TOWNSHIP OF NORTH FRONTENAC BUILDING DEPARTMENT P.O. Box 97, Plevna, Ontario K0H 2M0 Telephone: (613) 479-2231 or 1-800-234-3953, Fax: (613) 479-2352, or www.northfrontenac.ca George Gorrie, Chief Building Official Ext. 224 / cbo@northfrontenac.ca / Judy Tooley, Building Clerk Ext. 222 BUILDING APPLICATION CHECK LIST Application form must be completed, signed and returned to the Building Department with the following information/documents before your permit can be issued. (MINOR PROJECTS REQUIRE FIRST (7) SEVEN ITEMS ONLY). 1. A complete set of drawings, showing floor plans, elevations, cross section and truss layout. 2. Permit fee paid and receipt in file, fee will be determined by the CBO.(See fee structure By-lawavailable at the municipal office and/or on the Township website) 3. Survey of property, if available. 4. Copy of the deed. 5. Plot Plan showing distances from lot lines, high water mark and all buildings. 6. Health Unit Approval (Cloyne (613) 336-8989, for Barrie, Clarendon and Miller.) (Sharbot Lake (613) 279-2151, for Palmerston, North and South Canonto) 7. Entrance Permit and 911 number (civic number) from the Public Works Manager. 8. Letter of Direction/Authorization (attached hereto), if applicable. 9 New Home Warranty disclaimer (attached hereto), if applicable. 10. Well Records. 11 Heat Loss/ Heat Gain-Duct Layout (must be completed by HRAI certified designer before permit is issued). 12. Conservation Authority, Min. of Natural Resources, Agriculture and Environment approvals ( if applicable). 13. Ministry of Labour, Notice of Project (attached hereto) construction $50,000 & over. 14. Drainage plan showing method for dealing with surface drainage on property. 15. Hydro Permit is required through Hydro One (1-877-372-7233) if applicable. NOTES: 1. Permit must be posted on site within view. 2. It is the responsibility of the applicant/owner to ensure that all required inspections are completed. 3. 48 hours notice is required for all inspections.
Application number: received: Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act. For use by Principal Authority Permit number (if different): Roll number: Application submitted to: Township of North Frontenac A. Project information 911 number, street name Lot Conc. Municipality Postal code Plan/Part number/other description Township of North Frontenac Assessment Roll Number : 1042 - Health Unit Approval Permit Number (if Applicable) Current Zoning Proposed Use Permitted (Y/N) If property is located adjacent to water, do you own the Shore Road Allowance? Yes No Name of Body of Water Setbacks ( Indicate distance of proposed building location from each lot line ) Front Yard Setback m/ft or Lakeshore Setback (from H.W.M.) m/ft Side Yard m/ft Ext. Side Yard m/ft Rear Yard m/ft Size of Proposed Construction Length m/ft Width m/ft Height m/ft Number of Storeys Sewage: Septic Holding Tank Other Heating: Oil Wood Electric Other Hydro: On site Required - Permit Number Location: Is this property subject to water access only? Yes No Project value est. $ Area of work (m 2 /ft 2 ) B. Applicant Applicant is: Owner or Authorized agent of owner Last name First name Corporation or partnership Street address Unit number Lot/con. Fax C. Owner (if different from applicant) Last name First name Corporation or partnership Street address Unit number Lot/con. Fax
D. Builder (optional) Last name First name Corporation or partnership (if applicable) Street address Unit number Lot/con. E. Purpose of application New construction Fax Addition to an existing building Solid fuel appliance Alteration / repair / renovation Plumbing (new or alteration) Demolition Conditional Permit Accessory building Proposed use of building Current use of building Deck Change to existing building Description of proposed work (Provide description of proposed construction project. For example: New Cottage or Bedroom Addition or Kitchen Expansion with Up-graded Plumbing or Solid Fuel Appliance or Deck, etc.) F. Tarion Warranty Corporation (Ontario New Home Warranty Program) i. Is proposed construction for a new home as defined in the Ontario New Home Warranties Plan Act? If no, go to section G. Yes No ii. Is registration required under the Ontario New Home Warranties Plan Act? Yes No iii. If yes to (ii) provide registration number(s): G. Attachments i. Attach documents establishing compliance with applicable law as set out in Article 1.4.1.3. of Division A. ii. Attach Schedule 1 for each individual who reviews and takes responsibility for design activities. iii. Attach Schedule 2 where application is to construct on-site, install or repair a sewage system. iv. Attach types and quantities of plans and specifications for the proposed construction or demolition that are prescribed by the by-law, resolution, or regulation of the municipality, upper-tier municipality, board of health or conservation authority to which this application is made. H. Declaration of applicant I certify that: (print name) 1. The information contained in this application, attached schedules, attached plans and specifications, and other attached documentation is true to the best of my knowledge. 2. If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership. Signature of applicant Personal information contained in this form and schedules is collected under the authority of subsection 8(1.1) of the Building Code Act, 1992, and will be used in the administration and enforcement of the Building Code Act, 1992. Questions about the collection of personal information may be addressed to: a) the Chief Building Official of the municipality or upper-tier municipality to which this application is being made, or, b) the inspector having the powers and duties of a chief building official in relation to sewage systems or plumbing for an upper-tier municipality, board of health or conservation authority to whom this application is made, or, c) Director, Building and Development Branch, Ministry of Municipal Affairs and Housing 777 Bay St., 2nd Floor. Toronto, M5G 2E5 (416) 585-6666.
