HomeMy WebLinkAbout2022 Sig off Transmittal - Replace land with deck 4ittA.ir:
.,�t"Y;'� TOWN OF YARMOUTH
HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: 1/ 1 'VI k1/6/14A-<1-C- w G, a 'YV G.,
Proposed Improvement: ;A / Z I i ' mg. /o --y/c:. •- L c j
Applicant: 0-4W/ nA(14/C/1 Tel. No.5 ) 5-73 7( -3 Li
Address: 17 (cYG le--Or\vt / - ft )4( 04--- Date Filed: C' /7-•` a-)m,
**/fyou would like e-mail notification of sign off please provide e-mail address:
Owner Name: /hr ry 144a
Owner Address: / 7 fl4 - Owner Tel. No.:
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: / DATE: ? /?:)---=
/ PLEASE NOTE
COMMENTS/CONDITIONS:
66.45'
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EX.
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PROPOSED
DECK &
STAIRS ie
61;
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SEPTIC FROM ASBUILT UN 2 7 2022
ON FILE AT THE TOWN OCC .
HEALTH DEPARTMENT HEALTH DEPT.
BUILDER TO CONFIRM
SITE PLAN
MBLU 66-46
q/____ __._.
47 McNAMARA aVE
I CERTIFY THAT THE IMPROVEMENTS SHOWN ti YARMOUTH, MA
HAVE BEEN LOCATED BY A FIELD SURVEY.
a*
oee DATE: 3-22-2022DRAWN: RBS
cc, SYKES I JOB #: S682
No. 5418 N SCALE: 1"=30' DWG. CPP
o,�'PF 'o EASTBOUND
-13 o
gree Zilw Fss/c/S17
TENO`'�� LAND SURVEYING, INC.
3-22-2022 �j� P.O. BOX 442
will FORESTDALE, MA 02644
ROBB SYKES, P.LS. DATE 508-477-4511