Loading...
HomeMy WebLinkAbout2006 Apr 12 -Sign Off Transmittal, Plans - Screen Room_,,.� T _.. �� �-��-..,�.. . � . r _a_�..�._�,_m. . __ . ._ , .� -�.�.�.�-�- ,,. __ _ ��c. �ZFro�O .��-�Yqk.� TOWN OF Y�RMOUTH s� .�� ,��c HEALTH DEPARTMENT ., -.; " :.� '�r � � _ . -�� `'=��-N'`� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: j '�q � t' � Map No.:�_LotNo.:�� . ���,c� Proposed Improvement: �J C'�p e r1 r�U M 4�°� f� w c c� ..�,,. Applicant: ,'-Jt,��, �t�'�II� Tel. No.: I�I`�'7��3�� Address: 3�S �E�r�-�, S�- S�� � ��U� �C'u t'���4-nc��� Date Filed: � - 2 -G **If you woudd like e-mail notification of sign ofj;please provide e-mail address: Owner l�ame:���n�. �U�'�i�i� Owner Address: � �A rv�e � l`� Owner TeL No.: �]Q�-'� �-G 7Z � -�-----�------------------------------�----�---------------------------�---------------............_._.-----------------........-----....._..........._..-----..:....................--------........�-------------------..._------------------�-----�----------------------------�------------------------.. RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Toum Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit four (4) eopies 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 e�isting and proposed}- Note:Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, 'Fitle 5 application signed by licensed installer with fee. REVIEWED BY: DATE: PLEASE NOTE , COIVIl��NTS/CONDITIONS: c1 � � ._..- t � ,.--, �U h � y-�.. s t C�t_ /Q t'� � G r1�' `-''�� � �� �` W �� \ r � � m � � ;rr ^. c: � sr� �' �' � � w 2 � D -�u 'v' -�i � � 2 `'"` (� CJ �' �' m o Q � � � � �� i , �# r � r G .� +� !� � �7? W i � � � �'? �? � 4'�"} � � � . ! ,� � -~ t � � �. �� � � - • � � 3 _ __ �+TV1 �_ IXYV� V�V3 / . ... . . . � �� . . � / � r o � � � � � o c � � � � m % � � r � . � �-�-- - - - — ^ � � — � �_ —. � ;� � N � � �� X 'd' �� 1' �` p� �N � � 1 � C � m i� :p � � I � �. N � � !� --�� t. a _ ` — � — — — �� _._ _._ �. �._ f�l. C,;) t� tY F-t�`?�--t� �C.� �t� - t-- b_ � !Ls `� , i� � � ,� ..e � ,� .�,_ � � (�C� C�C:3 t�C t� � � cc � C.i h- � t1J CJ� h- —LL -- — H W U> U� � °D � � — � � OC _�t� �tt') - -- v7WU3 � tI7 � - -- � m � X cY� LU � �J� � �t.f"t � W G'�i LU Cl_ -- F— Z C� Li,_ � � � � � � Q � F... � � .�� ,_i .-� ..--. .--, ,.-.. ---, _ w � `� _— c�i r') d- tll c[? f�: c+p � � � � � � .�* i .' � ,�'"' � � �. .. . ,.� . . . � � �. ��'4 � � �� _ � f� �' '� � : � � � � F � � � � � � � ,� � �.�'- --.�.�;�----._ ��_ _ :�.�- �"" � � _..�,. �.. �� � � � � � � ..� � «� .,,-,� �- � — � � . �"' y �� � �.. � ' � �► ��► �,, :� a► �� . � � � �� � � �� � � � � ,«y► �a , � � � � � � � �, _ .��� ����� � �, � ��� � � . . �$ . � �� �, � � ��. � � � � �� � "�` �� � tT \ � � � � � � � . . o . F, t:� ,��_^, � � �� � � � . . � � - � � {p Cj� '� �i°3 �- st• ' � � *t� C� ��: � � � � �� "a' � �– _� ` � � � � 0 � �� � F— � �`f�� . ��,. � f ___. ���-��� �'" � ��� �_._�.----