The URL can be used to link to this page

Home My WebLink About2008 Feb 21 - Sign Off Transmittal Sheet, Sketch - Office Space ,;, ..�� -�-.�.� ,�-.m_ -�-�.--�_ . _.. _ _ . ._ 4 .,.y , , � _ _- - . . , � , - 7 ��.�� A ,' � . � . . � �•°��Y`�'4�o TOWN OF YARMOi��'H � y HEALTH DEPARTMENT � MR A „ �5�� . . . � �'°"""°+ �' PERl1�IT APPLICATION SIGN OFF TRAN5MITTAL SHEET �To �comple�ed by Applicant: , �' � �� Building Site Location: �t � Map No.: Lot No.: ,� � � � �c l� C"'S v� t.u€�..� ��.�t <r��t"(/l,s Proposed Improvement: • � p�.�,y'��, • b� ( / G�(/ Applica.nt: C� � ' Tel No.: " �� ,I , Address: Date ' � � c� � ad � � **Ifyou would like`e-mail notiftcation ofsign off,please provide e-mail address: � t;�� 1.�.�-�.. � , � �,� Owner Name: - Owner Address: � �\ QC� �Jy��--�. `� Owner�Tel. No.: �5' ��" �c�, ` ��.c�... �:--��.�-----t`��.x._��.�� _e...................................._c.�.bb�l--------.........._---------- ---------.._..... � ----....----......_..._...__. , `� . . _ -�� . , :m ., RESI�ENTIAL ANIftOR COMMERCIAL BUILDING ;: <�,_ ; �;,, � HEALTH DE�'ARTMENT: Deternunes Compliance to State and Town Regulations; i.e., Requirements �' For Septage Disposal and other Public Health Activities. Please submit four (4) copies of plans, to include; - . (1.) Srte Plan showing existing buildings, water line location, `� �" and septic system location; �. (2.) Floor plan labeling ALL rooms within building (all ezistiag and proposed)- ;` � -�Vote: Floar plans not required �jeeds, windows, roofing; (3.) If necessary, Title 5 applica ion signed by licensed installer �, with fee. ..................�-----...............�-- -�---�---�--�-�---- -----......- �-��-- -....,....-�- ----------��-------------...._...-�-----�----- -...................��--�---�--�-----...................-��- -.....---�--��-�-�-------�----...-�-�-�� ...`.---.......-�-�--�----...................----�---._.... � . � REVIEWED BY: DATE: _. c�1.� � � PLEASE NOTE i COMII�NTS/CONDITIONS: t ` � ��. �, wat��, c�r�r� — �llc� rY •� o w�- r � 1 �� •c�rc�- / � i _ ___ _ __ ___ ; a - : +; (� . � �� _ _ z��`�,`� �,��;� ' �V�, � � �-� . � ' n i �. ,��, r,.. u .<, v �'��• � � . n,�r, =i �� ny � �" . �L��?�/� . �t `v au � ...:..c �.. i �� .. i � . .=` � � r i��. 'r � _M--\`,� ( t ti --...._.......__....... ") �_, '`.f ✓� - �•_..�_:./----"... � �r�_ .� �l.� �"'^�J � ✓ ' ,��- �,. '"..,,,5 � '�,`",,� �; , i �� - E . � ... � /��f%/� �I � i � i �`\� � i t �L ` l L. \ � . ,y .i� ) ,� �t-� � '7'� �,� „_ [ � �~ i �. —�- ;�� \ �r ''f.��\ � \ i 1 I ,J � � ' � ir' ;r� , , .. ~� �� ri�.,--�J -�� ,� _�'' `� � ,��J ~�� i � ^ ! ' ,?-� /1" 1;' ' �,, �• ! � � � °l�l�a Hl�t��H �, ;{,r i � i�` 800Z Q 7, �:�-� �,: �� t �� F� „�� a � Iri�l [� �! �J �1 J �:-� �''�;� �� .,:��,�� '�� .� � r� ( ��i � _ _ _ _ _ _ _ _ _ _ _ _ . _