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Home My WebLink About2015 Sep 23 - Sign Off Transmittal Sheet, Plan Section - Basement Stairs�.� . .,._t : __ _ . _ _. _. y __ =oF��r,y TOWN OF YARMOUTH � �O HEALTH DEPARTMENT �'�•``Jx PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Appdicant: Building Site Location:_�_��/ Q� W, `/�p�T1-4 Proposed Improvement: Tn iSTYFZ 1 N 6tv �� Cr'R-'ST 73A5E��'r 5`74+ �S �1 ��re �� i,�7;�n'�f'v't �-cc�,S Applicant: �)�i.��tC�/ Tel. No.: �ci�' 73"7� 3 '2�1 q Address: � L;tJ�C �?7Y_L�CL�STD , M/L l S_�.- 02 bYfDateFiled: `�,C�"3�)S **Ifyou would like e-mail notification ofsign off,please provide e-mail address: Owner Name: ��P IQ,Z'R E i I'�C,7 Owner Address: �`h O/t1� 1-!J�L s�/ /F Owner Tel.No.: ..........._.....................__........_Q.i't�'�I�..............................._......_...................................................................................................................................................................._............................... RESIDENTIAI.AND/OR COMIYIERCIAL BUII.DING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulafions; 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 egisting and proposed) — Note:F[oor plans not required for decks,sheds, windows, roofing; � (3.) If necessary, Title 5 application signed by licensed installer ...............................with fee. � .........................._......................_.......................... ................................................................................................................................................................................................................ � REVIEWED BY: DATE: g��j—/� PLEASE NOTE COMMENTS/CONDITIONS: � �� /i�/o�i�r� ev� �.j,.Ti(G�P 9j�i /��/.f�f l��G//Q�OIi/�/�'/a'�'lf� . ._. .:... .. .. _ . . �VWF ,�, NQp �� ^ �ya4 NaLL �y�.Ji� . ... . . ._. . . . � �WV1 MfW� UW K O O Up "..... . ` _."a . 2�� 7 JO � �NW �WW �WW ��U �=U �=U 60 Z p �^p ��p ��p a , � M �� K �� r • aVi � i � A o I - �- W �- '� a � � w ___.. �' / w = ��" � O . �pP� �� a ,� � a� a �� ZZ � o t � Zo0 2 � m YZ O� �1�.� OmLL � � sm�w �� f QP'�M i \ � � � �+ ao � O . a UUOi� QIYj.� � 6 ` i ZF-.'N N F.. `L i j ,\ WQJN � m(JWQ Or �'/ �k � �� ,d `\ � 69�/ � �� dd �� 22� , W \ �� m / +� �� a o � � 22 z,., � � � M� �� N� ' ' �� ry, . ^N . \, , � � w2 �� \ ZZ � O� �'ry !. `�!� t-. '� ' co � r'�., cQ b � y _W 2 \ o � � '� ,r�`� ��y �6 � � �� 7"� , � .yti . �� '� .+ '� � OG41 °�7��G,�aq � � \ y�u �� Q T ytTb ,,, � i r' � �, a C7�S -22 �Ji` �� v� ;d�l , ' vZ"J6 .ry � N � �yy "> r�n 5 03 �^�+ �.��:L . � � "' . r Ji J P '� \N� � V C' d 7. �� 5' �� ,�� Q � f.3 . .J�c� � �)�i a, �i, P q� N � y,°'o d'v�� Y��s�' c�"��'� J��- s M� N � � vi''i o' �li r c�� °> _ 1 0 3 � i � �� . � �_ � 2 c2 ' / U N � -/'�! W SO /� yJ� �� W�Z /'/�Jp oZ7 �/� \ U77 i �� Q „� 00. /� � � om� C�2 �z2 `� ' " :� 3g � " � II � , z : , a : (V �6 �� i / .-1 r iVo �r � 'S O ~� " •c+� 5 � � .� �� ' J Q�,�N• �` / �1 O S, �o o�w � � � � � x o,n O � I—i C/] � � y � �� Y''" � Z�t+1NVl '^ . �� ` `c `�., m�fn W Q ��1 . S � � � � iW- �� g �= 2, �°e � � . � � �mo � � � � � � - � � �y`�' a `c� �T� � . � � s 4��1 N $ O U ,-. � � . � � � 2� ¢' � �t� U�0 (� �N y�}� C� _ �. ¢� � J � � '~ W 44. O � I� N N r, O `� (O (O w X} � �� s� � �� •� z � W �