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HomeMy WebLinkAbout2016 Sep 22 - Sign Off Transmittal Sheet, Plans - Kitchen Extension� _ _ ;� �; �-�,�� _ o�.---ak �� _ � ,� ,,� TOWN OF YARMOUTH � ��-`-�;c , HEALTH DEPARTMENT ��,',�ek'��K \ s.: . PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET . To be completed by Applicant: Building Site Location: �{ �.i�T 1 e t I t �pe(' i�h� , s� ��/�vj��, Proposed Improvement: �j t Applicant• l ' Te1.No.: ��-'�p 3 D—�n� � Address: o� ` 0 (' Date Filed:��� � . **If you would like e-mail notificatfon of sign ofJ,please provide e-mai!address: Owner Name: � , Owner Address: c�`t I..t �,�,r ����.�VQ(I�IUl�wner Tel. No.: S(�f/?'1�'. � ; , ........_.....................__._._..._...__...._......._.._................................................--�--.............................................................................:.........._.......................................................................................:............................................... ; RESIDENTIAL AATD/OR COMMERCIAL BUILDING I � � � � HEALTH DEPARTMENT: Determines Compliance to State and Tawn Regulations; i.e.,Requireme�ts ' For Septage Disposal and other Public Health Activities. Please submit three (3) copies of plans, to includes (l.). Site Plan showing ezisting buildi•ngs,water line location, 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. . .................................._.................�..,.........................................................._.........................................................................................._........_............ REVIEWED BY: DATE: `� a .(,,�. PLEASE NOTE COMMENTS/CONDITIONS: � � � . o., �c �a;� o � c L a��o o�m Z v O 0 a ; 8� � ; °$a��",m;a Z � 'Q N Z o � � �� o,,,,, .a o a � ^ �� m= �W°0����o FZ Z�� \ O � � o c o g� " a� �m ��mo'mcO�' �Q� Lp��(O,� \ p � 'L E N '� y S�E o w c� � o`� o c c o o'�'cv <( '�- Q�W p � !!1 o p o N �,-- � . a N M �NV�� �O�o ;!� qoO.oaD�� WQ W� e Y a. 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