BUILDING PERMIT-GENERAL INFORMATION

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Inc. Village of New Hyde Park BUILDING PERMIT-GENERAL INFORMATION THIS INFORMATION IS FOR BUILDING PERMITS ONLY. PLUMBING PERMITS MUST ALSO BE APPLIED FOR ALL PLUMBING WORK 1. Fee MUST be paid at time application is filed. 2. All FEES ARE NON-REFUNDABLE. 3. All blanks on the application are to be filled in. if an item is not applicable note as N/A. PLEASE PRINT 4. All applications are subject to Building Department and/or Village Board approval. Certain applications are issued at the discretion of the Village Clerk pending Board approval. 5. No license or permit will be issued if the applicant, business, or a principle of the corporation submitting the application has any outstanding unpaid violations due the Village. 6. The permit issued by the Village Clerk must be prominently displayed and readily available for review by any Village designated authority. 7. All permits issued are valid for one (1) year from date of issue and must be renewed if work is not completed, in a timely fashion, to avoid late filing fees. 8. Nassau County Board of Assessors Building Permit must be completed. 9. BUILDING PERMITS WILL BE ISSUED AS SOON AS POSSIBLE AFTER SUBMISSION OF ALL REQUIRED DOCUMENTS. DEPENDING ON SCHEDULING IT MAY TAKE TWO OR MORE WEEKS FOR APPROVAL. YOU WILL BE NOTIFIED WHEN YOUR APPLICATION IS APPROVED OR DENIED. IF APPROVED, WHEN YOU MAY PICK UP YOUR PERMIT. 10. ALL NEW YORK STATE BUILDING AND FIRE CODES MUST BE MET. THE FOLLOWING INFORMATION IS REQUIRED TO BE SUBMITTED WITH THE APPLICATION. ANY MISSING INFORMATION WILL DELAY THE APPLICATION PROCESS. 1. Two sets of plans drawn by and certified by an architect or a professional engineer. If plans are not drawn by an architect or a professional engineer they must be drawn to scale and must comply with minimum standards set forth in the New York State Building Uniform Fire Prevention and Building Code. Drawings not by an architect or a professional engineer are subject to rejection at the discretion of the Building Department. 2. Copy of the property survey (plot plan). 3. Copy of the deed to the property for the new construction. THE FOLLOWING THREE ITEMS ARE REQUIRED BY STATE LAW 1. If work is being performed by a contractor, the contractor must provide insurance indemnifying the Village and must provide a copy of his Workers Compensation Insurance and proof of Liability Insurance, as well as Disability Insurance (DB-120) 2. If work is being performed by the homeowner a form that is provided by the Village must be completed stating the work is being performed by the homeowner copy of the certification is provided. 3. Completed Nassau County Assessment Application. 4. For demolition: proof of Extermination Inspection by exterminator or Nassau County Board of Health. Upon receipt of the foregoing information your requests for these permits will be reviewed and submitted to the Board of Trustees for appropriate action. Upon issuance of the permit it is the RESPONSIBILITY OF THE PERMIT HOLDER to request inspections. An appointment may be contacting the Village Building Department at 516-354-0022.

EXPLANATION OF INSPECTIONS: All may not apply to your permit. 1. Excavation-before footings are placed. 2. Footings-forming and pouring of concrete. 3. Foundation-forming and pouring concrete for foundation. Upon completion CORE test results, by testing lab, must be provided to the Building Department. 4. Fireplace-inspect flue, chimney and hearth. 5. Waterproofing-before foundation is back filled. 6. Rough framing-studding, roofing and floor beams, blocking, roof sheathing and siding. 7. Plumbing-after all rough plumbing and all fixtures are installed-call FOR INSPECTION BY THE VILLAGE PLUMBING INSPECTOR AT 516-354-6589. 8. Insulation-of exterior walls and roof beams. 9. Electrical-list of permitted electrical inspections will be provided by Building Department. 10. Other- any and all inspection that are required by the type of permit issued. 11. Final- completion of all work prior to issuance of Certificate of Completion or Certificate of Occupancy. SCHEDULE OF INSPECTIONS-CALL FOR AN APPOINTMENT 516-354-0022 TYPE OF INSPECTION CALLED FOR INSPECTION INSPECTION DATE 1. EXCAVATION 2. FOOTING 3. FOUNDATION 4. FIREPLACE 5. WATERPROOFING 6. ROUGH FRAME 7. PLUMBING 8. INSULATION 9. ELECTRICAL A COPY OF THE COMPLETED FIRE UNDERWRITERS CERTIFICATE MUST BE SENT TO THE VILLAGE BUILDING DEPARTMENT WHEN RECEIVED. 10.OTHER FINAL INSPECTION

