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Home My WebLink About2015 Apr 07 - Sign Off Transmittal Sheet, Floor Plan, As-Built Sketch - Sun Room� _ _ _ . _ _ __._ ____ .. ,,I �' '" oF�R,� TOWN OF YARMOUTH I I 3{ -=� HEALTH DEPARTMENT o .� � �' ''��=••%l' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET ' To be completed by Applicant: Building Site Location: �� U� ��-h ��- �� ' '�� U��y ' Proposed Improvement: � � u' �� Di r lG I� � �(�CL � ti��S C= ►Z = h-Cri � L G tTC N- — OvJ SU!`!f4- �"✓ �' '' � , �}��.'� c��s `►-� s� v�y appiioanc: IG l�+-�c-��= t� {--I vc...w-r�,S Tel.rto.: � �9 0 - F� �y 9 �' `�� {{II-��-E l.P�� ,�J� S w�H- Date Filed: �� 2� • �5 Address: ddb3�d '#Ijyou wou[d like e-marl notrfication of sign o�;please prmide e-mail address: JG . f-I o��S �3 � �'�^�� i •/JL'i Owner Name: 1Cf'��'--��' �bt`S`� �1� �(LOc�J h1 I'� Owner Address: �cl 12 U J� �� 12 D • Owner Tel.No.: S�g � �� ''�� _....._........................_..................._............__..................................... ..._..... .._.... .........._.........._....._._... ............................................_................ ....._... .. ._. ......... ... ...._ssa� � RESIDENTIAL AND/OR COMNIERCIAL BUII,DING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulaflons; i.e., Requirements For Septage Disposal and other Public Health Activities. �i--- Please�sulimit 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 �i (all ezisting and proposed)– 'I Note:F[oor pdans not required for decks,sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer -� with fee. I� ....................................._.................................... ..... .............. . _....................... ........................................................................................................................................................................_............... REVIEWED BY: ' ` DATE:__� �— / J - � ' PLEASE NOTE COMMENTS/CO DITIONS: i, , S� �„T N� Sz�,�`'� ��s � � ��T r�i�� S��. 2� ' r vv�s7� • � � s' � - f � .: .- ✓�-�-r� CrsS�, � C uc�� —J� • / f f n � � � � :� . � , � � � � ; � � � , �' � � � ; � r � � °� � �' € - �' � � , � � � c . � c � � � � � � � � � � ' - ° � � w G � v � � � � � � � � � � � � � � � � _ � � � � � �� r - � �1�� s � � y � " � � � U-� � � f .r-p CJ� � 4� � � — o� ` � _ � � � _ ; �,I� .____._D ._ . 'L : �1l C� I j � ; ` N I � } •T I � � � ' � � . L� � . � � �� ,� � _ �. ; � � ; � � . � �, � � � �� h o � � � � 0 � �. �� " �: --� � ,�`f �'' ' t '`/`' � � m � �` � � � � C ;� �� o � � � � � J ( � ii; � I