Residential Building / Zoning Permit Application

Transcription

1 West Lampeter Twnship 852 Village Rad, PO Bx 237, Lampeter, PA Phne: Fax: Residential Building / Zning Permit Applicatin Dwelling Additin / Renvatin Demlitin Finished Basement Garage/Shed Deck Fence Pati Driveway Electrical HVAC Plumbing Ht Tub Date Received: Pl ( Abve Grund In-Grund) Hme Occupatin Ag Building Change f Use Other: Prject Descriptin: Applicant Name: (Print Clearly) Prject Address: City State Zip Mailing Address: City State Zip Cntact Phne #: Fax #: Lt # (if applicable) Ttal Square Ftage: Prject Cst: Signature f Applicant Date Cntractr Infrmatin (see attached) Cntractr must prvide a Certificate f Insurance listing West Lampeter Twnship as the certificate hlder. Cntractr: Wrkers Cmpensatin Insurance: Yes N* Federal ID# Owner Infrmatin: (if different frm applicant) * Attach ntarized exemptin frm I am the wner f this prperty and I am assuming all insurance respnsibilities fr this permit. Owner Name: Phne # Prperty Owner s Address: City State Zip The fllwing dcuments must be submitted with all applicatins: Tw cmplete paper sets f detailed site plans (shwing all prperty lines and impervius cverage) Tw cmplete paper sets f RESIDENTIAL building cnstructin plans. Water, sewer and highway permits must als be submitted if required. Twnship Cde Official may enter a building, structure r premises during nrmal business hurs r at a time agreed t by wner r wner s agent t perfrm inspectins r t enfrce the Unifrm Cnstructin Cde. Office Use Only Zning Officer Review / Apprval: Building Inspectr Review / Apprval: Permit # Date: Date: Revised 10/31/12

2 STORMWATER MANAGEMENT 230 Attachment 1 Twnship f West Lampeter APPENDIX A-1 EXEMPTION APPLICATION Date Received File Number Prperty Act # Prject Street Address: Owner s Name: Signature: Phne#/Fax #/ Persn/Firm t be cmpleting wrk: Phne#/Fax #/ Prpsed Activity: Are yu remving existing impervius as part f this prject? [ ] N [ ] Yes, Ttal area f existing impervius t be remved sq. ft. [ ] Remval f grund cver, grading, filling, r excavatin f an area (1,000 square feet r less) Ttal area f land disturbance: sq. ft. Type f Regulated Activity (check all that apply): [ ] Remval f grund cver, [ ] Grading, [ ] Filling, [ ] Excavatin, [ ] Other earth disturbance activity (please describe) [ ] Additin f Impervius Surface (1,000 square feet r less) Ttal new impervius surface prpsed sq. ft. Type f new impervius surface: [ ] driveway, [ ] shed, [ ] garage, [ ] deck, [ ] walkway, [ ] ther (please describe) Check all items belw that will be impacted by the prject: [ ] Fldplain [ ] Wetlands [ ] Slpes greater than 15% [ ] Knwn bedrck within 6 ft f the grund surface [ ] Riparian Frest Buffer [ ] Natural water flw paths (creeks, streams, pnds, swales, etc.) [ ] Existing knwn strmwater prblem areas [ ] Dwnstream prperty wners Sketch Prvide a sketch f the prpsed additinal impervius area r land disturbance. Official Use Only Review/Apprval Cmments: Date 230 Attachment 1:

3 Residential Building Permit Applicatin Page 3 Permit # Cntractr Infrmatin General Cntractr General Cntractr Address City State Zip Phne Fax Mbile Framing Cntractr Framing Cntractr Cntract # Scpe f Wrk Electrical Cntractr Electrical Cntractr Cntract # Scpe f Wrk Plumbing Cntractr Plumbing Cntractr Cntract # Scpe f Wrk Heating Cntractr Heating Cntractr Cntract # Scpe f Wrk Fundatin Cntractr Fundatin Cntractr Cntract # Scpe f Wrk/Type f Wrk

4 Residential Building Permit Applicatin Page 4 Permit # PLOT PLAN A plt plan shwing the lt size, existing and planned structures, existing and planned driveways and parking areas, interir and exterir strage areas, and all significant features such as fld plains, wetlands, easements, and drainage ways shall be submitted with this applicatin. Until a plan is submitted, this applicatin shall nt be cnsidered cmplete and shall nt be prcessed. Please shw the fllwing n the Plt Plan: 1. Size f the Lt 2. Lcatin f existing and prpsed structures (include setback measurements) 3. Street and driveway lcatin

5 West Lampeter Twnship Wrkers Cmpensatin Insurance Exemptin Cntractr Name: Cntractr Cmpany: Mailing Address: Federal r State Emplyer Identificatin Number: Phne #: Date: The undersigned swears r affirms that he/she is nt required t prvide wrkers cmpensatin insurance under the prvisins f Pennsylvania s Wrkers Cmpensatin Law fr ne f the fllwing reasns as indicated belw: Cntractr with n emplyees Religius exemptin under the Wrkers Cmpensatin Law Signature Subscribed and swrn t befre me this day f, 20 Ntary (Seal)

6 Cmmunity Develpment WEST LAMPETER TOWNSHIP 852 VILLAGE ROAD, BOX 237 LAMPETER, PENNSYLVANIA FAX PLUMBING SYSTEM FORM FOR NEW RESIDENTIAL CONSTRUCTION Public Water Service Size and Type f Pipe OR Private Well Pump/Pressure Tank Sink and Type f Pipe Water Distributin Piping Type and Branch Size at the Lwest Flr Level Water Distributin Piping Type and Riser Size t the Highest Flr Level Plumbing Fixture List Basement 1 st Flr 2 nd Flr Water Heater Size and Energy Surce NOTE: ALL COMBUSTION AIR MUST COME FROM THE OUTSIDE

