Loading...
HomeMy WebLinkAbout2008 Aug 18 - Sign Off Transmittal, Plans - Basement Remodel , .�. , , .. , ,. .-,� _ �� �����a� , ���. . e . ., , _ .�, . � ,�°� Y��o TOWN OF YA�;RMOUTH n y HEALTH DEPARTMENT N MATTA N S "� ��°"'°"''"°a��'� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: � `�l ,�C j�s �-��� �� y,q,�N�aD�Map No.: Lot No.:� ��— Proposed Improvement: ��C=-/y1-r...u�L ,oQ�-mo�!c-( ,�►t/i�� �wAom �-,�ff-5�j licant: -�- II� APP ���►2��S ��t c Eon.�, � Tel. No.:��� 7� /�Z- I, Address:�� 'y yh,,4 ��+c, ��- �C,�gy�,w�'C , Date Filed: � �`� C�� **Ifyou would like e-mail notifrcation ofsign off,please provide e-mail address: Owner Name: ��S.� � �. 4- ��VE�rt� s�' ��`�`� J�2J -�`�'it��t^J Owner Address: ,j y ��-,�S �j/1 �� � 4wner Tel. No.:�/�- �`?'~f y� � t, ---�---.........-�----�---------------......_�----------------�--�---------------�-----------......------------�----�-�--._........--��--..._.......-�---��----�-�-�-..............--�-------- �-�---------�-------�---�---------�--------..............-----------...__.......-__--�-�---............_---�----...._ i � r RESIDENTIAL ANDlOR COMII�RCIAL BUILDING � � i HEALTH DEPARTMENT: Determines Compliance to State and 'Town Regulations; i.e., Reguirements ; For Septage Disposal and other Public Health Activities. i Please submit four(4) copies of plans, to include: ! (1.) Site Plan showing ezisting buildings, water line location, I and septic system location; � �� (2.) Floor plan labeling ALL rooms within building ' (all ezisting aad 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: l � PLEASE NOTE rCONR�NTS/CONDITIONS: - ( '> .E' c�.� / � v�ov-w� Cy�� („" a G .,p12"CG � fC.v/��-+'�+.r �� �`�ca'�t C 4 'fY ( �°C�C.�,r ,�� (� � <:i� � � CJ � � � � r/d� I�c.��., G rl � — ��t� ,f"`,,�, � �' t�+�+ t�� 6R, �C�fC�p^�t� �v�r�J� .J 1 i � ',� �� f �� � � � a "�.. � .�; � x � � � � � � �, � � � � , � � ,� � � � � Y� �° � ; ��� � � � �._ � � e �3 � �� � �� � �� � � � � � � � � � � � � � a � � -- � � � �� � -� � � � � � � �- � �.y._. � �� _ _.�__� � : _e F , ; � . �.��_ .. .�__�__��_�. � � �. � a� r_.. g .����.� �..� � ,z_��..,�.��.._r._._.:...�_.�...�.�a � � � �; � � � € d ��.y� � "-Y 7 ��i �(� 4 ���'°dY�is s �� V f i �� £ 1' � �� ;� r y�^" ��"p+�^q q � r,m � .,,e�y�� T� . . ���� ..u.>_. € ,�r✓' ��. � ,�`�. ...�,,:. : R.w..r.Y. � r � � x . � � � .:��. � .�.�_—.. ���_a_ � � � � ��� : i `_ � ��`� �„��� �<�,� 4����`� � r§ `� �..�;� � Y � �.W.�. _.. .-= �:...__. ... _ .�}.�.�:�.�.�,___�. . __-�.,. � ; I E � �� r =, �, �-a ��2 �/ISE� 7��c�g