Inc. Village of New Hyde Park BUILDING PERMIT APPLICATION *** SEE General Information Sheet for Information and Requirements*** PAGE ONE-COMPLETE BOTH SIDES OF THIS APPLICATION Date: Property Information: Section: Block: Lots: Owner s Last Name: First Name: Address: Home Phone Number: Business Phone: Cell Phone: E-Mail: Applicant s Last Name: First Name: Address: Home Phone Number: Business Phone: Cell Phone: E-Mail: Description of Work: Address Location of Permit: Check all that Apply: New Dwelling: Alteration: Addition: Retaining Wall: Fence: Pool: Accessory Shed: Accessory Bldg: Mother/Daughter Conversion: Other: Property Information: Is this a permit to legalize an existing structure? Yes No Will any trees be cut down? Yes No If yes, Tree Permit # Estimated Cost of Proposed Construction: Sq. Feet of Lot: % of Lot Area: Size Proposed Bldg: Present Use of Building: Proposed Use: Sq. Ft. of Work Area: Architect/Engineer: Business Name: Phone No: Contractor: Business Name: Phone No: Electrician: Business Name: Phone No: Plumber Business Name: Phone No: OFFICE USE ONLY Violation File Checked: Documentation Required Received: Appl. Rec d. By: Fee Paid: Date Building Dept./ board Approved: Permit #: Date Issued: Issued By:

VILLAGE OF NEW HYDE PARK BUILDING DEPARTMENT OWNER S AUTHORIZATION I (we) hereby certify that: 1. The information provided on this permit application is true and correct. I understand that the Village of New Hyde Park will approve or deny a permit based on the information provided. 2. I agree to permit the Building Inspector and any officer or employee of the Village of New Hyde Park to enter upon the premises in the discharge of their duties with this application. 3. Approved plans and a copy of approved permit will remain on the premises at all times until Certificate of Occupancy/Completion is issued. These plans will be made available to the Building Inspector. 4. Building Inspector will be given a minimum of 48 hours notice to make the required inspection and no work will continue until such inspection has been completed and approved. 5. Owner or his representative will be responsible to arrange for all required inspections. State of New York County of Nassau ) Property Owner-Please Print Property Owner deposes and says that he/she resides at in the State of, that he/she is the owner in fee of all certain lots, parcel of land shown on the attached survey Section Block Lot(s) situated, lying and being within the Village of New Hyde Park; that I/we have read and understand the items 1 through 4 as here in stated, that the work to be done upon the premises, will be done in accordance with the approved application and accompanying plans, of which he/she totally familiar and that he/she hereby names as his or her representative to file this application on his/ her behalf. Signature of Owner: Sworn to me this day of 20 Signature of Notary Public DO NOT WRITE BELOW-FOR OFFICE USE ONLY APPLICATION FEE: APPLICATION #: DATE RECEIVED: ZONE: CLERK: BZA: SITE PLAN REVIEW: LOCATION: FOUNDATION SURVEY OK D DATE: SPECIAL CONDITIONS CHECKED: ELECTRICAL CERTIFICATE: WORK COMMENCED ON: FINAL INSPECTION DATE: DATE SIGNED OFF: INSPECTOR SIGN OFF: PLUMBING PERMIT #: ESTIMATED COST: SQUARE FOOTAGE X $: =