7 Cmmunity Develpment WEST LAMPETER TOWNSHIP 852 VILLAGE ROAD, BOX 237 LAMPETER, PENNSYLVANIA FAX MECHANICAL SYSTEM FORM FOR NEW RESIDENTIAL CONSTRUCTION Heating Equipment Manufacturer and Mdel/Size Cling Equipment Manufacturer and Mdel/Size Submit building lads calculated in accrdance with ACCA Manual J r Apprved Methd Cmbustin air frm the utside int an insulated/sealed mechanical rm OR Cmbustin air frm utside int sealed cmbustin appliance Gas Piping Sizing Pipe size and length frm Main branch entry t 1 st appliance 1 st appliance type and size input (BTU) Pipe size and length frm 1st appliance t 2nd appliance 2nd appliance type and size input (BTU) Pipe size and length frm 2nd appliance t 3rd appliance 3rd appliance type and size input (BTU) Pipe size and length frm 3rd appliance t 4th appliance 4th appliance type and size input (BTU) Pipe size and length frm 4th appliance t 5th appliance 5th appliance type and size input (BTU) Pipe size and length frm 5th appliance t 6th appliance 6th appliance type and size input (BTU)

8 Cmmunity Develpment WEST LAMPETER TOWNSHIP 852 VILLAGE ROAD, BOX 237 LAMPETER, PENNSYLVANIA FAX ELECTRICAL SYSTEM FORM FOR NEW RESIDENTIAL CONSTRUCTION Pwer Cmpany Cnnectin Number Amperage f Service Type f Service: Undergrund Overhead Number f Lighting Circuits Prvided Panel Schedule Indicate circuit destinatin, amperage, AFCIs, and GFCIs

9 West Lampeter Twnship s Strmwater Management Prgram Gals: Reduce the discharge f strmwater pllutants t the maximum extent practicable (MEP). Prtect water quality Satisfy the apprpriate water quality requirements f the Clean Water Act. What is Strmwater Pllutin? Plluted strm water runff is ften transprted t municipal separate strm sewer systems (MS4s) and ultimately discharged int lcal rivers and streams withut treatment. EPA s Strmwater Phase II Rule establishes an MS4 strmwater management prgram that is intended t imprve the Natin s waterways by reducing the quantity f pllutants that strmwater picks up and carries int strm sewer systems during strm events. Cmmn pllutants include il and grease frm radways, pesticides frm lawns, sediment frm cnstructin sites, and carelessly discarded trash, such as cigarette butts, paper wrappers, and plastic bttles. When depsited int nearby waterways thrugh MS4 discharges, these pllutants can impair the waterways, thereby discuraging recreatinal use f the resurce, cntaminating drinking water supplies, and interfering with the habitat fr fish, ther aquatic rganisms, and wildlife. EPA 833-F January 2000 (revised December 2005) Fact Sheet 2.0 Strmwater Runff in West Lampeter Twnship drains t three surface water systems: The Cnestga River The Mill Creek The Pequea Creek These streams all drain t the Susquehanna River, and ultimately t the Chesapeake Bay. West Lampeter Twnship 852 Village Rad, PO Bx 237 Phne: x kara@westlampeter.cm During a shrt perid f time, uncntrlled strmwater flws can cntribute mre sediment West Lampeter Twnship Cnstructin Site Runff Cntrl

10 Cnstructin Site Runff Cntrl Prgram Gals: 1. Develp regulatry mechanisms t require, inspect, and enfrce prper ersin and sediment (E&S) and waste cntrls. 2. Eliminate all instances f strmwater pllutin ccurring frm active cnstructin sites. Maintain a cnstructin site inventry t manage inspectin and enfrcement activity. Require cnstructin site peratrs t select, install, implement and maintain strmwater cntrl measures t cmply with all lcal, state, and federal regulatins. Require cnstructin site peratrs t design, install and maintain effective E&S cntrls t minimize the discharge f pllutants accrding t all lcal, state and federal regulatins. Establish prcedures t handle cmplaints generated by the general public n instances f active ersin. Respnsibilities f the Strmwater Management Crdinatr: T supplement the regular activities f Lancaster Cunty Cnservatin District staff, the Strmwater Management Crdinatr will perfrm the fllwing tasks: Attend all pre-cnstructin meetings, and track cnstructin activity. Perfrm site inspectins each time it rains mre than 0.5 in a 24-hur perid. Develp a list f active cnstructin sites. Ensure that cntractrs understand twnship requirements, inspectin schedules, enfrcements, and penalties. Prgram Objectives Enfrce rdinance requirements that regulate strmwater discharge, ersin, sedimentatin, and waste dispsal during all cnstructin activities. Enfrce rdinances that utline the inspectin and enfrcement schedules fr cnstructin activity, including apprpriate sanctins. Develp prcedures t cnsider ptential water quality impacts during the plan review prcess. Attend annual trainings t stay current with evlving rules and regulatins, and encurage lcal cntractrs t participate. As f January 1, 2015 West Lampeter Twnship will begin t levy fines n cntractrs if a pllutin event is bserved during a rutine inspectin. Be a partner in ur effrts t prtect Lcal Water Quality