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HomeMy WebLinkAbout2014 Oct 14 - Sign Off Transmittal Sheet, Plans - Sun Roomr--------�-- _ _ �f„AR,y, TOWN OF YARMOUTH o��"' HEALTH DEPARTMENT r� . . a --=•%/ PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: � � � 1 {��-t/ 6 ( `� 2 � � � � t ✓-Q x Proposed Improvement: C� tqJ Y� �� �2 J � c- Applicant: 1 � �A..Q, � ,, ` -cel. s7 7� � 7GtS Address: 7 l [y( � �/ —t� ate Filed: �L�' /� '=lfyou would like e-m !notifrcation ofsign ofj please prwrde e-mail address: Owner Name: � �-�w � (� ��Q Owner Address: � ��l�-w ��M.�'l L Owner Tel. No.. � \ ( 1 ................................................................................................................................................................................................................................................................................................................................................................. RESIDENTIAL AND/OR COMMERCIAL BUII.DING HEALTH DEPARTMENT: Detertnines Compliance to State and Town RegulaUons; 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, rooftng; (3.) If necessary, Title 5 application signed by licensed installer with fee. ...................................................................... ..............................................................................................................................................................................................................................................................................._..... REVIEWED BY: DATE: �% y���/` PLEASE NOTE COMMENTS/CONDITIONS: CERTIFY TO THE BEST OF MY PROFESSIONAL KNOWLEDGE, INFORMATION AND BELIEF THAT THE LOT CORNERS, DIMENSIONS AND SETBACKS TO THE STRUCTURE AS DETERMINED BY INSTRUMENT SURVEY AND AS SHOWN ON THIS PLAN ARE CORRECT. JVI OF MASs9 CyGN �0� o KtERAN d. 4 HEALY y o NO. 48135 0 0 G/STEIR SJ s/ONgL LANG 7 3� PROFE SIONAL ND SURVEYOff DTE CERTIFIED PLOT PLAN WITH PROPOSED ADDITION AT #73 INDIAN MEMORIAL DR. IN SOUTH YARMOUTH MASSACHUSETTS (BARNSTABLE COUNTY) APRIL 30, 2014 PREPARED FOR: Mr. JOHN WHIPPLE 73 .INDIAN MEMORIAL DRIVE SOUTH YARMOUTH, MA 02664 518-265-3181 jjcape73®aol.com BSC 349 Route 28, Unit D West Yarmouth, Massachusetts 02673 508 778 8919 © 2014 The BSC Group, Inc. SCALE: 1 " = 20' 0 2.5 5 10 METERS 0 .. , ,. 10 20 40 FEET PROJ. MGR.: CRAIG FIELD FIELD: P. HAGIST CALC./DESIGN: K. HEALY DRAWN: K. HEALY CHECK: CRAIG FIELD FILE: 9805-EXC.DWG DWG. NO: 6227-01 SHEET 1 OF 1 JOB. NO: 4-9805.00