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HomeMy WebLinkAbout2017 Jan 18 - Sign Off Transmittal Sheet, Floor Plans - Family Room Addition . _ _ ,:,. ,.. __ ,, : t m __ � .,.E`- r • �oY '�„-ra�o TOWN OF YARMOUTH �; �-`';c HEALTH DEPARTMENT o:..� �. _ .:�� ��'' ``��� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET �-�,w„E To be completed by Applicant: Building Site Location:� � �� n % e � y,-, > c-, , Proposed Improvement: �� � e � - , � � , I G,� Sc. '�� `�� �' C� � � APPlicant: � � �--Z '� � Tel. No.: -S�� -��/ �<�� � � �I Address: 2. � � � ��„ „< < � ,r� 1.�, Date Filed:�,� � �7 � I **Ifyou would like e-mail notafication ofsign off,please provide e-maid address: � �-- 1 � Owner Name: ���..�'� �-, /�', �z.. � � � 1 � 1 :� I Owner Address: Q �-ti c 1-r, � � Owner Tel. No.: SG�S- �''(' � -Z °S� II i RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPART.�IENT: Determines Compliance to State and Town Regulation�; 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, vvater line location, 'i and septic system location; (2.) Floor plan labeling ALL rooms within building � � (all existing and proposed) — � i Note:Floor plans not required fo'r clPcks,sheds, windows, roofing; ( (3.) If necessary, Title 5 application signed by licensed installer � � with fee. - � � ................................................................................................. .........:.............................................................................................:................:.......................................................:.:.:............................................................................... � REVIEWED BY: DATE: C / � � � ��.. i PLEASE NOTE i COMMENTS/CONDITIONS: �� � �� �� � /�� � ,n c� f � i � �.'1 � C l.v t K-, ��c . ��i i t ' i I ; �_.fr � �_ �...__�__�__�.� _� , � � � � � � � � �`°` � { �o -� � -�� M � � � � � .� �-� _ � .r -�—_ � � `� �� � � � � `� � `�'' �` `' �/' � � ` ('�� : � F . �►.r ; � 4� . � rf....�.._. ��..�� ""� � ,�� �, � - �` � .� ` �.,,� � � � � � � � ` a � E . � ,� � � �: � � � � � � � � � � � � � `', �� � 4 , � � � � � f � s � � ` � � � �� � � � � � � � � � �f ' �✓ � � F f � �,.�.Y�.,• ���...�-�A� n{.. F .ri { 4 ... � [ � � � � � �.� : � _�, , � � � � � � � � , , � ��;� � �� � .�a�_ _ � F - � � - � , � � . � ^ � . � I t.,�� O � ""� i -`�' ,c� C] 'rf � � �� � � � � � � X ; ` � Q � f � � 4 � i I � I 1 � a U �`.,1� r � ,�.t..►•�.»,��.�•�� ,,� ��ut? `•'1, /�'� ' 4��.P � .-i''• '� � "� �1 '�.s'�.."�.�..,� �`. � ..�...___. �w.. . �.___.._.._..T..�:�-�:,.--..�-. � �...., �•� � . � � "� .., _ i � l // `��''��''_4'+�-..~.�,,;�'-�"„ �. �f T � � _.;�,,/' �f �, �;i' � ";�i .�r'���' . � �7�� , . __. ,, EXI7 �- SEPTIC TANK OUT _ 7/;.�� �J (F��'1 �` �?��-N��-4 MA�,�-- ���,�o _ — _ _ _ __._ � ���'' ��� �,P� � I , i - ---"" � � � � � � � � j 1 . � � '� ���� � ��.�> - 1'� ,�. � � o o�� � '� � "� c� ; � s• � — ���� ��$ � � I � . ��. o . � �;r , � � _�l �: . � ,� �"' .` �7,.� i \ �— i � `1��4,oti�T ;��°o�� � . __ Q � ,,.(� �Cr i't '��,.. ; 1 ` � ��'f�tt�'� , � Z�� � �A.) � �� * ��# � l .x'.% �t °w . �' � ... �' ��. � � 1 � `�� . �!r� ��s �� � � � �<fi .,��� � ,` _ .�'' � ( ,��,����E�� . � �,��� ����``��` ��� , �-�' %��" � . � r , . $ � ,�,j ��' �, , � ,�� .�' /� . � '---\ � �� ' ,.�` ' � �, .`, b .__ ' ,� / 4� � __ � _ . _ ,�5i'. ` "�i O � � k�� _�r- _ � � � . `�'�� / I��;;�� `' , :' P� l q ,/ ��J p� !,(/ � � ..- � "-`� � .�.,� � � � , 1 .� , . 1 r (�� ` ���( /', . . \ . ' ` \ U ' �� 5 � �� � `� ��, ,� � � ���1�{�� \ � ,� ' , �� ,�, :../ '�,, ,� L �l � <i � ��l' ___ ----- i, �� 1 �� rl / �j� � �,.. � - --, .�t_� , �"' � ;.,�k�' N , . � (` , � I ,� ,.,� �� :�: _ , � ,� �,'` � `;, ,,� . � ��."� , � � Z�r" R�q,F�,r �y, � ` �'•, :_1 p� � i � x� tq� � g ` ^� _, Y p �+ � � �� � ,b�'Ak3� kF�`�F / ��+.j1j�d �.� G�,i�X��lf�1 f9R.r�\ ~���,. \ U /,. � \ � T6����� �'�`x ��F ' ` � �rt � ;�� �� � ��;��� �` �`���,�. �'�, ..�' (I �-.k �� � E �C.�� \ ._� e� � � ` !y � tij . �`_ j/. / ��y�•,i-�..y���_. ...Td � � , r���`�� �` ,"( � "� � f P'4 i�1��t d.l €�� ����,���,��� a�� �� ��•,. �.��' t i �i@a-"r.,��� n . t_' '� �(� ^`G �A�::4.o�i��� .. ` '� ` • ,�AN � s zo 'r` � 17 � � (�Q ; / H��LTH DCPT. � ._ , l ,� �` � ap /3� � Zf�.��f r :Y_,T___�,. Z- � � �t� �; � � ►'� I �aTiorvS X , ` � : ,� .._{;.�.:� (r1 ; „�„� . � ; DURs �—`�1 . � �1 � .�'' �_, �