HomeMy WebLinkAbout192 south shore driveTO\\,N OF YARIIOL]TI I
WATER DEPARTMENT
99 Buck lsland Roatl
!\'est \',lrn'routh. MA l)2(,:.1
Tt'lt'lthone: i508):71-7921 . Fn\: {.1(}llJ 7;1-7198
BUILDING PERMIT APPLICATION I'OR
\1'.TTER DEPARTNIENT SIGN OFF
1'RANSJ\IITTAL FORI\I
BUILDING SITE LOCATION:
PROPOSED WORK: -Po- t
lgi1 g l?'?, Souq-. SLc,,,c- b,,/'c--
G,X3L'
TELPHONE: bt1'111-O+-L COo etfvnL\6 q qot'QrA/\\g
RESIDENTIAL AND 'OR COM\4ERCIAL BUILDI\G
I Icalth Depanmenr
Firc [)cpartment:
I)ctcnnines Compliance of\\'ater ,\r ailabilitl' and or cristing location
Dclr'nnincs Conrpliance for Parking and Drairragc
Dctcrnrincs Compliance to \\'etlands r\ct; i.e. If lot(s) border any tlpe of
rvellands. slreams. ponds, rivers. occan. bogs. boy"s, marshland, ETC...
[)clcnrrines Compliance to State and 'lou n Rcgulations, i.c.
rcquircmcnts for Septage Disposal and othcr I'ublic Health Activites
Detcnuincs Compliance to State and -l'own Requirements for Personal
Sat'oty, l'roperty Protections, i.e. Smokc [)ctcctors, Spnnkler Systems,etc
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I)A1'EAPLSIGNATURT
Ot'FlCl: USE: COIIITENI'S ()\ PllRlll'l'.-\PPRO\-AI. OR DE\lAl-
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ED Y $'ATER DI\'ISION (SIGNATURE)
APPLICANT: Roriroi,,t E a"o-,"ra.^*, U IQO
ADDRESS: I12 So,t{t St 'o"-c- br, SouH-, Yo< y.*uLLy f\/A_1Lo tol
Watcr l)epanment:
Engineering Depanment:
Conscn'ation Conunission:
?hilEo- retlch L"d1t
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FLAGSHIP Land Wo]tc
P.O. Box 95
HaMichport, MA 02646 US
(774)836-2490
{lagshiplandworks@gmail,com
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BILLTO
Jeiiery
Parker Beach Lodge
192 South Shore Drive
Yarmouth. MA 02664 US
Pool lnstall -
Gunite Swimming Pool - Install a 16'x32'gunite pool with a
premium plaster finish (client to choose colofl and 6' band of
waterline tile (client to choose color) around the pool, Depth
to be 4' with corner starrs, we will provide a drawing of the
pool for final approval. Add ladder in the deep end, Pool
equipment will include Haylvard pump & iilter, 3 lights,
Hayward pool heater, and salt water system, Ali electrical
and gas connections to be made by others, Waterfill is the
client's responsibility.
Pool lnstall -
Payment Schedule-
lBtl.+sphp
|NVOICE # 1646
oA.:re 03/09/2022
DUE DATE O3IO9I2O22
TERMS Due on receipt
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