HomeMy WebLinkAbout2017 Apr 04 - Sign Off Transmittal Sheet, Floor Plans - Demo/Rebuild 3 Bedroom Home .o�-'Y'�� TOWN OF YARMOUTH
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PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 2'� ��2� �/�'N� �D. �/0�..
ProposedImprovement: �F'l'1�D t �jv/f!� �'(f�1,./ /�D/h�
Applicant: ,D�-� /� Tel. No.:��'J� ' 2 Z�7 3
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Address: � /(/��-�� �/��'� J�'� Date Filed:��"��
**Ifyou would dike e-mail notafication ofsign off,pdease provide e-mail address:
Owner Name: � s�1�'�'�
Owner Address: -� Owner Tel. No.: •
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% SIDENTIAL AND/OR COMMERCIAL BUILDING
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HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements � �
For Septa.ge Disposal and other Public Health Activities. � i
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Please submit three (3) copies of plans, to include: �
(1.) Site Plan showing existing buildings, water line 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 installer
with fee.
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REVIEWED BY: �(,Q1/ DATE: �r�'���
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