Johnson City Village Forms | Village of Johnson City, NY

Applicant / Property Information

Business Name*

Address*

Street Address City State ZIP Code

Phone*

Email*

Installation Company / Agenty to Owner

Company Name*

Contact Name*

Address:*

Street Address City State ZIP Code

Phone*

Email*

System Information

Select one:*

Light Hazard
Ordinary Hazard: Group 1
Ordinary Hazard: Group 2
Extra Hazard: Group 1
Extra Hazard: Group 2

Number of heads installed or to be installed*

Number of standpipes*

Number of fire pumps*

Proposed Starting Date*

Description of work to be done*

AFFIDAVIT*

By signing below, I hereby apply for a Fire Protection System Installation permit and certify that I have read and understand the
information package for the installation requirements pertinent to this permit and agree to abide by them. This application for a Fire
Code Operational Permit will be in accordance with all ordinances of the Village of Johnson City and the Fire and Building Code of
New York State and that any plans or specifications submitted with this application are the plans or specifications relating to this
permit.
I further understand this is not a permit but only an application for permit and construction work is not to start without a permit; that the
work will be in accordance with the approved plans.

I agree

Applicant Name*

Applicant Signature*

Application Date*

Comments

This field is for validation purposes and should be left unchanged.

Sprinkler Installation Permit Application

Sprinkler Installation Permit Application

Applicant / Property Information

Installation Company / Agenty to Owner

System Information