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HomeMy WebLinkAboutBLD-22-006665 ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 1146 Route 28, South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 1K....!It. ...../ t, 'i Massachusetts State Building Code,780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only RECEIVED Building Permit Number: c,.b-2Z-W fl3 Date App ' Ti rr ��,4 -t6- MAY a2,3 Building Official(Print Name) ` SignatureDateI SECTION 1:SITE INFORMATION RUUILDING DEPARTMENT v 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers cR g "Tat w1-0— LS hCorvt7ZA (A)CI(a.., 0 (:3 1.1 a Is this an accepted street?yes ✓ no Map Number Parcel NumberQ,OD 1.3 Zoning Information: 1.4 Property Dimensions: /t y 01iq - Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) l� "1 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required I Provided Required Provided Required Provided 1.6 Wate Supply: (Ivi.G.L c.40,§54) ` 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2. Owner' f Record: 1 z r w %..\kk r 2 c 'T ckA4 -0 .L N A 14 c y S.*kf�t vq.Aa„ Name(Print) City,State,ZIP r ZS ct"-tea '3L -r. y37-2'27- 23.J-" c o1. V�-j to ycAV1 \iio, tr.+ No.and Street Telephone Email Address r SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 I Owner-Occupied 0 I Repairs(s) ❑ Alteration(s) i/r Addition Demolition 0 I Accessory Bldg. 0 I Number of Units Other 0 Specify: Brief Description of Proposed Work2: ©-e..A ,a e c p K,r d il. 1Q c tc ( Q ,2 SECTION 4: ESTIMATED CONSTRUCTION COSTS. • Item Estimated Costs: Official Use Only (Labor and Materials) . 1.Building $ 1 t IC. 1. Building Permit Fee:$ I Indicate how fee is determined: *1 Standard City/Town Application Fee 2.Electrical $ 0 Total Project Cost3(Item 6 x multiplier x 3.Plumbing $ 2. Other Fees: $ 50 ce,0Z('r 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire --- .$ Suppression) Tatal All Fees:$ \ Check No. Check Amount: Cash ousts 1 51'- 6.Total Project Cost: $ `2 K 0 Paid in Full IS Outstanding Balance Du : 7 b /` AV SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Name of CSL Holder License Number Exp ration Date e. - cSn (...3-1 List CSL Type(see below) 0No.and Street Type Description S ' D"f -l4'i 1-f Gt w; 0 a C t z U ( Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted 18z2 Family Dwelling M Masonry • RC I Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances Telephone I Insulation Email address D I Demolition . 5.2 Registered Home Improvement Contractor(HIC) R vyr�t �,. � rt, �� I '87 i3 Co 3/5jz3 HIC Company Name or HIC Registrant Name HIC Registration Number Expiration Date P. e. a.3 A /mill No.and Street Coy ea:i-24.s.(t^ t add C.;.,,^ ge f4.} A-LA ClLC� el, S-12 3'I t e1 4 3 j Emait address f City/Town, State,ZIP Telephone ra1C ZOO f'i{ D� SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c.15v2.§`25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes ❑ No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTORPERMIT APPLIES FOR BUILDING PERT I,as Owner of the subject property,hereby authorize 1Q1�� I Ge A ,� C.— to act.iap behalf ' matters r tive to work authorized by this building e 7' i 1 ) permit application. t„ . (ik it Z. 1 / Prin Owner's N e cironic ignature) Date SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M,G.L. c. 142A. Other important information on the IIIC Program can be found at www.mass.00v/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts jut.. Department of Industrial Accidents R��� i 1 Congress Street, Suite 100 �' Boston, MA 02114-2017 www.rnass.gov/dig Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): (- ( 0\;) Address: ?' L) - / 373 "1-- City/State/Zip. (}'ZEE-a Phone #: ,j T_9-8q! 3 .3 Are you an employer?Check the appropriate box: I.1:9'1 am a employer with employees(full and/or part-time).