HomeMy WebLinkAbout2016 Aug 12 - Sign Off Transmittal Sheet - 10x12 Shed oY-Yq� TOWN OF YARMOUTH
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��4''+��%��� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: �� C�. � � �/ �• �
Proposed Improvement: j�? ,�, 1 0`�, ��i � ��b �L� �
Applicant: �Z�� �� Tel. No.: 1n�3 gr �O�-�
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Address: � . iled: � / �
**If you would like e-mail notification of sign o,f�j;please provide e-mail address: �
Owner Name: ��.��... ''
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Owner Address: 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 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. ;
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REVIEWED BY: {, DATE: �
PLEASE NOTE i
COMMENTS/CONDITIONS: i
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