"Application for Building Permit" - City of Peekskill, New York

Application for Building Permit is a legal document that was released by the Building Department - City of Peekskill, New York - a government authority operating within New York. The form may be used strictly within City of Peekskill.

Form Details:

  • The latest edition currently provided by the Building Department - City of Peekskill, New York;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Building Department - City of Peekskill, New York.

ADVERTISEMENT
ADVERTISEMENT

Download "Application for Building Permit" - City of Peekskill, New York

289 times
Rate (4.7 / 5) 16 votes
APPLICATION for BUILDING PERMIT
City of Peekskill, New York
840 Main Street, 914-734-4140
Permit No.______________
County of Westchester
Fee $ ___________
Date Issued _____________
Date Submitted ______________
INSTRUCTIONS
a.
This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Director of Public Works
b.
Survey showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and
giving a detailed description of layout of property must be drawn on the diagram which is part of this application.
c.
This application must be accompanied by three (3) complete sets of plans showing proposed construction and three (3) complete
sets of specifications. Plans and specifications shall describe the nature of the work to be performed, the materials, and
equipment to be used and installed and details of structural, mechanical, electrical, and plumbing installations.
d.
The work covered by this application may not be commenced before the issuance of Building Permit.
e.
Upon approval of this application, the Building Department will issue a Building Permit to the applicant together with approved,
duplicate set of plans and specifications. Such permit and approved plans and specifications shall be kept on the premises
available for inspection throughout the progress of work.
f.
No building shall be occupied or used in whole or in part for any purposes whatever until an application is made for and a
Certificate of Occupancy shall have been granted by the Building Department.
Location _____________________________________________________________________________________________________
(Give street number, name of street)
Section: ____________________ Block: __________________ Lot: ____________________
APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the New York
State Building Construction Code for the construction of buildings, additions, or alterations, or for removal or demolition, as herein
described. The applicant agrees to comply with all applicable laws, ordinances, and regulations.
____________________________________________________
(Signature of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, or builder _________________________________________________
If owner or applicant is a corporation, give names and titles of two officers and signature of duly authorized officer.
__________________________________________________
________________________________________________________
________________________________________________________
(Name and title of corporate officer)
1.
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy __________________________________________________________________________
A. TYPE OF IMPROVEMENT
1. _____ New building.
4. _____ Repair, replacement
2. _____ Additions (if residential, enter number
5. _____ Demolition, (if residential enter number
of new housing units added, if any
of units in building in Part C 13).
in Part C13).
3. _____ Alteration (see 2 above)
6. _____ OTHER _______________________________
________________________________
B. OWNERSHIP
9. _____ Private (individual, corporation, nonprofit, Institution, etc.)
10. _____ Public (federal, State, or Local government)
C. PROPOSED USE – FOR “DEMOLITION” MOST RECENT USE
Residential
Non-residential
11. _____ One Family
12. _____ Two or more family,
18 ______ Church, other religious
Enter number of units _____
19. _____ Industrial
13. _____ Transient hotel, motel or dormitory
20. _____ Parking garage
Enter number of units _____
21. _____ Service Station, repair garage
14. _____ Garage _____
No. cars _____
15. _____ Carport _____ No. cars _____
22. _____ Office, bank, professional
16. _____ Other - Specify _________________
23. _____ Stores, mercantile
24. _____ Tanks, towers
25.. _____ Other – Specify _____________________
APPLICATION for BUILDING PERMIT
City of Peekskill, New York
840 Main Street, 914-734-4140
Permit No.______________
County of Westchester
Fee $ ___________
Date Issued _____________
Date Submitted ______________
INSTRUCTIONS
a.
This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Director of Public Works
b.
Survey showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and
giving a detailed description of layout of property must be drawn on the diagram which is part of this application.
c.
This application must be accompanied by three (3) complete sets of plans showing proposed construction and three (3) complete
sets of specifications. Plans and specifications shall describe the nature of the work to be performed, the materials, and
equipment to be used and installed and details of structural, mechanical, electrical, and plumbing installations.
d.
The work covered by this application may not be commenced before the issuance of Building Permit.
e.
Upon approval of this application, the Building Department will issue a Building Permit to the applicant together with approved,
duplicate set of plans and specifications. Such permit and approved plans and specifications shall be kept on the premises
available for inspection throughout the progress of work.
f.
