HomeMy WebLinkAbout2017 Jun 07 - Sign Off Transmittal Sheet, Plan - Replace Part of Existing Deck .�Y Yq� TOWN OF YARMOUTH
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�� ;�.-;� HEALTH DEPARTMENT
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�- ,��-.NE PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant.•
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Building Site Location: � � K�,�� �K�r�'1�. �%• �,���t�`Wl,�.�� �
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Proposed Improvement: �,��,y�� ,X�.�' � (1 � eX'���;n� C��C�.. �� 'r��.�_�- ti�'.�
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Applicant: Y�1�� ���G� ��11�;�t�u.0 a'�DYl Tel. No.: ��l ' '��- �S oZ
Address: J SYi2�!�G �ct�e �J� (,ir�� t .� Date Filed: �' � � �'
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**Ifyou would like e-mail notification ofsign off,please provide e-mail address:
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Owner Name: �J1 ue. \��y� ��-�1�-, l
OwnerAddress: ��S �51�.}�� c��. �'�a�.cqh f�ri �� Owner Tel. No.: ��-3�/- ���
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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.
........................................................................................................................................................................................................................................................................................................................................................................
REVIEWED BY: '(�;`��"� DATE: �' � �j jl
PLEASE NOTE
COMMENTS/CONDITIONS:
�'armo+�th �c�ith �'1e��rrttrne�at
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2�.��' v r ��� /
sine �'?at�
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� KELP I.AN
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� LOT 4 �-
� 9,600 SFf '��4
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QQ � future
�N hcp ramp
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EXISTING DWELLING 00
` 1�RK MU�T CONFORNf T� A L
� WN BYLAWS & REGULATiO S
FORMER DECK �io.00' ._.J�-.�j��',���� r'� '�%
PROPOSED `1�{IIIOUTH WAT�R DEPT DA �
LAGOON
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FOUNDATION PLOT PLAN DCE# 12-279
PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHER USE
11 KELP LANE "
LOCATION � SOUTH YARMOUTH,MA.SS. PREPARED FOR: j
SCALE : 1" = 30' DATE : MAY 22, 2017 �Ex;ANDER WILL }
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REFERENCE : ASSESS. MAP 25 PCL 20 va��,ZHOFMqSSqC �
o� DANIEL y�s i
I HEREBY CERTIFY THAT THE STRUCTURE o� A. � ;
SHOWN ON THIS PLAN IS LOCATED ON THE " ���� `�
GROUND AS SHOWN HEREON. ,� No.40980 i
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down cape engineering, inc. �'_Zt^�1 � `�/ —,� ;
� C/VIL ENGlNEERS ` �
LAND 5[/RIiEYORS �
939 Maln Street — YARMOUTHPORT, MASS. DATE REG. LAND SURVEYOR j
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