Fillable General Building Permit Application.sflb.ashx

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General Building Permit Application.sflb.ashx

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CITY OF ALBANY
DEPARTMENT OF BUILDINGS & REGULATORY COMPLIANCE
200 Henry Johnson Boulevard
Albany, NY 12210
Phone (518) 434-5995
codes@albanyny.gov
GENERAL BUILDING PERMIT APPLICATION
A building permit is needed before any general construction, repair, rehab, gutting, or other work may be done. Project-specific building permit
applications may be available. Additional permits are required for specialized work such as electric or plumbing work which requires a license. Please
refer to our website or ask our staff if you have any questions about what permits your project requires.
STAFF USE ONLY
PERMIT NO.: ___________________
DATE REC’D: ____________
REC’D BY: _________
S&B PENDING
SCANNED & SAVED
BRC Form 001 Rev’d: 12/2017
Page 1 of 2
JOB SITE ADDRESS: ______________________________________________
ZIP: _______________
PROPERTY ACCT #: _________________________
ZONE: ______________
OVERLAYS: ___________
THIS INFORMATION IS AVAILABLE AT HTTPS://ALBANYNY.MAPGEO.IO
APPLICANT: _____________________________________________________________________________________
ADDRESS: __________________________________________________
ZIP: _________________
EMAIL: ___________________________________________
PHONE: (_____)___________________
HOW WOULD YOU LIKE TO RECEIVE YOUR PERMIT? (PLEASE CHOOSE ONE): PICK-UP MAIL OR EMAIL
THE APPLICANT WILL BE NOTIFIED BY EMAIL ONLY WHEN THE PERMIT IS READY FOR PICK-UP. WHERE “PICK-UP” IS SELECTED, PERMITS THAT ARE NOT PICKED UP AT OUR OFFICE WITHIN 6
MONTHS OF ISSUANCE WILL BE MARKED “VOID”. IF YOU WOULD LIKE TO RECEIVE YOU PERMIT BY MAIL, PLEASE INCLUDE A STAMPED, SELF-ADDRESSED ENVELOPE WITH THIS APPLICATION.
OWNER (IF DIFFERENT): __________________________________________________________________
ADDRESS: __________________________________________________
ZIP: _________________
EMAIL: ___________________________________________
PHONE: (_____)____________________
5
PROPOSED PROJECT: (PLEASE PROVIDE A DETAILED DESCRIPTION OF THE WORK TO BE DONE): ____________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
________________________________________________________________________________________________
DETAILED SITE PLANS OR OTHER DOCUMENTS DETAILING THE PROJECT ARE ATTACHED (RECOMMENDED):
YES NO
CURRENT USE OF THE PROPERTY: _____________________________________________________________________
CHANGE OF USE: DOES THIS PROJECT INVOLVE A CHANGE OF USE OR TENANCY AT THE PROPERTY?
YES NO
IF “YES”, PLEASE COMPLETE OUR “CHANGE OF USE OR TENANT” APPLICATION (BRC FORM 033) AND ATTACH IT TO THIS PERMIT APPLICATION.
DEVELOPMENT PERMIT: IS THIS PROJECT THE SUBJECT OF A PLANNING DEP’T ISSUED DEVELOPMENT PERMIT.
YES NO
10
TOTAL COST OF WORK: ________________________
INCLUDING LABOR & MATERIALS. BRC STAFF RESERVE THE RIGHT TO CONDITION CLOSURE OF
A PERMIT, INCLUDING ISSUANCE OF A CERT. OF OCCUPANCY ON PROOF OF TOTAL WORK COST.
11
PERMIT FEE: $_______________
FEES DEPEND ON THE PROJECT TYPE. SEE OUR WEBSITE FOR OUR FEE SCHEDULE OR CALL
OUR OFFICE AT (518) 434-5995 TO SPEAK WITH OUR STAFF ABOUT FEE CALCULATION.
APPLICATIONS MUST BE ACCOMPANIED BY PROOF OR WORKER’S COMP INSURANCE OR A FORM BP-1 “AFFIDAVIT OF EXEMPTION” AND FOR PROJECTS WHERE
THE TOTAL COST OF WORK IS MORE THAN $10,000 PROOF OF LIABILITY INSURANCE NAMING THE CITY OF ALBANY AS ADDITIONALLY INSURED.
WORK THAT WILL OBSTRUCT A PUBLIC RIGHT OF WAY WILL REQUIRE A SIDEWALK & BARRICADE PERMIT.
