HomeMy WebLinkAbout2014 Dec 18 - Sign Off Transmittal Sheet, Plans - Renovations {of�qR� TOWN OF YARMOUTH
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� ''�•<��% $ PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: � � C (�$��'� N �O��. `� c� , �OcJ� �l�'(LiMOV�
Proposed Improvement: \L�•S�v�� Ce��h� 2T K:�'� �:rv�:r+... �ow� + l:v:n� (l�ow.
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Applicant: �C`Pm1C0 ��Yherc7 TeI.No.: C�I}-�(� �-IZI�.
Address: �I CO� �Or� {Z.�. SOv�n �� I�LZiMOv� DateFiled: �Z 1 � ��
**Ifyou would Irke e-mail notifrcation ofsign off,please provide e-marl address: 1- I� 2 I 9 �BO �T M��� .�,dt.�
Owner Name: ��C Y�v cA �Av�'�2 r�
Owner Address: � 9 �C �2��A+V [�Q Owner Tel.No.:� 1�--�I(7$-I Z 1�
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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 ezisting buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all eaisting and proposed)—
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed instalier
with fee.
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REVIEWEDBY: � DATE: �,—/� '/�
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EP�E OFPAVEMENT
( 11ERE6Y CERTIfY Tt1AT, TC7 Tt1E BE9T OF MY KNOWLEDGE,
j AND kN MY PROFES5IQNAL pPlN!(?N, THE LOCATIC7N 4F Tk1E
' PRdPOSED ApDITION, AS SI10WN f1EREON, GQNFORMS WI711
THE F!C}R(ZONTAL SEl BACK REQU(REMENTS OP TFtE ZONiNG
6Y-LAW OF THE TpWN OF YARMOUTH,
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SITE PLAN �p� No.: 14129
��j DA7E: 09SEP I<F
YARMc�UTN , MA�SRCNU�ETTS �S�A�E: '"=2°' -- -
PREPARED FOR ����� oF M�ss'c
COTUIT BAY DESIGN, LLC
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Iand surveyors - eny�neers 5�,.
35 bmberlane drvve - mashpee - ma 02649 IAR�
Ph I Fax: 508.833.7 I 00