Certificate Of Occupancy Form
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CERTIFICATE OF
CCUPANCY FORM
COB
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COH
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BUSINESS:
HOME OCCUPATION:
BUSINESS ADDRESS:
APPLICANT’S INFORMATION
APPLICANT NAME:
TELEPHONE:
MAILING ADDRESS:
FAX NUMBER:
PROPERTY INFORMATION
ZONING DISTRICT:
PREVIOUS/CURRENT USE:
YES
NO
Will there be any interior or exterior modifications or renovations?
Will there be any plumbing or electrical work performed?
BUSINESS INFORMATION
TYPE OF
BUSINESS/NAME:
(HOME OCCUPATION APPLICATIONS ONLY)
YES
NO
Will anyone be employed other than members of the family living on the premises?
Will anything be visible from the exterior to indicate that this is being used for
anything other than a dwelling?
Will the occupation be conducted in your house (i.e., office, workshop) and not in
your detached garage or accessory building?
PLEASE READ RULES ON REVERSE AND PROVIDE SIGNATURE
I, the undersigned, have read the aforementioned provisions and certify that I will comply with the City
Code of the City of Winchester and the Zoning Ordinance pertaining to the operation of my
business/home occupation.
Signature:
Date:
FOR OFFICE USE ONLY
Date Received:
Temporary Certificate of Occupancy Issued:
Tax Status:
Permanent Certificate of Occupancy Issued:
Building Official Review:
Certificate of Occupancy Revoked:
Zoning Administrator:
Proposed Use _____is _____is not
approved.
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Parent category: Business