HomeMy WebLinkAbout2014 Dec 10 - Sign Off Transmittal, Floor Plans - New 4 BR House v _ : �-�,,.A- . , _ _ __ . .
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�oY�,,'�-aR,� TOWN OF YARMOUTH
� -�.`���� HEALTH DEPARTMENT
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�-""'�,���``` ' pERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET ''
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To be completed by Applicant: 1
Building Site Location: / b G �
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Proposed Improvernent: �-'"Z
t�PPli�ant: � � Tel.No.: •S'Q F' 2.�� ���''�
�"`ddress: � �� �',(QM. � � y�. �Z���1 Date Filed: (��-'-���
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*�If you would lilre e-mail not�cation of sign of�'please provide e-mail address:
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O�mer Name: `�� L,tiV��
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I '- .,�(�mer Address: I��(' �� ,� �, �.�.Y1i,1,�, G 2,,,G 7�i Owner Tel.No.: SQB� Z,��-7���{
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� ' : RESIDENTIAL AND/OR COMMERCIAL BUILDING 9
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�H�ALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
I For Septa.ge Disposal and other Public Health Activitie�.
'� 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 decks,sheds, windows, toofang;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWED BY: UCQPC���� DATE: � '"/D'"
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F�I.EASE NOTE
COMMENTS/CONDITIONS: ' / '
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