HomeMy WebLinkAboutBP signoff 9.20.22 0,'-7Y:.qR
o - \C) Conservation Office
i y TOWn of Yarmouth bdirienzo(c�yarmouth.ma.us
r,:-. 7:..,7,0g`' �� Conservation Commission
MAT �
Building Permit Sign-off Application
TO BE FILLED OUT BY BUILDING PERMIT APPLICANT:
Building Site Location: i 3-. V Q.-Wick; AV-a-r1/4;4-'.C.::. 442_1110 U't1-f M A c .GIS
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Lot(s)# ). 0
Property Owner i LE:si--ii . ki' t c Date filed: g*1 l a.
*Applicant: 1--- ..:, .i'.,tr41.L,T V 4.c.N
Applicant Address: ( l_ .vi — - c. A-J
Email L.4 tC O) _st-k- (v a. t . Cc -\ Telephone: 5t) 8 C l Q- C'6 (
Please note:by suppitting this application,thea licant grants permission to the Conservation Office to enter the location to conduct a site visit(if needed).
Proposed Project Description:
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Site Plan Title/Date: t I G12 �:T AT-Q&, W G S T\i%V2-v o t-1 i K�S S s' (
TO BE FILLED OUT BY CONSERVATION ADMINISTRATOR:
Does the proposed project require a permit? i<S
Refer to: SE83- ?„3 2) \ or DOA permit
Comments from Conservation Commission: Approved Conditionally Approved \. Rejected
Conservation Commission Sign-off Signature. 01t, 0 Date: 9 - IZZ
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*TO APPLICANT:
All work-related debris shall be taken offsite or disposed in a legal upland location. At the end of each
day, the area shall be clean and no debris shall be in the Resource Area.
If work is permitted under an Order of Conditions, please arrange a pre-construction site visit with the
Conservation Administrator. At the time of site visit, the MassDEP File Number sign must be installed,
along with the erosion control/work-limit line. A copy of the Order of Conditions must remain on-site
during construction. Please refer to the Order of Conditions for further details.