Inc. Village of New Hyde Park BUILDING PERMIT APPLICATION *** SEE General Information Sheet for Information and Requirements*** PAGE ONE-COMPLETE BOTH SIDES OF THIS APPLICATION Date: Property Information: Section: Block: Lots: Owner s Last Name: First Name: Address: Home Phone Number: Business Phone: Cell Phone: E-Mail: Applicant s Last Name: First Name: Address: Home Phone Number: Business Phone: Cell Phone: E-Mail: Description of Work: Address Location of Permit: Check all that Apply: New Dwelling: Alteration: Addition: Retaining Wall: Fence: Pool: Accessory Shed: Accessory Bldg: Mother/Daughter Conversion: Other: Property Information: Is this a permit to legalize an existing structure? Yes No Will any trees be cut down? Yes No If yes, Tree Permit # Estimated Cost of Proposed Construction: Sq. Feet of Lot: % of Lot Area: Size Proposed Bldg: Present Use of Building: Proposed Use: Sq. Ft. of Work Area: Architect/Engineer: Business Name: Phone No: Contractor: Business Name: Phone No: Electrician: Business Name: Phone No: Plumber Business Name: Phone No: OFFICE USE ONLY Violation File Checked: Documentation Required Received: Appl. Rec d. By: Fee Paid: Date Building Dept./ board Approved: Permit #: Date Issued: Issued By:

VILLAGE OF NEW HYDE PARK BUILDING DEPARTMENT OWNER S AUTHORIZATION I (we) hereby certify that: 1. The information provided on this permit application is true and correct. I understand that the Village of New Hyde Park will approve or deny a permit based on the information provided. 2. I agree to permit the Building Inspector and any officer or employee of the Village of New Hyde Park to enter upon the premises in the discharge of their duties with this application. 3. Approved plans and a copy of approved permit will remain on the premises at all times until Certificate of Occupancy/Completion is issued. These plans will be made available to the Building Inspector. 4. Building Inspector will be given a minimum of 48 hours notice to make the required inspection and no work will continue until such inspection has been completed and approved. 5. Owner or his representative will be responsible to arrange for all required inspections. State of New York County of Nassau ) Property Owner-Please Print Property Owner deposes and says that he/she resides at in the State of, that he/she is the owner in fee of all certain lots, parcel of land shown on the attached survey Section Block Lot(s) situated, lying and being within the Village of New Hyde Park; that I/we have read and understand the items 1 through 4 as here in stated, that the work to be done upon the premises, will be done in accordance with the approved application and accompanying plans, of which he/she totally familiar and that he/she hereby names as his or her representative to file this application on his/ her behalf. Signature of Owner: Sworn to me this day of 20 Signature of Notary Public DO NOT WRITE BELOW-FOR OFFICE USE ONLY APPLICATION FEE: APPLICATION #: DATE RECEIVED: ZONE: CLERK: BZA: SITE PLAN REVIEW: LOCATION: FOUNDATION SURVEY OK D DATE: SPECIAL CONDITIONS CHECKED: ELECTRICAL CERTIFICATE: WORK COMMENCED ON: FINAL INSPECTION DATE: DATE SIGNED OFF: INSPECTOR SIGN OFF: PLUMBING PERMIT #: ESTIMATED COST: SQUARE FOOTAGE X $: =

