Form Center

2. 
3. Application for Demolition Permit
4. 100 Winnacunnet Road Hampton, NH 03842
6. Building Address:*
7. Unit #:
8. Map / Lot / Zone
10. Building Owner:
11. Phone Number:
13. Owner's Street Address:
15. City:
16. State:
17. Zip Code:
19. Mortgagee/Lein Holder's Name:
20. Phone Number:
22. Mortgagee/Lien Holder's Address:
24. Mortgagee/Lien Holders Signature:
26. In the event thre is NO Mortgagee / Lien Holder then the following certificate is required by the owner. I hereby certifiy that there are no mortgages and that I own the property free and clear of any mortgage.
28. Owners Signature:
30. Signatures from the following departments:
32. All Property Taxes Current / Tax Collector:
33. No Hardship Liens / Accounting Office:
35. Department of Public Works:
36. Assessor's Office:
38. Hampton Fire Department: (Chief or Designee)
39. Aquarion Water Works:
41. Unitil - Electric:
42. Dig Safe #:
44. Unitil - Utilities:
45. Abestos Survey - Please attach copy of survey to this form.
47. Conservation Commission (603-929-5808)
49. State Permit Required

    1. Yes
    2. No
50. Special Permit Required

    1. Yes
    2. No
51. Type of property

    1. Residential
    2. Commercial
53. Where the Permit should be mailed

    1. Owner
    2. Contractor
55. Contractor's Name*
56. Phone Number*
58. Mailing Address*
60. I agree to comply with all local, state, and national codes relative to the demolition and disposition of all hazardous and non-hazardous material and provide documentation of proper disposal by a Certified Abatement Contractor.
62. I further certify that I will hold the Town of Hampton harmless and indemnify the Town of Hampton from any claims arising out of the demolition.
64. Signature of Applicant:
65. Date:
70. For Department Use Only
72. Fee $50
73. 1. Cash
74. Check #
76. Application Approved
77. Building Official
78. Date:
Leave This Blank:


79. Print Only

* indicates a required field