HomeMy WebLinkAbout2012 Apr 04 - Sign Off Transmittal Sheet - Patio Deck,�. �: ,� . ;,. . . ,�._�_F_-__ ,-_-_-.�.�.,�...��.�s�.�.-�-�m - --- „, ..��. . _ �
o�r'�a�e TOWN OF YARMOUTH
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'''�=E` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant.•
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Building Site Location: �� � r �S
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Propos d Irnprovement: �C � �J
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Applicant: Tel. No.: �✓�����lv
Address: �l�.X Date Filed: �
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**If you would like e-mail notification of sign off,please provide e-maid address:
Owner Name: �
Owner Address: Owner Tel. No.: I u � �1����'�"'
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RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to Stafe and Town Regulations; i.e., Requirements
For Septa.ge Disposal and other Public Health Activities.
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 requared for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWED BY: DATE: I w" L�' I �.�
PLEASE NOTE
COMMENTS/CONDITIONS: