70 Church Street, White Plains, New York 10601
Phone: (914) 422 - 1269 * Fax: (914) 422 - 1471
DEPARTMENT OF BUILDING
CITY OF WHITE PLAINS
BUILDING LONG FORM 12/18
http://www.cityofwhiteplains.com/
Section I - LOCATION OF CONSTRUCTION :
SBL
: Site Address :
N/E/S/W SIDE OF
FEET
N/E/S/W FROM INTERSECTION OF
FEET
Descriptive Site Address
:
Zone:
BUILDING LONG FORM ( Volume Added )Applicant to complete all items in Sections I, II, III, IV, V, VII , VIII. & IX .
APPLICATION TYPE:
Section III - APPLICATION TYPE & COST : (Please put an "x" in all applicable check- off boxes.)
MULTI- FAMILY DWELLINGS & COMMERCIAL CONSTRUCTION
RESIDENTIAL (One & two family dwellings only)
TYPE OF WORK: New Building Addition Alteration to existing space
RepairRenovation of existing space Reconstruction of existing space
Change of occupancy
COST OF CONSTRUCTION: ( These values shall include general construction cost only )
Cost of New Volume or Addition------$
Cost of Alteration to Existing Space--$
AUT
Garage
# of Units
APPLICATION #: DATE :
REVIEWED
C.E.O.
G/LDIS.W/C
PERMIT #: DATE : PLAN/REVIEWED:
FEE AMOUNT:
FEE AMOUNT:
DESCRIPTION OF WORK:
Page 1 of 7
TOTAL FEE:
Section II - CONTACT INFORMATION : (All information provided must be current.)
APPLICANT: ADDRESS:
CONTACT: CELL: PHONE: Email:
OWNER: ADDRESS:
CONTACT: CELL: PHONE: Email:
CONTRACTOR: ADDRESS:
CONTACT: CELL: PHONE: Email:
DESIGN PROFESSIONAL: ADDRESS:
CONTACT: CELL: PHONE: Email:
Print Form
Reset Form
RESIDENTIAL:
One Family
Two Family
Garage
MULTI-FAMILY DWELLING & COMMERCIAL:
Assembly
Business
Educational
Factory/Industrial
High Hazard
Institutional
Mercantile
Storage
Utility & Storage
Multi Family Dwelling # of Units
Use & Occupancy sub-classification:
Section IV- PROPOSED USE & OCCUPANCY: (Check off major Use & Occupancy and fill in sub-classification of same. )
Section V- CONSTRUCTION TYPE & WORK CHARACTERISTICS: (Check off & fill all applicable boxes)
TYPE OF CONSTRUCTION: Type I Type II Type III Type IV Type V
MULTI-FAMILY DWELLING & COMMERCIAL: RESIDENTIAL:LOCATION TYPE: (Pick one)
ALTERATION:
Floor (s) where work is to occur:
Square Footage of Alteration:
ADDITION:
Number of Stories:
Height of each Story:
Live load per square foot:
Total square foot of addition:
Total volume of addition:
Is the building sprinklered or will the addition be sprinklered?
Does the building have or will it have area smoke detectors in all spaces and rooms?
Does the building have or will it have a smoke purge system? (Commercial only)
1. Please refer to the International Residential or Building Code for Story and Story Above Grade Plane definitions.
2. In computing the square foot area , measurement shall be taken to the outside surfaces of exterior wall at each floor. Courts, yards, etc.
shall be excluded.
3. The term "height" of a structure shall mean the vertical distance from the curb level to the highest point of the roof beams. In the case of
flat roof or to a point of the average height of the gable in the case of roofs having a pitch or more than one foot in four and one-half,
except that in the case of a structure where the grade of the street has not been established or where the structure does not adjoin the
street, the average level of all the ground adjoining such structure shall be used instead of the curb level.
4. Total height shall be measured from 6 inches below the lowest finished floor to the outside of the roof, and in case of sloping roofs, to the
average height.
5. The cubical contents is the actual space enclosed within the outer surface of the outside walls and between the outer surfaces of the roof
and six inches below the surface of the lowest floors. This includes the cube of dormers, penthouses, vaults, pits, enclosed porches, and
other appendages. Outside steps , terraces, footings, courts, yards, light shafts, and buildings detached form main structure are not to be
included. ( Detached structures are to be separately computed).
Page 2 of 7
PLANNING BOARD
ZONING BOARD OF APPEALS
DESIGN REVIEW BOARD
TRAFFIC DEPARTMENT
DEPARTMENT OF PUBLIC WORK
TREE PRESERVATION COMMITTEE
ENVIRONMENTAL OFFICER
REFFERAL DATE STATUS RECEIPT # DATE COMMENTS
Section VI - OTHER CITY DEPARTMENT APPROVALS: ( To be filled in, where applicable, by Building Department Staff.)
