HomeMy WebLinkAboutMiscellaneous - 158 FOREST STREET 6/27/1996 FORM U - VERIFICATION FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: Phone
LOCATION: Assessor' s Map Number Parcel lei/9 A7M
Subdivision Lot(s)
Street `'f'�s r S/ �i St. Number �S
ial Use Only************************
RECOMMEND ONS OF T GENTS:
Date Approved
Conservation Administrator Date Rejected
Comments vulk, Jele
1 ( 1 A t Date Approved (�
Town Planner Date Rejected
Comments
Date Approved
Food Inspector-Health Date Rejected /
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_J tlL Date Approved (� �7�
Septic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector Date
FORM ® U ® LOT RELEASE FORM i ( '
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IN RUCTIONS: This form is used to verify that all necessary approval/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
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APPLICANT �:--I� �'r, ti a-y c� PHONE
ASSESSORS MAP NUMBER b�. LOT NUMBER .9 U
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RECOMMENDATIONS OF TOWN AGENTS
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DATE APPROVED
CONSERVATION ADMINISTRATOR
DATE REJECTED
CONMIEN'TS
DATE APPROVED
TOWN PLANNER
DATE REJECTED
CoM yffiNTS
DATE APPROVED
FOOD INSP TOR TH DATE REJECTED
DATE APPROVED
SPTI IN CTOR-HEALTH
`= DATE REJECTED
COMMENTS l
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PUBLIC WORKS-SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
DATE APPROVED
FIRE DEPARTMENT
DATE REJECTED
COMMENTS
RECEIVED BY BUILDING INSPECTOR DATE
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FORM U ® LOT RELEASE FORM iti+ S BA S.ec�c
INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
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APPLICANT U`2 o PHONE
ASSESSORS MAP NUMBER LOT NUMBER
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STREET STREET NUMBER
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RECOMMENDATIONS OF TOWN AGENTS
DATE APPROVED
CONSERVATION ADMIINISTRATOR
DATE REJECTED
COMMENTS
DATE APPROVED
TOWN PLANNER
DATE REJECTED
COMRVIErTTS
DATE APPROVED
FOOD INSP,Ef CTOR-'HEALTH DATE REJECTED
DATE APPROVED
SEPTIC INSPECTOR-HEALTH
DATE REJECTED . ��/�
COMtyIENTS
PUBLIC WORKS-SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
DATE APPROVED
FIRE DEPARTMENT
DATE REJECTED
CON94ENTS
RECEIVED BY BUILDING INSPECTOR DATE
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