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HomeMy WebLinkAbout2006 May 02 - Sign Off Transmittal Sheet, Plot Plan - Deck �A m .._...m.,��.__�.j.� ��,_�. _� � -. �--.------r.. --_---- �.� ��� '�w-� '�ar�Y�:�,. ,� ��� ;. - :: , . .. . . :: -: � � . .�- . - — , -:� , :��-. �`—'- �— , . . . . � � . R . . . . . . - . � . �� Y'�k.� TOWN +OF YARMOUTH :�:; s' � ;��c HEALTH DEPARTMENT �(� .. . ';� `.'i� .� 4y4.'�� . �� � . � � �. . . ��"-` pERNIIT APpLICATION SIGN OFF TRANSMITTAL SHEET To b��ompleted by Applicant: Building Site Location: �7/ STaT a.v R uh 1VIap No.� � Lot No.: � S�� Proposed Improvement: '�`e-��,� APPlicant: �.Arz�.� /����s a►�v Tel. No.: 3��r-'7�v o Address: __ �� iv�v�',cra� L.s►.�r- Date Filed: �. G ' , , � **If you would like e-mail notiftcation of sign off,please prouide e-mail address: f Owner Name:�a�� ���tc c��� � Owner Address: qG �d��e, �,,,� IV�.,j�, Owner Tel. No.: I-?F�I -F�y�/- 79 9Z ; ----�-----_.........................:..........�---------�----------.....--------.__...--�-�------------�-----------------------------------._..........-------------------------...--�---._.........___......_------------------�-----------.:_..........-----------_._........,.-----------------------------------�---.....:. RESIDENTIAL AND/OR COMMERCIAL BUILHING HEALTH 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 locati�e, and septic system location; �2.) Floor plan labeling ALL rooms within building (all ezisting and proposed)— Note:FToor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. --------��--------------------------------------------------------------�----- --�----�---�-�----------....---�----------�--�-------------------: .....-�-�--�----------...-----------�--------:......---................--�--------------�--�------------------..........:...-----��-------.......--�--�-------�-�-----------------------�-----....... REVIEWED BY: DATE: �� �"'� �< PLEASE NOTE . COMMENTS/CONDITIONS: � :�,. � - - - / � 3 � .� � � �� , ; �, , � - .��v���.� ��� -� �wN � . �__w� r l.f ,'� � ! E `�,_ � �`� ` r J � + � ��� i A � � I�7��Vti' ,� ,�-�7 2�; . � ; � ' N� ���-°t- � � _ _ � � � ( � ��aiG-,� (r� r E/:a � �.��a -�j_ � � . ' I l� ( �'� ��� .. �� ` ' � l`� Q �� I � �� B � �2.Zo � � µ��� �. I � � ��`� � �3'�`—� t��, Cp � 1 ,- �n�J,�` -�'� y) �_ � �i�� ��� 4�p , i �4 L J� � t � � '.'-5�f +� _ _ �� Z �� ���� � � ` � � � ,� '� � � � G� C� � � MC� D � .�0� � ��� Z� � biAY �0 2, 2006 � HEALTH DEPT. �DT.��'Tf}� L.oU.rs !s/�(oT !N TNE f�Q v/FEIL- jP�LoTE-"��t�n� . _.��i�z�y- ��s��2a�T . -7Cz�r� ; 30°Yo oF%t¢r ���1'�f G�F Tt�6� �oT = �f�/�?�117"1� A�5�.�71`Z_S JYlfj-P (c q. /SS =��.SD 1C ,3a°�o �_ � SLI >: CERTi F1 ED PLt)T PLA�f =Nv7�": 'TH� J��P�Ty 1JD�s AtoT Ffti� tv/�in.� �4 I�CATION 7�:S:�t.Tl.�?=1.�1/�.$:.Y.f.I�,���� ���-t#,�Z�tlz1� fGorz� zr��� �zD��,c "e� cdR/ / ... "��S S ffD �� � f ��Qtndlv_r�rTy��� tila. 2 s`p�}iS- ODa � r1'lr4-P �►� • `.l, , =3U . . DATE .�,��. E�.�a_. . �15��--�v�i1E !7� l 9�� 8y ��./I?� �, PLAN REFEFtE�lC'E ��'?��J SDv7���Y?`+'�?. . =�N��._ �z-_�v ��.��h� .�'. .ly�j. . ��-.� ���� - - srat� �1y.g �rn.l?L�.B .Y��tn!�?�°1�. . .��. . . . .- �c� i��_�'�3f,� lqs�9,s��'/,�f1n�✓.st_ � �a , : ��� �sT���,B�c:B�'r°�' 1.4�! . . .� r :� - / . . . . . . . . . . . . . . . . . . . . . . 4'� `�,�,�. ��,�v.```��� i CERfiF'lf Tlii4T THE ��J?'J,�r,".{'C.�UlV�f1'�/OIt� �.,z, ��� , t�� SHOlMI�i ON THIS PfJW IS � TED Oi�I THE�yO�-R�'�t)i�lND . . . . . . . . . . . . . . . . . . . � � � �4 ; � A� .�1'��wW H�RF�PI �.-fit'e'�'F CJc"��'".�'`"�c�+t � � # . . . . . . . . . . . � ���. *Cd�t�. t�t s'.§ , p ,'�� .' . . . . . .. . . � . . . . � r N r� � v T���r� ��E �/� 0 i0 :� � f.2jy���r,r� �-c-�. ��tt�or���: . . . . , . . � ����:� W�sY�' � ' R�OISTEREO !J`WO StJi�V�YQR