§ 63-1. Statement to accompany certain applications.

Every application, petition or request for a change of zoning, variance, amendment of an ordinance, license, permit, special uses, special exception, approval of or exemption from a plat or subdivision map, with respect to the use of land or any building or structure erected or to be erected thereon, and every application for a building permit or certificate of occupancy shall, at the time of filing such application, be accompanied by a sworn statement by the person making the application (hereinafter referred to as the "applicant"), which shall state and set forth the following matters:

A. 

The name and address of the applicant. If the applicant is not one of the record owners of the subject property, the application shall state the interest of the applicant in the subject property and the relationship to the record owners. If the applicant is a contract vendee, a duplicate original or photocopy of the full and complete contract of purchase, including all riders, modifications and amendments thereto, shall be submitted with the application.

B. 

The name and address of all owners of record of the subject property or any part thereof.

C. 

The date title was acquired.

D. 

The date and place where the deed was recorded.

E. 

The name and address of each person having any mortgage or other interest, including an unrecorded ownership interest, in the subject property, together with the nature and extent thereof.

F. 

Interest of officer or employee of village.

(1) 

The name, residence and the nature or extent of the interest of any state officer or any officer or employee of the Village of Lake Success, Town of North Hempstead or County of Nassau, in the person, partnership or corporation making such application, petition or request to the extent known by the applicant. An officer or employee of the Village of Lake Success shall include any person elected or appointed, whether paid or unpaid, to any village commission or board. For the purpose of this subdivision, an officer or employee shall be deemed to have an interest in the applicant, when he, his spouse or their brothers, sisters, parents, children, grandchildren or the spouse of any of them:

(a) 

Is the applicant.

(b) 

Is an officer, director, partner or employee of the applicant.

(c) 

Legally or beneficially owns or controls stock of a corporate applicant or is a member of a partnership or association applicant.

(d) 

Is a party to an agreement with such an applicant, express or implied, whereby he may receive any payment or other benefit, whether or not for services rendered, dependent or contingent upon the favorable approval of such application, petition or request.

(2) 

Ownership of less than five percent (5%) of the stock of a corporation whose stock is listed on the New York or American Stock Exchanges shall not constitute an interest for the purposes of this Subsection.

G. 

The name and address of each person in the chain of title for the five (5) years next preceding the date of the ap-plication.

H. 

Ownership by corporation.

(1) 

Where the record owner, applicant, contract vendee or any person holding, owning or having any mortgage, other than a duly licensed bank or insurance company, or other interest in the subject property or any part thereof is a corporation, the following additional information shall be submitted with the application:

(a) 

The name and principal office of the corporation.

(b) 

Date and place of incorporation, together with name and address of each incorporator.

(c) 

Name and address of each officer and the date of election or appointment.

(d) 

Name and address of each director and the date of election or appointment.

(e) 

Name and address of each shareholder owning or controlling five percent (5%) or more of any class of stock of the corporation, together with the number of shares owned and the date of acquisition of such shares.

(f) 

Whether any shares of the stock of the corporation or of any stockholders have been pledged, mortgaged, encumbered or are subject to any financial or security agreement and, if so, the name and address of each person having, holding, owning or claiming such interest.

(2) 

The provisions of Subsection H(1)(b) through (f) shall not apply where the corporation name in Subsection H(1)(a) is a corporation whose stock is listed on the New York or American Stock Exchanges.

I. 

Whether the present owners, or any of them, have entered into any contract for the sale of all or any part of the subject property and if, in the affirmative, there shall be submitted a duplicate original or photocopy of the full and completed contract of sale, including all riders, modifications and amendments thereto.

J. 

Such additional information as may be requested by the board, agency or commission having jurisdiction over such application, pertaining to ownership, operation or control of the subject property.