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HomeMy WebLinkAbout2015 Nov 04 - Sign Off Transmittal Sheet, Floor Plans �oE�q_�4 TOWN OF YARMOUTH �+ �� HEALTA DEPARTMENT o � --r � ''�._�•`' x PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: � � �V� l.�(/"1P W ya rm M��'� Prop sed Im rovement: -L Ji1 � Applicant:� Il.1Yl'(1 IVPIULI' L�C'��(�() Tel. No.: `�"�3�PU��0�77 Address: (Cf � �CP.YI� � �l'✓/'1 DateFiled: /Il�l..,�ls **Ijyou would Irke e-marl notifrcation of sign off,please provrde e-mail address:_�"/��0��(1 ��UQ�C�� Owner Name:-� Y 1 1 f'1(1 Q�Vu 'L�C�t�'J�U O Owner Address: �� I�P � !1 f'U Lv yl r� Owner Tel.No.: �� 3/pU L//71 RESIDENTIAL AND/OR COMA'I�RCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements ' For Septage Disposal and other Public Health Activities. Please submit t6ree (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:Floor plans not required for decks,sheds, windows, roofang; (3.) If necessary, Title 5 application signed by licensed installer with fee. ....................................................................._....................................................................................................................................................................................................................................................._............_........................ REVIEWEDBY: ►/U �`�1//i1' DATE:�y// S—` - PLEASE NOTE COMMENTS/CONDITIO�UT � �t �/S-Y� C� C c�. �r�V'O�'� � �' � � — � � y y � � � � �G � �� � ���� � � .___---- � � � � � � � Y � 7 ���� � � � � � � ` � � a a s � � � � � � y� � � \_ �' 7, � . � t^J D �9d/,� [ ( O d �'����.��� -� . � 9 � G � � � � �� � � � � � �---- � �. �, � �o� �� ,���-' p�l �ro� � � �� � ; �i � ! � �'n� Q �1-c�,fir�� � J I fxt,r�� � � 3- ����1 � � � � �s�� �� � �a�im � � m�rn � ►� D �,��L� � Q1�:h�i�l �� N�.�„c� � �b�P�X'J 91`�'�3 � � � � Y -��rn.M�►v � �;�� � ; � �L , �.1- � bs �-� i '' � �: i L � . � o , � I � ! � 3 i, _ � -- { �' v�,�' (� l�"'�'�" __._.._� � w ���, ��� � I �����' � � ( ���`�` . I I � ��y,o'�`"�M �u���� '-����� .T��2�' Q()�') ����'V ,� 5' �CS � lI �� �