Town of Ulster | Application for Alternative Heating Device

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Application for Alternative Heating Appliance

Property Location and Information

Property Address *

Tax Map Number *

Owner Information

Applicant's Name *

Applicant's Email *

Applicant's Phone *

Relationship to owner *

Owner's Name *

Owner's Address *

Owner's Phone *

Installer Information

Installer's Name *

Installer's Address *

Installer's Phone *

Manufacturer Information

Manufacturer's Name *

Model Number *

Installation Manual

If you are unable to upload the Installation Manual when submitting this form, a copy must be provided to the Building Department before your application can be processed.

Appliance Location *

Installation Date *

By clicking Submit application is hereby made to the Building Department for the issuance of a Permit pursuant to the New York State Uniform fire Prevention and Building Code for the construction or installation of a solid fuel burning appliance. The applicant agrees to comply with all applicable laws, ordinances and regulations. The undersigned hereby certifies that the above statements are true to the best of my knowledge and belief, and all work will be completed as specified with the manufactures’ installation instructions.

Signature *

Reset Signature

Signature is required.

Date *

Captcha *

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FOR OFFICE USE ONLY


Application Number ____________________

Permit Number ____________________

Permit Fee ____________________

Received on ____________________

Approved ________________________________________

Paid on ____________________

Issued on ____________________

CONTACT US

845-382-2765