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Home My WebLink About2016 Jan 13 - Sign Off Transmittal Sheet, Floor Plans - 2nd Floor Addition; 1st Floor Renovation. _ .. ..,�--�.. __ .�.w�,,� �....: � ..A.� _-�- r,_.��:_ � �-.�„-..,.,�,� . �.._ _ .�,.� _ � �o��?�,y„ TOWN OF YARMOUTH -n ��>� HEALTH DEPARTMENT , �`�` ,-%:� �"'��N�%' pERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET ' To be completed by Applicant: ' g 2 5 1-� . '� Buildin Site Location: Os,(� 1� < ��' � �"" I �t �/ �Q __..-- Proposed Improvement: ,�- r� l� ` 2- ��Ci � 'B�Q"�'� ��4- 7C k-/ ' �` sL e�o v _ ' y.�� -��,..1�..a� �r,� �� qdloC4 ��s�-�,,rt,w�� _ I Applicant�� , S � f'vt `� �� }� Tel.No. �� ` �3 z. � �l 5 �� I _�� ! . � Address: 2`�G CO V�t F � �'Jp 1.�12'ti f�'1 S 5' S D�te Filed: � � 3 � � ' **If you would like e-mail notification of sign of�j;please provide e-mail address: ' .- " �/ Owner Name: � �`�-�.. � �L�S ��''i,c, �Glu�/G�I-� Owner Address: Z �j fi��K�t � �-Q ��.�-- Owner Tel.No.: �v$ �� "- , ..............'...................................................................................................................................................:.............................:............................................................................................................................................................... RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Rec��e,�nts �' �- For Septa.ge Disposal and other Public Health Activities. ��' Please submit three (3) copies of plans, to include: . (l.) Site Plan showing existing buildings,water line location�,�� '�' : and septic syste�ti location; - (2.) Floor plan labeling ALL rooms within building ' � (all ezisting and proposed)— Noter Flbor plans not required for decks,sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer " with fee. � REVIEWED BY: DATE: � l� I� P EASE NOTE COMMENTS/CONDITIONS: ' C7�J�'_ � �'+'��t �l_ ��z'��/U f;�r; � ,�� .,��-� - �.� (`- GG✓ �� - �,� I ' �v c.�,�v�..,% - ! � 4�sC�-.. � � , ......�_Odvi �'�%'O d �� e ed! ;rear �"i �. ...... 1 A �. All a 1 t ti � 1 A �. All