HomeMy WebLinkAbout2023 Sign off Transmittal - Dinning Rm Addition TOWN OF YARMOUTH
HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: r n'1 et�� ��l'(iJ� �f CCf I `tt
Proposed Improvement: I / /rt tL /1. i ! `` L� j / 7- 9
Applicant: ,4?A Z7-{ b ( _ o AJ STil2(J C7% b Tel. No.: 50 8'3&O
Address: 6 7h&Q IO/14 t /32 L"j 4;03 / Date Filed: / /20 / t3
**Ifyou would like e-mail notification of sign off,please provide e-mail address:
Owner Name: Ka,G Lie R. lGL riL,
Owner Address: /0 T G�br t. /L /Yad L/Cv In 4 Owner Tel. No.: 8106-- S�J
to-
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: /aZ
EASE NOTE
COMMENTS/CONDITIONS:
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JAN 2 0 2023 -::s
HEALTH DEPT. S — 1
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R *r •- .._..__ _. Certified Plot Plan
4 RECEIVED t Location
�' "� � S 10 Thrush Trail
Yarmouth, AM
LrAi trviuu r prepared for
SURVEYING•ENGINEERING OLD
KiN�=S HIGHWAY Michael Ahern
HOME PLANNING & DESIGN
Scale: >" = 30'
•
3 GIDDIAH HILL ROAD P.O.BOX 439 Date. May 23, 2022
SO.ORLEANS,MASSACHUSETTS 02662
TEL:508.255.8312 FAX:508.240.2306
Reference:
Assr's. Map 144 Pcl. 40
PI Bk. 339, Pg. 25
, 'S� E RU s ITL C.P. 2732>-C, Lot 7
033 .
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HEALTH DEPT,
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r 0� Minimum Building Setbacks
/ 69
Front - 30'
\ Side/Rear - 20'
COVERAGE CALCULATIONS
• I certify that the dwelling shown hereon is
located as it exists on the ground and that as so Existing = 1,06> S.F.f ('9.29J
located it complies with the minimum properly
line setback requirements, of the Town of Yarmouth.
•
Professional Land Surveyor Date.
Job No. 12997
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