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Home My WebLink About2015 Aug 05 - Sign Off Transmittal Sheet, Floor Plan - Outside Stairs _ .. ,E._.�.w : �..�..._,�._ _ _. , .� . __ .__ _ __ _ _ _ _ toF�'�R,� TOWN OF YARMOUTH � =�� HEALTH DEPARTMENT � ''��_�•`' x PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: /t C `� � � �- �: Building Site Location: �� „� Proposed Improvement: C.+zG�r� � �� _.��=¢c�� /�� _✓�.�-�.-L.�- 0 Applicant: �/�v/� /,i,v/�/r'� Te1.No.: '$�6�- �5�5�� S� Adclress: 's9 ,�irs�_�.�-e� � DateFiled:� **Ifyou wou[d/rke e-mail notification ofsign o,(j,please prmide e-mai!address: Owner Name: ��l�- ��i G Owner Address: ��„..,.,.� `t,,� ,�"� Owner Tel.No.: _.........................................................._.........................................................................................................................................................:...................................................................................................................................... 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.) Floor plan labeling ALL rooms within building (all existing and proposed) — Note:Floor plans eot required for decks,sheds, windows, roofing� (3.) If necessary, Title 5 application signed by licensed installer with fee. ......................................._.................._............._....................................... ......... ... .................................................................................................. ......... ......`r, ............................................... ............................... REVIEWED BY: � DATE: /�// S � PLEASE NOTE COMMENTS/CONDITIONS: / S'tG4?N C �cr�Se c� — iZr k�4 L ��u,5 2 - � 3� �o U�. �(C — 1 l�v`�.' � �i c.✓� ' ' - ' - - - _ I- f- C � =� �� - , - 1 ' � i — � ! , l , , f r — -- � ��— — - - � — ,, - — - — — � - �� I , ,�,�� i � -- --- , ,- -- -� _ '"-* - — - --- f� -- -- � � � � � � ___. --� , n -_ � , —_= - ----- � - — — `—�-- � � _. , — -- - - - — }� ; ' � '..:_ ; , ,. ±-',,. , , �'.�-, - � -- __ � -�- _ - � - I � _.. _ __ �- ' ' �'^� , ', ' � '.. ' ' � ' ' _ , � - - - - , ! p , _--�'�� —.�� /� _ 3 � - $ i - , �--� � — , � � : - - - - - y . I t� - , �-3. � ' � �-__ --- - - - --='� , - �� , ,_ , � $ - i- j j ! 3 �j--� i � - - - � � - - �- � ; ' � � , ; , - - -- , - : �-- �� , , C , , s - � _- —�— -- -- -- - . � , ,! ' : t , , , - __� _ - __ _. �{_ ' ; ,. ; -- - , - - __ _ '- - -� � , 3 , , - � , -- _ _ __'- '__ _ _ _ '' , - - - - _ _ _ - '-�- - � , , - - -- ; -- _- -- � � ' "' - - - -- - � � � � --; - ---� - -- ' ___ - . �- - - -- --� ',_ �� - _ -- _ _ { - T - - - _ - -:- _- - - -- -- �- , - _ _ _ ____ - _ ----_ --- _-- ___ _ -- - -- ; , , , a , _ -- --;— ' , �; ,,' ' ', '�'- ,- _ : �- - ` , , .�.., .,, ,,— n',, ..� ,. , .��,, ', .- .- - -,— . , . _s_ . . , .. .. -- �,, � � �— '�,� -�.- � �. , �. . �.. . . , . . �� . , \ : ... , .. �., -- . ��. � , . . }J ,� — �,, ,.—�—�,-- . . ,--- --- ---- ��' , ', . / �� .. �I ,,. . � ' ..,. ' �— �, �. ..... —. --- — _,.. .,.. � ..,, ,.. ,.. ..... .._ , __ .— � .. . . . . . �, ---.._ -- �— �'�, . . �.. ,. '. ''�.. Vt' ',, �'. . . �, �.. I , ., �.. ��.. ,, .. �. '�_ � �,_ '... ��, �,,, . �, ,,.- . , , , Y �,, �, �, ,'. . ... , . ., ��.�. ,, ' ', � , �,, �_ �. � ., , �. ,. ��.. � '�. � . ',. .. .., ,,, ,. . � �I. ; , . '� �� , '. .. —',,�- ,,. � c,�, , , — � � — � — � — '�- ` ---Q g , ,` , , , �`_ -, - -- � �� I . ''.. �I � � ��... '� �.,,, ,��,. '... ��,. , ,,.. . �',_._ �'., .. .. �:�-� � . ',�.. �, � . . ., �, , . . ... .— . . _ - ., , , �, C� . .. � ,, - �� I ' '�.. � ., '. ',. � ',,, ''. '',,..- �... —�� , -- ..,— --