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VILLAGE OF WAPPINGERS FALLS <br />BUILDING PERMIT APPLICATION # ______-- ___________ <br />RESIDENTIAL BUILDING PERMIT APPLICATION <br />APPLICANT : __________________________________________________________________________________________ <br />ADDRESS : _______________________________________________________PHONE : _____________________________ <br />OWNER: _______________________________________________________________________________________________ <br />ADDRESS : _______________________________________________________PHONE : _____________________________ <br />BUILDER : _____________________________________________________________________________________________ <br />ADDRESS : _______________________________________________________PHONE : ____________________________ <br />BUILDING SITE LOCATION : ____________________________________________________________________________ <br />(Road:Town,County, State or Private) <br />TAX GRID NUMBER : #06 _____________---______________---____________ <br />ZONING DISTRICT : ________________________Fire Deparment \[ \] SW Johnson \[ \] WT Garner <br />Existing size of Structure (dimensions) : <br />Height : _________________________ Number of Stories : _________________ Number of Dwelling Units: ________________ <br />No. of Bedrooms: _____________________ No. of Bathrooms : _______________Finished Basement ? ____________________ <br />(Check all that apply.) <br />\[ \] Construction of New Building\[ \] Pool - Above Ground :Size ____________ <br />\[ \] Demolition\[ \] Pool - In-Ground :Size ____________ <br />\[ \] Factory Manufactures Homes\[ \] Garage, Attached <br />\[ \] Convension - Change in Use/Occupancy\[ \] Garage, Detached <br />\[ \] Alteration\[ \] Deck/Porch <br />\[ \] Addition to Existing Building\[ \] Other : <br />\[ \] Repair to existing structure <br />PROJECT DESCRIPTION : ______________________________________________________________________________ <br />________________________________________________________________________________________________________ <br />Proposed Setback Minimums : <br />Distance of Structure from ... Front Line: ________ Rear Line : __________ Left Side : __________ Right Side: ______________ <br />Road Frontage (feet) : _____________________________Lot Area (acres) : ___________________________________________ <br /> \[ \] Estimated cost of Project: ___________ <br />Required Submittals: <br />\[ \] Planning Approval -Site Plan, Special Use, etc. <br />\[ \] Construction Drawings stamped and Signed <br />\[ \] Village Variance (Attach ZBA resolution) <br />\[ \] Manufactured Home: Stamped and Signed Plans <br />\[ \] State Variance (attach Board of Review resolution ) <br />\[ \] Trusses: Stamped and Signed Plans <br />\[ \] Driveway Permit - Village, Town, County, State DOT <br />\[ \] Energy Code ComplianceSheet <br />\[ \] Water/Sewer Department Approvals <br />\[ \] Electrical InspectionAgency: Application Field <br />\[ \] Wetland \[ \] Flood Plain <br />\[ \] Attached Plot Plan or Survey <br />\[ \] SAN 34 Form-Dept. of Health Approval <br />\[ \] Consent Form from Homeowner <br />\[ \] INSURANCE / WORKERS COMPENSATION <br />It is understood that authorization is hereby given for the Building Inspector/Zoning Administrator/Code Enforcement Officer to enter <br />premises for purposes of inspections prior to the issuance of the Certificate of Occupancy. <br />All inspection are listed on Building Permit. All applications MUST be completed before review by an inspector. <br />Signature of Owner/Contractor/Agent <br />Date Signed <br />Zoning Dept. Use: <br /> Receipt # _____________ \[ \] Fee : ________________ Total Paid: _________________ <br /> \[ \] Code Enforcement Officer ApprovalDate <br /> <br />