HomeMy WebLinkAbout2019 Jul 16 - Sign Off Transmittal, Plan - Roof above Existing Deck ot-Yi+k TOWN OF YARMOUTH
{� '�- ° HEALTH DEPARTMENT
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`~ ' 0," PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location:_i 0 V '- ' '/ ' ' " /3Q4)f1 U`�-� w, i'li2. .
Proposed Improvement: C ��(" ' /Q--- `�Fc j ave.
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Applicant: 0 4187,4/ 6l' Of 2-711 / Tel. No.: g 7?S c5$
Address: ?. 6/-121/file-- g---1) i,--411- Date Filed: )f e0/J ,
*lfyou would like e-mail notification of sign off please provide e-mail address:
Owner Name: 6-10/26E.- 0i � '/fib
Owner Address: /0 1 f (2241260e- 12D Owner Tel.No. 32e( )Y??
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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 1
(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: Utc' ( !
RENEY, MORAN 4 TIVNAN, INC. MORTGAGE INSPECTION PLAN
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REGISTERED LAND SURVEYORS NAME GEORGE Sc PHOEBE BAYIDES
33 BURNCOAT STREET at
WORCESTER, MA 01605-181 I LOCATION 10 THORNTON BROOK ROAD 4
508-852-5203 (PHONE) WEST YARMOUTH. MA I
508-853-2913 (FAX) C
dtsvnan@aol.com (EMAIL) SCALE 1 "=30' DATE 8-14-01 1-:.
REGISTRY BARNSTABLE
DEED BOON/PADE 622451-1 348 11
BASED WON DOCUMENDATTON PROVIDED.REQUIRED MEASURE-
MENTS THERE MADE of ME FRONTAGE ND DUD (S)) _SHOWNPLAN BOOK/PUN 32595G
ON RES NORIOACE INSPECTION P1AN. N OUR JUDOCIEW ALL
VISIBLE EI�SEMOIIS ARE SHORN AND THERE ARE NO VIOLATIONS (0.1.1-ii�F WE CORBY THAT TIE BUIWING(S)ARE NOT WITHIN THE
OF mama REAURDlNTS NEWMAN STRUCTURES TD PROPERTYLINE OFFSETS.NOTE:NOT DEEMED ATE ABOVEGROUID PODI.S. GEORGE SPECIAL FLOOD T ADARO AREA SEE HUD WAP:
DAVESMII NPEC IIOS.OR N PUI SNOT AN INSTTRUM SURVEY.wnH NO FOUNDATIONS..Do NOIS TMORMAGE C)T USE EDWARD GERECT FENCES.OWER BOUNDARY STRUCTURES. OR TD PUNT SMITH,JR. 5� T71D7-2-92
sines LOCATION OF TIE STAUCRlRE[S) RograHEREON Is OTHER -Iwrol�ltlulcE1BIII tDCJAtmlw+c FORA PROPETNTYUNEOfssErNo.15153 FLOOD HAZARD ZONE HAS BEEN DETERMINED RV SCALE AND
REQUIR TORS,OR IS OO]PT FROM NdATION;ONFp plf tJ 6 NOT NECES.SANLY ACCURATE UNI7t.DEEM ME PIANS ARE
ACTION WIDER MASS.D.L.TITLE NL CHAP.AOA.SEC.7.UM. s Peel BY HUD /OR A VERTICAL CONTROL SURVEY 6
MEA OV NOTED.ERTIF TIES tSARE MCONMADE 6 NONETPVE (T . . a ' PERFORM, PRECISE ELEVATIONS CANNOT BE DETERMINED.
71#ATTOVE CERIFICIOIDNS ARE MADE 1WTII ME PROVISION THAT �7 SI
THE INFORMATION 411
USED PROVOEI 6 N CATER I ND A O THE MEASURE- S �
ITEMS ACOVIDED Y LOCATED M EDTHAN l0 THE I
PROPERTY LINES. •/ A
WORK MUST ' ON'ORM TO ALL
TOWN BY , S z 'EGULATI NS
YARMOUTH WATER DEPT DATE
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NO. . � ADDRESS :10
OWNERS NAME : 6O,7i 0 Prrg 6420/20Z
SEWAGE PERMIT 'NO. : Al -4S-NEW: REPAIR: r/'
DATE ISSUED:46:6 TZ.DATE INSTALLED :5 -oZ
INSTALLERS NAME : 4'4 OVCO
INSTALLATION OF : Dive .h05 ,e_ Masedel t0 I
WATER TABLE : - FINAL INSPECTION BY : /Eh/C/a
DRAWING OF INSTALLATION ON REVERSE SIDE :