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2016 Feb 24 - Sign Off Transmittal Sheet, Floor Plans _ . . _ _ , _I f � i I �o��A�,�,, TOWN OF YARMOUTH � �� -`�� HEALTH DEPARTMENT E � � �'''��% � PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 2'Z. ,,jk y L..,/N,E. l�R - V�/'. 'yf}�t1�ou�'r+ � � Proposed Improvement: ,� � ,� -r � S �. -r i v N fJ t� �2 2 i� i ��l.I2R . --�—' � y+�t.��r �• uv o�-• � _ � I APPlicant: �OliSk' �. /3,P�+l �i3reA y 3u,`�i�Er ) Te1�.1iN�• ��'� -� o `` � Address: J�p� l��9 c� fi��W��'H , r�1�4 Date Filed:�-�/8� /�a **If you would like e-mail notiftcation of sign of�;please provide e-mail address: � fr Owner Name: �pt�,�( �"�,ti ! � ; Owner Address: 22 .SkU,[.i ntE. /�.2 Mf 7'ARn�r�uTi-� Owner Tel.No.:9y�q��y�,� � ( E ..................................................................................................................................................................................................:....................................................................................::.,.:..................................................................... E � RESIDENTIAL AND/OR COMIVIERCI�L BUILDING � � ; � HEALTH DEPARTMENT: Determines Compliance to Sta.te and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Pleas��t three (3) copies of plans, to include: (1.�"'� Site Plan showing existing buildings, water line location, ' " , and septic system location,; � � (2.) Floor pla beling ALL rooms within building . k� � �� "�`�egishng and proposed) — - Note:Floor plans not required for decks,sheds, windows, roofing; ; (3.) If necessary, Title 5 application signed by licensed installer ee. � ................................................................................................................................................................ ................................................................................................................................................................................................. REVIEWED BY: DATE: a'��Y �� i ; I PLEASE NOTE � COMMENTS/CONDITION : ' �W Sc c,�� l� I�C 3 i3ec�v�-�--c : . � f I �� S •�_ _....�.w.. '+r....�v .w.`�___ _ sr.r....•�w�w�.a�.�wr� � t�}� w .�. . S � � � .__.__.z�..a�m-�:_.v._ � t � ....._"_ � � � ! • 1 F� ;€ 3 — t�.@ ! � i �y-� ��! � /, � � I � cj F� � LY. , �� f � . �,� � � �� x � � � Q � �� a � � � � � � � � , _ -� � � w.�--�` - _ - .._..� � �' � ?�. . �� ;._� ' -�� -�� , � � ; �►, � t`� q �" � ! � � � � � �r � � ; �� { �� 3 a �s � � � �^- � � � � � � �� . } � . � � � = � � : � �. . � � �� `� � �s� 3 � � � �� ; � . ' : �w , � � .r :� � � � ? � � r�i � _ � � ; � �..�.��..�...._ ```�.:� �-� �. ...�:.... , # ; �� , ; � �� j �� ' �� z �� i�i ��j' �. �y �� {{ � i } . � _ • ,� -- ` . a � i � 's � . ' i � ��_..i�Y�r'�c/�- ,C�� ` � kttt�Tl-� � � - 6 � i �f�NC-� � � � �._.. � a��5i�t�..... t,�� tl..� ��..� � � � '_� �� r I � � � � . �� t � R�c��vEo � ► � rtd24Z016 � � HEALTH DEPT, � �_ � ._...._...,.s._..�..... ..� } . � � ` � � � _ �* � � �� i ` � � —. ' i � � ` �d�� t � �; � ` � i i l+!'�I� T�� .1,��. . r L.� �'^� E� t r fJ l ' �f"'fG H `"3"`� -�L7 � �� :$�� . #