
necessary zoning and site plan approvals
and permits.
Site Contamination:
Lead Based Paint:
Refer to HUD “Guidelines for the
Evaluation and Control of Lead-Based Paint
Hazards in Housing” and EPA “Renovation,
Repair and Painting Rule”
Site Contamination:
Asbestos Containing Materials
NYS Department of Labor at 12 NYCRR
Part 56
*A – Not Applicable to this Program
**B – Consultation, Permit and/or Mitigation Required
A Checklist must be completed for each specific site, once it is chosen, and provide compliance information
in column “B.”
Individual site specific checklists must be submitted to OCR at time of Project Set up.
Access to Home Environmental Compliance Checklist
Updated 6/2013
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NYS HOUSING TRUST FUND CORPORATION
ACCESS TO HOME PROGRAM
Environmental Compliance Checklist
Site specific checklists must also be sent to EAU in circumstances such as:
 substantial improvement in a flood zone
 work on a building determined by SHPO to have historic or cultural significance
 ground disturbance
 zoning changes
 if the work constitutes a SEQR Unlisted action
Signature
I am the authorized signatory for the NYS Access to Home award to the entity named below. I have read this
Checklist and by signing this document agree with the statements made herein and agree that: (1) site specific
checklists will be prepared for each site; (2) site specific reviews will be conducted in conformance with the
described procedures; and, (3) site specific checklists will be submitted to HTFC EAU for approval prior to
project work in these circumstances: substantial improvement in a flood zone; work on a building determined by
SHPO to have historic or cultural significance; ground disturbance; zoning changes; if the work constitutes a
SEQR Unlisted Action.
Signature:
Printed Name:
Title:
Date:
Prepared by:
Title:
Phone:
Email:
Access to Home Environmental Compliance Checklist
Updated 6/2013
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