Application Form For A Building Permit - Warren County (Page 2 of 2) in pdf

3.3

If project is a business, commercial or mixed occupancy, specify nature and extent of each type of use

_______________________________________________________________________________________________________________

3.4.

Name of Architect or Engineer______________________________ Address______________________________________

Phone No.__________________________________________

3.5.

Name of Contractor________________________________Address________________________________________________

Phone No.__________________________________________

SECTION IV – ATTACHMENTS REQUIRED TO THIS APPLICATION

4.1.

A signed town or village Zoning Compliance Certificate must accompany this application.

4.2. Proof of Worker’s Compensation and Disability (not liability) insurance or proof of exemption of person(s)

performing construction is required before a permit is issued.

(See “Acceptable Insurance Forms”.)

If applicant is not owner of premises, a signed agent authorization form must be included with

4.3.

application.

Two (2) site/plot plans showing placement of proposed construction; distances to property lines and to

4.4.

other structures must be indicated as well as placement of well and septic system whether new or existing

systems.

Driveway length and width must be indicated.

4.5.(a) Two (2) sets of plans or drawings (signed or initialed by the town or village zoning officer) must

include elevations, floor plans, and cross sections of the construction.

Plans must include Energy Code

Compliance documentation.

Upon approval of this application, the Warren County Fire Prevention and Building

Code Department will issue a Building Permit to the applicant and return one approved set of plans to the

applicant.

(b) These plans may need to be sealed and signed by a NYS licensed professional engineer or architect per

the NYS Education Law.

This may not apply to residential buildings of a gross floor area of fifteen hundred

(1,500) square feet or less (exterior dimensions), nor alterations to any building or structure costing twenty

thousand dollars ($20,000) or less which does not involve changes affecting the structural stability and/or

public safety thereof.

(There may be circumstances when “stamped” plans may be required regardless of size or

cost.)

approval are necessary).

SECTION V – YOUR ACKNOWLEDGMENTS, AGREEMENTS AND SIGNATURE

I agree to comply with all applicable laws, ordinances and regulations, including but not limited to

5.1.

zoning, subdivision regulations and cleared or title restrictions.

5.2.

I acknowledge no construction activities may be commenced prior to issuance of a valid permit by reason

of applicable law.

I certify that the application, plans, and supporting materials, to the best of my

knowledge, are a true and complete statement/description of the work proposed, that all work will be performed

in accordance with the New York State Uniform Fire Prevention and Building Code and the New York State Energy

Code.

I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate

5.3.

of occupancy or completion.

I acknowledge it is my or my authorized agent’s responsibility to call for all

required inspections.

5.4.

I agree to allow access to the property for inspections.

5.5.

I acknowledge that nothing contained in this permit shall be construed to satisfy any legal obligation of

the applicant to obtain any governmental application or permit from any entity other than Warren County

whether, Federal, State, Regional or Local.

Date __________________________

____________________________________________________

(Signature of Applicant)

01/11

Application Form For A Building Permit - Warren County Page 2

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