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HomeMy WebLinkAbout2014 Dec 12 - Sign Off Transmittal Sheet, Plans - New Basement; Master Bedroom Addition ;Of�AR,� TOWN OF YARMOUTH � ' "-'c� HEALTH DEPARTMENT � '^�_�``` x PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: BuildingSiteLocarion: ���j �'n�) ��„n �M�� ni�'(n ' �� ILP S • fUr/�'�� �0� Propo�ImprGovement: 2�-a� \ � (�C W GUI�G� (�-e �A tPvn r�n j-- �r'l�,✓ �r c�o.t Nc-c.�1 h S-��WP�Q Lc �L Applicant: �h c� �5 �/C.���/'^ Tel.No.: �� S�i�}-'/ �f� I Address: a � 1'1 G „S P-Y �}-� ��f' S� »�v"i cl� J.✓i G Date Filed: �1 I •s/fyou would like e-mar/notifrcatron ofsrgn off,please prwrde e-mail address: Owner Name: �C�/a-,{�„/ �a 7SJ k S Owner Address:�� ,,-�� Owner Tel. No.:��c�—d,S��j ....._..._....._......_._......._..........__...._....._........................_..............................._......................._................................................................................................................................_.................._............._.............._................. RESIDENTIAL AND/OR COMA�RCIAL BUILDING �, HEALTH DEPARTMENT: Deternunes 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 showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all ex�sting and proposed) - Note:Floor plans not required for decks,sheds, wdndows, roofing; (3.) If necessary, Title 5 application signed by licensed instailer with fee. _............................_........................... REVIEWED BY: �_ DATE: / d��/�//� � PLEASE NOTE COMMENTS/CONDITIONS: a (��,�I vu�.k, .�.� a l��w�a.� ti REVISIONS: NO. DATE DESC. I CERTIFY TO THE BEST OF MY PROFESSIONAL KNOWLEDGE, INFORMATION AND BELIEF THAT THE LOT CORNERS, DIMENSIONS AND SETBACKS TO THE STRUCTURE AS DETERMINED BY INSTRUMENT SURVEY AND AS SHOWN ON THIS PLAN ARE CORRECT. .,SNOFA4q_�„ CRAIG A- FIELD N No.38039 LAND PROFESSIONAL LAND SURVEYOR DATE CERTIFIED PLOT P WITH PROPOSED HOUSE LOCATION AT ;poo INDIAN MEMORIAL. DR, IN SOUTH YARMOUTH MASSACHUSETTS (BARNSTABLE COUNTY) DECEMBER 9, 2014 DEC 12 2014 . HEALTH DEPT. PREPARED FOR: MARY & ARTHUR BROOKS 100 INDIAN MEMORIAL DR. SOUTH YARMOUTH :MA 02664 B, SC GROUPs 23 ' 349 Route 28, Unit D West Yarmouth, Massachusetts .02673 508 778 8919 © 2014 The BSC Group, Inc. SCALE: 1" 20' 0 2.5 5 10 MEnRS ff MZZ 0 10 20 40 nmr PROJ. MGR.: CRAIG FIELD FIELD: A. NELSON CALC./DESIGN: K. HEALY DRAWN: K. HEALY CHECK: CRAIG FIELD FILE: 9862-EXC-1.DWG DWG. NO: 6264-03 SHEET 1 OF 1 JOB. NO: 4-9862.00 . i .. .. I I1 1 . . CI I .% . .. I -1 __ \ .. - 1 \ I . . 1 REVISIONS NO. DATE COMMENTS A. I. DRALIM BY: : DE51GNED BY: MDH 5CALE: CHECKED BY: AS NOTED JOB NUMBER: Z . F- Q H Z ?_Z 7 J � � v Q J O O REVISIONS NO. DATE COMMENTS A. I. DRALIM BY: : DE51GNED BY: MDH 5CALE: CHECKED BY: AS NOTED JOB NUMBER: FILE NUMBER: DATE 155UED: I