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HomeMy WebLinkAbout2016 Dec 15 - Sign Off Transmittal Sheet, Floor Plans - Basement Family Room, Office �� � __ _ ��..��.- n---4- .�.�.��,. � , _ -�-:� � � ,o���� TOWN OF YARMOUTH �� ��° HEALTH DEPARTMENT o:..,� _ t-� ��''�-��%'I� P��MIT APPLICATION SIGN OFF TRANSMITTAL SHEET z ' To be completed by Applicant:t � Building Site Location: J� r C317 �'� � q y-� Yy , c.1 �" Proposed Improvement: /�C�'l��� ✓ /o Y� � �'-�� ��� ��° '7 �' �'I � � �l OG� l'�/ 1 c �—` A licaht: � 7 �J � / �� Tel. Na: �� ��C �/ %� 7 pp _ -- l � � Address: �C? S t �� �N� � - U c.J�f"� Date Filed:�_ ` / **Ifyou would like e-mail notification ofsign off,please provide e-mail address: Owner Name: � P � U j 5 � r. -- 1, Owner Address: f P G C �? J� J G}->'1�c:�f� Owner Tel. No.: ,..'SC��l�=y I/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 three (3) copies of ptans, to includ�: (1.) Site Plan showing existing buildings, water Iine 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 instalier with fee. ............................................................._....................................................................................................................................................................................................................................................................................................... J REVIEWED BY: DATE: r}� ��� �� PLEASE NOTE COMMENTS/CONDI IONS: . �/v�` 7,� t�-e v�e c� Q�. �. j�c�YOcy +i+/�� p x tt ' `�-1 � , ,� ,;, ��' � , x � ��, � n�-�� � 4 �° ^ ���� ���� G�� r � _ _ . _ _ 3 . '3 "3 _ � . � . : ,a . _ _ � �_ � _ -� _ _ .- _ _ . __. ��a °��'� _ . �_ _ _ � � _ , . _ .•� _ �_ _ _ ��o . � �- � , _. _ _ � _ � � _ � ;- � : _ _ . _ _ -�-- -�: - _ _ _ _ ___. � _ ! � _ --r- � J-- � : _ _ : -. � � � - - � � � � € « � � g .� � �� _ _ �_ +� r� , : _ - - �tl � �� _ � � --�,_� , ,._ � W LJ �� � ,� _ -� � . � �-j i . fi� ; _ _ _ _--- --._.__ _ ----- v. _ � _ s ,a � � � � � � � ---- � � � � .� C� � � � �� � _ � � � � _ _ :_ , ��� �.-... 1 - _ � � 1 .3'� �3 c l,r-3-��_� � � x �.�J�J � �/4��O�J: . _ k.�t w�t{J __ . � ��C�S"l��� . : . . �j - � � _ /a. ��-"� : . I � � � [ _ � . : : �q wr� � �.t�c�� ��C��: : . � � . � . ;� n ' ` I � � - � ,�: � . . � �� .� . . � . � . . � � .� � � �� �� r �� � '. �V� . . . . " . . . . . .. . . . . . �� �� �� . . � � L� � �6 � � .. � . , �.4 , L � � . . . , . . . . . _ . . . . . , _ : . �,�e'w`�+✓r4 � Ca _ . . - . ��- �� . : � . � : �: : . ; - - f o � � � � � � � � �:� �� � .� . : . .��b . . . � . . ���� . : � . 1 � l : � �.�� _ . ' . f 5; ��. � . j e : . : _. . . . : ; : _ , . V . . . ' _ : . _ - , ���✓ " -�"� ; : � � , _ - . � : : . . . . . ��5�.n'����3�0`�`�'� : . ; ! . : - :. - �. • , . . . . ' . _� _ _ -- - . . _, �.__ _ . ; _ � _. : : : ;DEC 15 2.Q16_. ; . . . _ _ - . . _� ; . . '_HEALTH DcPT.� � : � �y _ .- . . f : _ . , - - � ��: � i _ _ : . : . . _. � �S ^gr ,, : � . . . . : . . �os B��oN ; - . t-� Jvrs�" ; . : . _.� . r ; ._ ; . . _ _ . . � :_- _ , :. , , . . : - _; �c �Q-o Pos�j WhutrS � : � t . ._. , . , _ . , : . , : ) �i , ' . ,. ' ���� � `/� � . _. . : . . .' { U1� ' f3�� � ��vY `I;��; � �