"Application Form for Building and Zoning Permit" - Town of Guilderland, New York Download Pdf
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"Application Form for Building and Zoning Permit" - Town of Guilderland, New York

This New York-specific "Application Form for Building and Zoning Permit" is a document released by the New York State Department of State.

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Download "Application Form for Building and Zoning Permit" - Town of Guilderland, New York

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Application for Building and Zoning Permit
TOWN OF GUILDERLAND
Building Department
Guilderland Town Hall
Ph: 356-1980
P.O. Box 339, Route 20
Fax: 356-1990
www.townofguilderland.org
Guilderland, N.Y. 12084
Date: ________________________ , 20_____
Permit No. _______________
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit and Zoning Permit pursuant to
the New York State Fire Prevention and Building Code for the construction of buildings, additions or alterations, or for removal or
demolition, as herein described. The applicant or owner agrees to comply with all applicable laws, ordinances, regulations and all
conditions expressed on the back of this application which are part of these requirements, and also will allow all inspectors to enter
the premises for the required inspections.
NOTE – READ INSTRUCTIONS ON REVERSE SIDE
Applicant’s Name ___________________________
Zoning District _______________________________
Address ___________________________________
___________________________________
Tax Map Number: ____________________________
Phone ____________________________________
Flood Zone Designation________________________
Lot Size _______________ Area ________________
Owner’s Name _____________________________
Existing Building Size _________________________
Address _________________________________ _
New Building Size ____________________________
___________________________________
Phone ____________________________________
NEW BUILDING YARDS: Zoning Set Backs:
Fill in plot diagram on back
Property Location of Proposed Construction
Front Yard Depth ________________________ Feet
__________________________________________
Right Side Yard Width ____________________ Feet
__________________________________________
Left Side Yard Width _____________________ Feet
Rear Yard Depth ________________________ Feet
Existing Use ________________________________
Bldg. Height ___________ Feet ___________ Stories
Describe: __________________________________
__________________________________________
Estimated Cost $_____________________________
__________________________________________
Floor Area __________________________________
__________________________________________
Cubic Area __________________________________
Name of Compensation Carrier & Policy #
__________________________________________
Fee $_______________________________________
________________________________________
Signature of Owner, Applicant or Agent
NOTE: THIS BUILDING PERMIT FOR RESIDENTIAL WORK EXPIRES SIX (6) MONTHS FROM DATE
ISSUED – ONE (1) EXTENSION PERMITTED
Dated________________________, 20__________
________________________________________
Deputy Building Inspector
Application for Building and Zoning Permit
TOWN OF GUILDERLAND
Building Department
Guilderland Town Hall
Ph: 356-1980
P.O. Box 339, Route 20
Fax: 356-1990
www.townofguilderland.org
Guilderland, N.Y. 12084
Date: ________________________ , 20_____
Permit No. _______________
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit and Zoning Permit pursuant to
the New York State Fire Prevention and Building Code for the construction of buildings, additions or alterations, or for removal or
demolition, as herein described. The applicant or owner agrees to comply with all applicable laws, ordinances, regulations and all
conditions expressed on the back of this application which are part of these requirements, and also will allow all inspectors to enter
the premises for the required inspections.
NOTE – READ INSTRUCTIONS ON REVERSE SIDE
Applicant’s Name ___________________________
Zoning District _______________________________
Address ___________________________________
___________________________________
Tax Map Number: ____________________________
Phone ____________________________________
Flood Zone Designation________________________
Lot Size _______________ Area ________________
Owner’s Name _____________________________
Existing Building Size _________________________
Address _________________________________ _
New Building Size ____________________________
___________________________________
Phone ____________________________________
NEW BUILDING YARDS: Zoning Set Backs:
Fill in plot diagram on back
Property Location of Proposed Construction
Front Yard Depth ________________________ Feet
__________________________________________
Right Side Yard Width ____________________ Feet
__________________________________________
Left Side Yard Width _____________________ Feet
Rear Yard Depth ________________________ Feet
Existing Use ________________________________
Bldg. Height ___________ Feet ___________ Stories
Describe: __________________________________
__________________________________________
Estimated Cost $_____________________________
__________________________________________
Floor Area __________________________________
__________________________________________
Cubic Area __________________________________
Name of Compensation Carrier & Policy #
__________________________________________
Fee $_______________________________________
________________________________________
Signature of Owner, Applicant or Agent
NOTE: THIS BUILDING PERMIT FOR RESIDENTIAL WORK EXPIRES SIX (6) MONTHS FROM DATE
ISSUED – ONE (1) EXTENSION PERMITTED
Dated________________________, 20__________
________________________________________
Deputy Building Inspector
INSTRUCTIONS
1. This application must be completely filled in with ink and submitted in duplicate to the Building Department.
