HomeMy WebLinkAboutImage_028YARMOUTH WATER DIVISION
99 BUCK ISLAND ROAD
WEST YARMOUTH, MA 02673
PH.: 508.771 .7921
FAX: 508-771-7998
BUILDING PERMIT APPLICATION
DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET
Bldg. Site Location 7 Fillmore Rd [4ap #: Q3 Lot #: 67
Proposed Improvemertonstruct,a2 iedroom, 2 bath. 1 study addition willr basement
Applicant: Brian
addressgg D€iby St,L,l!_rySbqrn rer. #:7q1-6_0q-784! _ Dare Frted: 6lj1l2O
MA 02043
RESIOENTIAL AND / OR COMMERCIAL BUILDING
lvafer Department.
Engineenng Depa.tment :
Conservatron CommisEaon
Health Depatment
Frre DeparIment
Determines Compliance of Water Availability and o|. Existing Locdtron
Determines Complrance for Parking and Drainage
Determines Comphance to Wetlands Acts; r.e. If Lot(s) Border any Type of
Wetlands, Streams, Ponds, Rrvers, Ocean, Boqs, Bays, Marshland, Etc
Determrnes Comp[ance to State and Town Regulations, i.e., Requirements
for Septage Disposal and other Publc Health Actrvities
Determines Comp!ance to State and Town Requirements for Personal,
Safely, Property Protectron;, i.e. Smoke Detectors, Sprinkler Sysfems, Etc
6t11t20
Signature of appliaant
COMMENTS;
Da te
PLEASE NOTE:
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Reviewed by: Water Oivision
PROPOSED
36'X20'
ADDITIONo
No
36
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EXISTING
BUILDING
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WOR K MUST FORM TO ALL
TOWN Y REGULATI
YARMOUT WATER DEPT
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Richard A'NAME ' 11297-4?A . Crovrley
STREET 7 Fillmore Road - Lot 43
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vILLAGE llest Yarmouth
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