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HomeMy WebLinkAbout2014 Nov 26 - Sign Off Transmittal Sheet, Floor Plan - Pool House oF�aR,y TOWN OF YARMOUTH 3= - ���� HEALTH DEPARTMENT ���'����? PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 9� N°�"�f 4`^' ���� 1��"'"°"{� �O'�- Proposed Improvement: l�o o l f{.L�e /j� �X z y � � .;. ✓ ; , . Applicant: C �a , W ti "�� ''V Tel.No.: S of- 7�7- y�a 7 Addtess: 9 a No �'� Ge,,. ,:�.e: � Q' ,8�`T� � Date Filed: r�z s�,y ��4 **Ifyou would[ike e-mail notification oj'sign off,pleas�provid e-n1�aF1 dress: w/.'f/r.0 r" u�<<B� N�7`" Owner Name: C�w . � ^J�a � �� � , Owner Address: 9e n/� fi�N �r.. 7i..� ` � `. ,� Owner Tel. No.: -s��� �6�- �39d �,;a - {,� � : � s• _...............__..........................................................................................._........................ 7.. ..T..�..ti........................................................................................................................................................................ r , .a 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' 18beling ALL rooms within building . (all existing and proposed) — Note:Floor p[ans not required for decks,sheds, windows, rooJng; I (3.) If necessary, Title 5 application signed by licensed installer ' with fee. ' .•- . ............................................................................... ............ ..... .................. REVIEWED BY: DATE: I I P � � PLEASE NOTE COMMENTS/CONDITIONS: I _��I Nu�s� — n1�� �� �., l� r�c c� K �t�14� � sTN�` � syf�°-� • cv � :i U 1 I � �, � � , � ; �`. T,�. . � � . �. � .. . . . .. �� N 0 . . CO �. - � - � � . � Q .. �. � N� � . . . . . . � pl�l. � 7 [3 a x �o-,ti1 �0-<� � 0 � � _ � ; . � : M Q Q Q Q � ' _ , :,� , ^ w ' . . ..O � ... � . . � J •O � Z � N � � a --- : � o 3 Z w o � - � --- .Q �¢ J � : � � �x W `" � o Q Q � aZ , o -� I— wo � .N. . . ..._ . . . �. . � .. . .N . � . �1� � . N 3 z LL ��-uZ�L L—L-,£� 11J � O «z � �-, " I ��� Z o n �' -- --- : U W _ - u � --- -- � � � , , ' — � o .t ------ " - Y � - - _i � = N . .T'_'________ � . _I . . -- N . . . . . � . � . . . � . . � _' '___ -r . . � . .� . . . .. . _ . .. _ � .. ... . � . "'_ __ N .. Q� .Z��„�. � . . . i . � _ . � ____ '_" � ^ . . . . .. . ri � m0 Z � � . � _______ . :. .J N . . � . . � � . . .. �. . .. . �. . . � . � . . . I � . . � . � . . � ; . . � � . . . . � . . N . �: .. . . . . . . . . � a � �� . �� r� � � � -.� � :. - . . �� , . . . � . . . . . . . . . � . � . . . . I. � � .. . ... . . � . . � . . � . . � �.� . � :� . . . �— . . . . . � . . . .. .. � . . . .� . .. . �. „Z L Cl—,t ' pb/l Ol_ �.� l L-�9 _ „0-,Z „b � ti-.5 n0-,ti l - ----------------------------------------------- --- -+ -