LANDMARKS
of New York State
Natural Landmark Survey Form
Enter the requested information, then click on "Submit the Form" to complete the process.
Note: It is not necessary to provide all the information requested, partially completed forms may be submitted. If necessary, more information may be submitted on a new form at a later date. Digital photos/scans may be submitted in jpg format by email to this address: info@nysLandmarks.com.
Send an email to snyaia150@verizon.net with any questions.
Name of Landmark
  • Historic Name
  • Current Name
  • Location
  • County
  • Township
  • Address
  • Directions
  • Type of Landmark

    Other:
    Landmark Designation
    National Register
    Natl Register Desired
    Natl Register Historic District
    Other:
    Local Landmark
    Local Historic District
    State Historic Marker
    Historic Marker Desired
    Landmark History
  • Date Built
  • Builder
  • Architect/Designer
  • Original Owner
  • Original Use
  • Past Uses
  • Other Information
  • Significant Physical Features
  • Natural
  • Man-made
  • Current Owner
  • Name
  • Ownership

  • Other:
  • Owner Address
  • email
  • Phone
  • Current Use
  • Current Condition
    Excellent
    Good
    Needs Repair
    Deteriorated
    Threatened
    Funding is Needed to Restore/Repair
    List Threats to this Natural Landmark:
    Public Access (indicate days & times, cost, phone, email, etc):
    Why is this Landmark Important
    Surveyor Information
  • Name
  • Date Surveyed
  • email
  • Phone
  • Organization
  • Persons Interviewed
  • Name
  • Date of Interview
  • Address
  • email
  • Phone
  • Title (County Historian, Town Historian, etc.)

  • Name
  • Date of Interview
  • Address
  • email
  • Phone
  • Title (County Historian, Town Historian, etc.)
  • Location of Information
    Local Library
    County Library
    Government Office
    Historical Society
    Private Collection
    List Any Other Sources of Information
    Describe Historic Photos/Documents that are Available
    Website Address
    Additional Comments

    Check Here if you plan to send more information later on this Landmark.

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