2. Plot plan 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.
3. This application must be accompanied by two (three for commercial projects) complete sets of plans showing
proposed construction and two complete sets of specifications. Plans and specifications shall describe the nature
of the work to be performed, the material and equipment to be used and installed and details of structural,
mechanical, electrical and plumbing, heating installations.
4. Call the building department if a fee amount is needed before submitting the application.
5. Be sure NYS Workers Comp. & Liability Insurance information is up to date and on file at the Building Department.
A waiver of liability is available on the Building Dept. website for applicants completing projects using their
Homeowners Insurance.
6. The work covered by this application may not be commenced before the issuance of Building and Zoning Permit.
7. Upon approval of this application, the building department will issue a Building and Zoning 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 the work.
8. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Department.
9. Costs for the work described in the Application for Building Permit include the cost of all of the construction, and
other work done in connection therewith, exclusive of the cost of the land.
10. Any deviation from the approved plans subject to the same procedure established for the examination of the original
plans. An additional permit fee may be charged predicated on the extent of the variation from the original plans.
11. A PERMIT AND CERTIFICATE OF APPROVAL MUST BE OBTAINED FROM A THRID PARTY ELECTRICAL
INSPECTOR FOR ALL ELECTRICAL WORK. PERMIT MUST BE OBTAINED BEFORE STARTING ANY
ELECTRICAL WORK.
PLOT DIAGRAM
Locate clearly and distinctly all buildings whether existing or proposed, and indicate all set back dimensions from property lines. Give lot and block
numbers or description according to deed, and show all easements and street names and indicate whether interior or corner lot, or supply an
approved plot plan showing all the above requirements.
NOTE: TO PREVENT ANY DRAINAGE PROBLEM, SHOW ELEVATIONS, GRADING, SWALES, CULVERTS OR DRAIN PIPES ON
OR WITHIN 30 FT. OF PROPERTY, ETC.
C
D
ELEVATIONS OF FINISHED GRADE IN
Rear Line ………… Ft.
RELATION TO CROWN OF ROAD.
A. ___________ E. ___________
Rear Yard
B. ___________ F. ___________
………………… ft.
C. ___________ G. ___________
D. ___________ H. ___________
GROUND FLOOR ________________
1. Are Foundation Drains Required?
2. If So, Where Will Drains
G
H
Discharge?
REMARKS
Sideyard ft.
SIZE ____X_____
Sideyard ft.
_________________________________
_________________________________
_________________________________
_________________________________
E
F
Curb cut to be obtained from
Front Yard
appropriate state, county or town
…………… ft.
highway department.
Frontage
A
B
……………………… ft.
Street
Notice of Utilization of Truss Type Construction,
Pre-Engineered Wood Construction and/or Timber Construction
TOWN OF GUILDERLAND
Building Department Phone: 356-1980 Fax: 356-1990 PO Box 339 Guilderland NY 12084
www.townofguilderland.org
To: _The Town of Guilderland Building Department (Cc: Fire Department)_
From: _________________________________________________________________
[Name of Owner of Property]
Property Address: _____________________________________________________
Property Tax Map #: ____________________________________________________
Please take notice that the (check applicable line):
_____ New residential structure
_____ Addition to the existing residential structure
_____ Rehabilitation of the existing residential structure
to be constructed or performed at the property referenced above will utilize (check each applicable line):
_____ Truss type construction
_____ Pre-engineered wood construction
_____ Timber construction
in the following location(s) (check applicable line):
_____ Floor framing (including girders and beams) F
_____ Roof framing R
_____ Floor framing and roof framing FR
Date: _________________________________________________________________
Signature: ____________________________________________________________
Printed Name: _________________________________________________________
Owner
Owner’s Representative
DESCRIPTION OF MATERIALS
PLANS SHOULD INCLUDE THE FOLLOWING INFORMATION AS APPLICABLE
SITE OF PROPSED CONSTRUCTION:
Name of owner
ROOFING:
Address of project
Type of material
Distance to property line from new
Ice & water protection locations
construction
Flashing locations
FOUNDATION:
STAIRS:
Footing sizes
Width of stairway
Foundation wall size & material
Height of risers
Column/Post size & material
Depth of treads
Girder/Beam size & material
Height of handrails
Dampproofing/Parging material
Spacing of spindles
Anchor bolt size & spacing
INSULATION:
FLOOR SLAB:
Submit a Department of Energy
Vapor barrier thickness & material
compliance checklist
Slab thickness & material
OR
Material & R-Value in ceilings
CRAWL SPACE:
Material & R-Value in walls
Ventilation opening size & material
Material & R-Value in floor/basement
walls
FLOOR FRAMING:
Joist size & spacing
WINDOWS:
Sub-floor size & material
Type of glazing material
Finish floor material
Area of glazing
Method of attachment for joists to
Openable area
girder/beam
Height of open area
Width of open area
WALL FRAMING:
Height of sill above finish floor
Stud size & spacing
Sheathing size & material
DOORS:
Exterior/Interior finish size & material
Size and material of door
Type of door
CEILING FRAMING:
Joist size & spacing
HEATING:
Interior finish size & material
Type & efficiency of furnace
ROOF FRAMING:
PLUMBING:
Indicate rafters or trusses
Location of fixtures
Slope of roof
Supply pipe size & material
Rafter/Truss size & spacing
Drain/Vent pipe size & material
Ridge board size
Indicate town sewer & water or private
Rafter tie size & spacing
well & septic system
Sheathing size & material
Ventilation method
Attic access size and location
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