HomeMy WebLinkAbout2015 Sep 10 - Sign Off Transmittal Sheet, Plot Plan - Inground Pool � ����� �:�r�.�� �w�.��.,�
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,�« PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: .S� �/U�S"f 7 Q (✓►�(h..f7/1 It-pcC� W Yc+��ry�4 ��
Proposed Improvement: ' (o k � �- --�'Y1��'�t''��,�--�� �
APPlicant: v ^ {` � ✓i � !t f Vu�_. Tel.No.:_ ��"7 3 o�'J`��~t�
Address: �Z.( t,�.,��1�"`�c rw�r���-K /`�F� Date Filed: /D 1 �
**Ifyou would like e-mail notification ofsign ofJ;please provide e-mail address: ���`��' ���yY , j , t G-�„
Owner Name: LC��rz� �j�-�.�
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Owner Address: �(� vu.� a S G �J 0� Owner Tel.No.: y�f-���i�
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RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
For Septa.ge 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 ezisting and proposed) —
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWED BY: � C� ' DATE: I�%(J '�
PLEASE NOTE
COMMENTS/CONDITIONS:
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PROPOSED �
16' X 32'
POOL _.
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TO THE BEST OF MY INFORMATION, PROPOSED PLOT PLAN
KNOWLEDGE, AND BELIEF THE WEST YARMOUTH, MASS.
FOUNDATION SHOWN ON THIS PLAN LOT 3, PL. BK. 328 PG. 40 f
HAS BEEN LOCATED ON THE GROUND DATE_8/7�2015 SCALE 1" = 50' ;
AS INDICATED. � JOB 4635-00 CLIENT DUBLIN
�$ � 20�5 ��=�-�' SWEETSER ENGIN�'ERING �
203 SETUCKET ROAD
DATE PROFESSIONAL LAND SURVEYOR o�. 508 38° so 13 SOUTH DENNIS, Ma o 08s o�-699� '
C: I S8 I PROJ I 4635-DO I dwg � 4635-03-POOL-PPP.DWG � 2015 SWEETSER ENGINEERING ,