Black River, NY · Jefferson County
HVAC Permit Application
Property owners and contractors use this application to request a Village of Black River permit for planned heating, ventilation, or air-conditioning work.
What this form is
This application requests a permit for a planned HVAC project in the Village of Black River. It asks for property owner and contractor contact details, whether the applicant employs workers, a project description, and estimated construction cost. Applicants must provide insurance documentation as applicable; work involving ground disturbance also requires contacting Dig Safe NY at 811 before the permit is issued.
Who needs it
Property owners or contractors planning HVAC work in the Village of Black River should complete this application before work begins.
How to submit it
Submit it to the Department of Code Enforcement, 107 Jefferson Place, Black River, NY 13612. The form lists phone and fax numbers but does not specify a submission method.
About notarization
This application is signed and dated without a notary; it requests insurance and, in some circumstances, an exemption form, but does not say these attachments must be notarized.
How to submit this form
- 1
Download The Application
Download the HVAC Permit Application PDF.
- 2
Complete The Application
Do not use pencil. Provide owner and contractor details, describe the project, and enter the estimated construction cost.
- 3
Gather Required Documents
Include applicable proof of liability insurance and workers' compensation insurance or an accepted exemption form.
- 4
Submit To The Department
Submit the application to the Department of Code Enforcement at 107 Jefferson Place, Black River, NY 13612. Do not begin work until the permit is issued.
Frequently asked questions
- What does the HVAC Permit Application ask for?
- It asks for property owner and contractor details, whether the applicant employs workers, a project description, estimated construction cost, and the applicant's attestation.
- What documents may need to accompany the application?
- The form requires proof of liability insurance and, for contractor work, proof of workers' compensation insurance. Under certain circumstances, a CE-200 exemption form is accepted.
- Do I need a notary for the HVAC Permit Application?
- No. The application is signed and dated without a notary. It requests insurance and, in some circumstances, an exemption form, but does not say those attachments must be notarized.
- How do I submit the HVAC Permit Application?
- Submit it to the Department of Code Enforcement at 107 Jefferson Place, Black River, NY 13612. The form lists phone and fax numbers but does not specify a submission method.