Building Permit Application For The Town Of Camillus printable pdf download

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 ____________________________

Building Permit Application For The Town Of Camillus

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