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Home My WebLink About2017 May 12 - Sign Off Transmittal, Site Plan Showing Proposed Pool k" . ' ':�n'.�,,..�lY?.f1l.�-e=,< . •:r'__.._.__. .�. ... . _..._"___.-.__.�..�.__..-..._...-_... � .... .........�..�-..--m.-e�.-.- . .,-_—.t .. ' � .. _ , -a „ . . , � ... . - .. . . ., .. . :, . ,. .. , -.. . . �� .. , ._ _ . -,ti.^-. L. -� ,. _�-•,, .oF j k,� TOWN OF YARMOUTH �{ = �--,� HEALTH DEPARTMENT a;.� �. -� ��4`'��+`�� ` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: �� %e G � Proposed Improvement: r'b�< < �� l 6� X \ S w� M � � ^� - l o U\ -� C�M�,�, — � C� �;p( A_Jt^.. � wl�� w rT�l � � hJ��M., ,.Jr-� �F�C'� -FJ Jv�� . �I � ' Applicant:�10►e��n�e 1'c�o�� 1 i.�C C�-�f� `� � ( 11 ( �c �^ Tel.No.:_5 0�-�/52- 3�'`(5� , Address: ZU? ��e�� ANue R�� `IA(w�c�i . �lA 62G�(S DateFiled: S /� / `�' *�Ifyou would like e-mail notification of sign o,fJ'please provide e-mail address: Owner Name: ��1 h�C�� ' ' `e cX�t' t c�S Owner Address: 6�C� �v�z e 6 /� 1/A R M o��t�Po 2 i, ,G1 A 0 26 r�Sawner Tel.No.:S(,�-3S S-�-3�2, .................................................................................................................................................................................................................................................................................................................................................................. RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to Sta.te and Town Regulations;i.e., Requirements For Septage Disposal and other Public Health Activities. � Please submit three (3) copies of plans, to include: (l.) Site Plan showing existing buildings,water line location, and septic system location; , (2.) Floor plan labeling ALL rooms withi� building (all ezisting and proposed)— Note:Floor plans not required for decks,sheds, windows, roofang; (3.) If necessary, Title 5 application signed by licensed installer with fee. `` ....................................................................................... ............................................................................................................................................................................................................................................................................. REVIEWED BY: DATE: �� PLEASE NOTE COMMENTS/CONDITIONS: � . .� � . . ��. � �� ' . . F �.; . � .. y�� . . � . ... � . r �../.� y � �w.�w� ; „ � � ��. �� . . . � �� m ,�r� 5 .,,� . .: , > _ �� ; �° W �' _ . s- , ,.. � .. _ � . �� .. � � . „ _ :., :. �,> , �.,� _ �. � � �� . �, , . :. 'r�+«. � # . ,.,s . x x . �- . i „ � 3` �s i _��. n�: .#:� � a �# �� 9a..,.��,�� . �� , . � � � . .... � - . . � r v • � s� • M� 04� F!i'�jnj� t0 �;� � , �, �,� witfi 2 qahs. shown i� "�� ,�r � � ��-��•'� ,. ..� . � f` t � #� .,or �� . �� . �� . l+°► '�� ,.'P ... . � � �i r '• .rr ..�''�"��,�M �� ...� �+ k � . . � '� ; � � �v. i �'p, :, Y ,� Propos�d C , s , '�' R�tt�n� �vsfl �,'" ��r�E ��,,,�» ' � � a + �� r = , �. M � �, � �,��`t��. ,.'' x ,,, /"" � ; d �i+,+�,r� � ; �,'� , � � ,�+ �� : r� � f ..�� '� J}' i : �.'�..°,y�,.�...aw'� . �'~""" � � � � � �� ° '3Ma�� s � � � ;� �� , � � � t r^/ 6 �¢ 4.a�t i � 8 ♦ �.�� .M1� pine � s y � y" � s � � ' J � � � �� .- ; � � _ , ,.* �� ' ," i s , • � ` s� � �` r ��"r�'� � .,� ;�: ��, f { r +r ' �� '` . .. � � � � ` '� �� ,� �� ,� � .� � � �� , �� .. �✓ � �,,,'" f� s �r .�'� t� r'� �, � � � � � � i. r � , ,� '' � � � � �� '"� �'� � �` , � M�"� ,r ✓ �,,�,. -� , � � � ��c��ad�� ` � �# � � ��. , �. ��"�� ,� �,�, � .� - 12 2Q11 • �� ,�� ,,� �` �` �r'� �. ,.�. � .� 4�v�� _ �.,s � , � � �` � �EALTH DE�,.,� "'" �.� �,� � ,- r � � �.� � �r� ' � ,s� �*' '' s � �e s �"`� '"�� '�� ,f� �/ � � � ' � � � � .� ! ' �+� �: � � � �� w *; „ � .,�...........,r.....�...,«•' �, �w+ .. ,.. , � � � �� `�� : � �� y' a �,+�' 9 � �� ' i � �.- !'` �„� �� ' 9 � l! � '� : �� +� � �� e �� r+" .+ „. ` � ...�. .. s� i � � � � �� :w. �.a . � ; _ .� . . �`� .. '-`� �� . .. � _. .. . ..... -i�Yw� u �- ' �'