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HomeMy WebLinkAbout2016 Sep 06 - Sign Off Transmittal Sheet, Floor Plans - Finish Basement 'l,' �.oY���a �'OV�N OF YARMOUT�S y� �-_1� HEALTH DEPARTMEN�:� o:..� <.� ��''���%��� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be complet�d by Applicant: Building Site Location: ��,Lq vo,� ,f��[ tj�'�t✓",�-�-o v'�7L i F j.�,i`' C /+�r� � F si �s�'� f d r+� �_ r��'"�.. ;��.4✓ Proposed Improvement: , e,�, o� T � � �o � � ? � Applicant: y' ;� Tel. No.:S'�d P 7�„�7 - �''.�� pa:,,,.A r �. 9 .wr� Address: 3S �qvp N /�r�. � Date Filed. **If you would like e-mail notification of sign o,f�j;please provide e-mail address• „a°�;r4y . Owner Name: !/�,�c r.� �' ��CL�- f` « /-� 4 ya,�o J�k P�r?�" H^-p � ;; Owner Address: �5' .�}vG� %� Owner Tel. No.: SG� SG G �'l.Z�'3,., ', ` ........................................................................................................:............................:..............................................::. .......................................................:................................................................................................................... � . , ;� 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 egisting and proposed) — � °� �''Note:Floor ptans not re uired or decks,shea�`� windows roo in • 4 f � , f g� (3.) If necessary, Title 5 application signed by licensed installer with fee. ............................:..............:............:..............................................................:.........:............................. ...............�.......................................................:..........................................:. .................................................................................... . __.,.� REVIEWED BY: DATE: 9 � G - PLEASE NOTE COMMENTS/CONDITIONS: - ��s� �� ,��.��,s 3 ��-�����, — .z �.�--� �� �����, . , ., " <<�,r�, a �3� �u cn,q c��� ''"" � i I i � f � � � � =� a � � N 111 o � � � � � � � � � L � a -�, � � � � ° � � � ' -� .� � � � � � � � � � M � � _� � � ` ' 3 `��x`3 ��� � � � �r a�� � S � �� � � � � �� � � {� � � � � � � � � � � � � � � � � J � s� s � � � � ;� _� � � — �� � � � `�, =� s � � ��3��� S' M � M s � �� � � �� � � � � �1 �i ` � y� �� � � � � � a n � � �� � o � a Q, , ` � .r, � o , g ; ` ` o � � � �' �- � �- � �� -�. � � �-- x � � � -� ` x . � . : -� � � � � ` � ' . � o � � � � i r � � � � � o� � � � g + ; � ' � � � � 3 "�j � � -� :i i � v � � � � I i � � I a' -� : � � 0� p � � � � � N � � � � � � � � � � � � C� s �- � � � � � �" ° � � `�`�n � � `�.. � � x, � � �s �- � � � � � � � o � � � [ I � � � � � � � �. .� �� � �� � _ � � , S ; � i � I� � � � � � � ; � � ; {y � � � � � ' � a �� � � o � � � � � I �� i � 1 � ! � �� �f ; � , � � � � � a 3 ; � � �/ �j�LJ » � �� ? (� �� � i I i � � � � � � � � i i� � ' �) � f I { f , , � � � � i � I� �C 7� � + � �1 f J� �` 1{ r �' 1 � � � � i