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Home My WebLink AboutUnit C - 2017 May 17 - Sign Off Transmittal, Floor Plans - Use & Occupancy . . �. � __ � r �__ - . _. � .:.�.,��.� ,.- ;,�-�.;--a--;�t�:: _ . ... 4 o�''-rak TOWN OF YARMOUTH � '°""�`�4 �; �w ;� HEALTH DEPARTMENT a:_� _ . � Y��'`� ``�� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET �� To be completed by Applicant: Building Site Location: SvNF1ow2� I'�aRk.e� 1�1Uce �Z,� R-I �OA �Iac.Y,c�,ah (�pr� �}U�� (, Proposed Improvement: (��-`'�,�. �Qt�t,Q, Applicant: Amer,tuY, ��r�1 �Tsac,uk�� - �oNu e, S�e;ner a Tel< No.: q}b - ��..3�}{0'1 , Address: �12,3 ,�,,,ae G�.� ya�r�,o.:�h �o�� lt� OZ t��5 Date Filed: 51 �� a **Ifyou would like e-mail notification ofsign off,pdease provide e-mail address: Owner Name: Owner Address: Owner Tel.No.: ...................................................:.:.........................................................................................................................:...................................:.................................................................................:............................................................ RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage 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 required for decks,sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. .................. ......... ................................:................................................................:......... ......... ......:........:............_ .:....... ....... .............................................:...............:.................... REVIEWED BY: C�.. " l7'�/ GC�Ik� DATE. �l' 7 PLEASE NOTE COM(�`�T(°.PCO L�11-(ION�D' !f/ �/�'P U S-� '� G�� m V ' 0 � � v ', Y � n � � � � � .� � � a � U `� � ? � ---- --- — ---- � —�-----�� ----- � —J�—� —�_,_ ___--- �J v// � ��. ��__�s�>�1_� --=-Z� �� - � �� _ o o .� --- -_ �, 0 � � U ------ > _ � \ �._._ � ,� �� J = , � � � 'i! U V O `�- O e � � E � � -- � a W i �—_—� _ __---__— - -- A > ! - — ------------ _ � � - � � xa � a ' � 0 � � � � �� m ,� � � C � � _ � � � � � � � � II � N �� v � �� i �� ---�--- - -- �-------�-=, - i � � � � �,a � � , : � � � p� /y,� �� 4 � N.,� LL � �`�l ` W C U� �� Ill �`r � � � 3 I � = I � � � �� ` �� ---�------ , _ ; � � --- � ��_�,—_ � , �_ � � _� _._ � � � , � � f , � �: � _�' �� -�o--�� m� , �'�' ^ � �y �� 1� _� � � �� _� LL ii� �. � 'gN '� � , \ � �•,� �g��'' � �� o� �'� x�s��o u �, � � _�_ '� � � _ _� �� . N � � - �� '�$ _ m� j (� N � "'---------'"`....� (� � � � � __ � � � � — �S'% �$' � `=� _ ' � __ _ �� ,'� '� � � N --�- — � oQc _,_.__---____ — � �N - � � a' _ �,,.�— \ N -' '� � >�. 1 _ ;� _ --- .% -, -- � � � �o �� ._ , , i _---� � �..J�. _.�.1_�___(_ , , � � � _ _ ' _g Q o� I i'p��4 u.��p�j s o- O'a'3 ��3 ��' �6) '-'�On . �,t0 � �n S-' s>m� �a.u�� i'� i � a� =c�`4� -� �° c m �p� �Qy� �� c� I `-"+.,.� (V �� C� '6� y �N �'N V- 4�Q � µ, „__�=---�..—�, —_ �� g ��i �di I I I �� -_ \ _� � _�� I `=`'�--_____ � � t�.� � � =_'�~–=.=�_� __� � O � � ¢ - � -._____-� � 4 � � � � +� w� z � ,�'�� C� o�� =N � ��' ��