HomeMy WebLinkAbout2017 May 05 - Sign Off Transmittal, Plan - Pool & Fencing�� ,. ,� � : �
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W TOWN OF YARMOUTH
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� ; �-;c HEALTH DEPARTMENT
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� ��"'��.=E%��� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
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N To be completed by Applicant.•
Building Site Location: �U � ury,u q t�c I �v c,d �2 ��2ti'l a-v�. �r�.? ; �'✓'f''
Proposed Improvement: �Q a l-- � �E��, �•�
Applicant: .��,S A�t1 S�:�� vc�� � Tel. No.: ��r�C � �Y �j - 6 7�!y
Address: ��� �a u� �'e 1!p�.�,, ��, ��{�r�.ct.,. 1--1 t��..R Date Filed: .� S !
**If you would like e-mail notification of sign of�;please provide e-maid address: p r,� 5 f?�/��`+�)p`('�? �p L� � ��
Owner Name: .�,,S �!�, �e P-t f ti</` y
Owner Address: �C;� G v H s � e d I e -�., (�2 ��,/Z,J"'� U� t-��� 7� Owner TeL No.: �''�,$ • �,�y– � ��y
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RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTIVIENT: Determines Compliance to State and Town Regulafions; 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:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
.....................................................................................................................................................................................:..................................................................................................................................................................................
REVIEWED BY: DATE:�S'` ��
PLEASE NOTE
COMMENTS/CONDITIONS:
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LOT 41 I
22.222 SQ. FT.
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TO THE BEST OF MY INFORMATION, ��PROPOSED�� PL�T PLAN
KNOWLEDGE, AND BEUEF THE YARMOUTHPORT, MASS.
STRUCTURES SHOWN ON THIS PLAN �OT 41, PB 203/111
HAS BEEN LOCATED ON THE GROUND DATE 9-10-16 SCALE 1" = 30'
AS INDICATED JOB 7759-00 CLIENT PARADISE
5-1-17 G� ,��
g-�O-�6 SWEETSER ENGINEERING
203 SETUCKET ROAD
DATE PROFESSIONAL LAND SURVEYOR Po sox 7rs souTx DErrrris, Ma ozsso
OFF. 508-385-6900 0 - - 991
C: I S8 I PROJ I 7759-00 ► dwg I 7759-EPP.DWG O 2016 NG