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HomeMy WebLinkAbout2015 Jun 12 - Sign Off Transmittal Sheet, Plans - Addition 2of�`j.k,� TOWN OF YARMOUTH g �� HEALTH DEPARTMENT y Y '' _•`'� x PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed byApplicant: Building Site Location: �� ��(P/��i�� �L ,������'�u I��� �� ' Pmp�osed/Improvement: �.�i r�G� l��i%�a�, t��o I��'4�� ?'o �(Q�tT ��%. �i �CO�i j� /�nlC �7.<//'.cpM e.,� �M.�S�'.rrL Q��c//l�.� Applicant: ,!/S�U/�/u�QN�.i Tel.No.: S(�8 $72 7622 Address: 7�.f2�C',f'�'�-A7 C� .S. �((A�v+�icw�f /Yl� C�6�� Date Filed: 6 / ••lfyou woedd like e-mail nodficatian ofsign off,please provide e-mail address: Owner Name: r��d /3G[��i � � �7�i -�lj•;:� Owner Address:o(� �Up/��r.�P 1,� yT�Q/� Owner Tel.No.: RESIDENTIAL AND/OR COMMERCIAL BUII.DING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please suhmit three (3) copies of plans, to include: (1.) Site Plan showing eaisting buildings,water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all ezisting and proposed)— Note:F'loor plans notrequired for decks,sheds, windows, roofmg; (3.) If necessary, Title 5 applicafion signed by licensed installer with fee. ....__........_.._....... REVIEWED BY: DATE: � l� l S� PLEASE NOTE COMMENTSlCONDITIONS: l �. .. -a ; ..�, , �� � . �,' � � o � , �-. , - 7 �� „ � d_ , ; �'how�� � � . _ _._ �.__ . __ ; . ; � ����, , �� sT�� � 1 ' � � I �� � � � � ! � ; _ _ � REVISIONS: NO. DATE DESC. I 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. 11A OF MgSsgcyG o KlfMN J. cHEALY o NO. 481 o IS �Fss�oNGTE�9 LA r KIERA J. H , PLS DAT FOR THE BS GROUP, INC. CERTIFIED PLOT PLAN WITH PROPOSED ADDITION AT X22 DAUPHINE DRIVE IN YARMOUTH PORT MASSACHUSETTS (BARNSTABLE COUNTY) . JUNE 10, 2015 ------------- JUM'3'i LD- PREPAREDFOR: EARL LEGETY 42 KINGS WAY HYANNIS, MA 02601-3002 C/0 dhanbo59®comcast.net M.BSC 349 Route 28, Unit D. West Yarmouth, Massachusetts 02673 508 778 8919 © 2015 The BSC Group, Inc. SCALE: 1 " = 20' 0 2.5 5 10 METERS 0 10 20 40 rEEr PROJ. MGR.: CRAIG FIELD FIELD: A. NELSON CALC./DESIGN: K. HEALY DRAWN: K. HEALY CHECK: CRAIG FIELD FILE: 9927—cpp.dwg DWG. NO: 6311-01 SHEET 1 OF 1 JOB. NO: 4-9927.00