Home Occupation Application
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This is the Town of Centreville Home Occupation Application form used to register a business run from a residence. It gathers applicant and contact information, business location and name, a description of activities, square footage used, proposed alterations/renovations, materials and equipment, how products/services are provided, days/hours of operation, client visits and deliveries, and whether hazardous materials are involved. The applicant must sign under penalty of perjury, any alterations/renovations require a permit, and a zoning administrator must sign; the form also defines a home occupation (family-run, limited outside employees, and restrictions on products sold or stocked).
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THE TOWN OF CENTREVILLE 101 LAWYERS ROW CENTREVILLE, MD 21617 410-758-1180 FAX 410-758-4741 WWW.TOWNOFCENTREVILLE.ORG HOME OCCUPATION APPLICATION Applicant/Business Owner: Home Phone: Mailing Address: Business Phone: Cell Phone: Business Web Address: Email address: Location of Business: Street Address City State Zip Property Owner (if different from applicant): Property Owner Address: Street Address City State Zip Name of Business: Briefly describe your business and types of activities occurring in the residence: Business use of home: Total square footage of residence Square footage used for business including storage Alterations/renovations proposed to residence: Materials/equipment to be used: How are products distributed or services provided to customers: Days and hours of operation: Will clients/sales people visit the residence: (cid:1) Yes (cid:1) No Frequency: Will deliveries be made to the business? (cid:1) Yes (cid:1) No Frequency: Will business involve the use of hazardous materials? (cid:1) Yes (cid:1) No Describe: Applicant signed and declared under penalty of perjury that all of the submitted information is true and correct to the best of his/her knowledge and belief. He/she understands that any misrepresentation of submitted data may invalidate any approval of this application. He/she understands and will comply with the definition and conditions of a home occupation described on the back of this form. Applicant’s Signature: **ANY ALTERATIONS / RENOVATIONS REQUIRE A PERMIT** Signature – Zoning Administrator Date W:\0-PERMITS\APPLICATION Permit Forms\2015-Oct applications forms\Home Occupation Application.doc Rev. 12/8/2015 THE TOWN OF CENTREVILLE 101 LAWYERS ROW CENTREVILLE, MD 21617 410-758-1180 FAX 410-758-4741 WWW.TOWNOFCENTREVILLE.ORG WHAT IS A HOME OCCUPATION An occupation or business conducted only by members of a family residing on the premises, and conducted within the dwelling or a secondary structure, provided that no product is sold or stocked except as is produced on the premises or dispensed in connection with a service that is rendered. In addition to members of the immediate family, up to two additional employees may be permitted by special exception. Home occupations shall include such customary and incidental uses such as, but not limited to, the office of a resident physician, dentist, architect, engineer, attorney, contractor, real estate agent, insurance agent, accountant, or similar professional person. W:\0-PERMITS\APPLICATION Permit Forms\2015-Oct applications forms\Home Occupation Application.doc Rev. 12/8/2015