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Home My WebLink About2015 Oct 27 - Sign Off Transmittal Sheet, Floor Plan - Finish Basement y . w p4,_?r�1R� TOWN OF YARMOUTH �� `�. •`�� HEALTH DEPARTMENT �' '�"��••' x PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: �� -x✓ � �n� �� Proposed Improvement: t' � �l '. �� `�'"'P^'� � � � �- 7a S� Applicant: �X '�'� +�'S �✓�"� Tel.No.: �t�! S Address: �io � / �i GI 5 �Cl ��u�� s d�l� U�(„a ) Date Filed: /G � S � *•Ifyou would(rke e-mail notifrcation ofsign oJj,p[ease prrnide e-mail address: Owner Name:�(�T ✓�'��i�- � 'T U� �- Owner Address:��r f WG�T� � n �� s Owner Tel.No.: Sb�'S77-7d3 � RESIDENTIAL AND/OR COMMERCIAL BUII..DING � HEALTH DEPARTMENT: Determines Compliance to State and Town RegulaUons; 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:FToor p[ans not required for decks,sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. ....................._...................._.................... REVIEWED BY: DATE: �G PLEASE NOTE COMMENTS/CONDITIONS: \O � � � 24'0" 3' 11' N � � � . . o , . : . . C � S 2 � . ` !'� V .. . r. � � A �_� c � � -� s � � � s � � � �N N � '-� � � I x � 4, p„ � �� . o °' .. �. .:. �� : 0 � � . �'` . � . . �. . . �� . � . I � � � 00 — „0 ,tr f� � � � � � o � � S O s� . o � (1" . y � �, ' �. . � . � � � : . � N (,.' ... . . . � �5 .i � 7� � . G N C` ' � � �. � m o � , , �-- � � o'� � � .. . : � '. N. �. . � . � :. . �C . . . . � . �. ,� � -� . � � � � � . � ' � � � . ... �_-�'�� : - . . C � � . �: . . . . ... . . -1-, . .. . . .. . , . . 1. .. . . �2 J 24' 0" , :