HomeMy WebLinkAbout2019 Oct 18 - Sign Off Transmittal, Plot Plan - Inground Swimming Pool I
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;,01.:Y4 � TOWN OF YARMOUTH
x, c HEALTH DEPARTMENT
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PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 1 IlAutnci UC-
Proposed Improvement: I i . ? k )t h f dark. . C tA)i t 1r�J1 ( c }-c e( bob,L( i
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Applicant: ;1 �na ?oI \14‘ g c 1D Tel. No.: C( --75---(72(4. 3 z I
Address: 7 ttikereo ,e Y cl t 11, .�I (`) Date Filed: /I
#If you would like e-mail notification�Lô
of sign off please provide e-mail address:
Owner Name: (\JttO\C_
Owner Address: t ) LA C LA d /C c>>Yc{t"1 44\ Owner Tel. No. }1 7 . . 70)
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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.
4 ...
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: (5"---A7 DATE: / ./14/61////
PLEASE NOTE
COMMENTS/CONDITIONS:
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PROP. PROP. (�
X141, a, ocL FENCE
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cry ap_ $ �O..
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p• — EX. '5 12 G
z PROP• 0 DWELLING,
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• -e PORTABLE
HOT TUB
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190 � ` DECK
TANK
EX.
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STOCKADE
FENCE
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PROP. ��
• CL FENCECE. 11g 66
/ RECEIVED
DOOR ALARMS REQUIRED //'� (,QCT 1 8 2019
SEPTIC SYSTEM PLOTTED poo FROM INFORMATION PROVIDED Iooc.HEALTH DEPT.
BY OWNER. BUILDER TO CONFIRM
CERTIFIED PLOT PLAN
MBLU 52-146
CD\ 13 LAKELAND AVE
I CERTIFY THAT THE IMPROVEMENTS SHOWN YARMOUTH, MA
HAVE BEEN LOCATED BY A FIELD SURVEY. DATE: 10-11-2019 Re 's 2s SCALE: 1 =30 DWG. CPP
EASTBOUND
,/� LAND SURVEYING, INC.
� P.0. BOX 442
4,v (i /'"i/'/ , ,�/;vFORESTDALE, MA 02644
ROBB SYKES, P.LS. DATE 01
'L7 508-477-4511