Section VII - AFFIDAVIT OF OWNERSHIP:( To be completed by Applicant and notarized )
STATE OF NEW YORK
}
COUNTY OF WESTCHESTER
}
(PRINT NAME) (OWNER, LESSEE, ARCHITECT, BUILDER, CONTRACTOR)
being duly sworn, disposes and says: that
(PRINT NAME OF PRODERTY OWNER)
is the owner of the premises to which this application applies; that he/she (the applicant) is duly authorized to make this application; and that the
statements contained here are true to the best of his/her knowledge and belief, and that the work will be performed in the manner set forth in the application and
in the plans and specifications filed therewith, and in accordance with all applicable laws, ordinances and regulations.
Signature of Applicant/Contractor
Westchester County License#( if applicable)
Applicant Sworn Before Me This
Day of
20
NOTARY PUBLIC
(NOTE: The filing of this application does not constitute a permit to commence construction)
Section VIII - BUILDING OWNER CERTIFICATION (If applicable):( To be signed by Owner)
I, , hereby certify that i have full knowledge of the proposed alteration at my property as
described herein and take no exception to such activity.
Signature of Property Owner Date
Note: A notarized letter granting the above signed applicant permission to submit this application can be attached to application , in lieu of completeing owner certification.
Print Name & Title.
Section IX - BUILDER / CONTRACTOR CERTIFICATION:( To be signed by Builder or Contractor and witnessed )
I, , the Builder/Contractor, to the fullest extent permitted by law, shall save, keep , indemnify
and hold harmless the City of White Plains and their respective officers, officials, employees, and agents from and against all liability,
injury, loss or damage, cost or expense in law or in equity that may at any time arise directly or indirectly by reason of or in the course of
performing the work pursuant to the Building Permit, which may be occasioned by any willful or negligent act or omission of the permitee,
any of the permitee's employees, volunteers or any subcontractor. The foregoing provisions shall not be construed to cause the permitee to
indemnify the City of White Plains from it's sole negligence. The Builder/Contractor hereby agrees to perform said work strictly in
accordance with the conditions of the permit, the provisions of the Charter and the Ordinances of fhe City of White Plains , and the rules,
regulations, and specifications of the Department of Building.
Signature of Builder/Contractor Date Westchester County License # Signature of Witness Date
Name of Company or D/B/A
Print Name of Witness
Section IX - ARCHITECT/ENGINEER CERTIFICATION (If applicable):
I, , hereby certify that the plan (s) submitted herein were prepared under my supervision and to the
best of my knowledge are in compliance with the applicable provisions of the International Building Codes, Codes of New York, including
the White Plains Supplemental Code.
Signature of Architect/Engineer Date Signature of Witness Date
Print Name & Title.
Print Name of Witness
Page 3 of 7
70 Church Street, White Plains, New York 10601
Phone: (914) 422 - 1269 * Fax: (914) 422 - 1471
DEPARTMENT OF BUILDING
CITY OF WHITE PLAINS
Building Long Form Requirements12/18
http://www.cityofwhiteplains.com/
BUILDING LONG FORM REQUIREMENTS: ( VOLUME ADDED )
1. Six (6) topographic-survey-plot-plans and three (3) assembled sets of complete architectural,structural and
mechanical plans.
A. Topographic-survey-plot plans must show:
- Topography with appropriate contour intervals extended 10' into adjoining property. Location of buildings,
driveways and any retaining walls, with all dimensions and setbacks. Indicate all trees on private and city
property.
- Name of street, with elevations at center line of street.
- Reference grade to curb along center line of building and elevation of lowest finished floor and roof, if flat
roof.
- Location of utilities in street and connections to buildings. Indicate invert and rim elevations at manholes
closest to property side lines.
- Drainage system with detail of catch basin, and/or dry wells, and yard drainage, showing finished grade
elevations and detailed storm runoff pattern (using drainage arrows).
- Driveway profile from center line of street to garage floor or parking space. Indicate slopes by percent (%)
of grade. The driveway profile must indicate the following-" 1\\4 inch to 1 foot pitch from property line to
TOP of street curb". Elevations at center line of street, TOP of curb, and at property line must also be
indicated on profile. Where there is no curb, the elevation at center line of street is assumed as curb elevation
and should be so indicated.
B. Plans must include dimensioned floor plan, cross sections, details and elevations with existing and proposed
grades to property line.
C. Plans to include certification by a New York State Licensed Professional in accordance with the New York
State Energy Conservation Construction.
D. "Tree Protection Preservation and Reforestation Plan" : Submit said plan showing existing trees and
protection thereof per the Tree Preservation Protection Standards (see separate standards for design details).
