HomeMy WebLinkAbout2016 Mar 30 - Sign Off Transmittal Sheet, Plan - Renovate Bathroom:_ _ . __ _
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o'����?�„ ; TOWN OF YARMOUTH
�� -' '�'c '" HEALTH DEPARTMENT
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��"'°�.�=�``� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: �(�� 1 C_P��j(�,,J�� Q(�, �,�f' t�.f ��,��1,����
Proposed Improvement: �,�.►Ld V(L-t„ G h(l�,�,�.V�126��„��l�t'� f(,�,� (,.1,�`� �
�r:�n����.r. �I d l , o� ts�i���.0 ed r.
APPlicant: � e 0 V�i� ���.�iT�{'l..(', Tel. No.: ,��,� :��Q��c����
Address: ��j,�j �b Y t� �r I�. �l t�, I'��P`�;��, ���,.�yy�0(,�,� i Date Filed:�2�
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**Ifyou would like e-mail notiftcation ofsign off',please provide e-mail address: ,
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Owner Name:,��V n n y�: �� -�1' I��
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, ��?wner Address:� � �e ,�C�� t:-s�, Y��p.�f_,_.�/l Owner Tel.No.:_(o�� � ��qTQ�'tf O
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' RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e.,Requirements
For Septage Disposal and other Public Health Activities.
Please submit three(3) copies of plans, to ioclude: �
(1.) Site Plan showing exYsting buildings, water lme location, �
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing 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
COMMENTS/CONDITIONS:
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i P�-�per�y of �ecr�e �av�s, Enc.
' Qca f�a� �?4��o�uce
3/24/2016 �xistin Bath Remodel
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Page 1 of 1 g
I No Layout Ghanges
Existing Window
GonVert tub
to shower
� New Toilet
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� �lew vanity,
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' top & s'tnk
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New Floor
Scale 1/2" = 1'-0" �
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Plans for: .
'.. '.•.. ... '�" D61G.�`.BUILD.RE,WVAtE .
Jim and Deb 5quires Yarmouth Health Uepartment 33 North Main Street
16 I ce House Road APP VED South Yarmouth, MA 02664
5outh Yarmouth, M,� - �-�j� (508) 394-4832
�filame Date wvvw,GeorgeDavislnc.com ;
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