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HomeMy WebLinkAbout2007 Jun 14 - Sign Off Transmittal Sheet, Floor Plans� : ,_ . _ _. ,_ _. . .�- � ,� � � ,�°�� ��. TOWN OF YARMOUTH a � `- HEALTH DEPARTMENT � MAttA N ESE � ��`°"°°"""°"�c� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET �.. To be completed by Applicant: � Building Site Location: /I?v p No.: Lot No.: � Proposed Improvement: ��j,�0 L/�'" �j�� 5't fi /�G6�. ��/�.9/Z 5 �r e�l����= t.�,-c � � �lcU �� \ Applicant: // U/C��5�j ��'" � TeL Aio.: SCl�� y��_ 3�,� Z Address: (�p � �/)9��j'j ( d �� ��5���.G S /��(t<'' Date Filed: t t O **Ifyou would like e-mail notifcation ofsign off,please provide e-mail address: `�y, . . ..� Owner Name: �/�`/f?-,�' �/G' � �/� �S�I O�mer Address: /(o �� /�i��,�fi' �� Owner Tel. No.: sd� 3 g �''��� ---�----�-�.��.'..�.c�._...v.....�-:�-------...�...�...�..r�:..�`.:.----�-.........................:..........................._........ -� -._...._........................----------___............:...---....----...-�------._..._._____._.....------�-------�----- RESIDENTIAL ANDl�R COMMERCIAL BUILDING �IEALTH 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 existing buildings, water liae location, and septic system location; �.;, �-'z` (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 S application signed by licensed installer with fee. ............................. - ...........................----.............................. -- --- ---�-----.........................._-�----- --- -........................_..-�---�--..............-� -- �-- .........---......................._......-----�------...---:_:_... REVIEWED BY: DATE: �"'l�'.� � PLEASE NOTE COl�rIlVIENT S/CONDITIONS: � A � « � � i . ; � � � , � j ,._ � f � � � � � a �� � � � N �� � �.. Z r � � �� �� _ _. E- a' �w (� 3 4 �. A � � o ,�u � v ' �� .� � p z p p' � � , � ,Q � � � � � Wz � � � � o v�i � �I� �" N �� (� X � �F � Z ,� � c� Lu 0� a � � �� a .s � � v � w � r�,,a � 1� . j� � � � ar � �` �._. . � z o � 1� � o s �, � `� '� .: � a � Z y Z o ,�, � ' . . � tu Su o w z � � N � � � �'� � _ _ � 1/ . . 3 i- � � 11 � il � � � N � � � � �i �� � p�� � W . . r i � �� ..... _ ,�;\ , � 1i Z � a :si � 11 �n��,� ����� s � �� � ---: o�� �. 11 � .��. � . � � � ' _�����l �:3=�,�l==�� o � �'� -� r :� � ����. �, �1 �c� . ` � • ;. � � . � ' , � � u b- �, �: 1� �� ��� �i � 1�' 1! s .� ;; II ` � � .� M . �� 1. �� �� � S� _:� . 11 �--� � �- . 1� 5���1�.,� r .. wr �� � ... " - �.. . " ... "� 4 �--�► : � ._ � � � � � � � � � � . � t� �� � � _ _. ir � Z ii � � M � •� � �, �� � � " � I' s�. y �' f � . _ . 11 = �� � _�-� �` __ ;� ... , . N . __ _ � � , � � 1 ' �� i� �' ♦ ' r• �� � s/��--1`� 4' �r �� �1 .� 1� E � :� � i� �� ----.._.. .. ._ . . . . . . . • � � � ��i� .� M ��: ��s�i����=�� � w� N � , � ; 11� i 9 �c o 1� � � � • �i � ovr � If � 11 � �n��;: �� ;Y, ' .._. . . _ �� � � :; � ~ , � � . .�_ .. �_....._ . .. . � ' /� L � • � �� j � � �� _._ . ^ I I � �t � �' , � �� ' 4 � . ,