The URL can be used to link to this page

Home My WebLink About2017 Apr 27 - Sign Off Transmittal Sheet, Floor Plans - Finish Basement with Bathroom � ,��. : --m,�.�..-.� ..„,��,. > ,�,.,-- :,-„�-��.:—�-�.am.�,�- ��.�.� a_.,._ ..� ._,, .- _. r., :, _ ,� ___ _ ._,..� ..� .�.��m„'s. .,.��.�.�.-9.,.�...- .� F ♦ � . . . ��i�.. . ' .. . . . "� ��.. . . . . '.12 - . � .oF ��,� TOWN OF YARMOUTH �,'� ��r:� HE�LTH DEPARTMENT o:.�.. : _ _� _ �'�'r��E�'�� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: ��C�SolJ �A�l� IJ��JT `��"��"T� �^� � 1 b� � Proposed Improvement: F��r��3 I"3 11 S r N+c"�J'T {�r i� H- � U� L r��T H��"` � Applicant: Z�I� (C-�� t�-� S�t-��'`� 2- Tel. No.:�2�'� - ��t�- 6�4�. Address: � ��t��+��c' t.�K s'c Y��as�� MA- 0 2�� 3 Date Fil� '��'l� -;;:� **If you would like e-mail notification of sign off,please provide e-maid address: r^ � � OwnerName: '�/�5��.5 sc�n�r-�c Z— tt� c'? Owner Address: $ ��C�S nN /4 tt t wi:S�Y/9�n+�o.•7c.� r-�-�Zb�'�Owner Tel.No.: 2 �`��C{�-�`�tF�- � ..........................::..........:......:.................:...............................:............:....:..�s.::;:°.:..................... ..................................................................................................................................................:........................................................ t"�_� _ � �� . . RESIDENTIAL AND/OR COMMERCIAL BUILDING t HEALTH DEPARTIVIENT: Determines Compliance to State and Town Regulations; i.e., Requirem�;s For Septage Disposal and other Public Health Activities. ' ,� y p''lease submit three (3) copies of plans, to include: ;; , ..a_. (1.) Site Plan showing existing buildings, water line locatio�� and septic system location; �� ` (2.) Floor p�an labeling AI.L rooms �vithin building �i (all existing and proposed) — 4 � ~ � , � Note:Floor plans not required for decks,sheds, windows, roofing; - (3.) If necessary, Title 5 application signed by licensed installe� � with fee. � :.:...... ......... :::.......................... ....:..:.............:............ .................................. ..............................................:.............................................................................................................................. . 1 l �,�� i � REVIEWED BY: DATE: 1 �4�� '�, PLEASE NOTE � COMMENT CONDITIONS: r f �a 4z-Mr�.�` a� `� �- c�S�c d � S � �� `- 1rQC�c"''L " U�„�S� r,•w.e� � �'Uc.•� civt I`� -< <- lC�ull � _,n,_. ---- � i ; � i � � V � � y � � � � � � � � 0 � � _/ / �, � �.� f ( ( c, � a W ;N W � W � O � � N � � � P,1 p! Q s � � 3 1 � Y� ` � I � � � ' � - - � � � , �. Q �' �� ' �' ` � � � ; � � � J ;�,, � � � � � �� -�o� � � � �� . Q � � � � � �� - ' � � : � i . ''�� t� �� n � � � � � � � _ � i v � y, � '� �� .� � o v �' �� "� S �l � � " ' � S .�s � � � ` � . `� � �� -� _ � � t -.� � � � � - - � o � +� x � � � � �� i � � ��2 � � � � � � � �� . � � �� o � � � r^ w c ~ � � r-- � � w � � �� n � 4 -._ � � � - � ��'�,��5 :� � � � . cti �h L � r-. � � n �J � � r S `�' q :�� .x .r � ?S" � � � �� ` _ —a— �— � ? � � �� ` : � � � ; � � � �� : ZZ � � � �'' � � � �� ,��a� Z� �� , � ;�S � �� Y�� t� ' � • � �