HomeMy WebLinkAboutWater sign off 3/2/23 4" 0 kr
`€V a1 WATER DEPARTMENT
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BUILDIN(; PERMIT APPLICATION FOR
1VA'i'E:R DEPARTMENT SIGN OFF
TRANSMITTAL FORM
lit II.t)ING SITE LOC 1TIO : °C
'lI lifill Rd
PROPOSED WORK: (�;G1 f- f3o.o.. (%... 1 Y`L -' ( (.,,,,, c
APPLic\\T- 670e-
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ADDRESS: 5, Pr,--- , SY----:
u_..fed--- likkaSe 1124 °A .L7C
IEPIONE. (----- e-yi c -�J 7_ .x?..... I_
RESIDENTIAL AND -'OR COMMERCIAL Bt 1f_DING �R'�'r Y !j •
Water Depart mein l)c L nnnie:(`"inpl ,iiiCe of t1"a€er A3,ialabihi)• and or exi.tuts- 1(1""on
?ngmecring Department: Dctcnaunes Compliance for Parking and Drainage
C'r}nser‘ation Commission: I)encrnancs Compliance to Wetlands Act: a-c.if hots)birder any type of
wetlands, atteatims, ptxids, risers,ocean,bogs, boss, marshland_Ft('
f tcalth Department: I)eterniine ('onslili it ce to State and I Rceulziti,m.. i e.
requirements fir Scptate Disposal and other Public I IcaIth.Actir ites
Fire I)epainient: Determines Compliance to State and Town Requirements for Personal
Safe ° Property Protections, i.e.Smoke Detectors, Sprinkler Spsterns.etc
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Appyi 1NT SI(;\,ATt`RF: l)I I..
OF >•: ESE: COMMENTS ON PERM I APPROVAL OR DF:At ii.l.
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RE VIE ;I)III N, Al ER DIVISION(SIGNAEt RE) DATE