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Home My WebLink About2008 Feb 25 - Sign Off Transmittal Sheet, Floor Plan Sketches - Bath in Basement ..._..._..�..�._�..� ..o...�a..�:�=�;��- ,.-,�. ,�°��Y`��.o TOWN OF YARMOUTH � c HEALTH DEPARTMENT � � MATTA M CS � �� ``"""""°�`p�'�. . . PERMIT APPI�ICATION SIGN OFF TRANSMITTAL SHEET � To be completed by Applicant: _ r-.-f ��,�y'�:�'1��""� J Building Site Location: � ,�� ,�,�' _�'17` Map No.: Lot No.: Proposed Improvement: � fj��C� /��' ��,-,,: f;� � � � }44e � � i u � v�c S7� ,. (� � _ ` r �„� - �yri.- � � �,'. ��'"_ Applicant: y---2---� ,� �� Tel. No_:�� '`r�'�.�' f Address: �,�c�� .� ,�''� �. ,�!-� ,,-�,%',�'./,.r/j r�%'�.,r✓ Date Filed:��`�`�`�t�`�'` ,�-�,�-� �a�..s�� r�//_; _.� � **I,f you would like e-mail notification o sign off,please provide e-mail address: Owner Name: �. .,� � ��"`�`=-- "''`��` _.. �f Owner Address: ��/•�1��/ Owner Tel. No.: 7,,5 � � �-� � ------------------�------------------.._....----................._............._.._:.........._...----------...--------...--��---------------------_.........._.........._............:............._................-----------------�---------------.....---.........---�-----------.................._.__......-------.._......... 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 four(4) copies of plans, to include: (1.) Site Plan showing ezisting buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all ezisting and proposed)— , Note:Ftoor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. -�---------------�-�-�------------............-------.........---��---.......-�-�--�----................._....---..............................---.....-� -----------------...-�--------............ .........---- -�-��- - ---�-�-�-�----�-------- � �� -------------- --�-----------�----------.... REVIEWED BY: DATE: r�- �= � a � PLEASE NOTE CONIlV�NTS/CONDITIONS: � �{U�Se ?b ��a. � � � �� v o o•�..,,, u55� "�� Uc/1�S �" • � � �4 �JSt �J t Jac�� L, �s w$ o.. �u/' ; � � � � � �,',� ; C�# . ,� � y, i ;� �� r .� t l ��.. , �,�_ .,.. ,._ ., �µ '"' � . :��, ,;�;, ��. ��+ .____._ _. _-____ _._____._._.._��__j.� i i , � i � � -- _ _ �. 4 � �u�� f � � } r � � ��ti� � >,y � . � � ..� .._ . M._�, � _�_��.. �e�_� ,_ ._�� . _.�._..____ � � � ��`5 � �`,:� � r � �;� �5e'�r � / � � ' - \ �� ` �� o � � o � � � � ._. .��.__ _ > _ _ . r_..�,_.�-- _ � � � � � � � � I�' 9� LLI � � � � � + � I �� r � �� ! � �, ��C"/ � �- _.��:,� �, , � �� —�� f � � — ��__.__ �.,`� ___.__.�.___a__ � t; U ; ; � `� � � - . . i 1 � -,..n . � i r^�- � `�Q � � �—=�� I �� F��-� ; n� � �� -_� .� . _�. �. <_� -.- j � �� .�� t� � � �= � ��= , �� - � � � '�� , � � f ' � � ; . " � � �\ `�. J I �.00 } i � � � �- � y� t: f ll �4 �j � , �� i � � � ; ; � ; � '� � � �� ' � � �: i � , _ . .i�"", _ � `"�`Jr",w.,.:= i �. ��a I �. � i � . � ' i ..... . . . � . . � � V,�,�^�,� �j . . . . . . . .. L- -� i t `i , j I � � ; � �� ; � �.y.--_._�..�_��_.� . � � : �' � � � � � .i,, 'v � � � `-� � "7`' s . \� �� \ � • V � Ss � v � � � � � w � o ' � Y, � � � � � � � �� 1 / � � � �� / _ � � �. �'`y\� \ � � y�.+ � i � � � � ,�,"'� �^"� � E � � � � � �: ' f I 3 , ` �_ ,.`} �� ___� 1 � 1 . � f,,