The URL can be used to link to this page

Home My WebLink About2016 Apr 15 - Sign Off Transmittal Sheet, Seating Count - Renovations oY=-'Yqk TOWN OF YARMOUTH . ,,�.�.� �� X�=•� HEALTH DEPARTMENT s:� �_ " ,.,,-� ��''�-V�%�J� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: � � � ` �� ' � �1 �� V � � � Building Site Location: � � � t.�-�e� t�r� ��'��' ' , . • . Proposed Improveme t: � �T ,� �� ,� {� � � �,.;, �; ' �t�_ t� ?�1.. t� . � , ",� Q1 � � �LZ t(.�� 'R.f^� tY �� . ,C'n �'�,. !�� 'eV'�d� � , LC.� �f�tiN al C� � Applicant: � dv f �3� �� a�� di Tel. No.: E�`'� �.�f` '�� ,�,�� Address: " �r� c3t} .,,�,� . Date Filed: ��(S /� **Ifyou would like e-mail notification ofsign ofJ;please provide e-mail address: ' Owner Name: �� :eS�- , �� v� Owner Address: Owner Tel. No.: �"o`� �- f�3�, ' .................................................................................................................................................................................................................................................................................................................................................................. RESIDENTIAL AND/OR CONIMERCIAL 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 incluc�e: r (1.) Site Plan showing existing buildings, water line location, � and septic system location; ' (2.) Floor plan labeling ALL rooms within building j (all egisting and proposed) - ' i 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: �'r s ` � �� 4 PLEASE NOTE COMMENTS/CONDITIONS: 1 �'�'c.� � � � �Z �'l`�-( t.� st �� r: �c'r�J �- .� Q ! � � � � ' . i , � �a�re�' � cs � ; � tJ�` t�.>� z- � �� ( ,�'�� S e � �(�. � �� ."'t�ts� ��' ;�-v"� -2�.-t�- e�.v ��..1�� (��-�- 1 ►�� R p � --;�, Nv��l�� a� � cn 1 `-� i3-�vv�� .v�-'�` � � m q � � � N � � F- , Q � DINING RDOM AND BAR SEATING COUNT � Z . o !35) TABLES �+T �f SEATS = 140 N (U TABLE �4T 3 SEATS = 3 `n BAR SEATS - 21 � w , TOTAL SEATS = I�O PERSONS � , � O ' U � oc w z O � � � m Q i � � � � I ��n�� Z a � Ar� � � "LU16 HF.��,TH DEPT. � � - v � 1 � �--�-� � F-- � : � Q m , � � - � o � U � � � — J � � O v U v / � W ; � � I"� Q � - � � _ , � � = U � � � r � t � � � E � � � W � �