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HomeMy WebLinkAbout2006 May 30 - Sign Off Transmittal, As-Built Plan - Deck ,�R.�., ��_-r _ ��-_ �__,,,. -, � � � ..� .� _-R,.-�.., � , __ ��m ._ _. , . _ � .; .�� Y�k.� TOWN OF YARMOUTH �� ," �.,�c ` HEALTH DEPARTMENT ., _� „ ;_ .. . :,�, � �'' ��-N``�t PERNIIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: r Building Site Location: '�..�'f��� Q,��/„/�GN u,.►� ,� �-/-,t--�,Y�t,_,�-�,�,Map No.: Lot No.: Proposed Improvement: ,-��_� �"" G v� ( �S � w� -e- Applicant: `U e�i�,tvt� r�r tj.1 tLs o� �'el_ No.: �C7Q 't?$t7658 Address: 2'T9 t-��c.K�rv s Fv�::�- R� C-�r�.r`�.�vf c.�r�= �r'��1 Date Filed: ' �-o a� **Ifyou would like e-mail notification ofsign off;please provide e-mail address: Owner Name: J..�tz �,, -� �7 ,v rv (�4 �a,1�.c�.�,( N��rrc�N n^� Owner Address:'�� "�¢���c�-���=�� �'� ���z` r� �s 2��� Owner Tel. No.: �t`? �,4 3 C'��2 c� --_...._........:......_................................................_...------------�-.............._...__._._....._------........._----......_.......------..._....._..............................................-�--�--�--.._____......-------------................--------....------............--�------------.... RESIDENTIAL AND/OR COMMERCIAL BUILDING �IEALTH DEPARTMENT: Deternunes 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: (1.) Site Plan showing ezisting 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, windaws, roofing; ` (3.) If necessary, Title 5 application signed by licensed installer �'� with fee. r ' -------�--�----------------------------_.---�------------------------- - -----------------------..........-�---..........------- -- - -----------------------�----.......----------.....---� � ----------------...._...---...--�---.:...------��-�- -- --------�--�--�--�-------------�--------------�-�--�--- REVIEWED BY: DATE: � U G' PLEASE NOTE ( , COMIV�NTS/CONDITIONS: I R � �c/�«. �-�,h�"� Tv `�-r �j--�� !'�ac.l�- (Jtc. C. �b ( t O l" ]�• ��' t I . :. .. ..... . .. . . .. . . . • �� MAP NO.�� .. � . . _ ' �0. :�_ADDRESS: �� '6C,� �/a�OUc OWNERS NAAIE: S�r r� ' � � 1COMAl�,C_ SEWAGE PERMIT NO. : ci�-q(o NEW; REFAIR: -�����c:� DATE f����:_ � DATE IPiSTALLE): � �� : i�7STALLERS NAME, s ��o ' INSTALLATIOi�i OF: /S(� ST- j�, �ax, aS,� �,��S ' WATER TABLE:��FINAL INSPECTIOh BY: , DftAWING OF IIvSTALLATION\ON REVERSE S IDE: � � � i� � d � � M�Y 3 0 2006 HEAI.TH DEP�T. _ ; � _ �� . � �1 n � ,-- - - �� .h� .. � � co T � � -h�l �'' , _ p/� -£'� , -; - - � � C--�—�---�� f3� -�8 ¢ � � { �- �•£� -�e� � � S ��� . , �•y r -�e� .. . �J r :__, ��,� �� �'�1 -i41 S �, �. �' °)h l 'j b� -C-v r � � � . �},� !��• r�. � ' ��j���t b � � • • . w � t . � ,,;. , , ,t ` I � . � I i �� �, ' 12�,,� , . � �. ..,�-� ���' -rY� � � • ��4� �ti �4� �f : , , � , . r Q,, , 'r3)_ ,�` . _ / � . �. � I �► . f /2o n-�� / �T"(r. ` � � �i+�; • � w /� '� �7 L. j �r. J C: � � ���., B�� � J � �� . . � � . ;}__ t ��V �°�1, . 'p ��. � . � ��� �'�� . � ` �, h 6 ��? °°y `� f ' � . C.�„ ,� � � � ��Z�,��rizl6�y� 2���� _ , , . ; .�..�., ., '� , ;' � ��� �,,, r,�?y � � �f'� 7'r '-'�In ��I�01 f7"r,'"�O r..J +.S t,� t•.r,�.r;"�"rr.1 r , ��.,�'�� �j�{j{;�"� I�� t����I��r/ i !' V.��. `�.�rl�.,;. f�jii�-'+l' fjsr..� !' rJ t,�',• w„�, �1 .�e r�(!C rc� TH� BE S T d F M Y I N F 4 R M A T I O N, � '� A S-- BUILT' PLO'1' ��' . � I<�WLED�E, A� BEL!E�' ?1�lE vA �p T � rJ�J �d ` . t L�3..CtiM��r�l�� L�1V �._.,-.���?--.�__ SHO:I�YN; H!S MASS, PLA� WAS B�EN LflCA'TEd ��.�r �.,�' � �':� �'� /7'.� '�' GRauNn ,�S ��idfCaT�a '' - � ��4T �y��S' i9��' SCALE �;: s�� � «� ,1Q8:�� c� Z-vv CL�ENT �'� �`.�.,.•-�..� _"` � �r,��J e Q � ,fi�/f " �.7' . �?;5,�"1� L'1�G�I�V�'l.�lt��J1YCT � �4, 3S G'nCllT t+v�STE:!'?N ltAAt3 DA'fE PROFESSIQNAI LA �'.o. eox 1�3 � � sou��t� t��'�Nis, �.��ess. 3 —� 2 a�Gr . . ---__ _..,.._.�.._ ... �� 1',;C� .39�;-�QG�S �, . ._._.,._.._.,. ....., . � •d 6CS0 Ei�� L'[9 a�aH �d�T -�1 90Q2 8t -+at