HomeMy WebLinkAbout2014 Oct 20 - Sign Off Transmittal Sheet, Floor Plan - New 4BR House� w�.�� �__.. _ __ .
oF='`R TOWN OF YARMOUTH
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I e���=-^``�� � PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
� To be completed byApplicant:
Building Site Location: `� 1� c� e C�, n c" „ �r� -� ,(y�.q
t ProposedImprovement: �e...-J Co���-� ,�-��, r, y h���r�, ,,,� �,.��i�
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Applicant:�.,� �,,.�.} �, ,.r„ �s wacY TeL No.: G��'-455-��pc�
Address: G S � S u� ,.-. �c� l� ra�c .,"�- MA 1 ��� DateFiled: /O o�� � -
•'Ifyou would like e-mail notiftcation ofsign ojj;please prrnrde e-mail address:
Owner Name:_S'�-c„� c.-c�' �N� AS�uc.c�
Owner Address: �1 S � � uix.�. �2��� r,..�� Owner Tel. No.: Cj 7 ?l ' �(S�f -(eh.a
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RESIDENTIAL AND/OR COMNI�RCIAL 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:F[oor p[ans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWED BY: DATE: �� �D
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PLEASE NOTE
COMMENTS/CONDITIONS: