HomeMy WebLinkAbout2016 Jul 12 - Sign Off Transmittal Sheet - New Home .. ��-.� ,� __-s-�.�.�.a�..,�..,.��
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•a'-`'Ya'� ' TOWN OF YARMOUTH
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�=°=`-' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: � �/�i�. ���5 �� ��;�,� �� ���'
Proposed Improvement: �,1,�W �yy,..Q,,
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Appli�cant: � /4- - UI 1�;�n7 !Yl C, Tel. No.:_1 ��'Z(2 -�t.�'�"
Addr�ss: �� S{j'f� ��-� �p�Q , �� ��,�,��u�'j-� Date Filed: � f�
**Ifyou woudd like e-maid notafacation ofsign off,please provide e-mail address:
Owner Name: /`�?n..��� IJ l'!/\1/�1
Owner Address: .�� �--dY��r /�i�-�'�,,Lpw ,��'j�,. Owner Tel. No.:,�j� -��¢�-_�g�i
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RESIDENTIAL AND/OR COMMERCIAL BUILDING '
HEALTH DEPARTMENT: Determines Compliance to State and Town R�'gulations; i.e., Requirements '
For Septage Disposal and other Public Health Activities. j
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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 building 'i
(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.
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REVIEWED BY: �UC�/ DATE: 7^"/� %
PLEASE NOTE
CO ENTS/CQND IONS:
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