Demolition Permit (PDF)
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| Pages | 1 |
|---|---|
| File Size | 0.1 MB |
| Folder | Departments/Building/Forms & Reference Documents |
| OCR Status | Searchable (OCR processed) |
| Source URL | Original |
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Estimated Cost $_____________ Fee $____________ P:\Forms\Demolition Permit.doc TOWN OF WATERFORD, CT PERMITTING / BUILDING DEPARTMENT APPLICATION FOR DEMOLITION PERMIT PERMIT NUMBER ______________ DATE _______________________ Job Site Address:______________________________________________________________Year Built:______________________ Size of Main Building:_____________________ Area:________________ Number of Stories:___________ Year Built:__________ Outbuildings:____________________________ Area:________________ Number of Stories:__________ Year Built:___________ Foundation / Footing Material:___________________________________________________________________________________ List Demolition Method and Equipment:___________________________________________________________________________ Owner:___________________________________________________ Phone:____________________________________________ Street: ______________________________________________________________________________________________________ City: ________________________________________________________ State:__________ Zip:__________________________ Owner’s Signature___________________________________________________________________________________________ Demolition Contractor:_______________________________________________________ Phone:___________________________ Street:__________________________________________________ City:_______________________________________________ State:________ Zip:________________________ State License Number:________________________________________________ Insured With:_____________________________________________________________________ (Please attach copy of Certificate) *Attach receipts of notification to adjoining property owners. SEE SECTION 29-406 CONNECTICUT GENERAL STATUTES Property Damage:_______________________ Certificates Received:_____________________________ Aggregate: ___________ UTILITY SERVICES DISCONNECTED, AS REQUIRED BY CONNECTICUT GENERAL STATUES SECTION 29-406 Electric: Yes______ N/A______ Water: Yes______ N/A______ Gas: Yes______ N/A_____ Sewage: Yes______ N/A______ Cellar Hole Filled__________________________________ Septic Tank Emptied / Removed:_______________________________ Gasoline Storage Tanks Removed: ___________________________ Debris Removed:_____________________________________ Asbestos Survey Provided: Yes______ No______ Lead Paint Abatement: Yes______ No______ I hereby agree to conform to all the requirements of the laws of the State of Connecticut and to notify the Demolition Officer of any changes in these specifications for which this permit is asked and described in this application. Contractor’s Signature: __________________________________________________________ Date:______________________ Delay of Demolition: Yes_____ No _____ Building Unfit & Hazardous: Yes____ No_____ Approved On:_____________________________ Demolition Officer:___________________________________________________