The URL can be used to link to this page

Home My WebLink About2009 Sep 04 - Sign Off Transmittal Sheet, Floor Plan - Use & Occupancy "T"*3� .�.r^s�,r' .. `:"�"�'-"f . .R""--^:.`F='a-....�-�a-..*�rx°"g ,.q.;aRa+=,ow.^...,,,�_�,a�. �°� Y��o TOWN OF YARMQUTH � � H�ALTH DEPARTMENT 0 , y ��`��sC�.�" PERMIT APPLICATION SIGN OFF TRANSII�IITTAL SHEET To�ie completed bY Applicarrt: Building Site Location:_ ��f J'Y)r4i/� � T dc T.-� Map No.: Lot No.: Proposed Improvement: ��P�,•1i n,� .�... �, ,,�7��,� Gt..`�`t�n u `tL �C �� -- � APPlicant: ��vc tc rv� ��h� Tel. No.: 54�5`� 35c� �/ _ZK.� � So�-- �bo- G�4 2 z. Address: �� MQ r „v 5-r- �?T ? � Date Filed: **Ifyou would like e-mait notification ofsign off,please provide e-mail address:�"�p�y,L��p�.,��,, ('. �. L C�� Owner Name: � (�. ��p� �, �]',� �S-r Owner Address: �d.f�-v "�7�) Sc� C..�v�►��r.r a��-/ /�1�� • Owner Tel. No.: ��- .3�'`i' �'s�'iSSla / ....................._..---..........._....--�--------...._......---�-------...................---...........-�---�-----._...........................------.............-�---..........-------...........................:.........-------�-�� RESIDENTIAL AND/OR COMMERCIAL BUII.,DING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposa.l and other Public Health Activities. j Please submit four(4) copies of plans, to include: (1.) Site Plan showing ezisting buildings, water liae 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, roofing; {3.) If necessary, Title 5 application signed by licensed installer with fee. ........�............................................................................................��-----........-�-----...._...................._..._..._........... REVIEWED BY: DATE:_ `�"' �-/- � �'f � PLEASE NOTE CO NTS/CONDITIONS: 1 ..5 i .L �► � �, �r , ��} — � � � � ` � � � � � ¢ t � � � � � � � � � � � � � .� � � � � o ¢ � � � .� � m � ._ � . . �_ � � � � � � s , � -� `� U � � �, � � � � � � � � � �. � ° � � � �- .-� _ � � y - ,_ 1 , f.� `�/y � � � � - � ' �'y � ..... � � � � � � _ �� ,� � �"7 :x � . � _ � � �� ,� � ' � � { � Q � .� . � : � ' � � �- � � � � � � � � � � U � . .� ' s +� ,� � � � , � � �`� l � � ,. � � .�� ! � _ �'►.... .. .. �� .,� , � � �, # � �a� � o v o � � � .� � � _. � �� t/.f 3 � � �� `� ° � - a o �, �a � � �, � �r - � � � � � � �� -� . � a � � � � ,�� ;� : _� �`� � � �