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Home My WebLink About2014 Feb 25 - Sign Off Transmittal Sheet, Floor Plans, Info - Use & Occupancyr � I � I .o:;,�,� TOWN OF YARMOUTH f' 'q �` �- � HEALTH DEPARTMENT pF�'�i�-7 r,�'�•�s pERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: a _ •� - ` 7.S Proposed Improvement: iJ — Applicant: � G _ i , , /tk'AriGK �ca1Tl�-�o: 77�{'�- 7�'�� 1N Address: i , � ' 4�G DateFiled: - /i 2p/¢ •*Ijyou wovldlike e-mar!notification ojsign off,please prwide e-mait address:��/�r/iiizQ (p'�_/'�!°�e>�.-� t�of'eqN' // � ,bwner ame: C i N�_/ /.PcJS� / �� , �... �/ � o2L7h OwnerAddress: / � iCl71�S'Ci�'�i(/��,�/�?�N�JI�[(o2t OwnerTel. No.:SDR—,��G� 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 existing buildings,water line location, ^'and septic system location; , {2.) JFioor plan labeling ALL rooms within building (aIl existing and proposed)— � (rwi u.�� '�s�`i�J?�D l�� Note:Floor plans xot required for decks,slteds, win�lows, roo tng; ••r-u:t (3.) If necessary,Title 5 application signed by licensed installer with fee. REVIEWED BY: � DATE: oZ �S� PLEASE NOTE COMMENTS/CONDI ION : J��u y �. r��T�•s� PR�02 7ti �i�e��'�-t. i . . - •� t i . . . _ . I iL�G I .; skfi/�� 9-1-- � . : _ . :.. I ,,,,�,,� 6z„y��r o8L . . . _. . . . , t la rytil, �7/ - • � v ' I.�-,q.�, -�2�,�c� �� . .. �� ' . ; � . � �� o!. . . �.� . ; �-�+n°�/''� �i F . �� ' � : - � � : o NF�' 7 ' . . • .• . • ' � . ' � ' � �.�" },. . .. .. . � .. '. •. -S��' �� .. . ' . `ce ' ... � �� ' � . � �j . . Q ..� : �� O . •, ra� � O 0 t -. `e " _ �� Cc��„j ' .�T . � s � �'_. ,� __ ; . : � o .. .. . . � - TUN-03�2006 11:01 ' � � - I ' � . . ' o g . � - . p � �- :�.. � � =, � . _ : f � . . . . . . � �, .� _ : - - . . ti . :. -��. . � � C� �� - \ . . . .. .. . . . . . _:� �. � - . � . �. . � �_ _. _�� .�_. . . i �} _ . . . : . y �, � -�. . �; .� � Q .- � � . .� .. � � - � � Q � ��-. � �� P �' _ . . . . . . �. .� � � � � ` y . � . �� ._ .. � � I �'. ( � ) �,,,,�n„q�g i � �( ! . . , . ��J "'7''l� (b . � i . � � . . . . � v � , . . ' � '. . . Q • ' . � _ . _�_ .. : : O . . . . . '. ' , ; '.... . � � I . . .. . .. . . i : :ra'�C.=�1�� _ -, _�—_r_ i , : . . � . ,, : . . . . . .. , � �t �. ��,�� . . . . . . . � . =.ua—�rt� �-1.r+ L�, � �� ` � � _ l�? `- `� . �� ' _s s � �y i'�� .A.�' �v��.al i � m v �f � � � � t ■i , � �, � r j.�- � \� �' �� . �1: I � �1 � .r � C; � C�1 V � ' �-� � 7� _ `�' � -� � -n � , � ,.� `�" � � � � � � J �Yy�� i ------ _1 ,-' � �, Q� � . `�' �.�- - � � � • � ,� � �'' � ,��y?,i, i � i;� i�.ti� �, � � '��°�� ' I a , ` m h. � : � � — .' �_ , � TJS � � I � � rS'� �, �� j. �- v�. ; • ;�,� �•.� r . , .. ;___-� �: , ; «,.s�..{�— fj i---!� �� C`�� : �' ' �il.--%_ .� � � , � � � � � �' 'R' � � ; _ � �---� ��:.� � I � S� m i ' � � a E � �_ � E, /�v� �\ � �+��_.� �'— � � `� . S i � a -- ��-" -- ��,� "�'°�� ,� � '"� � O �'� ; �� ' I U o �� ; � {.,�� C� `� ; �� p ' „t�" i � �, �v- z; � ,. � � - >_ �^ u. � Y`� � � � � ��` � I C�-. r c� ' � �� . , '� . • I �,,,C7 C \ P �� \ i ' - _ .�� F+. � � � � � ��„c.� �,�,, C� �J � .c� � �� r ; _ O 7� � � 3 n! �� "Gd i� , ' ,a � C �' P� t� s� � \l � .3 1� � ,L �'�� .�� ( V.1 �i� �"„�J `. , '� = Ll _ _�==-. ._ � � , _ ,. � � � — `J c� . �:: L_. � �. ,__.�.,—�-j-_� t j –� �� CGwAe& E Lm -est- 4e /, n t S )� CA, vC rS ^'`,^C1 hL on f -4 L�CA K�roog, 01/� Yq CHT Ct U� �U nz-,�•,S `�nOtif 0 tfSt�cs IJ i Franck Champely - Chef / Owner 774-722-0629 frank@chezfranckcatering.com www.chezfranckcatering.com r lc5z6) 310 a — G 0 -z �g t