HomeMy WebLinkAbout2016 Apr 29 - Sign Off Transmittal Sheet, Plans - Finish Basement o�'Ya� TOWN OF YARMOUTH
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s'�f ;�+-�c HEALTH DEPARTMENT
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� '�=� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant.•
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Building Site Location: Q - r
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Propds d Improve ent: �► yf -- S
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Applicant:<'� Tel. No.: ,j�'" f�,�..�G_���"Cj
Address:___"�,�',o Date Filed:
**If you would like e-mail notification of sign off,please provide e-mail address:
Owner Name:
Owner Address: Owner Tel.No.:
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RESIDENTIAL AN�/�.COMMERCIAL BUILDING ''
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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:
(l.) 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
r with fee.
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REVIEWED BY: C/ '` DATE: � ".-� c7 �"�6
PLEASE NOTE
COMM NTS/CON ITI NS: ,� �/� ' �.�
_�` Gs�ld / �-Ll-�' l��2�'1,S' �'���Zl/i�� /lij �l���'�/t���l/ .
33'
WINDOWS:
(5x) 14" x 18"
DOOR - EXTERIOR
(2x) 36 x 80"
Yarmouth Health Department
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Name Date