HomeMy WebLinkAbout2015 Dec 23 - Sign Off Transmittal Sheet, Floor Plans c� _ � z.,.
{°����, TOWN OF YARMOUTH
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� ~'''���E``� � PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET I,
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To be compdeted by Applicant: �
` Building Site Location: � � �?f�/j�E ,/�l/�
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'` Proposed Improvement: �Q�r,� To ,3 C,� ��S'
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Applicant: ! �I"1i9�'L,�`�'' Tel.No.: ���'f,,j���
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Address• -c!� Da�e F�d i�'l� �
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**Ifyou would like e-maid notification ofsign off,please provide e-mail address:
Owner Name: /�' �1
Owner Address: i�'rj� f�riK ./�dC'/ Owner Te1.1�'`0.7�����o�j�
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RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
For Septa.ge Disposal and other Public Health Activities,
Please submit three (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 ezisting and proposed)- =- :
Note:Floor plans not required for decl�s,sheds, windows, roofang;
(3.) If necessary, Title 5 applicatioa signed by licensed installer
with fee.
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REVIEWED BY: DATE: � o� .� '"�
_ PLEASE NOTE
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