HomeMy WebLinkAbout2015 Aug 31 - Sign Off Transmittal Sheet, Floor Plans - Demo/Construct New Home�
oF Ya� TOWN OF YARMOUTH
�� �-.w��, HEALTH DEPARTMENT
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�` ��.. '� � PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
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To be completed by Applicant:
Building Site Location: '�"� �rJ�"teV� `'�� �- � Zvl�'D��"t
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Applicant: . tiS�2�f' Tel.No.: ,�l��C'�G'�!7 7�
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Owner Name: 'J�U 4�2. �e��OW
Owner Address: �- �3vPZ�` ��)c'�-� 2�° Owner Tel.No.:
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RESIDENTIAL AND/OR COMMERCIAL 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 include: � �
(1.) Site Plan showing existing buildings, water linelocation, �
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.
...........................................:........................................................ ........ ....... .............................................................................................................. ............................. .........................................
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REVIEWED BY: ` CJ�::����� DATE: <F' "�///.�
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DATE: 07 / 29 / 2015
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