Loading...
HomeMy WebLinkAbout2019 Sep 09 - Sign Off Transmittal, Plans - Addition of:Ydut TOWN OF YARMOUTH Q; ,-, HEALTH DEPARTMENT .)i F*\'' i . all PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building"Site Location: Cil 1,E7 1 W-- 2-"7-57 <A1/ T 14 i 01 4 Proposed Improvement: 3(1a 4D A /7 ' X 40 ' ,I ,)2)/7 OM Cewtve-eri Ala TO 'W eXi IT/A/6 4 frfvfv 0 4 / v/4/6 'roar L4!/7N Xis Al V-1 it L�/)LA Ce . r"h4,v5 WA t c? f C'v .c7/7'/4(6 ?Ct 1," 44-/V Applicant: 457?V 6.- /7t ©2-/ A/2-7Y Tel. No.: 17$4 3??-OS-63 Address: g5 CC :4N AK& . St/77,/ Yoimi,?7.7.--- Date Filed: 7,�.s o/q **Ifyou would like e-mail notification ofsign off please provide e-mail address: Owner Name: 1/t GLrI D 41 ern/> / Owner Address: ,...5P-- e1)&� � � .' 5weer Tel. No.:76V-g2o S6o 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: 1)/-1,31.------ DATE: l/ ?// PLEASE NOTE COMMENTS/CONDITIONS: d. i7c.g..,✓ 4 14 — c 4 c,uw v/f— Of err n 4 1 < -Z-- if\ 1 f' 3 , -3 A 10-\ I \ t bz 0.....'---) -,I— L 4 4,cr.. c. 0 ZP \f) e•.• in vci.., -z ,st .... .....„..,_ fI):, %%:, � s 4 a _a ili .*2, ' 'il%' :si: V I.1:: , ® oCL I-ua g ' y i lz 4s,iti 1 SS �o 's3. , / /(x.SHED ,. ss TANK .ss, 00 4 2.O . EX. .1DWELLING try ,• EX. DECK 2se 7. �<1 /A v RECEIVED `C/ � t IJP 9 722O6 M VQSj 9 20 19 HEALTH DEPT. WORK MUST FORM TOALL S TOWN BYL & REGU s_� SEPTIC FROM ASBUILT ON FILE AT THE TOWN YARMOUTH WATER DEPT ATE HEALTH DEPARTMENT BUILDER TO CONFIRM CERTIFIED PL D T PLAN MBLU 30-294 I CERTIFY THAT THE IMPROVEMENTS SHOWN Q 5 CADET LANE HAVE BEEN LOCATED BY A FIELD SURVEY. s40 YARMOUTH, MA 9GDATE: JULY 162019 #•DRAWN: RBS � JOB S595 1, ,SCALE: 1"=30' DWG. CPP u, EASTBOUND £ L7o eLAND SURVEYING, INC. :.. "�� '� /''� 7-17-19 s- P.O. BOX 442 ROBB SYKES, P.LS. DATE / FORESTDALE, MA 02644 f'' 508-477-4511