[ ] Construction Drawings
[ ] Insurance /Workers Compensation -Form C105.2
Affidavit of Exemption
[ ] Consent Form from Homeowner
[ ] Electrical Inspection Agency: Application Filed or
Signature of Owner/Contractor/Agent
Date Signed
Zoning Dept. Use:
FEE : _____________ Receipt: __________ Cash/ Check: _________Deposit : ________________
Balance : ___________________ Total : _________________
Code Enforcement Officer Approval
ELECTRICAL PERMIT APPLICATION
Date
PERMIT APPLICATION # _____ -__________________
VILLAGE OF WAPPINGERS FALLS
APPLICANT : _______________________________________Email Address_____________________________________
ADDRESS : _______________________________________________________PHONE : ____________________________
OWNER (if different than applicant)_______________________________________________________________________
ADDRESS : _______________________________________________________PHONE : _____________________________
BUILDER : ______________________________________________________ PHONE : ____________________________
PROJECT LOCATION : _____________________________________________________________________________
DESCRIPTION : _____________________________________________________________________________________
_____________________________________________________________________________________________________
Required Submittals:
Work conducted pursuant to a building permit must be visually inspected by the Code Enforcement Office and must conform to the New
York State Uniform Fire Prevention and Building Code, the Code of Ordinances of the Village of Wappingers Falls and all other
applicable codes, rules or regulations.
It is the owner’s responsibility to contact the Code Enforcement Office at 845-297-5277 Monday through Friday from 9:00 a.m. to 3:30
p.m. at least 48 hours before the owner wishes to have an inspection performed. More than one inspection may be necessary. This is
especially true for
“internal work” which will eventually be covered from visual inspection by additional work (i.e., electrical work later to be covered by a
wall)
DO NOT PROCEED TO THE NEXT STEP OF CONSTRUCTION IF SUCH “INTERNAL WORK” HAS NOT BEEN INSPECTED.
Otherwise, work may need to be removed at the owner’s or contractor’s expense to conduct the interior inspection. Close coordination with
the Code Enforcement Office will greatly reduce this possibility.
OWNER HEREBY AGREES TO ALLOW THE CODE ENFORCEMENT OFFICER TO INSPECT THE SUFFICIENCY OF THE
WORK BEING DONE PURSUANT TO THIS PERMIT. SUCH INSPECTION(S) IS(ARE) LIMITED TO THE WORK BEING
CONDUCTED PURSUANT TO THIS PERMIT AND ANY OTHER NON WORK-RELATED VIOLATIONS WHICH ARE READILY
DISCERNIBLE FROM SUCH INSPECTION(S).
I, _____________________________________________ , the above-named applicant, hereby attest that I am the lawful owner
of the property described within or am the lawful Contractor /Agent of said owner and affirm under the penalty of perjury that
all statements made by me on this application are true.
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signature
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