Roxbury, NY · Delaware County
Application for Certificate of Compliance to Close Out a Demo Permit
Property owners use this application to request a Certificate of Compliance confirming a permitted structure has been taken down or removed from their property.
What this form is
This application requests a Certificate of Compliance to close out a demolition permit after a structure has been taken down or removed from the property. It asks for the permit number, application date, property address, type of structure removed, owner name and mailing address, telephone number, and the owner’s signature and date. The form lists a $25 fee.
Who needs it
The property owner holding a demolition permit uses this application to request a Certificate of Compliance after the permitted structure is removed.
How to submit it
The form lists the Town of Roxbury at PO Box 189, 56 Hillcrest Drive, Roxbury, NY 12474, and [email protected]. It lists a $25 fee.
About notarization
This application is signed and dated without a notary; it lists no notarized attachment or sworn step.
How to submit this form
- 1
Download the Application
Download the Certificate of Compliance application for closing out a demolition permit.
- 2
Complete the Application
Enter the permit and property details, describe the structure removed, and provide the owner's contact information.
- 3
Sign and Date
The property owner signs and dates the application.
- 4
Submit to the Town
Send the application to the Town of Roxbury using the mailing address or email listed on the form; the listed fee is $25.
Frequently asked questions
- What does this application request?
- It requests a Certificate of Compliance declaring that the structure covered by the demolition permit has been taken down or removed from the property.
- What information does the application ask for?
- It asks for the permit number, application date, property address, type of structure removed, owner name and mailing address, telephone number, and the owner's signature and date.
- Do I need a notary for this application?
- No. This application is signed and dated without a notary, and it lists no notarized attachment or sworn step.
- How do I submit the application?
- The form lists the Town of Roxbury's mailing address and [email protected]. It also lists a $25 fee.
Need something notarized?
This Application for Certificate of Compliance to Close Out a Demo Permit doesn’t need a notary — but if you have another Roxbury form that does, a commissioned online notary can help.