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HomeMy WebLinkAbout2015 Apr 22 - Sign Off Transmittal Sheet, Floor Plan - New Kitchen, Bathroom 204;aR,� TOWN OF YARMOUTH o ' '--��y HEALTH DEPARTMENT ���_=•`%�� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 3�1 (,Q�1J �S Ic.O71 c� , W , �%Acl-w.o�t�l. /vU� 1 �� � � sh�n lQS� Proposed Improvement: 1JP� �i z�ti.uN lar�d, ��+t'Mr� V�O.,� S.F�Aa .5�1 ne ,���� ibAcac- l�e(t- , �(►�,nao� �-�caw��x(AY r�.ckn� c�.n�l �e.a �1�� (6�r Pi.,.ti,e,p�� C'..,ven. Q„c. b¢dteo,.n l.r�t.y f�.h. w/ n+w sw..krod� Applicant: 1-�'�•�Cr�y /�'ZtAteQ� Tel. No.:4�3 zIo'�SRS" Address: ��� Date Filed: `� ?2 I ••Ifyou woald like e-mail nodfication ofsign off,please prwide e-marl address: Owner Name:_ _�1 111��1 I'1� Owner Address: �t �f..w i S '��J W � �A-tl,he u'F� Owner Tel.No.:�t�`3 �i�(�-`19'3�- _.............................___................._..........._............_......................................................__.........._................................................................................................................................................................................................. RESIDENTIAL AND/OR COMNIERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Healih Activities. II 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) — I Note:F[oor plans not required for decks,sheds, windows, roof:ng; ' (3.) If necessary, Title 5 applicallon signed by licensed installer ' with fee. �i REVIEWED BY: DATE: �� �Z � PLEASE NOTE COMMENTS/CONDITIONS: J- � � ; ri � -_ _ � _.. ��e_w�.3 _.....� _ _ —_� , _., I ��� � � �cg� ; � � � i _ � i � � ,,,, , - _ r --� � , � � . . � ,� � �- I , _ _ _ ' N � � � �- _ �., ` _ � __ _ _ ' . N . � . _... . . _ . _. . . . .. . _ .. .. . _ ... _ . . ..,,.. . . �� ._ ._._ .x_ ._ . . _: . . � i ,I � .; _... _ .. ._ . . .. _ _ . . . . . . .__ .. . _. ._. . . . ........ ..� Q ` _ .. . . . ._ '' . . _ ___ g� . - _ ___. . � � . _- _. �.. ..... . ._ I _. � ... � .. .. .. . ... .. � .._. ._. ._. __.. . I . . __ ..a._ . _. I . . I I ._ _ .. . . , - ..� � ... i ___. ._ ._ . . ... . �. . ... � 3 � �� . . . . . .. � � .. ~� /9. _ .... . . . . _ .. . p ,-� 4i � C � , _ _ � w�.��_ . . _ , ' � - ' � � � i �__ "� _ _ ' . _ ' _ �- _ __ � I _ � _ _ _ _ . � - __�- _ . � �: � _ _. ,__ _ _ - , � � � � � � i a _ a , - , _ � }� 3 _ _ �- _ ' _ � �x - , . . . . . . . . . . . � . . . . ._ _.. . . . I� . . .. . . , ` . .. . ... � . .._ ' � . . . �. . .. � . _ . � �I. . � ' 1 � _,_ . . � . - _�`_ . . . ._ t� � . . _._ _ . . ... .. ._. .� I! -- . ._ .. ___ I � . . . .. . _ . .. . .. . . _. . __. . .._ .. . ... __ .. � . . . � .. .. . _. _ . . . ;: . .. .. � _. . . . . . .- ._ . . . `.._ + ., . ... .� i�. , . . : . _ . �'. � � ._ . I _. I.� i �j