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HomeMy WebLinkAbout2015 Aug 31 - Sign Off Transmittal Sheet, Plans - New Deck � __ _ _ _ : _ n. _ ,���_ � __ __ _ , - � ` � + _ .. � �� E��,� °� TOWN OF YARMOUTH �.� � � _�� � :�="` HEALTH DEPARTMENT o -� � �;� �. ?' ^• �• PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant. Building Site Location: �0 [�Q,�IJ I IJ� �e j Aemovt�, mp� oa.�� Proposed Improvement: ��c.x 1�1 P.1.1� � �GIC, a � Applicant: `\OT�I�S � t �llmES Te1.No..C�rJr�-��J�Q—Iot3� n c'4lF�d $lal — k Address: �D �0,1C��)NP l �Q Date Filed:��� i ' O t� 'sIJ'yau would like e-mail notifrcation ofsign off,please provide e-mail address: Owner Name: �[L�'Q 10 S t �� I YY1�S ' Owner Address: � � 'i' �R S f�N� �� Owner Tel.No.: �- '� �� I _............._....W.......t 1�.4...�.C�.r.va.�....,..._...t�J,�l°�..........:..Q...._.2.�_�..�.."�.........................................................._...............................__...........................__....................._........... � RESIDEIVTIAL A�iD/OR COMMERCIAL BUII.DING HEALTH DEPARI'MENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. , Please submit three (3) copies of plans, to include: 1. Site Plan s6owin existin,g buildings,water line location, � ) g � � and septic system location; �:r: �:� (2.) Floor plan labeling ALL rooms within building ' (all existing and proposed) — Note:F[oor pla�rs not required fb dec ,sheds, windows, roofing; rs Ij (3.) If necessary, Title 5 application signed by licensed iostaller ' with fee. I I ..._.._............._.........................._.............._............._........_............................................................ ........................................................................................................................ ....l...._.. .........................._........................... REVIEWED BY: � DATE: � � S � m , PLEASE NOTE COMMENTS/CONDITIONS: I r R�q�H�•... �, ° MA!' lS PA�E � REF: S�TE � SEWRG� P�RN t�EY:_\I'2A-95__ Pi1RCEL N BooK 203 Paq6�? �� �:' C u R��NY �.oe�7i�� ,'tf�P 20tY�,vG R- 25 �+taP �q � :J7' d� � ia,�e3 + Sa. SE76AC�S QA�C�I. (0.25 ± q�� F 30' S �O' R 20' ,yh•� FLvoD ZONE R f2 �EL t0� -t�{I¢.2� ,�5. 3 _._�,_ �- - ..u.:�..� i6(�. �p` .}4•� 9' �.9 '� �o �� 8, e' � � i-- - - - � t — � � ^ ` ' r S' ` I - - - -Ji ` � � 1 I S °�Posg�-- . —-� ._ � � 1� / 0 9/ _ S 'l38SF � 7.9' � _ O j 1 0 . � � ����.X�.�/�.f!' ^� .. ' ` j � . � �� ��L��+� � O i'r� . / ..•�4� . .�f.i. = ��:� t fl / . . f q. 8 h � � �� ,' / ,` Tq_� . $.4 �� — — — ,f -��.��.--= � '� _ � �' � � �`V�.�i,tP�� . . �1 i. � r ��Q���ti t �I.+�� , t / . �� � � i ;� � � - ,- - �y � j, ` e . __ � , � , � �° ��.�. �• _ ,,,�.,.�. ,._..[ � ��-- - `�.Z 7. 4- 7. 9 Ft�tr t)�PAV��,6� C�RK�rV�lt.� C1,�'� 31? ' ' ' TO fJARKERS .t'� iV E1� � W�i'T �R LN'l.e`e"�' G3GC�C�OMGDD � � AUG 31 T015 � � HEALTH DEPT. � �oo FRo��N-D"�-__--"�- �AI ME.S �PRoPE.R'T`t _ _ _ � �'k� BARKEN'CtNE C�C� Se.Yhevrw�sTFi BY------------ ------ ---------. DATE ---- ---------------- CHKD. BY._---- DATE---- - -------------- ZAt___1..---._f1E4 SUBJECT. --- - -------------- Z� -w, --------------------- : ---------------------- T -- - ------- �RE�.-F ------- G /X T SHEET NO.-------I----------OF ----------- JOBNO.,--------------------------- ------------------- 3hcv- *"/�a� 1�9,ek- No,r e S., ALL PT. CoNsT, SSD 7�lRD AQ C-A- e;f. /,% 't V I 1 1-1 �>ccKlwGj (PT ) 11 I - 5A Moe + y"�R)IJVTQ 4��� ij, E L —ok VIRE CIAALE QA kL tNj S (t et)) ,S4f.w 4, -a � " SIVE. � S V-ruj A, G E 'BOOK 20-4, Loc.ft-r(c�j,, mA\p t5 , �PrrFt- wGz POWT,X