HomeMy WebLinkAbout2016 Aug 01 - Sign Off Transmittal Sheet, Plans, As-Built Sketch : ...a�m,,,,�.,�--_, �, . - . �,� .-��..-�--.-�
q
oY.-Yq� TOWN OF YARMOUTH
. �,,,. �
y�� �-,� HEALTH DEPARTMENT °
o:..�,. -. -,���. ;
��'''���%��� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
� To be completed by Applicant:
� . Building Site Location: �'T , U�✓�O�.rt `"�
T
Proposed Improvement: ���� j�'„� ;�j���/�i��%/}?�� �(/�
� �b �l,u r►� t N�t��, '" . 1����r7_5 lv�V t � �c� . �
�IG t �c'1 r ✓CJ�"l r�a. "?�' ��Z VuoM�'1 C.N.1 �.,' J`' r/(I/ ( t
.—�—
Applicant: ���. �� G( �1(,{,�ih.�„ Tel. No.:�;v�-�0�'��P/.�
Address: I� ,�i.,� t'Vt i,�t' �lLi� a+�.�IU�, /M f�` ,p 7,,�{ps„3 Date Filed: � / �r�
**Ifyou would like e-mail notification ofsign off,please provide e-mail address:
Owner Name: �6t r'1 Cr/�/� ��(,�,��
Owner Address: �� '� �(�� /7��t/J .,�1i" Owner TeL No.:�1?�j�a-S 3c.'7G
.:.........:.......................:....�'.�....�.....-....... :..�.:�,.C..�._.a..��....�....�1..�=::.
� .. ...yt......................................................................................................................................................... �.
...................................................
RESIDENTIAL AND/OR COMMERCIAL BUILDING ,
�� HEALTHDEPARTMENT: Determines Complia�ce 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:
(l.), , 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:Floar plans not required for decks,sheds, windows, roofing;
�.)' If ne�c�ssa�y, Title 5 application signed by licensed installer
__.�._.�.�- with fee.
.................................................................................................................................................................................:.....................................................................................................................................................................:...............
REVIEWED BY; DATE: � � ��' �
PLEASE NOTE
COMMENTS/CONDITIONS: a��
� �-� a --�.z ���,���., � ���2.
_ � . m� . � ';
,
i
� Cape Cod Septic Inspection
Discount Septic Pumping
PO Boz 1466,Harwich,MA 02645
508-240-2500
i
Randy Darwell 6/13/2016
� 687 Main St
Harwich,MA 02645
a
i
�
RE: 294 Old Main Street S.Yarmouth,MA 02664
As�built
; �
i �Q�
� :
_ _ _ _ �
I
i �
2
3
Q ¢----����e�
CeSs�ooi
O Al-30-0 B1- 14-10
2-36-0 2- 18-0
3-42-0 3-22-8
- 7-0 4-37-2
5- 5-2 5-22-4
' ��� , :'�""
_ � - �:
����.-.____..�....._..�.�r.� '.
� �` i'' JI III � �
COATS
4'-7"
40 01 oe
i
r
�CONL00�
a,
AAN1820
RECEIVED
AUG 01
2016
EALi}� ®EP%
p AN " FOP,
ppUpOS�b I�Up��X � S
f?W �
131�1/�N MUI�f�NY & f�/�NbY PA
PRAWN f3Y._.
PL-Q
YA[�MOUTI-t MA
3 ,
PAS
6 19 I6
ON;
294 OLb MAINS
c PRAWING NLIMDER
I� O� N 11? CtION SHALL
ALL MAT�I?IPJ:-� ANi2 M�TNO S CO S U
>MA5 ACNUS�tTS STATI% �UIL.tJING COYJ�,A135�NC�
CONFOI'M TO TNC 5
V p A4 OF'4
OF 51'�G�IC ITEMS I�I20M f�K:AWINGS YJOFS NOT pFLl� � ANY AJ2TY
EI?OM COY)E pEQUI[vE/v1ENT5