HomeMy WebLinkAbout2008 Jul 22 - Sign Off Transmittal Sheet, Plot Plan - Swimming Pool . ,
°��Y`��o TOWN OF YARMOUTH
�� � y HEALTH DEPARTMENT
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��"°""",�c� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
7'o be completed by Applicant:
Building Site Location:__�� �a���'�%'� �� Map No.: /!�, Lot No.:�
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Proposed Improvement: ��5��� � l�.,� 3b� /«J9i�;���,-�G' �c-t! r�.t� � � T'(11?� '
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Applicant: (��c��Ft,c� ��rv0.� �r Tel. No.:.�U�6 �,��� ` 9� 7 9
Address: .� �'j��j �'t�( �-/n� �T �a �� � s l G b t,� (� f� Date Filed: �``� � ���
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**Ifyou would like e-mail notifrcation ofsign off,plerrse provide e-mail address: '
Owner Name: �� �2 f �'LtA�'/'�<f- l��/�wt Ct�
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Owner Address:�� <'R2.�QA�cc��l. �!�• /�t 2�-cc1�"��j�,r"' Owner Tel. No.: ��''�1 y " �'�Z��
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RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements.
For Septage Disposal and other Public Health Activities.
Please submit four(4) copies of plans, to include:
(l.) Site Plan showing egisting buildings, water liae location,
: and septic system location;
(2,) Floor plan labeling ALL rooms within building
(a�l ezisting and proposed)—
Note:Floor plaies not required jor decks, sheds, windows, roofing;
(3.) If necessary, Title 5 appl�cation signed by licensed installer
� with fee.
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REVIEWED BY: _,� DATE: % .�� ��.�'
PLEASE NOTE
COMh�NTS/CONDITIONS:
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ELEV.=68.0' �V'•
LDT 17
49,593 SFf p
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Y�AMOU H WA R OE�T '
FOUNDATIC)N PLUT PL�A►N °�E #°'-°49
PREPARED EXCLUSNELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTNER USE
LOCATION : 23 CARRIAGE LANE YARMOUTH PORT, i�1A ;
SCALE : 1" = 50' DATE : MARCH 27, 200$ '
REVISED DATE : APRIL 3, 2008 — GARAGE FOUNDATION PREPARED FOR:
REFERENCE : ASSESSOR'S MAP 112 P A R C E L 4 8 pETER TR�����IAN
LOT 17 LCP 23966C � . '
I HEREBY CERTIFY THAT THE STRUCTURE �'` `�� �`'s.` `�' �
SHOWN ON THIS PLAN IS IOCATED ON THE `�x �`` ' JuT�`' `� i: ;
GROUND AS SHOWN HEREON. �� 2f � i , j
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V LANO SUR✓EmRS DATE ��'` RE . LAND SURVEYflR
939 Moin Street - YARMOUTHFORT, AlAS�
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