General Building Permit fillable
document center
| Pages | 1 |
|---|---|
| File Size | 0.1 MB |
| Folder | Departments/Building |
| OCR Status | Searchable (OCR processed) |
| Source URL | Original |
Document Preview
Full Text (OCR Extracted)
ESTIMATED COST $_________________________ TOWN OF WATERFORD, CT - BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT ROOFING, SIDING, REPLACEMENT WINDOWS, FLOORS, FIREPLACE, WOOD STOVES LOCATION INFORMATION: Property Address_____________________________________________________Unit #__________Waterford____Quaker Hill____ Owner _________________________________Leasee___________________________Telephone # ( )_______________________ Address________________________________________________________________________________________________________ Street City/Town State Zip Code CONTRACTOR/AGENT INFORMATION: Contractor/Agent_________________________________________________________Telephone # ( )___________________ Address_____________________________________________________________________________________________________ Street City/Town State Zip Code Contractors License #_____________________________________Expiration Date_______________________________________ Workers Compensation insurance submitted? YES______ NO_______Affidavit YES_______ NO_______ PERMIT REQUEST: Purpose of Permit_______________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ The owner of the above property guarantees that all the applicable requirements of the Town of Waterford, Zoning Regulations, CT Basic Building Code and the CT Public Health Code in so far as they apply to the design, erection and location of the building described in this application will be strictly complied with. And also authorizes the Planning & Zoning Commission, Building and Health Department and its staff to enter upon the property in question for the purpose of inspection and enforcement with regard to all of the above requirements. Property Owner Signature__________________________________________________ Date______________________________ Printed Owner’s Name____________________________________ Email Address _______________________________________ Contractor/Agent_________________________________________________________ Date______________________________ Printed Contractor/Agent Name____________________________ Email Address _______________________________________ I hereby certify that the proposed work is authorized by the owner in fee and I have been authorized by the owner to make this application as his authorized agent. *************************************************************************************************************** OFFICE USE ONLY TC [ ] UC [ ] BUILDING PERMIT NUMBER ___________________ FEE $_____________________ Final Inspection Date: ______________ STATE FEE $______________ Inspector: ________________________ TOTAL $__________________ F:\PUBLIC\WS\FORMS\Building Permit.doc SIGN