Demolition Waiver - Town of Carleton Place

Demolition Waiver Form

This form shall be completed by the applicant, and submitted with the application for permit, where demolition work is likely to affect the items listed below.

Civic Address Number and Street Name

Description of Demolition Work

Building Safety and Occupancy

If the proposed demolition will affect the safety of the occupants of the building, or if the demolition will remove any of the conditions of occupancy listed under Division C Subsection 1.3.3. of the code, prior to any demolition taking place, the building or part of the building shall be vacated, or measures shall be taken to ensure that safety of the occupants is not affected.

If the demolition involves removal of the entire building, or removal of a portion of the building, the demolition will be undertaken in a manner that does not affect adjacent buildings or adjacent properties, and the site of the removed building will be cleared of debris or refuse and left in graded and levelled condition.

Designated Substances and Asbestos

Prior to demolition, materials that contain or that are likely to contain designated substances regulated by the Occupational Health and Safety Act, including but not limited to asbestos, will be examined and tested in accordance with the applicable regulations.

Second ChoiceIf materials that contain designated substances are found, and they are removed, disturbed, or affected by the demolition work, the designated substances will be handled, managed, or disposed of in accordance with the applicable regulations.

If materials that contain designated substances are found, notice will be provided to any Building Inspector or Town employee, prior to their entry into the building or work site, informing them of the materials found, and confirming that the work site is safe for entry in accordance with the Occupational Health and Safety Act and designated substances regulations.

Services and Infrastructure Disconnection

First Prior to demolition, if any excavations are to be undertaken to remove or disconnect underground services or infrastructure on the property, a request for locates will be submitted and completed through the Ontario One Call system, in accordance with the Ontario Underground Infrastructure Notification System Act.

Second ChIf removal or disconnection is required for any services, prior to the removal or disconnection, approval will be obtained from the owner/operator of the service/infrastructure, including but not limited to the following listed below, and the removal/disconnection will be performed to the requirements of that agency: o Hydro One o Enbridge Gas o Town of Carleton Place Public Works Department for Water, Sanitary, and Storm services o Bell, Rogers, telephone, cable, or internet providers

Name

First Last

Date