ADDRESS OF DEMOLITION: ________________________________________________________
Demolition is scheduled to begin on: and be completed by:
Method of Demolition:
Applicant Signature: Contact #
Signature Date
Auburn Engineering Dept.
60 Court Street
Tel: 333-6600 Fax: 333-6625
Auburn Water & Sewer District
268 Court Street, Auburn
Tel: 784-6469 - Fax: 784-6460
Auburn Fire Department
550 Minot Avenue, Auburn
Tel: 784-5433 - Fax: 784-3283
Auburn Highway Department
296 Gracelawn Road, Auburn, Maine
Tel: 333-6670 - Fax: 782-4187
Unitil ATTN: Mark Allen
Email: allenm@unitil.com
Tel: 541-2502 - Fax: 797-3763
CMP Company - Julie Goodell
740 Main Street, Lewiston Maine
julie.goodell@cmpco.com
Tel: 629-4510 - Fax: 629-4910
Consolidated Communications– Tracy Porell
Tel: 985-3513 - Cell: 595-0090
Email- tracy.porell@consolidated.com
Charter Communications - Christopher Dugal
Tel: 555-3110 - Fax: 786-2563
Email- christopher.dugal@charter.com
Permit Number:____________________________________Address: ____________________________________________Owner:_______________________________
Note: This Department is not responsible for changes in any of the information provided above. It is suggested that you contact each agency prior to visiting them to
confirm contact persons and hours available. Have you adhered to all asbestos requirements?
As the responsible agent of the company, utility or City Department indicated below, you are hereby notified of the intended demolition of the above
mentioned building(s) and of the contractor’s method of demolition and your signature below will verify that you have been notified and that
appropriate action has been taken to terminate any service connection of your utility and to remove all appurtenant fixtures which belong to you.
Building Dimensions: __________________________________ Square Footage__________________
For Official Use Only
Date
Issued:______________________________
Zone:_______________________________
Map No.: ___________________________
Bldg. Code: _________________________
Est.Cost: ____________________________
Fee: _______________________________
Owner Address: ______________________________________________________________________________
Contractor: _______________________________________________Cell #_________________________
Project Description: _DEMO of:__________________________________________________________________
Economic & Community Development
City of Auburn
Owner: __________________________________________________Cell #_________________________
DEMOLITION PERMIT
Application
W:\DEMO Related\DEMO Permit Application Revised-3.8.19
Instructions for Completing the Asbestos Inspection Form
Contact: (207) 287-2651
State and Federal laws require that buildings be inspected for asbestos-containing materials before
renovation or demolition activities begin. To determine whether you need to have an inspection
performed by a Maine-licensed Asbestos Inspector, or whether you can have an evaluation performed by
a knowledgeable non-licensed individual familiar with asbestos containing building materials, (e.g.
building inspectors and CEO’s who have asbestos-awareness training) depends on the age of the building,
current/past use, and number of units. If you are renovating a building you need only inspect the area(s)
that will be impacted by the renovation. If you are demolishing the building, the entire structure must be
inspected.
For projects in single family residences and residential buildings with less than 5 units, please read and
answer the questions on the Asbestos Inspection Form
provided on the reverse side. You are not required
to submit the form to our department, however, you should sign and keep a copy for your records. If you
answer Yes to any question, you need to have your building inspected by a Maine-licensed Asbestos
Inspector.
Except as noted above, the following applies:
Buildings other than residential buildings with less than 5 units
(ie institutional, commercial,
public, industrial) must be inspected by a Maine-licensed Asbestos Inspector.
Residential buildings with 2-5 units that were built before 1981
can be surveyed for likely
asbestos-containing materials by knowledgeable non-licensed people (e.g. building inspectors and
CEO’s who have asbestos-awareness training); any materials likely to contain asbestos must be
tested by a DEP-licensed inspector or assumed to be ACM.
Single-family residences and residential buildings built after 1980
are not required to be surveyed
for asbestos-containing materials prior to demolition (residential buildings built after 1980 are not
likely to contain ACM).
In lieu of any required inspection you may assume suspect material to be positive for asbestos
and have it removed accordingly. You may never
assume material to be non-asbestos.
If your renovation
project will impact more than 3 square feet or 3 linear feet of asbestos containing
materials, the ACM must be removed by a Maine-licensed asbestos abatement contractor prior to
renovation, except single-family homeowners may remove some asbestos under certain circumstances
(Contact DEP for more information). Before you can demolish
any building, including single-family
residences, all asbestos materials must be removed from the building; again the removal of ACM must be
done by a Maine-licensed asbestos abatement contractor. Once the asbestos is removed, the renovation or
demolition project may be performed by any preferred contractor.
