CITY OF HAVERHILL
BUILDING DEPARTMENT

APPLICATION FOR FOUNDATION PERMIT

PLEASE PRINT LEGIBLY

Project Location:_________________________________ # of Units______________

Applicant/Owner:
Owner’s Name:___________________________________________________________
Owner’s Address:_________________________________________________________
Owner’s Tel.#_________________________________________

Applicant/Contractor:
Contractor’s Name:________________________________________________________
Contractor’s Address:______________________________________________________
Contractor’s Supervisor’s License #__________________ Expiration Date____________
Contractor’s Tel.#______________________________

Description of proposed project:_______________________________________________
_________________________________________________________________________

Debris Location:____________________________________________________________

Cost/Valuation:___________________________

City Plot Plan – Room 214 _______________ Conservation Dept. – Room 205__________

Residential:______________________ Commercial:_____________________

Foundation Size:__________________ Foundation Type:__________________

Foundation Thickness:_____________ City Water:_______________________

Private Well:_____________________ City Sewer:_______________________

Private Sewage System:____________ Smoke Detector Permit #____________

Attached Garage:_________________ Detached Garage:__________________

PLEASE NOTE: SITE PLAN REVIEW PROCESS MUST BE COMPLETED PRIOR TO SUBMITTING THIS APPLICATION FOR PERMIT.

AN ACCURATE SET OF HOUSE PLANS AND ENERGY REPORT MUST BE SUBMITTED WITH THIS APPLICATION.

ALL NECESSARY PERMITS AND AUTHORIZATION LETTERS MUST BE SUBMITED WITH THIS APPLICATION.

Incomplete applications will not be date and time stamped.