AN ADDITIONAL INSPECTION FEE OF $100 MAY BE CHARGED WHERE PREVIOUSLY CITED CORRECTIONS HAVE NOT BEEN MADE, NO ONE IS AVAILABLE TO MEET
OUR INSPECTOR OR THE WORK IS NOT READY FOR INSPECTION AT A SCHEDULED INSPECTION, AND WHERE THE INSPECTION IS REQUESTED TO ISSUE A TCO.
NEW STRUCTURES AND SUBSTANTIAL ADDITIONS OR ALTERATIONS, INCLUDING TWO-STORY DECKS AND ALTERATIONS TO OR REMOVAL OF LOAD-BEARING
BUILDING COMPONENTS, MUST BE ACCOMPANIED BY PLANS STAMPED BY A LICENSED ENGINEER OR ARCHITECT.
JOB SITE ADDRESS: __________________________________________
ADDITIONAL CONTRACTOR/CONTACT INFORMATION (WHERE APPLICABLE)
12
CONTRACTOR: ______________________________________________________________________________________
TYPE: ELECTRIC PLUMBING HVAC ELEVATOR SPRINKLER OTHER COST: $_______________
ADDRESS _______________________________________________________________________ ZIP: _______________
EMAIL: _____________________________________________________________ PHONE: (_____) _________________
CONTRACTOR: ______________________________________________________________________________________
TYPE: ELECTRIC PLUMBING HVAC ELEVATOR SPRINKLER OTHER COST: $_______________
ADDRESS _______________________________________________________________________ ZIP: _______________
EMAIL: _____________________________________________________________ PHONE: (_____) _________________
CONTRACTOR: ______________________________________________________________________________________
TYPE: ELECTRIC PLUMBING HVAC ELEVATOR SPRINKLER OTHER COST: $_______________
ADDRESS _______________________________________________________________________ ZIP: _______________
EMAIL: _____________________________________________________________ PHONE: (_____) _________________
CONTRACTOR: ______________________________________________________________________________________
TYPE: ELECTRIC PLUMBING HVAC ELEVATOR SPRINKLER OTHER COST: $_______________
ADDRESS _______________________________________________________________________ ZIP: _______________
EMAIL: _____________________________________________________________ PHONE: (_____) _________________
Certification: I hereby certify that I have examined this application and know the information contained therein to be
correct. I understand that the granting of a permit does not grant authority to violate or ignore any law, that this permit
authorizes only the work described herein and will expire, unless otherwise noted, in one year from the date of issuance.
Applicant Signature:___________________________________________ Date: ___________
APPLICATION VALIDATION (STAFF USE ONLY)
APPLICATION ACCEPTED (ALL REQUIRED INSURANCE, WORKER’S COMPENSATION, AND PLANS HAVE BEEN SUBMITTED).
APPLICATION REJECTED. WE ARE UNABLE TO ACCEPT YOUR APPLICATION BECAUSE IT IS MISSING THE FOLLOWING:
- INSURANCE INFORMATION
- WORKER’S COMP INFORMATION
- DETAILED PLANS
- PLANS STAMPED BY A LICENSED ARCHITECT OR ENGINEER
- APPLICATION ILLEGIBLE
ADDITIONAL INFORMATION: ____________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
APPLICATION PROCESSING (STAFF USE ONLY)
OTHER PERMITS/APPROVALS PENDING: PLUMBING
ELECTRIC
SITE PLAN
HVAC
OTHER: ____________________________________________________________________________________
ASSIGNED TO: ____________________________________________
DATE ASSIGNED: ____________
APPROVED BY (SUBJECT TO CONDITIONS): ____________________________________________
DATE: ____________
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Completed 10 July 2020

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