demolition permits utility sign-off sheet

DEMOLITION PERMITS
UTILITY SIGN-OFF SHEET
Prior to the issuance of demolition permits by the Building Division, the applicant
is requested to notify utility companies. Please obtain signatures below to certify
that notification for removal of utility services or equipment has been received by
the utilities listed below.
NOTE:
The demolition, dismantling or moving of a building or structure shall be
commenced or continued only when all existing gas, electrical and other
services that are likely to endanger a worker having access to the
building or structure have been shut off and discontinued.
The
Occupational Health and Safety Act, 1978 Section 158 158-B.
UTILITY
Address of Proposed Demolition: __________________________________
Name of Owner/Contact Person: __________________________________
Demolition Contractor: __________________________________________
Contact Name: ________________________________________________
Phone Number: ________________________________________________
Is building vacant?
Yes
No
Vacancy Date:
COMMENTS OR CONDITIONS OF APPROVAL
City of Guelph Water – 519-837-5627
Waterworks Place (Off York Road)
Billing Address for Services:
Company Name: ___________________________
The water meter is to be removed and returned to the Waterworks Department. Please call for final inspection.
**NOTE** APPLICANT CHARGED EQUIVALENT METER CONNECTION CHARGE IF WATER METER IS NOT
RETURNED.
Comments: __________________________________________________________________________
Contact Name: ____________________________
____________________________________________________________________________________
Address: ______________________P/C: ______
____________________________________________________________________________________
Phone #: ______________ Fax: _____________
____________________________________________________________________________________
Signature ____________________________________
Date _________________________
1-855-228-4898 ext. 5111118
(Reference Energy Act, 1971 Section 18)
Signature ____________________________________
Date _________________________
Mike Pontes
Guelph Hydro
395 Southgate Drive, Guelph
Phone: 519-837-4733
Fax: 519-822-4963
Email: [email protected]
** 48 HOURS ADVANCE NOTICE REQUIRED**
(Reference Public Utilities Act, Section 50 Sub-Section 3)
The demolition contractor and property owner must ensure all commission equipment is de-energized and removed
prior to demolition.
GUELPH PLANNER
Union Gas Company
FAX 1-866-263-0581
Signature ____________________________________
Date _________________________
PLEASE NOTE: Any other utilities not listed above (Bell Canada 519-744-0065, Rogers Communications 519-894-8138)
should be the responsibility of the owner to contact prior to demolition.
March 2014
Building Services
T 519-837-5615
F 519-822-4632