BLDG PERMIT APPL - 112224

Oct 28, 2026

Building permit application form for the Village of Cornwall-On-Hudson. Collects property information including zoning district, building type, existing and added areas, stories, construction classification, basement/attic and other unfinished space, flood zone and related items such as fences, sheds, swimming pool/hot tub, solar energy system, and generators. Requires full legal owner details, a description of proposed work, and selection of work scope and permit type, plus occupancy classification. Includes contractor insurance requirements and states that applications without documented Workers’ Compensation and disability/paid family leave compliance will not be accepted.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Property Information

Property Legal Owner Information

Description of Proposed Work

Scope of Work

Type of Permit

Occupancy Classification

Insurance and Compliance Requirements

VILLAGE OF CORNWALL-ON-HUDSON BUILDING DEPARTMENT 260 Shore Rd. Cornwall-On-Hudson, NY 12520 845-534-7656 fax 845-534-7607 [dpwadmin@cornwall-on-hudson.org](dpwadmin@cornwall-on-hudson.org) MANNY A. CARMONA Code Enforcement Officer BUILDING PERMIT APPLICATION Form Revised 11/22/2024 BUILDING PERMIT \# APPLICATON SHALL BE COMPLETED IN ITS ENTIRETY OR WILL BE REJECTED PRINT CLEARLY 1. PROPERTY INFORMATION | Street Address | □ Apt. \#
□ Vacant Land | Sec./Block/Lot \#: | Work Area Sq. ft. | | Construction Cost | | --- | --- | --- | --- | --- | --- | | Zoning District: □ SR □ CBS □ CR-1 □ CR-2 □ CR-3 □ VPD □ WR □ I | | | | | | | BUILDING |
EXISTING CONDITIONS | | |
ADDING NEW | | | □ Residential □ Commercial □ Mixed | Residential Units Commercial Units | | | Res Com □None | | | Number of Stories ///////////////////////// | | | | floor(s) □ None | | | Building Type of Construction /////////////////////////////////////////////////////////// | □ I □ II □ III □ IV □ V □ A □ B | | | | | | Living Area Sq. ft. ////////////////////////// | | | | Sq. ft. | | | Commercial Sq. ft. ///////////////////////////////////////////////////////////////////// | Bldg. Total Your Space □ None | | | Bldg Space □ None | | | Basement Area Sq. ft. ///////////////////////////////////////////////////////////////// | □ Finished □ None
□ Unfinished | | | __________
__________ | | | Attic Area Sq. ft. /////////////////////////////////////////////////////////////////////// | □ Finished □ None
□ Unfinished | | | __________
__________ | | | Unfinished Space other Sq. ft. ////////////////////////////////////////////////////////// | □ Storage □ Crawl Space
□ None | | | □ None | | | Bedrooms (\#) ///////////////////////////// | | | | □ None | | | Full Baths (\#) ////////////////////////////// | | | | □ None | | | Partial Baths (\#) /////////////////////////// | | | | □ None | | | Flood Zone //////////////////////////////// | □ NO Base Flood Elevation ft. | | | □ None | | | Fence ///////////////////////////////////// | □ Yes □ NO | | | □ None | | | Shed sq. ft. //////////////////////////////// | □ Yes □ NO Sq. ft. | | | □ None | | | □ Swimming Pool □ Spa □ Hot Tub | □ Above-Ground □ In-Ground □ None | | | □ None | | | Solar Energy System //////////////////////// | □Yes □ NO | | | □ None | | | Generator ///////////////////////////////// | □ Yes □ NO KW | | | □ None | | 2. PROPERTY LEGAL OWNER INFORMATION | Complete Legal Name: | | | --- | --- | | First, Last Name and Title: | | | Street Address: | City: State & Zip Code: | | Phone \#: | E-Mail: | | Description of Proposed Work: | | --- | | ________________________________________________________________________________________
| | ________________________________________________________________________________________
| | ________________________________________________________________________________________
| | ________________________________________________________________________________________
| | ________________________________________________________________________________________
| 3. SCOPE OF WORK 4. TYPE OF PERMIT 5. OCCUPANCY CLASSIFICATON | □ ADDITION
□ ALTERATION LEVEL
□ AWNING
□ CHANGE OF USE
□ CRANE
□ DECK
□ DEMOLITION
□ STRUCTURE □ INTERIOR
□ DUMPSTER
□PAD □ ENCLOSURE
□ ELETRICAL
□ ELETRIC CAR CHARGER
□ ELECTRIC SERVICE UPGRADE
□ FENCE L.F.
□ FIRE ALARM SYSTEM
□ FIREPLACE
□ FOUNDATION ONLY
□ GAZEBO
□ GENERATOR
□ LIFT
□ MECHANICAL EQUIPMENT
□ NEW □ REPLACEMENT
□ NEW CONSTRUCTION
□ PERMIT RENEWAL
□ PLUMBING □ PIPING
□ FIXTURE □ FIRE SPRK
□ REPAIR/REPLACEMENT
□ RETAINING WALL
□ RE-ROOFING □ 2ND LAYER
□ SCAFFOLD
□ SHED
□ SIDING
□ SIDEWALK L.F.
□ SIGN
□ SOLAR PANEL ENERGY SYSTEM
□ Roof □ Ground Mounted
□ Building Integrate

FAQs

What information is required in the property section of the building permit application?

The form collects the street address, zoning district, building type and construction classification, existing and added floor/work areas, stories, basement/attic conditions, flood zone data, and details such as fences, sheds, pools/spas/hot tubs, solar energy systems, and generators.

What does the application require for the property’s legal owner information?

It requests the complete legal name, first/last name and title, street address, city/state/ZIP, phone number, and email address.

Why are insurance documents required, and when will the village reject an application?

The form states contractors must maintain Workers’ Compensation and Disability & family leave insurance, provide liability insurance on the ACORD form, and attach valid certificates with the project address and the village as certificate holder. The office will not accept applications or issue permits without documented compliance and attached valid insurance certificates.

Oct 28, 2026

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