How do I submit the heating permit application?

Mail the signed application, $50 fee by check payable to the Washington County Treasurer, and required documents to the Washington County Department of Code Enforcement at 383 Broadway, Fort Edward, NY 12828.

What documents must accompany the application?

Include the proposed appliance's installation instructions and materials describing its clearances and manufacturer specifications. The application also lists insurance documentation and a signed Local Regulation Compliance Form.

Jackson, NY · Washington County

No notary required

Heating Equipment and Chimney Installation Permit Application

This application requests a permit to install supplemental heating equipment or a chimney and is filed with the Washington County Department of Code Enforcement.

What this form is

Use this application to request a permit for supplemental heating devices such as pellet stoves, woodstoves, and gas fireplaces; it is not an operating permit application. The application asks for project, property, applicant, building, and proposed equipment information. It also requires installation instructions, manufacturer materials, insurance documents, and a signed Local Regulation Compliance Form before a permit can be issued.

Who needs it

Residents, property owners, or installers planning to install supplemental heating equipment or a chimney should complete and submit this permit application.

How to submit it

Send the completed, signed application, the $50 application fee payable by check to the Washington County Treasurer, and required documents to Washington County Department of Code Enforcement, 383 Broadway, Fort Edward, NY 12828.

About notarization

This application is signed and dated without a notary; the related Local Regulation Compliance Form and any CE-200 exemption certificate require signatures, but the document does not require notarization.

How to submit this form

1
Download The Application
Download the Heating Equipment and Chimney Installation Permit Application PDF.
2
Complete And Sign The Form
Complete all sections in ink, provide the requested project and equipment information, and sign and date the application.
3
Gather Required Documents
Attach installation instructions, manufacturer clearance materials, required insurance documents, and the signed Local Regulation Compliance Form.
4
Submit To The County
Send the application, $50 check payable to the Washington County Treasurer, and documents to the Department of Code Enforcement, 383 Broadway, Fort Edward, NY 12828.

Frequently asked questions

Do I need a notary for the Heating Equipment and Chimney Installation Permit Application?: No. Sign and date the application without a notary. The related Local Regulation Compliance Form and any CE-200 exemption certificate require signatures, but not notarization.
How do I submit the heating permit application?: Mail the signed application, $50 fee by check payable to the Washington County Treasurer, and required documents to the Washington County Department of Code Enforcement at 383 Broadway, Fort Edward, NY 12828.
What documents must accompany the application?: Include the proposed appliance's installation instructions and materials describing its clearances and manufacturer specifications. The application also lists insurance documentation and a signed Local Regulation Compliance Form.
What heating equipment is this application for?: The application is for supplemental heating devices such as pellet stoves, woodstoves, and gas fireplaces. It is not an operating permit application.

Need something notarized?

This Heating Equipment and Chimney Installation Permit Application doesn’t need a notary — but if you have another Jackson form that does, a commissioned online notary can help.