FORM 87-06 pg. 1
DIVISION OF BUILDING AND HOUSING
APPLICATION FOR PERMITTED USE CERTIFICATE
Fee: $ 200.00 Receipt #: _________________ Date: ________________
By: ___________
Filing Requirements:
1. One Copy of the Survey to Scale & Legible;
2. Three Copies of Floor Plans drawn to a scale of not less than 1/8" to 1 foot showing walls,
windows and doors, area separations and sanitary facilities;
3. One Copy of the Certificate of Occupancy for the Premises;
4. Copies of the First Page and the Signature Page of the Lease, if applicable; and
5. A Copy of the Decision by the Zoning Board of Appeals with Exhibits, if applicable.
Zone: ________________ Tax Map #: 0400 - ________ - _________ - _________
SECTION BLOCK LOT
Property Address: ________________________________________________________
________________________________________________________
Filed Map: ______________________________________________________________
Property Description: ______________________________________________________
[N/S/E/W SIDE OF ROAD DISTANCE & DIRECTION TO INTERSECTION]
Name of Intended Business: ________________________________________________
Mailing Address: _________________________________________________________
[IF DIFFERENT THAN ABOVE]
Intended Use: ____________________________________________________________
_______________________________________________________________________
Occupancy Classification: * [See Page Two] ___________________________________
Last Use: _______________________________________________________________
[ATTACH A COPY OF THE PERMIT CARD OR CERTIFICATE FOR THE LAST USE]
Name of Applicant: _______________________________________________________
[PRINT OR TYPE]
Address of Applicant: _____________________________________________________
_____________________________________________________
Telephone of Applicant: ____________________________
Applicant’s Signature: ____________________________________ Date: ____________
Name of Property Owner: __________________________________________________
[PRINT OR TYPE]
Mailing Address of Property Owner: __________________________________________
__________________________________________
Property Owner’s Signature: ________________________________ Date: ___________
FORM 87-06 pg. 2
DIVISION OF BUILDING AND HOUSING
THE CERTIFICATE OF PERMITTED USE
A Certificate of Permitted Use is available to establish the lawful occupancy of a
premises including compliance with the Zoning Ordinance. It is not, however, a
substitute for a building permit. Therefore, if there is any construction activity, a building
permit would be required instead of an application for a permitted use certificate.
Typical examples of construction activity are adding or removing walls, adding doors or
windows, and replacing stairs.
A typical example of a permitted use is a new business starting in an existing tenant
space. Neither the property owner nor the business owner is changing the floor plan that
was used by the previous tenant.
A typical example of establishing compliance with the Zoning Ordinance is a permitted
use certificate for a two-family dwelling approved by the Zoning Board of Appeals. This
is sometimes called “legalizing” a prior nonconforming use.
New York State regulations require a building permit any time the occupancy
classification is changed. Therefore, a permitted use application is not available when
the occupancy classification has been changed. There are ten classifications for the
different types of occupancy. Of course, a building may have more than one type, but a
change of occupancy classification will require a building permit. For more information,
consult a licensed design professional or see Chapter 3 of the Building Code of the State
of New York. * The ten occupancy classifications, or groups, are as follows:
1. Group A – Assembly
2. Group B – Business
3. Group E – Education
4. Group F – Factory
5. Group H – High Hazard
6. Group I – Institutional
7. Group M – Mercantile
8. Group R – Residential
9. Group S – Storage
10. Group U – Utility
Once the application has been filed, the premises must be inspected. It is important to
schedule the inspection as soon as possible. A Certificate of Permitted Use will not be
issued until the inspection is approved. The Inspectors’ office is in Room 112. The
telephone number to schedule inspections is (631) 351-3163.