Schedule 1: Designer Information Use one form for each individual who reviews and takes responsibility for design activities with respect to the project. I. Project Information 911 number, street name Unit no. Lot/con. Municipality Postal code Plan number/ other description Township of North Frontenac J. Individual who reviews and takes responsibility for design activities Name Firm Street address Unit no. Lot/con. Fax number K. Design activities undertaken by individual identified in Section B. [Building Code Table 3.5.2.1. of Division C] House Small Buildings Large Buildings Complex Buildings HVAC House Building Services Detection, Lighting and Power Fire Protection Building Structural Plumbing House Plumbing All Buildings On-site Sewage Systems Description of designer s work L. Declaration of Designer I declare that (choose one as appropriate): (print name) I review and take responsibility for the design work on behalf of a firm registered under subsection 3.2.4.of Division C, of the Building Code. I am qualified, and the firm is registered, in the appropriate classes/categories. Individual BCIN: Firm BCIN: I review and take responsibility for the design and am qualified in the appropriate category as an other designer under subsection 3.2.5.of Division C, of the Building Code. Individual BCIN: Basis for exemption from registration: The design work is exempt from the registration and qualification requirements of the Building Code. Basis for exemption from registration and qualification: I certify that: 1. The information contained in this schedule is true to the best of my knowledge. 2. I have submitted this application with the knowledge and consent of the firm. Signature of Designer NOTE: 1. For the purposes of this form, individual means the person referred to in Clause 3.2.4.7(1) d).of Division C, Article 3.2.5.1. of Division C, and all other persons who are exempt from qualification under Subsections 3.2.4. and 3.2.5. of Division C. 2. Schedule 1 is not required to be completed by a holder of a license, temporary license, or a certificate of authorization, issued by the Ontario Association of Architects. Schedule 1 is also not required to be completed by a holder of a license to practise, a limited license to practise, or a certificate of authorization, issued by the Association of Professional Engineers of Ontario.
TOWNSHIP OF NORTH FRONTENAC BUILDING DEPARTMENT SETBACK WAIVER Concession Lot Former Township Plan Number Part 13R Civic Address (911 number) Roll Number 1042 - To the Township of North Frontenac: The owner/agent hereby acknowledges that the issuance of a Building Permit and/or a general site review by the Building Department Staff is not confirmation that all zoning setbacks have been adhered to. This includes but is not limited to separation of structures to the high water mark, lot lines, septic systems and other structures. It is understood that it is the sole responsibility of the owner/agent to meet the zone setback requirements. Owner/Agent (Please Print) Signature
TOWNSHIP OF NORTH FRONTENAC BUILDING DEPARTMENT LETTER OF DIRECTION / AUTHORIZATION Concession Lot Former Township Plan Number Part 13R Civic Address (911 number) Roll Number 1042 - To the Township of North Frontenac: I / We, the owner(s) of the above noted property, herein directs and authorizes to act as my/our agent in regards to the application for a Building Permit at the above location. Owner (please print) Owner (Signature) Owner (please print) Owner (Signature)