* Type of project(required): 2.0 I am a sole proprietor or partnership and have no employees working for me in 7. Rern deljcon tlCtion any capacity.(No workers'comp. insurance required.] 8. ❑ Remoeling 3.0 1 am a homeowner doing all work myself. (No workers'comp,insurance required.]t g• ❑ Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will 10 El Building addition ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 11•❑ Electrical repairs or additions 5.0[am a general contractor and I have hired the sub-contractors listed on the attached sheet, 12' Plumbing repairs or additions These sub-contractors have employees and have workers'comp. insurance.t 13.Li Roof repairs b.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[OtherC 152,§1(4),and we have no employees.(No workers'comp. insurance required.] *Any applicant that checks box K1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing ail work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:_D'OW\ t A ry 0 ./ z, I Policy 4 or Self-ins.Lic.;I: W C.C,.SOV )93 13 2 2 ,'fit �/ , Expiration Date: 51't,3 Job Site Address: Z S — O A tkrk a W Q—y City/State/Zip: l.s`4 1 t Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. Ida hereby certify under the pa•rr —d penalties of perjury that the information provided above is true and correct. Signature ~ Date: St)T Z?— Phone 4: - RFq -J33 ? Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License f Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. EIectrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone//: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22* ext. 1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at Z S J c - `,)L ov, Work Address Is to be disposed of oat the following location: S C cO-PAAr,, Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. --- Sit )) 22_ mature of Application Date Permit No. Commonwealth of Massachusetts Division of Professional Licensure 91 Board of Building Regulations and Standards Cons v,liit/ A .visor f, CS-083390 ' ••47,"` a Aires:08/14/2022 RAYMOND JATE “IP, PO BOX 1532 1 i f C SOUTH DENNII M1 f'*"" .. O Commissioner c )id0• K. bl&ice. f Office of Consumer Affairs&Business Regulation I HOME IMPROVEMENT CONTRACTOR TYPE:Individual Reaistratioti Expiration 113'11 03/05/2021 RAYMOND J.CATTE - D/B/A RJC-BUILD140 ENANCE RAYMOND CAT',I �� �_'� 56 CAMP ST :.r • W.YARMOUTH,MA 02673 Undersecretary i • ede-s0 r/C b B )X-"nLj Sears, Tim Can) From: Sears, Tim Sent: Wednesday, May 25, 2022 1:35 PM To: 'raycat200@yahoo.com' 6--v C,T'\ ; I �Q/ACT Cc: Slack, Christine;Water Department Subject: 25 Tam-O-Shanter Way \\Qd ((Ivy Raymond, \z,2 I have reviewed your application for the deck addition and there are some items needed. 11 Health Department sign off / Water Department sign off +'3 Certified plot plan showing setbacks to proposed addition Detailed framing plans showing footing detail, beam connections,etc. Please submit these items for review This email is considered a written denial of your permit application per Section 105.3.1 of the Massachusetts State Building Code. Section 105.3.2 states in part that "an application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been pursued in good faith" You may appeal this denial to the Building Code Appeals Board in accordance with M.G.L. c. 143 §100,within 45 days of this notice. \ Timothy Sears CBO Deputy Building Commissioner Town of Yarmouth 508-398-2231 Ext. 12.59 mailto:tsears@varmouth.ma.us 1 GI) 0.4 00 4 "T1 Is3 CO "t) > CO 0 I Pla ... • 6- 0 aF fItt c\s3 LA\ 'T1 4 itt mak (on 4,41010,06.. >464 CO rs%) ts.) 0:7 Co) rs.) ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/VYYY) 05/06/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Tina Reeves NAME: Dowling&O'Neil Insurance Agency PHONE (800)640-1620 FAX (A/C,No,Ext): (A/C,No): 973 lyannough Road E-MAIL treeves@doins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Hyannis MA 02601 INSURER A: Western World 13196J INSURED INSURER B: Associated Employers Ins Co 11104 RJC Building&Maintenance,LLC INSURER C: P.O.Box 1532 INSURER D: INSURER E: South Dennis MA 02660 INSURER F: COVERAGES CERTIFICATE NUMBER: CL225610781 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,DAMA000 RLTED CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A NPP1577306 10/02/2021 10/02/2022 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. GENERAL AGGREGATE $ 2,000 000 X POLICY JECT PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X STATUTE EOTH AND EMPLOYERS'LIABILITY Y/N 500000 B ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA WCC50050173132022A 05/05/2022 05/05/2023 E.L.EACH ACCIDENT $ , OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 Ryes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations,and endorsements.Nothing contained in the Certificate of Insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Rebecca Newman ACCORDANCE WITH THE POLICY PROVISIONS. 71 Sunset Circle AUTHORIZED REPRESENTATIVE e ' i , Mashpee MA 02649 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD / ONE or TWO FAMILY— BULDING PERMIT APPLICATION REGULATORY APPROVALS NOTICE Address of Proposed Work: 2.-5 Tct" - C - .("1izvi C Limy Scope of Proposed Work: YN€11oNrF ,PC:,q41a. a il1Srv'\\ \Co' x ` 6 t A-LC k &O e , .`1 v r Q ) 1 ; ft o f 1 c mac► / G,-t 6,'1 fi j Z lc i© ?. . I Z°' . 0 . G Date: c// i / 2--v 1 — Based on the scope of work described above,the applicant is required to obtain approval sign- offsm the following departments as checked-of below: Health Dept. —508-398-2231 ext. 1241 Conservation —508-398-2231 ext. 1288 Water Dept. —99 Buck Island Road, 508-771-7921 Old Kings HWY. Hist. Comm. —508-398-22631 ext. 1292 Engineering Dept.—508-398-2231 ext. 1250 Fire Dept.— Kevin Huck/Scott Smith, 96 Old Main Street, SY Note: Please call Fire Department for an appointment. 508-398-2212 Other Appropriate plans and/or application shall be provided to each departments checked-off above. Each of these regulatory authorities has their own requirements outside the jurisdiction of the Building Department. All applicable approvals shall be obtained prior to submitting a building permit application to the Building Dept. Thank you for your cooperation. Receipt Acknq nt: -...f7/1/4t Applicant's Signature Date Rev.Jan. 2019 ( dam . 47. R)w:0 OF VAR\l()t;�tt 0AN WAT E R DEPARTMENT 4 t)—.1 '1 t �t �99 suck (;Iand Redd ``., : acr<ts e4- t.\"'c: Ydri':touth, MA 0267 j t. , i, .t:..' 1. i ,-`1a>n€ ,50hi `) 921 1,1x: i-dii �°i, 't.7‘i:#If BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSZIITTAL FORA BUILDING SITE LOCATION: '�` Iv. PROPOSE D WORK.; ft Jk ; c ,v 4 ,,"Y APPLICANT: 1VY A l . ', ,, - ,`\ TELPIIONE: M ' RESIDENTIAL AND OR COMMERCIAL BUILDING Water Department: Determines Compliance of Water Availability and or existing. location Inginecring Depanment. Deeternrines Compliance for Parking and Drainage Conservation Commission: Determines Compliance to Wetlands Act: i-c. If lobs)border any type of wetlands,streams, ponds.rivers.ocean, bogs, boys. marshland. ETC.,. Ikaltb Department: I)ctennines Compliance to State and Town Regulations, i.e. requirements for Septage Disposal and other Public Health Activites Dire Department: Determines Compliance to State and Town Requirements for Personal Satety. Property Protections.ons. i.e. Smoke Detectors. Sprinkler Systems.etc „ram . __---- (di Z L I'I. CANT SIGNATURE DAI E. OFFICE USE: C'OMIMEN'I'S ON PER>1CC APPROVAL. 