2. Two (2) completed Building Long Form (Volume Added) with appropriate fee.
A. Affidavit of Cost Form must be filed for any job over $5,000 after completion.
3. For all construction costing $20,000 or any structural changes, submit one completed form entitled, "Designers
Affidavit for Approval of Plans and Specifications". Submit form entitled, "Owner's Affidavit for Provision of
Construction Field Inspection by a Licensed New York State Design Professional" in addition, owner's affidavit
for "Controlled Procedures by Design Professional" is required. Plans must be signed and sealed by a New York
State Licensed Professional Engineer or Registered Architect.
Page 4 of 7
Print Form
4. Provide certificates of insurance ( Accord Form) made out to The City of White Plains as Holder.
A. General Liability showing The City of White Plains as additionally insured for $1,000,000 coverage/occurrence.
Exception: Homeowners shall provide General Liability showing City of White Plains as additionally insured
for $500,000 coverage/occurrence.
B. Automobile Liability for $1,000,000 coverage CSL.
C. Statutory Worker's Compensation.
Exception: 1. Contractors with no employees, submit stamped NYS Worker's Compensation Board Form
#CE-200(12-08);#C-105.2 or U-26.3; #SI-12
2. Homeowners with no employees, submit a completed NYS Workers' Compensation Board form
#BP-1(9-07)
D. Statutory N.Y. State Disability. If no employees, please submit Applicant Affidavit Hold Harmless.
Exception: 1. Contractors with no employees, submit stamped NYS Worker's Compensation Board Form
##CE-200(12-08);#DB-120.1; #DB-155
2. Homeowners with no employees, submit a completed NYS Workers' Compensation Board form
#BP-1(9-07)
Any questions relating to NYS Worker's Compensation forms should be directed to the Board's Bureau of Compliance at
866-298-7830 their official website: www.wcb.ny.gov
5. Written approval from the Westchester County Department of Public Works, if any of the property bounds on a
County Road, or if there is any access to County Road.
BUILDING LONG FORM REQUIREMENTS ( VOLUME ADDED ): (continued)
6. Applicants for one and two family dwellings shall submit one completed "Look Alike Affidavit".
7. Separate applications and permits are required for the following: Electrical, Plumbing, HVAC, Mechanical
equipment, (elevators, conveyors, battery rooms, generators etc.), Hoistings, Fire Suppression systems, Fire Alarm
systems, Signs and Awnings.
8. File in person at Building Department. Plan/Review consultations and new Applications are processed between
the hours of 9am to 1pm.
9. Incomplete applications will not be processed and will be considered abandoned after six months.
10. Provide all fees in form of Check or Money Order.
11. Provide all applicable Building Zoning Ordinance Criteria in Tabular form on drawings. Refer to Building
Department Zoning Compliance Form for guidelines and format.
12. New York State Department of Environmental Control requirements for new one and two family projects:
A. Provide a completed "Short Environmental Assessment Form" (NYSDEP form) with application.
B. Provide an Erosion & Sediment Control Plan per standards outlined in Appendix E of the NYSDEP standards.
Ground Snow
Load (psf)
Wind Speed
(mph)
Seismic Design
Category
Weathering Frost Line Depth Termite Decay
Winter Design
Temperature
Ice Shield
Underlayment
Flood
Hazard
Subject to Damage From
20 125 B Severe
3' - 6'
Moderate to Heavy
Slight to Moderate
12 Yes
F.I.R.M.
(Sept'2007)
Page 5 of 7
1500
CLIMATIC AND GEOGRAPHIC DESIGN CRITERIA
52.2 degrees
Air Freezing Index Mean Annual Temp
Page 6 of 7
WHITE PLAINS BUILDING DEPT FEES EFFECTIVE 07/01/12 (updated 09/18)
RESIDENTIAL: ( One and two family dwellings)
1. NEW BUILDINGS & ADDITIONS -VOLUME ADDED ( cubic feet).
FEES:
1,000 to 5,000 = $110.00
Over 5,000 = $110.00 + $10.00 for each additional 1000 cubic feet (or part thereof)
Note: Minimum fee of $750.00 will apply for all new buildings.
2. ALTERATIONS, DEMOLITIONS, EXCAVATION, GRADING OR FILLING,
MECHANICAL INSTALLATIONS, HEATING, A/C, etc. - TOTAL ESTIMATED
COST ( dollars) - NO VOLUME ADDED.
FEES:
First $1,000 = $100.00
Each additional $1,000 = $100.00 + $10.00 for each (or part there of) $1,000 additional cost.
3. PLUMBING SYSTEMS - TOTAL ESTIMATED COST (dollars).
FEES:
First $1,000 = $50.00
Each additional $1,000 = $50.00 + $30.00 for each (or part there of) $1,000 additional cost.
