DeRuyter, NY · Madison County
Septic System Permit Application
Property owners or applicants use this application to request a permit for a new or modified on-site residential septic system in DeRuyter.
What this form is
This application is for a permit to construct a new on-site residential sewage disposal system or modify an existing one in the Village or Town of DeRuyter. It asks for the property location, zoning district, tax map number, and owner, applicant, and contractor contact information. Applicants for a new system must provide proof of compliance with the stated standards before permit issuance, and the owner or applicant must attach the contractor’s insurance certificates or a New York State exemption certificate.
Who needs it
Property owners or applicants seeking a permit for a new or modified on-site residential sewage disposal system in the Village or Town of DeRuyter need this application.
How to submit it
The form lists the Code Enforcement Office at 735 Utica Street, P.O. Box 394, DeRuyter, NY 13052. It lists Thursday, 9:00 AM–noon, as office hours.
About notarization
This application is signed and dated without a notary; the contractor’s insurance certificates or exemption certificate are attachments, and the signer just signs and dates the form.
How to submit this form
- 1
Download The Application
Download the Septic System Permit Application for the Village or Town of DeRuyter.
- 2
Complete The Application
Select new construction or modification, then provide the property, owner, applicant, and contractor information requested.
- 3
Gather Required Attachments
Attach the septic system contractor’s insurance certificates or a New York State exemption certificate.
- 4
Sign And Date
The owner, applicant if different, and septic system contractor have signature and date lines.
- 5
Submit To Code Enforcement
The form lists the Code Enforcement Office at 735 Utica Street, P.O. Box 394, DeRuyter, NY 13052.
Frequently asked questions
- Do I need a notary for the Septic System Permit Application?
- No. This application is signed and dated without a notary. Attach the contractor’s insurance certificates or exemption certificate as directed.
- How do I submit the Septic System Permit Application?
- The form lists the Code Enforcement Office at 735 Utica Street, P.O. Box 394, DeRuyter, NY 13052, and Thursday office hours of 9:00 AM–noon.
- What attachments does the application require?
- The owner or applicant must attach certificates of insurance for the septic system contractor, covering liability, workers’ compensation, and disability, or a New York State exemption certificate.
- What information does the application ask for?
- It asks for the property location, zoning district, tax map number, and contact information for the owner, applicant if different, and septic system contractor.