A P P L I C A T I O N F O R B U I L D I N G P E R M I T
THE FOLLOWING MUST BE TYPEWRITTEN OR PRINTED IN INK
do hereby apply to The Town of Ramapo Building and Zoning Department for a Building Permit as required
by Chapter 376 - 144 of the Town of Ramapo Zoning Law.
Closest Intersecting Street: _______________________________________ Zone: __________
Value of Construction: $ _____________________________ Fee: $ ___________________ (leave blank)
Present Use of Land: ______________________________________ (single family, two family, house of worship, etc.)
Proposed Scope of work:________________________________________________________________
*Print Full Name, Address and Telephone Number of Contact Person:
certifies that he/she is the owner or agent of all that certain lot, piece or parcel of land/or building described in the application and if not the
owner that he has been duly and properly authorized to make this application and to assume responsibility for the owner in connection with
this application and agrees that the Town of Ramapo Zoning Ordinance will be complied with as well as other proper regulations relating to
the construction or use of the proposed buildings and the land described on this application.
PERMITS ARE VALID FOR ONE YEAR FROM THE DATE THEY ARE ISSUED.
I FURTHER AFFIRM I WILL CALL FOR A FINAL INSPECTION WHEN PROJECT IS COMPLETE.
DO NOT WRITE BELOW THIS LINE
Town of Ramapo
237 Route 59
Suffern, NY 10901
845-357-5100 x 280 PHONE 845-357-5140 FAX
Michael B. Specht
Permit # _____________ S.B.L._________________________________
For the Following Use:________________________________________________________
Date of Issue: ___________ _________________________
Ian Smith, Building Inspector