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Home My WebLink About2016 Aug 12 - Sign Off Transmittal Sheet, Plans - Garage Addition �,��---�-�._� �� _,� . .� _ _ �,. _ .�._-�,,.,,��T�.-�,;T a�.��._�.T� . , � :,._ e � o!�-Yq� TOWN OF YARMOUTH • .�.:� �� --� HEALTH DEPARTMENT Q;,.� -t y ��i..+�'� `�v,l;x �'�-Er PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant.• Building Site Location: ��,��t �d:f1 �� . Proposed Improvement: S�•c{�'t�� nf�t+� Gvh� cU�r��'. /�.� h(�u�' d� ��•i�. _��'►�� b �sP �nZ,�+g�itr�t . Nb �(�I Y�Jrkr� [_�i/�G( :�lD r0(�^' C/�,(��.i/�./Ct�1 �4!t W4(� .. 7 Applicant: /,/U�-P��Da-��' �,��>�ti. ��,,,+-,pc,�� Tel.No.: S�K - 3 ly-3�•� � Address: a0 Ncr� /�G'� S�f-�� S� l'�'�� A C��C`4 Date Filed: /aZ av�.G **Ifyou would like e-mail notification ofsign off,please provide e-mail address: Owner Name: Q�C t �i (�/v �fJS��t ,� ;�Owner Address:L (��L f G�.d� �/'/��t t,�rK�� d�Z? Owner Tel. No.: � T� �• ..............................................:................................................................................................................................................................:..............................................................................:........ .................................................:......... RESIDENTIAL AND/OR CONIlVIERCIAL 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 tocation; (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. ..........................................................................................................................................................................................................:...........:.........:...................:..............................................................................::................................... REVIEWED BY: DATE: ��- l� PLEASE NOTE COMMENTS/CONDITIONS: [� �' ` • I �: . �NJ{ \ �} ■[ J �� I � �� , � T �-M� � � ��s � I _ . f � �. � �� .: .�� `' ' 1 '�, �� '� - \ �� ' —�� 'a :' �„ \ �., � � :, �'� �� ,�� . �� - �� `� �+�� ;�� t �� I �� --— - � s . ` � ��' � ;_� ;� !!�1 i�V tii ;�II ? �� , , � =�.:��, I �p� i� � � �� ; i � �� , _i �r �� * � � � � �� y' i�� f�� i�� , � � � �� ^��--- � �'' I 1�i _�I �� 1�� I �� _ � ,-� � �� ;,, � — - �� ,� 1 i � � � `� �f w � k � � ` � a �� ,. � j��_`�;'.a�'�� + � ��., �' �� i �� -�' I ��'� �i�l �� _� F�;; — �� „��,�f ��u�j � ��`1 � � �a �� lF1/i�■�!'!� I `�i�� ,��i � _ "�" x- ��•� - � tk_ _s,�`"� � } 11�U1� IIilL�l I 1��;1� �[i�� t ��` F i ,.� - - � _ �� =— , .� i � �/,' �'I (_ <�il�� I�: �� `j � �` �� ' 1 � � : � � � �� ` _.� �"� � �f ` � F� � � �,�'.. �,;: �.� � � ;l'i�9! �r:PC, I 1�� i�_ ,t '� �" � ,,.`�f� � �' � � �,m i� mn�.�, , ��. �,' �� _ _� � �� :� �� i� �� , � � �;� , �� , i� ��i � �: l, ��G�� ,��,�� ',#��,'� �`�.,ta:.r- •. _ ,,.� �� i ��.,�� 1� � � � � '� , � � � �i �� __�._.� � ..,__ _-� r:�r��t��.��.�..�.� � ,� -��.-:��s_�� ,� --� ��: i ��j � � s � a� `i��6i� � � �� - !1I�! � - = C --;,.� .��,� �:� � ._r��. � �: , -• �, � , �► � _�_ __ _ , ---=--� �� ,�--- �� t�� _ � �� „ ,,,. . � ,�,E,� .E ,s ,, \Y..�� c�' '� E� �� ! �• �� ,� �..� �� ;�i � _ - �._ 7 -s f� ' , _\! r��il��+�n ".�'� � � c�i.e��'� r�� .. ` �,'�,_�' � � �� ` � . � ,.,—a� � � � � � � �,;� `�� ` �,,_ � ��; ' \ �� : _ '� `�� , ��. ,`;� '; ' ;� -`�� €-. , ��,� 1 � �, � � , � `:=� _ � 'i � �s�;-' � C, � ; i �°�u� �. ( f 5 �Q�' ��; .�.�1� 1 � �;� � , N _ �i''� � l �rw�a-,v��'- �°�°��'' ' ,►� Pr � � � � ��.� .o�i �I�do��.1 �I% �}•T �1�� X,.�. ti'V' o � � � ��r�� - � . � �' � �o � � � � � _ � � � � , . �, P �; , � � , ' . �i �� 3�rd. � j . - �; 1 � - � �� .� r � �� - • - � _ X$ � l �� 1'� pu (��O.G � v 1 � . a, _� �a �X t '��'� Z� , - �,pr �1bn. Vl�ti-�41� �'�6' . . '�� - . RECEiVEi�� wUG 1 2 2�16 i � . HEALTH DEPT. lz (12 VU r; 6G r7 10 7-,elI V2� 4:99 J +i 15 HEAL T H DIEPT. ►gyp,,\ 1 % ��