HomeMy WebLinkAbout2017 May 12 - Sign Off Transmittal, Plan - Deck �,. -�. , ��.a.�,
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oti Y'�� .��'�TOWN OF YARMOUTH
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��"''�=�.=�%�f� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant.•
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Building Site Location: ��( ���=�(1��� ��+✓�-�,
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Proposed Improvement: �,,�(,� �Z � Z v� ,�� �--�
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Applicant: .1 �..�� ���� n �? Yt�t t J��,t TeL No.: f G' �"��� ,. r 2��
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Address:��� U'U��,�c:� �� a � r L't-(�� �Y;�,��,u.G(�..- v �:{�, � Date File : �._,._ _ (�
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If you would like e-mail notification of sign off,please provide e-mail address: l
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Owner Name: ' / i cc_.-v`-�"" r ,n. ',�'Ge_ � �,r�,� �r2 4��t.,2- �I='
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Owner Address:__q ��cc d Q�2 � � S � � t, oti t�" z c�Z Owner Tel.No.: [ ��� �r�'�.�.35""'
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RESIDENTIAL AND/0R CONIlI�RCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
i For Septage Disposal and other Public Health Activities.
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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 builtling
(all egisting 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: DATE: ��j �--- I �
PLEASE NOTE
COMMENTS/CONDITIONS: �`