"Building Permit Application Form" - Town of Camillus, New York

Building Permit Application Form is a legal document that was released by the Code Enforcement Office - Town of Camillus, New York - a government authority operating within New York. The form may be used strictly within Town of Camillus.

Form Details:

  • The latest edition currently provided by the Code Enforcement Office - Town of Camillus, New York;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Code Enforcement Office - Town of Camillus, New York.

ADVERTISEMENT
ADVERTISEMENT

Download "Building Permit Application Form" - Town of Camillus, New York

403 times
Rate (4.8 / 5) 28 votes
Cash:
Check: #:____________
Credit Card:
Building Permit Application for the Town of Camillus
Office Use Only:
Permit Number__________________
Total Fee
Issue Date__________________
_______________
SBL Number _______-_____-______ .___ Zoning District ____ Fire Department District (F)(C)(M/W)(L)
Applicant General Information:
(fill in all blanks, please print legibly)
Owners name/ Agents name__________________________________ Phone number____________________
Project street address _______________________________________________________________________
Permit description (reason)
: _______________________________________________________________________________________________
New building, addition, alteration, conversion, pool, fence, sign, demolition, site development, renewal, other
Value of Construction: ($) _______________ Permit duration: Start date_________ Completion date_______
NOTICE: Accompanying this application, and forming a part thereof, are two (2) true copies of the general
working drawings showing the proposed erection, alteration or repairs, and the specifications showing the ma-
terials to be used and the methods of construction, etc., and the purpose of the applicant to comply with the
requirements of the Ordinances of the Town of Camillus. Permit expires after one year from date of issue.
Renewals may be made for 3 month intervals up to eighteen months from original issue date.
Contractor information:
Name: ___________________________________________________________________________________
Address:__________________________________________________________________________________
Phone/Cell/ Fax: ___________________________________________________________________________
Proof of Workers Compensation Insurance:
Date ______________ or Owner Affidavit
Architect/ Design Professional information:
Name: ___________________________________________________________________________________
Address: _________________________________________________________________________________
Phone/Cell/ Fax:___________________________________________________________________________
Office Use Only:
Specific information:
check or circle all that applies
Construction drawings attached: Y / N Survey attached: Y / N Length______ Width______ Height______
Driveway Permit (attached or NA), SPDES Permit (yes) (NA), Storm Water Permit (SWPPP) (Attached) (NA)
Potable water source (public) or (well); Sewage disposal method (public) or (septic approval)__________
Electrical inspection required_______ Plumbing inspection required________ Flood Hazard: Y / N
Heating source/fuel __________________ Energy analysis compliance (attached or NA)____
Occupancy classification______ Type of Construction (circle one) 1A, 1B, 2A, 2B, 3A, 3B, 4(HT), 5A, 5B.
Instructions to permit applicant, READ AND SIGN: It is the permit holders responsibility to call for re-
quired inspections. A Certificate of Occupancy (C.O.) or a Certificate of Compliance must be issued prior to
occupying the premises. The foregoing are hereby certified to be correct, true and full answers to the several
questions to which they relate, and the undersigned hereby agree to comply with the provisions of the Ordi-
nances of the Town of Camillus, and with all other laws and regulations of said Town, applicable to the work
intended to be prosecuted under this permit. Permission is hereby granted to the Town of Camillus Code En-
forcement Officer to inspect the premises at any reasonable hour.
Signature: owner/ agent_________________________ Approved by _______________________________
Print: owner/agent ____________________________
Cash:
Check: #:____________
Credit Card:
Building Permit Application for the Town of Camillus
Office Use Only:
Permit Number__________________
Total Fee
Issue Date__________________
_______________
SBL Number _______-_____-______ .___ Zoning District ____ Fire Department District (F)(C)(M/W)(L)
Applicant General Information:
(fill in all blanks, please print legibly)
Owners name/ Agents name__________________________________ Phone number____________________
Project street address _______________________________________________________________________
Permit description (reason)
: _______________________________________________________________________________________________
New building, addition, alteration, conversion, pool, fence, sign, demolition, site development, renewal, other
Value of Construction: ($) _______________ Permit duration: Start date_________ Completion date_______
NOTICE: Accompanying this application, and forming a part thereof, are two (2) true copies of the general
working drawings showing the proposed erection, alteration or repairs, and the specifications showing the ma-
terials to be used and the methods of construction, etc., and the purpose of the applicant to comply with the
requirements of the Ordinances of the Town of Camillus. Permit expires after one year from date of issue.
Renewals may be made for 3 month intervals up to eighteen months from original issue date.
Contractor information:
Name: ___________________________________________________________________________________
Address:__________________________________________________________________________________
Phone/Cell/ Fax: ___________________________________________________________________________
Proof of Workers Compensation Insurance:
Date ______________ or Owner Affidavit
Architect/ Design Professional information:
Name: ___________________________________________________________________________________
Address: _________________________________________________________________________________
Phone/Cell/ Fax:___________________________________________________________________________
Office Use Only:
Specific information:
check or circle all that applies
Construction drawings attached: Y / N Survey attached: Y / N Length______ Width______ Height______
Driveway Permit (attached or NA), SPDES Permit (yes) (NA), Storm Water Permit (SWPPP) (Attached) (NA)
Potable water source (public) or (well); Sewage disposal method (public) or (septic approval)__________
Electrical inspection required_______ Plumbing inspection required________ Flood Hazard: Y / N
Heating source/fuel __________________ Energy analysis compliance (attached or NA)____
Occupancy classification______ Type of Construction (circle one) 1A, 1B, 2A, 2B, 3A, 3B, 4(HT), 5A, 5B.
Instructions to permit applicant, READ AND SIGN: It is the permit holders responsibility to call for re-
quired inspections. A Certificate of Occupancy (C.O.) or a Certificate of Compliance must be issued prior to
occupying the premises. The foregoing are hereby certified to be correct, true and full answers to the several
questions to which they relate, and the undersigned hereby agree to comply with the provisions of the Ordi-
nances of the Town of Camillus, and with all other laws and regulations of said Town, applicable to the work
intended to be prosecuted under this permit. Permission is hereby granted to the Town of Camillus Code En-
forcement Officer to inspect the premises at any reasonable hour.
Signature: owner/ agent_________________________ Approved by _______________________________
Print: owner/agent ____________________________