With the exception of a single family home, building owners are required to submit the Asbestos
Building Demolition Notification to the DEP at least five (5) working days prior to the demolition
EVEN IF NO ASBESTOS is present.
If you have any questions or need assistance completing the forms do not hesitate to call the Maine DEP
Asbestos Program at (207) 287-2651. You may also go to
www.maine.gov/dep/rwm/asbestos/index.htm to access forms and other information on asbestos.
Asbestos Building
Demolition
Notification
State of Maine
Department of Environmental Protection
Lead & Asbestos Hazard Prevention Program
17 State House Station, Augusta, ME 04333
TEL (207) 287-2651 FAX (207) 287-6220
FORM
D
Page 1 of 2
2015
Notice
Prior to demolition, building owners must determine if there is any asbestos-containing material(s) (ACM) in the
building. An “asbestos inspection” by a MDEP-licensed Asbestos Consultant is required for all buildings
regardless of construction date, except single-family homes and residential buildings with 2-4 units built after
1980. In lieu of an asbestos inspection, pre-1981 residential buildings with 2-4 units can be
surveyed to identify
possible ACM by someone knowledgeable about ACM, such as a c
ode enforcement officer or building
inspector.
If your project involves the demolition of a single family residence or a residential building with less than 5 units,
please answer the following questions to determine whether you need to
have your inspection performed by a
MDEP-licensed Asbestos Consultant:
Does this demolition/renovation project involve more than ONE residential building at
the same
site with the same owner?
Is this building currently being used, or has it EVER been used, as a commercial,
government, daycare, office, church, charitable or other non-profit place of business?
Is this building to be demolished as part of a highway or road-widening project?
Is this building part of a building cooperative, apartment or condo building?
Is this building used for military housing?
Have other residences or non-residential buildings at this site been scheduled to be
demolished now, or in the future, as part of a larger project?
Is more than ONE building to be lifted from its foundation and relocated?
Will this building be intentionally burned for the purpose of demolition or fire department
training?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
If you answer ''no'' to all the questions above, your building can be inspected by a
knowledgeable non-
licensed person as applicable.
Any ''yes'' answers to the above questions requires an inspection by a MDEP-licensed Asbestos
Consultant.
Important Notice
Before you can demolish any building, including single-family residences, all asbestos materials must be
removed from the building. The removal of those materials must be done by a MDEP-licensed Asbestos
Abatement Contractor, except single-family homeowners may remove some asbestos under certain
circumstances (Contact MDEP for more information).
With the exception of a single family home, building owners are required to submit the Asbestos Building
Demolition Notification to the MDEP at least five (5) working days prior to the demolition EVEN IF NO
ASBESTOS is present.
Asbestos Building
Demolition
Notification
State of Maine
Department of Environmental Protection
Lead & Asbestos Hazard Prevention Program
17 State House Station, Augusta, ME 04333
TEL (207) 287-2651 FAX (207) 287-6220
FORM
D
Page 2 of 2
2015
Inspection/Survey Results:
Were asbestos-containing building materials identified or presumed positive?
If Yes, is the removal of ACM subject to MDEP asbestos regulations?
If No, explain WHY NOT: __________________________________________________
Yes No
Yes No
property address:
building description:
pre-1981 residential with 2-4 units
post-1980 residential with 2-4 units
othe r:
asbestos survey/inspection performed by: (name & address)
telephone:
asbestos abatement contractor
telephone:
property owner: (name & address)
telephone:
demolition contractor: (name & address)
telephone:
demolition start date:
demolition end date:
Whenever more than 3 square feet or 3 linear feet of ACM is identified, the ACM must be abated in accordance with the
Maine Asbestos Management Regulations by a DEP-licensed Asbestos Abatement Contractor. This includes materials
presumed to be ACM. Check www.maine.gov/dep/rwm/asbestos/index.htm for a listing of asbestos contractors.
Prior to issuing a local demolition permit, the MDEP requests that municipalities have applicants for municipal demolition
permits complete this form and fax it to the MDEP at 207-287-6220. Municipalities should not issue local demolition
permits if the required asbestos inspection or survey has not been performed and identified ACM removed.
This demolition notification does not take the place of the Asbestos Project Notification if applicable
I CERTIFY THAT THE ABOVE INFORMATION IS CORRECT
_________________________________________________________________________________________________
Print Name: Owner/Agent Title Signature
____________________________________________________________________________________________
Telephone # FAX # Date
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