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Y 9 U ,� '\� V AkZPJH'AfAAV !ND .a °xNtv 8•x�rn �� id, aa!! x &, i ap d ® : I 1 � tow 4404, 2 p --, iA $o g,UpU d' 6 v' W �h; s�. �8 • ' ' \\./X - t5;.. 1 nwefg�-mad N� BY SIGNING THIS FORM, THE APPLICANT, OWNER. AND EXCAVATOR ALL ACKNOWLEDGE AND CERTIFY THAT THEY ARE FAMILIAR WITH,OR,BEFORE COMMENCEMENT OF THE WORK,WILL BECOME FAMILIAR WITH,ALL LAWS AND REGULATIONS APPLICABLE TO WORK PROPOSED, INCLUDING OSHA REGULATIONS, G.L. c. 82A, 520 CMR 7.00 et seq., AND ANY APPLICABLE MUNICIPAL ORDINANCES, BY-LAWS AND REGULATIONS AND THEY COVENANT AND AGREE THAT ALL WORK DONE UNDER THE PERMIT ISSUED FOR SUCH WORK WILL COMPLY THEREWITH IN ALL RESPECTS AND WITH THE CONDITIONS SET FORTH BELOW. THE UNDERSIGNED OWNER AUTHORIZES THE APPLICANT TO APPLY FOR THE PERMIT AND THE EXCAVATOR TO UNDERTAKE SUCH WORK ON THE PROPERTY OF THE OWNER, AND ALSO, FOR THE DURATION OF CONSTRUCTION, AUTHORIZES PERSONS DULY APPOINTED BY TIIE MUNICIPALITY TO ENTER UPON THE PROPERTY TO MONITOR AND INSPECT THE WORK FOR CONFORMITY WITH THE CONDITIONS ATTACHED HERETO AND THE LAWS AND REGULATIONS GOVERING SUCH WORK, THE UNDERSIGNED APPLICANT, OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO REIMBURSE THE MUNICIPALITY FOR ANY AND ALL COSTS AND EXPENSES INCURRED BY THE MUNICIPALITY IN CONNECTION WITH THIS PERMIT AND THE WORK CONDUCTED THEREUNDER, INCLUDING BUT NOT LIMITED TO ENFORCING THE REQUIREMENTS OF STATE LAW AND CONDITIONS OF THIS PERMIT, INSPECTIONS MADE TO ASSURE COMPLIANCE THEREWITH,AND MEASURES TAKEN BY THE MUNICIPALITY TO PROTECT THE PUBLIC WHERE THE APPLICANT OWNER OR EXCAVATOR HAS FAILED TO COMPLY THEREWITH INCLUDING POLICE DETAILS AND OTHER REMEDIAL MEASURES DEEMED NECESSARY BY THE MUNICIPALITY. THE UNDERSIGNED APPLICANT, OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO DEFEND, INDEMNIFY, AND HOLD HARMLESS THE MUNICIPALITY AND ALL OF ITS AGENTS AND EMPLOYEES FROM ANY AND ALL LIABILITY,CAUSES OR ACTION, COSTS,AND EXPENSES RESULTING FROM OR ARISING OUT OF ANY INJURY, DEATH, LOSS, OR DAMAGE TO ANY PERSON OR PROPERTY DURING THE WORK , CONDUCTED UNDER THIS PERMIT. APPLICANT SIGNATURE DATE EXCAVATOR SIGNATURE(IF DIFFERENT) DATE OWNER'S SIGNATURE(IF DIFFERENT) DATE: For Citv/Town use--Do not write in this section PERMIT APPROVED BY PERMITTING AUTHORITY DATE CONDITIONS OF APPROVAL Revised 7/17/2018 Health Dept. Trench Permit Page 2 of 2 '. Yfti TOWN OF YARMOUTH HEALTH DEPARTMENT 0.cPERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: 5 " " 5-11\.! Proposed Improvement: 12 M m° 1" \ , r " f 6 f� - r c Applicant: dy /// • ,'r '' C Tel. No.:.� � a9 j3 3-7 Address: P. t� x J _ Date Filed: \ ( i/ 1 11 **If you would like e-mail notification of sign off please provide e-mail address: S a S 9 � 5 c V " q J Owner Name: I I ( ) c W tN r\ Owner Address: t ) CP~' , rF^ t W Owner Tel. No.: 33 tr-2 z i - Z33' 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: pbG� (1.) Site Plan showing existing buildings, water line location, MAY 1 1 2022 and septic system location; (2.) Floor plan labeling ALL rooms within building HST 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: 1.4 DATE: c �U PLEASE NOTE COMMENTS/CONDITIONS: C ,rt c C c_. ems' 5-cLC,1C /` ' E . , . . . Lrr 2, , „L.,,,.., .. x---,, .- • - k L. , , . .... . . . . ...:BUILT" BU1 :143 C;I:F1U1AL CERTIFIED AS BUILT IS REQUIRED BEFORE FINAL INSPECTION 1 —. , . S 0A,irs ,,,,,),,,3\,,,,,,,.'!,,,,, ' • , T.. N4.1 I 2 Y k 15 S 40V7i Ilk , ..„.-... .. _ i, • ) . , ; I . . . ..,...,,,. 4,— rc t N, ) . i ii 1 t i . , ' 1i4t11114 tkt (7 /0,04,-7.