Fillable Insp-25 TOWN OF HUDSON

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Insp-25 TOWN OF HUDSON

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U.S.A. forms for Town of Hudson

BROWSE TOWN OF HUDSON (NH) FORMS

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INSP-25 - Rev. 7/2016
TOWN OF HUDSON
FIRE DEPARTMENT - INSPECTIONAL SERVICES DIVISION
12 School Street · Hudson, New Hampshire 03051 · Tel: 603-886-6005 · Fax: 603-594-1142
CERTIFICATE OF OCCUPANCY APPLICATION
This Certification of Occupancy Application shall be completed and
submitted to the Inspectional Services Division a minimum of two
weeks prior to the date of the desired permit.
All applicable fees due to the Town of Hudson shall be paid in full at
the time of submission.
Certificate of Occupancy Application fees:
Residential $100.00
Commercial/Industrial $200.00
Please confirm the exact amount due with the Inspectional Services
Division at the time of submission.
INSP-25 - Rev. 7/2016
TOWN OF HUDSON
FIRE DEPARTMENT - INSPECTIONAL SERVICES DIVISION
12 School Street · Hudson, New Hampshire 03051 · Tel: 603-886-6005 · Fax: 603-594-1142
CERTIFICATE OF OCCUPANCY - PLEASE PRINT
Address: ___________________________________________________________
Type of Construction: _____________________________ Unit #_________
Office use:
Map: _________
Lot: _________
Zone: _________
Permit #’s
Building: _______________ Electrical: _________________ Plumbing: _________________
Fire alarm: _______________ Sprinkler: ______________ Tank installation: ______________
Mechanical (gas or oil): ________________
Sewer
or Septic
Town Water
or Well
Fire Alarm System Yes
No
Fire Sprinkler System Yes No
Commercial/Industrial Uses
Will the applicant/owner manufacture, assemble or produce any product, regardless of water use?
Yes
(Need IDA Form) No (Need IDA Checklist)
*Please consult the Town Engineer at 886-6008 with any questions
(NEW BUSINESS: PLEASE SUBMIT A BUSINESS SURVEY FORM UPON APPLICATION)
Proposed Use: _____________________________________________________________________
Name to Appear on Certificate: ______________________________________________________
Date Certificate Requested For: ______________________________________________________
____________________________________________ _____________________________
Signature of Applicant/Owner Phone
_____________________________
Print Contact Name
Email: _____________________________________
Please Do Not Write Below This Point
State of NH Septic Approval for Operation #: _____________________________________________
Dated: ____________________ Number of Approved Bedrooms/GPD: ________________________
EPA Laboratory Water Test #: ____________________________ Dated: ________________________
*Copies of the State of NH Septic Approval of Operation and EPA Laboratory Water Test are
required at the time of Certificate of Occupancy application.
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Insp-25 TOWN OF HUDSON

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Completed 13 July 2020

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