4. ELECTRICAL PERMITS - TOTAL ESTIMATED COST (dollars).
FEES:
First $1,000 = $85.00
Each additional $1,000 = $85.00 + $10.00 for each (or part there of) $1,000 additional cost.
5. PLAN AMENDMENT $100.00 each amended plan.
6. TEMPORARY CERTIFICATE OF OCCUPANCY $75 per inspection.
7. CERTIFICATE OF OCCUPANCY IS $75.00 per inspection.
8. SUBSTITUTE/ UPDATED CERTIFICATE OF OCCUPANCY :$50.00 per inspection.
MISCELLANEOUS FEES:
1. TEMPORARY STRUCTURES - tents, reviewing stands, etc. $50.00 each.
2. REINSPECTION ALL TRADES - $100 per occurrence.
Exception: Vertical Transportation- $200 per occurrence.
Scheduled inspection cancellation without 48 hours notice-$200/occurrence.
3. SIGNS - $50.00 per sign plus $2.00 per sq. ft. of sign display surface.
4. AWNING / CANOPY - $25.00 each.
5. BUNTING - $50.00 each.
6. HOISTING PERMIT - $200.00 each.
7. LEGALIZATION - Two(2) times calculated permit fee per trade/permit.
8. PERMIT REACTIVATION - $150.00
9. SPECIAL PERMIT, SITE PLAN & ZONING FEES - See separate chart
10. Rental Registry Program- $125 for 1
st
Dwelling Unit + $10/each additional unit.
Rental Registry Program- Annual renewal fee = 50% of Initial fee
Page 7 of 7
WHITE PLAINS BUILDING DEPT FEES EFFECTIVE 07/01/12(updated 09/18)
MULTI-FAMILY DWELLINGS & COMMERCIAL CONSTRUCTION:
1. NEW BUILDINGS, ADDITIONS, ALTERATIONS, DEMOLITIONS, EXCAVATION, GRADING OR
FILLING, MECHANICAL INSTALLATIONS, HEATING, VENTILATING, A/C, SCAFFOLDING,
PAVING, FIRE SUPPRESSION SYSTEMS, ELECTRICAL INSTALLATIONS, etc. - TOTAL
ESTIMATED COST ( dollars).
FEES:
First $1,000 = $100.00
Each additional $1,000 = $100.00 + $15.00 for each (or part there of) $1,000 additional cost.
2. PLUMBING SYSTEMS - TOTAL ESTIMATED COST (dollars).
FEES:
First $1,000 = $75.00
Each additional $1,000 = $75.00 + $30.00 for each (or part there of) $1,000 additional cost.
3. PLAN AMENDMENT $200.00 each amended plan.
4. TEMPORARY CERTIFICATE OF OCCUPANCY $75 per inspection.
5. CERTIFICATE OF OCCUPANCY INSPECTION: (Minimum $300)
- CONDOMINIUM :$75.00 per unit.
- MULTI-FAMILY DWELLINGS (RENTALS)$25/unit.
- HOTELS, MOTELS etc.: $25.00 per room.
6. SUBSTITUTE /UPDATED CERTIFICATE OF OCCUPANCY INSPECTION:
- MULTI-FAMILY DWELLING: $80.00 minimum plus $10.00 for each dwelling unit over three, up to
a maximum of $300.00.
- NON -RESIDENTIAL BUILDING: $100.00 per certificate.
MISCELLANEOUS FEES:
1. TEMPORARY STRUCTURES - tents, reviewing stands, etc. $50.00 each.
2. REINSPECTION ALL TRADES - $100 per occurrence.
Exception: Vertical Transportation- $200 per occurrence.
Scheduled inspection cancellation without 48 hours notice-$200/occurrence.
3. SIGNS - $50.00 per sign plus $2.00 per sq. ft. of sign display surface.
4. AWNING / CANOPY - $25.00 each.
5. BUNTING - $50.00 each.
6. HOISTING PERMIT - $200.00 each.
7. LEGALIZATION - Three(3) times calculated permit fee per trade/permit.
8. PERMIT REACTIVATION - $150.00
9. SPECIAL PERMIT, SITE PLAN & ZONING FEES - See separate chart
11. OCCUPANCY POSTER- $35/Year.
12. CABARETS: Bldg Fee- $500 (New application) $100 Annual Bldg (Renewal)
SP/Zoning Fee- $500 (New application) $500 (Renewal Special Permit)
13. OUTDOOR DINING: Bldg Fee- $500 (New application) $250(Annual renewal)
14.
Rental Registry Program- $125 for 1
st
Dwelling Unit + $10/each additional unit.
Rental Registry Program- Annual renewal fee = 50% of Initial fee
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