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Home My WebLink About2016 Sep 26 - Sign Off Transmittal Sheet, Plans - Open Sun Room, _ _ __ _ � , _ __ _ � _ :z.� , _ _ --, __ .o!�-�-'-�q� TOWN OF YARMOUTH � ' �`';�:'�. �, � ��° HEALTH DEPARTMENT j � p:...,�-.•,_ - -t�3 i ��4'`� ``�l`� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET �E To be completed by Applicant: Building Site Location: � y �l-►f'a-Pr�a� �>G�� v i Propose Improvement: / �Z �...,,,...�.,;:` " �; t„�; � ��, " �t v�.�,,,, n. Svr� �' �'G�'�6'i� �sa)t � Applicant: /Cw��r „�...�,�s n��' /7.�,�,� r� ,�",.,c._ Tel. No.: y�3 5 3 a • �/.� S� Address:� y' �.-1� „� �,,,7`,%� R N-ra� �4 Date Filed:�3 I � c��v�ts i'R+ **Ifyou would/ike e-mail notification ofsign off,please provide e-mail address: ?��, �, .--�-� ..---� Owner Name: ,�5-r.-L.,,,�.�-�-�,. �s'+E .•;;� (3"r i L •F`f�Y�,�rr . Owner Address: �� i4ry� -�v.�,4 � � Owner Tel. No.: � • .��4 . ..................................:....:....��.�,t..'"c'...........�-�:�.........�...�............��.............................................................................................................................................................................................................. 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; (3.) If necessary, Title 5 application signed by licensed installer with fee. ......................... 3 REVIEWED BY: y DATE: � �� '' PLEASE NOTE COMMENTS/CONDITIONS: f • � . PRaPERTY BOUNDARY PLAN KENNETH B.TAYLOR Prepared By:Robert D.O'Neif Jr.,RP.L.S. #14 CAPT.NICKERSON ROAD 66 Drury Lant � SO. YARMOUTH,MASSAC�iiJSETTS Worcester,Massachnsetis 016A9 Scsle e 1"�30' Date:,;PRII,17,20i2 Td./ Fsz. (Sfl8)755-3513 Ref.: B.D.R.D.Deed Book 977i Pg.2I3 Ce[I (508}868-SI44 B.D.R.D.Plsa Boak 258 PI.119 1.P. Fad 0 1�� •� a '+�*s.�,�, � LP. �Gg Oa' 9, , ��GFh�q�'`� Set a7A �� R09��'iJ. �� o� ' 43'!�E:�S� n'- �r AREAL4'L�$ Aa $ � ��5$��4 . t �,� °;�s�`�� wrn� , rs�os �r-��t-��. . st��a� �, . - r � � � t , � _ � . 1.P. 3 ��, � a � � o �� _ � _r . ,.. � ab l!?' � �' r � � � �,� R�o� � e � 1�►IF � . � � S[agte • , # 14 � . '" " _ , �_._ w. ,_.. o � , � e N �� • � . A r . �s /2,c.x.�v�rv � � � ' �s� _µ . _._ �....a�.� �P. [.P. � I1U.00' . Sa �_"_. � ..�— s��3r�o�w • • - CAPT. lYICKERSON ROAD . (PUBLIC-40 FT.WIDE)