HomeMy WebLinkAbout2016 Jan 29 - Sign Off Transmittal Sheet, Floor Plan - Renovations ��.-Ya�e TOWN OF YARMOUTH
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`��=�%' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
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To be compdeted by Applicant:
j Building Site Location: �j t�q r ��wr,� � t'.
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� Proposed Improvement: �. �1 w� i v+���. � ho.�l'• � ��' !<, �I.�.o v� � �^� vr�u�,� a d;G�.<v�1`
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Tel.No.: v 3 �� �'b 5�
A p p h c a n t: ��� � ����-i v�a S �
' Address: �/v )i,-���ow h r«a I� 2ck w�S E-- �u v w�.��c,�. Date Filed: /-d I- /6
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j **Ifyou would like e-mail notafication ofsign o,f,�'please provide e-mail address:
Owner Name: '�ob�e v'� �.e�v�v' v�t0.k
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Ownen,Address: 5 �.r ��^�'�c�. \�t`. Scw� �4��'�'f l� Oumer Tel.No.: 5 U�v S`i ; - y S 6 l
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', RESIDENTIAL AND/OR COMMERCIAL BUILDIATG
'' HEALTH DEPARTMENT: Determines Compliance to Sta.te and Town Regulafions; i.e.,Requirements
I` For Septa.ge Disposal and other Public Health Activities.
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! Please submit three (3)�opies of plans, to includes
(l.) Site Plan showing existing b�ildings, water line location,
and septic system location;
', (2.} Floor plan labeling ALL rooms within building
(all ezis�ng and proposed) -
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
, with fee. �
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REVIEWED BY: DATE: / � � ��
PLEASE NOTE
t COMMENTS/CONDITIONS: j�, ? —
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