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Home My WebLink About2016 Aug 23 - Sign Off Transmittal Sheet, Plans - Deck - ,..-..�,. ._,� - oY Yq� TOWN OF YARMOUTH �� '� �-� HE�LTH DEPARTMENT o;1.� :,,_ _ ::v� . ��+r�. `�� . . � �� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: �'��. 1��A� `�- t�� Proposed Improvement: �� 1� � a � �- D� ,v a u �3`e S �� 1 t �� t J 4 t��c.lr Lr 1�e..c1 ,v C� v-►- t.v:fi ►-? Applican�t:--�./P v , � �..../� � w�c.,�,J Tel.No.:S a�' �6 7 S`��( •- --�Q n� ,� S-t— c...> � S'� �\._--� Address: j � ` •��--� '� �� D�te Filed: ��3 �� **Ifyou woudd like e-maid notification ofsign off,please provide e-mail address: Owner Name: �'%-E'..-�/-� .e.„� N�''�o) ',-#"A,�..>G Owner Address: /�7-� �� z �� Owner Tel.No.: G/� ��7 g - 4�77C3 .........................................................:................................................:........:...................................................................................:................................:................:........................................................................................................ 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 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 required for decks,sheds, windows, roofing; II (3.) If necessary, Title 5 application signed by licensed installer � with fee. ..............................................................................................:.................................................................................................:................................................................................... � .................................................................................... REVIEWED BY: DATE: � � / �� i ; � � PLEASE NOTE i , COMMENTS/CONDITIONS: '; � i i MORTGAGE/NSPECTlON PLAN 15-06436 � tocarro*�:is2DrAr�avENc� BOSTON CITY,STATE:SOUTHYARMOUTH,MA .9PPLICANT: SURVEY, INC. CERTIFIED TO: SCALE:1 INCH TO 20 FEET P•O.HOX 290220 CHARLESTOINN,MA 02729 . DA TE:JCJLY 2�201$ 7(677)242-7303;F(617}242-7676 . Y✓WV✓.80STONSURVEYIMC.COM � RECEfVEI� ` AI�G ? � 2Q16 HEA�� PT. 105.00' — i i SNED LOT 903 � � ; � , ;, DFcx ' �; � ! 'i�,. . ;�i� � �,/.i;,,�/ . . ;✓:;�:i i',. , ! a � rn � N0.192 � ;STORY / j•��r_/;�i,!<i':;i' 2S' i �' ,J /,/%`/.':%:/ ��%.G:-�•l'� i I � � � T 105.OD' �. DiANE AVENUE FLOOD DETERIv17A'ATIO.N REFERENCES Accordiag m Fedual E�nergrncy�laragement.4geacy maps,Bre DEED:�DOC.625812 � major improvements on:his proPm•'Y ia17 in as arra daignated as PLAN:NO.31209D 0��`j�O��cyG ZONE: !� COMM�TY PANEL No.Z�d�W��3 NOTE Tu shou�an accvram sca7e this plan musr 6e prinred �� GEO E � EFFECT7VE DATE: '�� ('�"2G on legal siYd paper/8.5^s fa�) o ,, `� " CO NS "' The pemunml ravcNres arc approximately locamd on the gmzmd as sncxa. 77:cy eifhcr canformed w the sctbnck rcqvimments No 1784 oft6c locvl mning ordinanm in etYect ar che�ime of cans[.vc:ion,or ar_exe.r.pt Irom vio7atlon rnforcemcnt actinn unda M.G L.TiUe Vll,Chaprcr 40,1,Secdon 7,and tha�a+r no rncrxchmena of major improvemrncs eithu way across pmperty ��P �`Q�aP O� lines cxcept az sho+vn and noted hc:�n. q �l a $UR�6 NOTE This is not a 6oundar}+or tltre ras.uar.0 rurvey. ITris plac x�as propared in acuudance to proccdural and tcc5niql standalds forMongage Loan L�specrions as adoptcd by rhe:dassachusetu Baerd oFRegistndon ofrynkssional mginecrs a:d Land Sarveyots,250 CMR 6.05,and use for any other purpose ia prohibitec. This plan is not w be uscd for rccarding, George C.Collins,PI.S prcpeling de.�descriyGons,or wnsvuction. � . _ . _ _ __ __ _ . _ _ _ _ I __ __ _ , - __ _ _ i . _ __ _ ._ _ ._ _� ___ _ _ _ _ _ __ _ _ _ _ �- _ _ _ __ _ __ _. __ __ _ � �; _` � _ __ _ V� . . _ __. _ _ _ . _. _ �''_.. � __ _ � . , � ,__ � ^. J 2 ,_ _ _ _ . __ _. .�__ _. _� ___ __ _ _ _ _ �r , 1 {� _ " _.. � __. ._ . .� _ .._.. _ �._ . _ __ ..... , /'i .. .. ..: ....I� Y _. . ..... . � � . ti 1 . . � ..._ ._. _.. .... . _._ � � ._. _. .... . S„_ ... ._� . . .... ..... �__ ... ..... U I� , � . � p . _ _ �1 ._ � ___ _ _ � , Q � � � _ . _ _ .__ . � , ' ' ',�r ^� V' "� �Y -,� _ a _ _ __ _ _ __ __ k fl _ __ �__ _ _ __ ,� � ? �.. 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Systsm Information (corn) �k��e Disposal System: Pro�ide a view of the sswage c�aPosed system, i Porman�rrt referonce landma�lcs or bancMnarks. Locate ail wells within 100��ocate� � �Fwro fc w�ef sup�iy��rs th�e building. �heek one of the baxes�ow: , hand�ketch in the ar�ea lxfow ❑ drewing attachsd s�a�ely z� �Y��G1=- G/p / /'/ � _ l�,t , /-roh T (l4tw}!, �'--� � � �. � ��f Or�vt '4's•� �`�' �/ �� -// �� 3 ��z - �� 3 - /y ��-30 �..�,� nr.satd.r r.pella„pa„a si+wi.r.o.s,wp.Ohva�l s�rm•Rq.1�d n _ '