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HomeMy WebLinkAbout2015 Aug 18 - Sign Off Transmittal Sheet, Floor Plans ._�. __-_-� _ _. � _ � _ ,�,�,-�-�.�_ � r_� _.�,..,�....,.,.v .�� _______ roF�'9k,� TOWN OF YARMOUTH � - ��� HEALTH DEPARTMENT o� --r � �� x PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET ���cM< To be completed by Applicant: Building Site Location:Sf �'Xa,�,„, ,� Proposed Improvement: O z- Applicant:��� Tel. No.: 7�4 5'q3 9 0� Z Address:[.to .�,A,,,,,„,.,.���y. o a.a i o Date Filed: �f t d tS ss/fyou would like e-marl notifrcation ofsign off,please provide e-mail address: Owner Name: � C�a��o-� Owner Address:S'1 lyX.a,.,.... �t.+c Owner Tel.No.: Sog 77L 9,.G f ..........................................__..............._..._........_.........._......................_........................._............._.............................................................................................................................................................................................. 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 s6owing ezisting buildings, water line location, and septic system location; (2.) Fioor plan labeling ALL rooms within building (all existing and proposed) — Note:Floor plans aot required for decks,sheds, windows,roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. .........................__............_........__.............._..............................;...._..................................... ............ ..........................................................._.................................................................................................................................... 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