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2022 Sign off Transmittal - Addition 2nd Floor
�� Y� TOWN OF YARMOUTH c HEALTH DEPARTMENT ' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: 1-1 I L/ L fJ i)Gi Pood Dr f6te f Proposed Improvement: t o u ���`� 'v f tkir c, Applicant: t\ JVCXr e Caro 0 Tel. No.: SC>U Address: LI �� Uv • ' Pond �� Date Filed: IL{ 1 ZZ� **If you would like e-mail notification of sign off please provide e-mail address: S t i ve rc / rwc -7c/? (C Wt«S f1 ti OWner Name: iv ijt I E{' C u((A Owner Address: Owner Tel. No.: RECEIVER MAR 14 2022 RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPT. IEALTH 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: DATE: , PLEASE NOTE COMMENTS/CONDITIONS: E(--.-7) r . . , ; S C-P .77` /a / c_ 7 EXIT 8 6 R.R. RpP� STgTO o qL J w 'y(iF N RO � pN0 P �pNG LOCUS O LONG p0 LOCUS MAP NOT TO SCALE I CERTIFY TO THE BEST OF MY PROFESSIONAL KNOWLEDGE, INFORMATION AND BELIEF THAT THE LOT CORNERS, DIMENSIONS AND SETBACKS TO THE STRUCTURE AS DETERMINED BY INSTRUMENT SURVEY AND AS SHOWN ON THIS PLAN ARE CORRECT. MERANJa HEALY p NO. 48135 � /STE��® ®�9I LAND { KIERN J. HEA YP DATE FOR THE BSC GR UP INC. PLAN OF LAND 414 LONG POND DRIVE IN YARMOUTH MASSACHUSETTS (BARNSTABLE COUNTY) PROPOSED CONDITIONS FEBRUARY 4, 2022 NO. DATE DESC. PREPARED FOR: MARIE CARON 797 ROUTE 28 SOUTH YARMOUTH, MA 02664 SILVERCLOUD797®COMCAST.NET on 13SC GRDUP 349 Route 28, Unit D W. Yarmouth, Massachusetts 02673 508 778 8919 © 2022 BSC Group, Inc. SCALE: 1" = 10' 0 5 10 20 FEEr FILE: 50516-EXC.DWG DWG. NO: 6748-01 SHEET 1 OF 1 JOB. N0: 50516.00 Tara V, ij DlN IN6 RDdM Kx,v- "M Oxo �.nPs`"� Si'J�fif-5 n 6A,CoM tJh-'' Yarmouth Health Depar'tment � APPROVEI? , ;>r ��, �(�' �. ��-�� ivy 1I17,71 d`��Z�ik6J 6' (,( 9 1-7?Ob Fi ; sru�� yv (F �rniwmw: ouwwn Sw Name Dat@ rvs uea�e wnz 14 1u ' •nro q�-�o�. BhrLv aiewna uu��a Fi4ST Fi..W0. !'fit -MJ (EX)�T) y rtF.S