2013 Rev. Inc. Village of New Hyde Park BUILDING DEPARTMENT-FEES BLDG.- APPLICATION FEE FOR ALL BUILDING PERMITS $100.00 NON-REFUNDABLE BLDG.-COPY OF C/O FOR EXISTING STRUCTURE $50.00 CERTIFIED COPY BLDG.- COPY OF EXISTING BUILDING DEPARTMENT CERTIFICATES $0.25 PER PAGE BLDG.-INSPECTION $75.00 USED FOR ALL OPEN PERMITS BLDG.-RE-INSPECTION $75.0 AFTER 2 ND FAILED INSPECTION BLDG.-ISSUE CERT. OF SUMMARY REVIE W $75.00 CERTIFICATION OF ALL CERTIS & PERMITS IN FILE BLDG.-ISSUE CERT. OF EXISTING USE $250.00 RESIDENTIAL-PER DWELLING BLDG.-ISSUE CERT. OF EXISTING USE $250.00 BUSINESS/INDUSTRIAL-PER UNIT BLDG.-PERMIT-ELECTRIC METER $50.00 NEW OR ADDITONAL BLDG.-PERMIT-FENCE $50.00 NEW OR REPLACEMENT BLDG.- PERMIT-FINISH CELLAR $75.00 BLDG.- PERMIT-FIREPLACE $75.00 ANY TYPE FUEL BURNED BLDG.-PERMIT-LATE FILING FEE $150.00 PER PERMIT-ANY PERMITTED WORK DONE W/O A PERMIT BLDG.-PERMIT-BUSINESS/INDUSTRIAL $300.00 NEW CONSTRUCTION-PLUS $0.95 PER SQ.FT. BLDG.-PERMIT-BUSINESS/INDUSTRIAL ADDITION OR ALTERATION $200.00 PLUS $.95 PER SQ.FT. OF CONSTRUCTION AREA BLDG.-PERMIT-BUS./IND/ MINIMUM FEE $100.00 BLDG.-PERMIT-RENEWAL (12 MONTHS MAX) 75% FIRST SIX MONTH RENEWAL= 75% OF ORIGINAL PERMIT FEE 50% EACH ADDITIONAL THREE MONTH RENEWAL=50% OF ORG. PERMIT FEE BLDG.-PERMIT-RESIDENTIAL BLDG.- PERMIT-RESIDENTIAL- ADDITON OR ALTERATION $150.00 NEW CONSTRUCTION- PLUS $0.95 PER SQ. FT. $100.00 PLUS $0.75 PER SQ. FT. OF CONSTRUCTION AREA BLDG.-PERMIT-RESIDENTIAL -ACCESSORY BUILDINGS $75.00 PORCHES, SHEDS, DECKS, GARAGES, ETC. BLDG.-PERMIT-RESIDENTIAL-MINIMUM PERMIT FEE $75.00 BLDG.-RENTAL REGISTRATION-2 YEARS $150.00 PER UNIT (UP TO 4) $50.00 EACH ADD. L UNIT BLDG.-REVIEW SITE PLAN OR SEQRA $150.00 PER 4,000 SQ. FT. OF LOT AREA OR PART THEREOF BLDG.-REVIEW SUBDIVISION APP L $200.00 PER 4,000 SQ. FT. OF LOT AREA OR PART THEREOF BLDG.-REVIEW SUBDIVISION APP L $200.00 PER 4,000 SQ. FT. OF LOT AREA OR PART THEREOF BLDG.-SIGNS $50.00 PER SIGN PLUS $150.00 ARB FEE BLDG.-SPECIAL USE $300.00 PUBLIC HEARING BEFORE THE VILLAGE BOARD BLDG.-COPY OF SIGN LAW $5.00 PER COPY

Workers Compensation INSURANCE REQUIREMENTS FOR CONSTRUCTION OPERATIONS Coverage Extensions Notice of Cancellation Evidence Statutory Voluntary compensation All states, coverage employers Employee s liability-unlimited 30 Days Certificate of Insurance Disability (DB-120) Notice of Cancellation Evidence 30 Days Certificate of Insurance Comprehensive Liability Coverage Occurrence-1988 ISO or equivalent Limits General Aggregate $2,000,000.00 Products- Com/Ops/Aggreg $1,000,000.00 Pers. & Advert. Injury $1,000,000.00 Each Occurance $1,000,000.00 Fire Damage (any one fire) $ 50,000.00 Medical Exp.(any one person) 5,000.00 Notice of Cancellation 30 Days Additional Insured Inc. Village of New Hyde Park, all elected and appointed officials, employees and volunteers using ISO Form CG2010 (B) or equivalent Evidence Certificate of insurance and copy of additional insured endorsement Owners Protective Coverage Limits Premium Payment Policy Period Notice of Cancellation Evidence Occurrence Minimum limit-$1,000,000.00 CSL Responsibility of Contractor Start of project and until project is accepted as completed by owner 30 Days 1) Certificate of Insurance 2) Copy of Binder 3) Copy of original policy to be delivered within 45 days of start of project