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HomeMy WebLinkAbout2016 Apr - 08 - Sign Off Transmittal Sheet, Floor Plans - Add Bedroom, Bathroomin Basement ,o�-'Ya� TOWN OF YARMOUTH "r�� -, ,��:'�i° ` ;��;c HEALTH DEPARTMENT �;._� , _ _� Y�i''���-`'�J� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant.• Building Site Location: .,�� �����.r.�,— /`'v F � A-�.,.�o�,��,. �o.t T .�J�} O Z l.l� Proposed Improvement: l���v�v,4-� �x�5,�tiU ��•4-�.� � � � r4-��u � n p..�A�r.� ��-C.ov.c� jA�v,a �•'►�l,�oa.�-r .�v ��.�c�.4�r� Applicant: �if"f T�1'Z �✓c.r—� ��a.. /��� U ic-.4- Tel. No.: ��c�-2�D -2a 3 3 Address: ��` ��g � �-r. /�xt- �vl'fS �i d.cti � ,� �- Date Filed: � f�(��c **Ifyou would/ike e-mail notification ofsign off,please provide e-mail address: �A�v � , t�'f v?�c����4 �t�,�{,q�L._'�°�o�c.� Owner Name: .1 ,p �t� ��S� o�-,___���y Owner Address: s�/o G?.�,�r��c�,,,� .S�- , Owner Tel. No.: �/�- �fj'�"•`�/�� J�P,ti, ,H o�r•i I'`1,4 o z r S� ..............................�........... ..............,.................................................................................................................................................................................................................................................................................................... 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 include: (1.) Site Plan showing existing buildings, water line 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. ............................................................................... ....:.................................................................................................................................................................................................:...................................................................:.......... REVIEWED BY: DATE: �" �� PLEASE NOTE COMMENTS/CONDITION S: ( �UuS� Gr-� � � F` .r cn��l � --�' � R-cc'V'0 o�✓J _' � 'VI_ ' (�v-�tiJ' � � � I r - � I _ '� �` � p � t„ �-r J �.�.�.-..,� � ___..� � � � � � � �� -- _� � � � � '�' Q E __� __.______ ,_____._.._r_.._ _. � ��' \ � � z� •9 � j � � � !=� � � V M1`� o �`"` �, a 1�- �- � � � � �- -++�-� �+ r -� � 2 a � fi � �n 4� �- � : ; i .. � .� t� � � � , � � � tn c, _ i �; rn � v � 4 � � r � _` i � v' �f: \C' �i% �` � h �` 1 ; _ 3 `� : � ; ja 3 c�i� � � � ;� Z �, �9 � � 3{ �'- V� j w � � � � : a � � Y � � � ,� � � h — � �� � � � i � ti � � � { `�� � �` � � 3 , - --- ; �, �______M __,____ __._.. v M � � °� � �------t -�__ i �� i e 2 � O � , � ( � 3 ' �J , a - � ; � o� � N ��� { o � ��1 � / j ' � �,� � � _ �; ►--° _ .._ __.�i- -. . `�.. � � . .. . � . � � _... .._w.._�__.�,.._..�,_---� . a � � � � s , � � � � � �/ � °' � • S � � ; ! 3 � �' � i �h `� � � � � �E � � � ° ! ' � � ; r � � � � , f i � �` ti, ; i -�a � � � ` � I --J-s � .__. __.__�._ ______________...�M �� i � �`�-�—_ _ -! �� Q � � � j � � � ; � �i �J f Y. i � t � i - � � � � � 1 ; � � � ��� � Z � E ? �i __._____.. _�,.,,.��- � �C -� i � , ; 4L � � q � ; E � �. w o —,� i-�.1.� �, `` � n � i � � I � cf �3'�' - —' � 7 � ' �' p T j ►- � ' � J � h7 i � � � E v; ° �• i 1� `, ; rJ ;.a t= � � -Z i ` �J' o w s' � i , � `�'' � � � p � ; : � `� Z € � j�•... �� � a i� � -~-t � ��� � � � � � s � Z l� �, � ,9 et. o � eJ � � � '`� V � � q � � � ~� � V 1 � - o � , �' � , a � � � � ? I 4 W � J � � � l � � I� � Q �a � w � ? � � 4 � I o � � � � � `�' z r� � ►- �' ' �h � 4 � N � � � � � � � 4 � � � `� � � � � �i I I I c� � T N `� � � � W � � � � � Q � w S � � � ? o � � � °C � I � f�` -- � � � r � � ; Q `� J � � `�j O � � � v � � J � �p � � � � �G � `� � A b � �' � � �, o