HomeMy WebLinkAbout2015 Aug 28 - Sign Off Transmittal Sheet, Plot Plan - 2nd Floor Deck; Change Masonary Deck , � _ . - - a.� � _ ,. __ _ .____ � _-p-�„-,
of�'�r TOWN OF YARMOUTH I
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HEALTH DEPARTMENT
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'�•_••`� � PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET I
To be completed by Applicant:
Building Site Location: ll C(�i2C2\RVC �--tl�U�� �H.2c10�7C1��o�' --
Proposed Improvement: qO� ��9 �tr�p(2. '7EG�.' ti G�,A�c9E �R�Y.�eY i�Ec_�{
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+k�►('�) s6o-bso - 3'760
Applicant: l�l�L��c5�1 L p x�. � �os�c.,-�. Tel. No.: �5C�6 � ��
Address: 10"1 �EAc3�1 ��. k�rc�tul5 ��G}. c��G,'�f�. Date Filed:
••Ifyou would like e-marl notifrcation ofsign off,please prwide e-mail address:
OwnerName: �ETEa_ � ��i��UA �RO+�"C�14�
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OwnerAddress: �� ����A�` �..�Nr� ��q�2 ov'C�'� ���i'� OwnerTel. No.:
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RESIDENTIAL AND/OR COMbIERCIAL BUILDING
HEALTH DEPARTMENT: Determines Cornpliance to State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Healih Activities.
Please submit three (3) copies of plans, to include:
(1.) Site Plan showing ex�sting buildings, water line location,
and septic system 1 `"ation;
(2.) Floor plan�abelin�ooms within building
(all eaistin�nd_pro ose�
Note:Floor plans nor��'ar�yireil or decks,sheds, windows, roofing;
(3.) If necessary, Tit�-g"application signed by licensed installer
with fee.
__........................................._................................_........._.. .............................................. .................................:..............................................................._...........................................................................................................
REVIEWED BY: �VGy DATE: ��� / �
PLEASE NOTE
COMMENTS/CONDITIONS:
Yarmont6 Heaith Deportmeat
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' LANE
' 40> .� n�
� �pRNprE �L,2p1.63' u
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, `PG, - ��a
I ('jP�¢ � Replace Brick Step
i w/ Nantucket Stoop;
�, 4' x5' w/ 2Steps
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MAP 112
PARCEL 48 N �� � ���
`s MAP 112 �Jr �
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Auc o 20�5
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New Porch & Roof o ������ � �GyWAY
Deck; 10' x 16' �
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PN2CEL'�� ]2.1.7
FOUNDATION PLOT PLAN DCE #14-312
PREPARED IXCLUSNELY FOR 7HE PURPOSE OF OBTAINING A BUILDING PERMIT. NOT FOR ANY OlHER USE
LOCATION : 23 CARRIAGE LANE YARMOLITH PORT, MA
SCALE : 1" = 50' DATE : MARCH 23, 2015 PR F
REFERENCE : ASSESSOR'S MAP 112 P.�RCEL 471 I,E TMAN
I HERE6Y CERTIFY hIAT THE STRUCTURE � � �ANIEL
SHOWN ON THIS PLAN IS LOCA7ED QN THE �'l �N��.
GROUN� AS SHOWN HEREON. �; ,a, -
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down cope �e»gineering, inc. 3_-Z-y _�� � � y3,�`-v�� �� _
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GAND SURYEYORS
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939 Main Strce[ — Y A R M IX J 7 H P O R T, u w s s. �A T E REG. LAND SURYEYOR
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