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HomeMy WebLinkAbout2023 Sign off Transmittal -Kitchen / Bath Renovation TOWN OF YARMOUTH HEALTH DEPARTMENT '�• ` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location:_ ) �1 E 1' F1 E�1� ,� V.i _ �ldf'.1�4' -z Proposed Improvement: ('.�d,, � k.,-cc,ke% / ,, Ikdd 3 � 3 e-iy'cuns ,1 /I0p kx'o' Cr"nS,6:i Applicant: G`l, ,$( fel Tel. No.: 5 c `1 L213 L Z Address: )k ) S, 5 ems., Ave uji,s i y, .r"`4 Date Filed:_ 3 y, -23 **/fyou would like e-mail notification of sign off please provide e-mail address: _ Owner Name: j( c CC i-/ V L u' C Owner Address: .Z S �tf t� {� i ���� , 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: 6t t , __,_ (1.) Site Plan showing existing buildings, water line location, BAR and septic system location; ® pg� (2.) Floor plan labeling ALL rooms within building HEALTH DEPT (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: air-(--0 DATE: /- ) v � � 3 PLEASE NOTE COMMENTS/CONDITIONS: �� ,� �� � � �� �� .� � I 1 _ c � Zone R-25 25,000 Sq. Ft. Road 150' Frontage D e e r f e d Setbacks 4 �' W i d e) Front 30' Side 15' — — _ — — Rear 20' 58.67' Max. Coverage — R Existing Coverage I � 83`36 30 -' — �— % r " E 100' � Q5 _ � � 4.08' � � � Proposed Coverage � ( N s66 _T( 11 I z' (0/fir I Lot 44 U, -P( ( 13,667± Sq. Ft, Q L'I Map 23 :)rcel 295 ( \ Proposed ( \ Addition-- ( `\ ` l\ o 3.0 ti \ < Shed \ , Map 23 Parcel 308 / 4.2 0 ooy °ram �>l S T�6 ' E QDB � go� / > O / /House #25 / 2 Bedroom \ Deck I �2 O Map 23 OTE: Parcel 310 DCATION OF UTILITIES IS APPROXIMATE AND ALL NDERGROUND AND OVERHEAD UTILITIES MUST BE ETERMINED IN THE FIELD PRIOR TO COMMENCEMENT F ANY WORK, THIS INCLUDES, BUT NOT LIMITED TO, EQUESTS TO DIGSAFE, ANY PRIVATE UTILITY COMPANIES ND THE LOCAL WATER DEPARTMENT. Proposed Addition \S� Map 23 Parcel 293 ik L MAR 3 0 2023 HEALTH DEPT. Sq STEPHEN q Z- Notes 1.) Assessor's Mop 23 Parcel 294 2.) C220232 3.) LC Plan 17149—F Lot 44 4.) This lot is not located in the Aquifer Protection District 5.) This property is in Flood Zone AE Firm Map 25001CO588J Doted 7/16/14 25% 6.3% 7.5% 0 0 J eke ter Qu/° °ne °°d ¢) Sil ve,-/e° ocu � on e WEST YARMOUTH, MA SITE LOCUS NOT TO SCALE Plot Pan for Proposed Addition Located at 25 Deerfield Road West Yarmouth, MA Prepared for: Lewis Bay Builders Prepared by: All Cape Septic and Survey 618 Route 28 West Yarmouth, MA 02673 (508) 771— 4200 allcopeseptic@gmoil. corn Date: November 7, 2022 GR,%PHIC SCALE 20 0 10 20 40 IN FEET ) 1 inch = 20 ft. Dwg #524