OCCUPANCY PERMIT CHECK LIST
STORIES_______ï¿½ï¿½ BLOCK________ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ PERMIT#_____________
PROJECT, BUSINESS, OWNER'S NAME___________________________________________
UNIT, LOT, STREET #_____________ ADDRESS__________________________________
THE ABOVE INFORMATION MUST BE FILLED OUT PRIOR TO REQUESTING SIGNATURES OF
ANY PERMIT TO OCCUPY A RESIDENTIAL, COMMERCIAL OR INDUSTRIAL BUILDING OR
UNIT REQUIRES THE FOLLOWING LISTED CITY DEPARTMENTS TO SIGNIFY TO THE
BUILDING INSPECTOR THAT THEIR RESPECTIVE REQUIREMENTS APPLICABLE TO THE
OCCUPANCY OF THE ABOVE CITED BUILDING,LOT,UNIT, ARE IN COMPLIANCE. YOU ARE
REQUIRED TO PRESENT THIS ORIGINAL FORM TO EACH OF THE DEPARTMENTS/BOARDS
CITED BELOW FOR THEIR APPROVAL PRIOR TO SUBMITTING THIS FORM TO THE BUILDING
INSPECTOR TO REQUEST AN OCCUPANCY PERMIT.
WATER DEPARTMENT 125 AMESBURY RDï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL.ï¿½ 373-8487ï¿½ï¿½ï¿½ï¿½ï¿½
The water department advised that the required water service (s), meter(s), lines and appurtenances to service the building/unit/lot above have been installed, inspected and meet with the Water Department's Approval.
WATER DEPARTMENT ROOM 300-4 SUMMER ST. HAVERHILL, MA 01830
The Water Billing Department verifies that the bldg/unit/lot above is connected to the city sewer system which will create a wastewater bill.
SEWER-C/O ENGINEERING DEPARTMENT ROOM 214-4 SUMMER STï¿½ï¿½ ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 374-2335
The city Engineer advised that the required engineering service (s), meter (s), line (s), and appurtenances to service the building/unit/lot above have been installed, inspected and meet the City Engineer's Approval.
HIGHWAY DEPARTMENT HOURS 7AM-3PM -ï¿½ 500 PRIMROSE ST ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 374-2360
The Highway Superintendent advised that the required street/R.O.W. improvements to service the building/unit/lot above, have been installed, inspected and meetthe Highway Department's Approval.
CONSERVATION COMMISSION ROOM 205-4 SUMMER STï¿½ï¿½ï¿½ï¿½ ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 374-2334
The Conservation Commission advised the required improvements approved under Order of Conditions #_____ have been substantially completed to service building/unit/lot above.
PRIVATE WATER SERVICE-C/O HEALTH BOARD ROOM 208-4 SUMMER ST ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 374-2325
The Board Of Health advised the required private well necessary to service the building/lot/unit above has been installed, inspected and meets with the Board of Health Approval
PRIVATE SEPTIC SYSTEM - C/O HEALTH BOARD ROOM 208-4 SUMMER ST ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 374-2325
The Board Of Health advises that they have on file written certification from the Disposal Installer and the Designer of the septic system necessary to service the building/unit/lot above, that the septic system was constructed in compliance with 310 CMR 15.000, the approved design plans and all local requirements, and that changes to the design plans have been reflected on as-built plans which have been submitted to the Board of Health, and meets with the Board's approval.
BOARD OF HEALTH APPROVAL FOR FOOD SERVICE ESTABLISHMENTï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL.374-2325
The Board of Health advises that when a food establishment is to be constructed, extensively remodeled, an existing structure is to be converted to use as a food establishment, or a new operation is to be added, the
applicant must adhere to the requirements of 590.058 of the State Sanitary Code for Food Establishments. A floor plan and menu must be submitted prior to approval. FOOD ESTABLISHMENTS ARE REQUIRED TO HAVE DUMPSTERS FOR THE DISPOSAL OF THEIR REFUSE.
WASTE WATER DIVISION APPROVAL FOR FOOD ESTABLISHMENTSï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 374-2382
The Waste Water Division requires a sewer discharge permit for food establishments in accordance with City Ordinance 208-31I B (18).
FINAL PLUMBING & GAS INSPECTION - ROOM 210-4 SUMMER ST ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 374-2341
The Plumbing & Gas Inspector advises that only the licensed plumbing contractor request this inspection.
FINAL ELECTRICAL INSPECTION -ROOM 210-4 SUMMER STï¿½ï¿½ ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 374-2341
The Electrical Inspector advises that only the electrical contractor request this inspection.
FINAL SMOKE DETECTOR INSPECTION - FIRE DEPT. 17 HAMILTON AVE ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL.373-8460
The Fire Department advises that requests for final smoke detector inspections be made in advance. An inspection fee may apply.
FINAL RESIDENTIAL FIRE SPRINKLER INSPECTION 17 HAMILTON AVE ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 373-8460
The Fire Chief advises that requests for fire sprinkler inspections be made in advance, and only with the licensed sprinkler installer.
FINAL INSPECTION-BUILDING INSPECTOR ROOM 210-4 SUMMER ST ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ TEL. 374-2338
The Building Inspector will accept requests for final inspections from either the homeowner or the licensed contractor providing all of the above inspections have been made and meet with each Department's requirements.
RETURN THIS COMPLETED FORM TO THE BUILDING INSPECTOR'S OFFICE AT WHICH TIME
AN OCCUPANCY PERMIT MAY BE ISSUED.ï¿½ BUILDING INSPECTOR'S ARE IN THE OFFICE
8:00 to 9:00 A.M. AND 3:00 TO 4:00 P.M. MONDAY - FRIDAY.
ALL OCCUPANCY PERMITS ARE TO BE SIGNED BY A BUILDING INSPECTOR.