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HomeMy WebLinkAbout2017 May 12 - Sign Off Transmittal Sheet, Plan - Garage' o�-Ya�r TOWN OF YARMOUTH I • .P.--�:� � �� - -�-,c HEALTH DEPARTMENT . o:_� �� ,�„� ..__ `,�,�. � ''��.�`�' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: '"i }"� (1����,.$� , ��G1,C"W�.t����# p��— 0�'%�"'" , 2 Proposed Improvement: k ' ttJ�A. Q N S �..�1 �' Applicant: ��,��-�C�,.t,p� Tel. No.: �J'3S3--G8SaZ C�e� �C - �'"-!�` r M�d��r\ Address:� 0. �f�X 3'�y Y�rrv�a�Po�" , �'Yl W Or�!/ `7S� Date Filed: � �/'7 **If you would like e-maal notiftcation of sign o,f�j;please provide e-mail address: OwnerName:�/,�\ �UYVI(7�� �" 0 .� � Owner Address: ��7 �pt't Yt�I��:�GtG1�,j"" K�'� }�— ���"" Owner Tel.No.:��- , �j� rj(-3$/Q ..............................................................................................................................................................................................:................................................................................................................................:.................................. 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 egisting 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: �/��-/I �• PLEASE NOTE COMMENTS/CONDITIONS: �,; .� dY �".! r 3;y"f r�, �� 5 ���-2 F�' "��.- �'� �.(c, �. .,�a f' V•"� � �r�J'�"a R Y i f�� � � ,�; �1,��►� ��� Cerz�ified Ploti` :�lar.�,� ' '�`� �v Location.` :�f ,�,�=;7,�������,-�,, SURVEY(NG � ENGINEERlNG 4�7 North I>ennis�~ o z�'"�'"��-�l�,,.. HOME PLANN WG&DESIGN Yarmoutti, ��1 _�~�`�- �repdred far s ciDD1Ax x1L.i.ROAD 1>czn2el �umo�'tt po sox 4ss SOUTH ORLEANS,M.A 0'366R 508-455-85 I4 Scale.• 1�'= 50' www.ryder-wilcox.com Ddte: fuly 5, 2016 _ >9�5.33' �, i 1 •� -H 't I � Lot ,2 % � EXlST}NG � 14reck• � , DECK �O,DD4 S.F.�- � � �D,91 .4e.f) � �� 68�� tiEXISTING � � ' '� � � SHED �� 0 PROPOSEO ��� � GARAGE � c�,�3 O ,g ,� � 22 , � ,_ �O o� =:°:;;`';��i;� \`�� 4� �� •-�••-:•- � � SEPTIC PER �h' ,(� -�::::::;.:,:.: , - '��.:#�� 12•6 B.0 H. AS—BUILT �, V _:�:- � ,� r � � � �0 .� , x � �. o �O¢�'�'' .'``1 � N , � _ .. � ,- �,.:, : _ .,.,r '`., _ ;.: _ � .: ,. , .s , ,: . Reference.• � � ; � � , �, . �ssr s rnQ� >36, � _.'��� %�� _��/ � � Pcl. 24 •,,�--- r ,_� _ . .--�..�—-�..—.. ������� MAY 1 2 ZQ1] j certi,� tlzat tjie dwelling showrc he�on is loc¢ted it exists an the g�uytd a�d tltat as so located it �J a'r�'-5� ' om�lies witti tlie rrainirraum pro�rty line set8dck ��-���� ` quire�nertts of tlze Town of �mmoutli. 4�� �t�����;, !�;.�',�"%��� / ��� �'�;; �oy I�ute.• �!✓r/�� Fhr� ssio�¢Z �;�� r�?!!_1P � -��� r�,f� Lr�nd Surveyor �::�< �, ���: _.._+`, :`_LIS � � f�`! ""''�`. :''f'T� � rTob No. 1170v i ,� �_::�:�i � � s � ; . �����ss�°`�Q. � ��0$UFtVE��� , ��,-�lC'