HomeMy WebLinkAbout2015 Sep 30 - Sign Off Transmittal Sheet, Plans - Additions to Back of House 2of�e o TOWN OF YARMOUTH
��� HEALTH DEPARTMENT
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^�/ PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
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Building Site Location: � ��� / �, ,(� v � �/� G Y G�'� 0�) ��'I t�0 � � �
Proposed Improvement: a � �- � ��� s �o � G� -� � -, r, ✓ s �
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Applicant: � -�' i � .:� %�/ iJ h �.) Tel. No.:�'���'� .�i��� ����� �
Address: � /%�c �/ � ��.��ia v ���� �.,�_i�T�� Date Filed: ���
•*Ifyou would like e-mail notrftcation of sign off,please provide e-mail address:
Owner Name: � /`
Owner Addres� � i � / Uwner Tel. No.: � '�c�-���-6 .3`�
RESIDENTIAL AND/OR COMNIERCIAL BUILDING
HEALTH DEPARTMENT: 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 showing existing buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed) —
Note:Floor plans not tequired for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWEDBY: DATE: ��
. .,
PLEASE NOTE �
COMMENTS/CONDITIONS: y,� /�� �
I�U �'S C f U / �Z a-�1 c{ t vt /�.- ��vacn,.- � ,
�r ��h � �-v � I u ua v e- c v w�,�,L �,�- < < —
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ZONING DISiRICT: R-40
FRONT: 30�
SIDE: 20'
REAR: 20'
FLOODZONE X
PROP. BLDG. COVERAGE:19.6% F����
8�' c�Rc<F
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P' '�.0
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25.86 �
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�j�z� 26.36
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',• EXIST. /
,v DRIVE. ; .3z E%IST. STOCKADE FENCE
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y ' :3i� . 2oi ��—\ z s
�� � i � �1 � � EXISi1NG SEPTIC TANK
� `� ��? � 5'� �—� TO BE RE—LOCATED (OR
Q. °' / o REPLACED WITH 1500
� / Q EXISi1NG GALLON SEPTIC TANK),
� DWELLING 0 MINIMUM 10' FROM
.zs.eo o �2. FOUNDATIONS/LOT LINES.
HOLD TOP OF TANK
ro ELEV. OF 25.2'
IAT IB .92 0� �.
71,564t SF j ^ PROPOSED EXPANSIONS
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' SEP 3 0 2015 ��'��V�� , ��9s✓ ,,.
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T,yYqR��th'K `,'� �h
PLOT PLAN °`'��, ,s�242 � �< �� ;
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PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHE�t`i�4f •'��� i�
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LOCATION : $ MATTIS DRIVE, YARMOUTH PORT �'�_^%
SCALE : 1" = 30' DATE : SEPT. 3, 2015 PREPARED FOR:
REFERENCE : MAP 141 PARCEL 13 R�i GI UNO
DB 1444 PG. 1039
�SNOF,U�S
I HEREBY CERTIFY THAT THE STRUCTURE o`'`�DANIELs�cyL„
SHOWN ON THIS PLAN IS LOCATED ON THE
GROUND AS SHOWN HEREON. < A °'+����
�> OJALA s�!`;
� on sae-a�z-wi ,o No, 40980 I�
fm SOB]82-9880
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C/OW/7 CO ELAND SURUEYORS inc. ---�-3— l / — —_----i—� 6��� \
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939 Main Street — YARMOU7HPORT, M.qss DATE REG. LAND SURVEYOR
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