Town Of Warner Certification Of Structural & Life Safety Code Compliance (Page 2 of 2) in pdf

TOWN OF WARNER

CERTIFICATION OF STRUCTURAL & LIFE SAFETY CODE COMPLIANCE

I, (Contractor/Builder) __________________________________________________________Representing (DBA),

_____________________________________________________________________________Do hereby certify on this date

__________________ that all New Hampshire Energy Code related components and systems installed in the struc-

ture located on (Address)_________________________________________________________, the Town of Warner, New

Hampshire meet or exceed the standards of the New Hampshire Energy Code, and comply with the statements

made on my Application for Certificate of Compliance and approved by the Public Utilities Commission (approval

number) ________________________________. Any person who violates the provisions of the Energy Code (RSA

155:D) shall be guilty of a misdemeanor.

________________________________________________________________________

Signature of Builder/Contractor

CERTIFICATION OF NATIONAL ELECTRIC CODE COMPLIANCE

I, (Electrician) ___________________________________________________, New Hampshire licensed master electrician

(License #) ___________________, representing (DBA)_________________________________________do hereby certify

on this date ________________________________ that all electrical work installed in the structure located on (Ad-

dress) ______________________________________________________, in the Town of Warner, New Hampshire, meets

or exceeds the requirements of the current National Electric Code.

________________________________________________________________________

Signature of Electrician representing the above company

CERTIFICATION OF PLUMBING CODE COMPLIANCE

I, (Plumber) ______________________________________________________________, New Hampshire licensed plumber

(License #) ___________________________________representing (DBA) ___________________________________________

do hereby certify on this date ________________________________ that all plumbing work installed in this structure

located on (Address) ________________________________________________in the Town of Warner, New Hampshire

meets or exceeds the requirements of the current Plumbing Code.

_________________________________________________________________________

Signature of Plumber representing the above named company

Upon completion of the structure, the above certifications shall be signed by the builder,

electrician and plumber and submitted to the Building Inspector. The signed certifications are

required before an Occupancy Permit is issued.

Town Of Warner Certification Of Structural & Life Safety Code Compliance Page 2