HomeMy WebLinkAbout2015 Jul 16 - Sign Off Transmittal Sheet, Plans - Garage with Storage Above -�� _ _ . _ .
�'e, TOWN OF YARMOUTH
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�3��� � a `�}� H�ALTH DEPARTMENT
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�"'� �' ''�,�N�`' pERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
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�'o e completed by Applicant:
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Buildin Site Location:
Proposed Improvement: 7�k ,?d ��4�R�,4�
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A li N T 1 - � I
PP cant: ���"�� �� � 6 � E,�!'PT�4Ny e .No.:�l�� 3(o"�-O Z�
Address:zD ��,G���v �'" J'��.�,�Moc�� /� Date Filed: 7"'�' � l v%�", �
**Ifyou would like e-mail notiftcation ofsign o,f,J;pdeaseprovide e-maid address: ��
Owner Name: U�` �
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Owner Address: /UrG ��v� �=�.Jr �a.�-� Owner Tel. No.: I
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RESIDENTIAL AND/OR C011��IIVIERCIAL BUILDING I
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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 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, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWED BY: DATE: �'' ��"�� � �
PLEASE NOTE ��
COMMENTS/CONDITIONS:
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NOTES:
1. NO DETERMINATION HAS BEEN MADE AS TO d ' 1PLIANCE WITH .
DEEDED OR ZONING REGULATIONS. OWNER ,% A PLICANT IS TO
OBTAIN .SUCH DETERMINATION FROM APPROP1111 t,'E AUTHORITY.
2. UTILITIES SHOWN ARE APPROXIMATE ONLY, E IX .1 VATION CONTRACTOR
IS TO CALL 'DIG -SAFE" AT 1-888-344-72." 3 +,.T LEAST .72 HOURS
PRIOR TO COMMENCING WORK ON SITE.
3. CONTRACTOR IS TO VERIFY GRADES AND ELN '; nONS AS WELL AS.
SITE CONDITIONS PRIOR TO COMMENCING WOPK -i')N SITE. ANY VARIATION
IS TO BE BROUGHT TO THE ATTENTION OF TIE DESIGN ENGINEER
IMMEDIATELY.-
4.
MMEDIATELY.4. PARCEL IS IN FLOOD ZONES C & AE t f
5. LOT IS 'SHOWN ON ASSESSORS MAP .,. IS PARCEL
WE, .
LANr
Sc �J 1,IC1 a . OU SACHU
AS PREPARED FOR
IMiUE ROIL ROAD REALTY*TRUA"' .
SCALE '1" = 20' JANUARY 16, 20►:
0 10 20 40 60 80
;fir '� �% 1c�es►rI
a7 a i? M
203 SETUCKET ROAD
P.O. BOX 713 , .'1 31341
SOUTH DENNIS, MASS. I
02660 rig► Iw
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(508) 385-6900 .""
FAX (508).385-6991 13973-00
C: I S8 1 PROD 16973-00 1 dwg 16973-SITS-PLAN-NAD88. DWG 0 20.i"- +SIir==R ENGINEERING