HomeMy WebLinkAbout2022 Sign off Transmittal - Finish basement TOWN OF YARMOUTH
•11,-1 HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: -6-t7 (-reQ4 y / -20-peM /2,6 Sc.) c-T,ty
Proposed Improvement: FoT/U..,zs y eA 41,Efur /24.9m
r,, L L 13 Cr- OC •„-
Applicant: ,Z 0L14Zzo(L'/-/, Tel. No.: 6/7-RP 9C
Address: LV /4 F4,4/4 /14 sot/7%f Date Filed: Y�.?9/2�
**/fyou would like e-mail notrfrcalion of sign off please provide e-mail address:
Owner Name: / ZZojC(L
Owner Address: 477 i ;e ,64' /ree2. croGr/ Owner Tel. No.: 6/7-I'`Po?-1)C
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;
REC / (2.) Floor plan labeling ALL rooms within building
,t 1 :� (all existing and proposed) -
022
Note: Floor plans not required for decks,sheds, windows, roofing;
HEALTH DEPT (3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: 44
DATE:
_ PLEASE NOTE
COMMENTS/CO ITIONS:
/me--(4.J viek c_4 1 1<Q(4 � O Cir Its 11 -e
I.
• - . • rc.traD QY RrDF ?-1'�.=' �4) .4.r►. (Z9 —B l4 A=o.34Ac '
•
ti13.a3 r ;
- - LOT ,
�`' '_ • , .: �. -
. $ 15, 0
-
l)'= 15. . 12•
rkrSTIN4. . _ In
.
•r
-oi�J D.
. N N
• Water -r-
• Line zit •
# 50 •
r
I . .
• I
... ... �oo.,oc� ; �'R 29 2027
HEALTH •
3R AY FARM R Oi\D
. 1 •
sEr-42.5 i Sul.Li✓A0 .
c&TT/F/E-1� , 1=P1-€,7" L.c-7A/ 1
N ars : z'b of r n v D.
Loc' rioAtil: Vaq t-'ti'L3 A ,A f,
�Cq.Lt: • • t Nn. as:;/rc: -4"1" 15 a. L AeDt•e `--"-N
. z.,c-E'LCA✓c : 6e i►.)L ,..c I .l-j
A , .s,.4,-,,,,..),....) 1'.l: PO/A-1 IA) e bti i
3N PL.. (31.. :'77 •P,'.; E€ _ --
•
•
• U7
. •
•x Nrctal-d 4-40LTIF1.0 TA.IA77- 77.1E, dU/L.Q1. /G
ss loAvAJ o.4:1 TI•IIS . 'L '/ I Loc 097-E a o v 77/4 " _..�v""•
Q ou vD q5 �Adb Mai NE'cCOA✓ i=1A.J D 7###97 _17-9
I T "`: . ' �,
Al
1.b FS CC.A1P'o .4-/ '.° Ti•I,,6�-- �o.cli.VG /-''•'-.-_..
8Y 4,444/S OF rAie- 7Z7K/N OF 9:+ /r-1 t tirt- ,.v ,• •\� LIU
aV JCA./ GG.✓3TC[JG7'E D. 1: 4' . 4
L.O L J E W E L L E,e 3 //y c. ' . '� : ''''
r'e-e_/5/9 3
Yt9,'(7O u71-/ , /'-2 $s . =were-i
./
MAP NO. / J
LOT NO . 4,7ADDRESS : D /'G f";
or— 50tiri
OWNERS NAME : a%)
SEWAGE PERMIT NO . : NEW : REPAIR :
kt.ripti7Z-d
DATE ISSUED : DATE : -- i o
i NAME . prY 4294!-eftrifr
OF : / h 14 A 1-
WATER TABLE :/6C FINAL INSPECTION BY :
DRAWING OF INSTALLATION ON REVERSE SIDE :
0
APR 2+? 2022
HEALTi/° A , 41C1 g -Dv
R.
X41 3 �f
frd-- 3 '7
A3 -c),1
f
1 vi 1: 1 1% -
Ir• •
Q
� J
>4 En
1 az
1 43 14
\ 1 •••1 \ Z tn0
I
• • H v E—+
‘ F.4 VI
r
A4
` J H
k0 cn A t fr..1 0
CIJ ! < H
P • . 1. H .
f..1 ice, E :
��11 ,::?)1.
H
e
`� C] ccs . z
1 � • • 2E-4 • • � z
W z z 0 W
fi 0 041 ill cn N
p U r4 H a Z
Z P4 0 < 1-1
.. iz < W H H W .?
a H Z E4 c1) - v] Fr
0 -•+ H 3 A
IC) '1111111iikii•
I
3
50 RAA 1 FA rzAt teD ,S YA-r2 vtA o" 4 1.-: e:7.---
-r-{,e, g pt-A dki —
_ os,,:Ak /1/41- : Ul1 F --./4.r.MI ab
EIL-LEIN2D
MAY 1 2022
HEALTH DEPT.
I \
tFl>12C0 W\ 1 3A-r: ‘-
It:r;f(41f-IP ;
,1----
___________
i--1'). .:),36-
. ,
C_-t-gro6-
i evt),(A i
____,
5- Ar-I 1b
—
J SA-‘iimitArr-
__. 5-e eak) D R_OceZ.,
1 .
1 5/€:-.W2001°11/4- d- MTH ROOM I
1 - 1
1 .
_ _....._
. , 4
.._._ .
3fet2i)vtitAk 3 1 '
I ,
fa.`
I --+v6 kV-�r66,HT -NJ t2ou&H0
<1 �ta9 C�Itoue*s
r�JZCAAaVF 6-1.UO^N
STF-k L- g4 4A 4k 14
'7'�-
u
FAM -r-1411 (Z®Um
M
prlec`rD(�
/0,/,
UNf-:rj=s1{ �
�3 A
M nl=
5111,laa pev�r-S--r-ow
RII(NOWER: Do
MAY 16 2022
HEALTH DEPT.