HomeMy WebLinkAboutShed - water sign off 4/26/23 Ot Y.Ut TOWN OF YAR\t('L'TI I
4
ro WATER DEPARTMENT
t �,r 97 Buck Eland Road
XV4,t}armouth MA I2(
- 5qr1 -7t•7921 • Fa\.i 08,7-1•'998
BUILDING PERMIT APPLICATION FOR
WATER DEPARTIIENT SIGN OFF
TRANSMITTAL FORM
BUILDING SITE LOCATION:f' f'p/U /it . S VQjj,, ,t ,266'q
PROPOSED WORK �-t o!Jet s'r, _
APPLICANT: LG-rj-A•. 11(Tc
ADDRESS: c$O ,,, - 1...
'fl LPHONE: 4 4- 2 a/P t g-p t7 YvS71 r�w1(, G9 i—
RESIDE"I IAL AND'OR COMMERCIAL BUILDING
V\(itcrDc(ummenC I)ctenninrs Compliance of Wafer Atailahilitp and orest:nine location
Engineering Department Determines Compliance for Parking and Drainage
C'onervation Commission: Determine,Compliance to Wetland:Act:i c.WINO)border any type of
it et lands.streams.ponds,ricors.cxum.bogs.ho)s,marshland.ETC...
I Icalth Department. Di act Is mil Compliance to State and Ion n Regulations,i c.
requirements or Septage Disposal and other Public health Activitcs
Fire Depanmenl: Ucicrnutus Compliance to State and Town Requirements for Personal
Safety.Ptolemy Protections,i.e.Smoke Detectors.Sprinkler Systems,eic
CFPLICANTSIGNATURE DATE
OFFICE USE:COJIJIFNTS ON PERMI I'APPROVAI.OR DENIAI.
4--243Z g
REVIEWED Y R`AT.R.R DIVISION(SIGNATURE) DATE