No building shall be occupied or used in whole or in part for any purposes whatever until an application is made for and a
Certificate of Occupancy shall have been granted by the Building Department.
Location _____________________________________________________________________________________________________
(Give street number, name of street)
Section: ____________________ Block: __________________ Lot: ____________________
APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the New York
State Building Construction Code for the construction of buildings, additions, or alterations, or for removal or demolition, as herein
described. The applicant agrees to comply with all applicable laws, ordinances, and regulations.
____________________________________________________
(Signature of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, or builder _________________________________________________
If owner or applicant is a corporation, give names and titles of two officers and signature of duly authorized officer.
__________________________________________________
________________________________________________________
________________________________________________________
(Name and title of corporate officer)
1.
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy __________________________________________________________________________
A. TYPE OF IMPROVEMENT
1. _____ New building.
4. _____ Repair, replacement
2. _____ Additions (if residential, enter number
5. _____ Demolition, (if residential enter number
of new housing units added, if any
of units in building in Part C 13).
in Part C13).
3. _____ Alteration (see 2 above)
6. _____ OTHER _______________________________
________________________________
B. OWNERSHIP
9. _____ Private (individual, corporation, nonprofit, Institution, etc.)
10. _____ Public (federal, State, or Local government)
C. PROPOSED USE – FOR “DEMOLITION” MOST RECENT USE
Residential
Non-residential
11. _____ One Family
12. _____ Two or more family,
18 ______ Church, other religious
Enter number of units _____
19. _____ Industrial
13. _____ Transient hotel, motel or dormitory
20. _____ Parking garage
Enter number of units _____
21. _____ Service Station, repair garage
14. _____ Garage _____
No. cars _____
15. _____ Carport _____ No. cars _____
22. _____ Office, bank, professional
16. _____ Other - Specify _________________
23. _____ Stores, mercantile
24. _____ Tanks, towers
25.. _____ Other – Specify _____________________
CHARACTERISTICS OF BUILDING- ESTIMATED COST AND FEES
D. Estimated Cost
E. Principal Type of Frame
F. Principal Type of Heating Fuel
Fees
29. _____ Masonry (wall bearing)
34. _____ Gas
Building Permit _______________
30. _____ Wood frame
35. _____ Oil
Site Plan Review ______________
31. _____ Structural steel
36. _____ Electricity
Total ________________________
32. _____ Reinforced concrete
37. _____ Coal
38. ______Other –
33. _____ Other -
Specify ______________
Specify _____________
G. RESIDENTIAL BUILDING ONLY
39. _____ Number of bedrooms _______
40. Number of bathrooms
Full _____ Partial _____
H. TYPE OF MECHANICAL
I. NUMBER OF OFF-STREET PARKING SPACES
Will there be central air conditioning?
45. Enclosed ______
41. _____ Yes
42. _____ No
46. Outdoors ______
Will there be an elevator?
43. _____ Yes
44. _____ No
J. DIMENSIONS
47. Total sq. ft. of floor area, all floors, based on exterior dimensions ________
48. total land area, sq. ft. ________
49. Dimensions of existing structures, if any: Front ________ Rear ________ Depth __ ______ Height ________ Number of Stories ________
Dimensions of same structure with alterations or additions: Front ________ Rear _______ Depth _______ Height ______ Number of Stories _______
50. Dimensions of entire new construction: Front ________ Rear ________ Depth ________ Height ________ Number of Stories ________
51. Size of lot: Front __________ Rear __________ Depth __________
52. Zone or use district in which premises are situated ____________________________________________________________________________________
53. Does proposed construction violate any zoning law, ordinance or regulation? _____________________
54. Name of Compensation Insurance Carrier ___________________________________________________________________________________________
Number of Policy ______________________________________
Date if Expiration ____________________________
55.
Will electrical work be inspected by, and a Certificate of Approval obtained from the New York Board of Fire Underwriters or other agency or
organization? If so specify __________________________________________________________________________________
IDENTIFICATION – To be completed by all applicants
Name (Please Print)
Mailing Address
Telephone Number
Number, Street, City, State
1. Owner
2. Contractor
3. Architect
4. Westchester County License #
STATE OF NEW YORK,
COUNTY OF Westchester
_________________________________________________________________ being duly sworn deposes and says that he is the applicant above named.
(Name of individual signing application) – Please Print
He/she is the _______________________________________________________________________________________________________________
(Contractor, agent corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements
contained in this application are true to the best of his/her knowledge and belief, and that the work will be performed in the manner set forth in the
application and in the plans and specifications filed therewith.
Sworn to before me
this _______ Day of _____________________________, 20 ____
_______________________________________________
(Signature of applicant)
_____________________________________________________
Notary Public
________________________________ County
I:\dpwoffice\forrms\Bldg Permit Ap
Page of 2