HomeMy WebLinkAbout2017 Apr 18 - Sign Off Transmittal, Floor Plans - Garage Room ,� ,. ��. _ �_
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���'''�=`%�l� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: � � ��� G T�/��.�,3 �� -
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Proposed Improvemen • 3^-� �� �Q,,, Lin G�� �'�C �'
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Applicant:_ _. �� /Y '(�!f'�CQy,.�' Tel.No.: ( ��'.�l�2-��
Address: /� S�jJ( �r't�l�. /�oP . � �- ����� �it�(.-� Date Filed: !�. /t�
**If you would like e-mafl notafication of sign o,fJ;please provide e-mail address:
Owner Name: �'t � � �/ W d-!i'►
Owner Address: �� ��P�G�-/�,t.�'k�� �F', Owner Tel. No.:
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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. �
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Please submit three (3) copies of plans, to include: '
(1.) Site Plan showing existing buildings, water line location, r
and septic system location; r
(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.
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REVIEWED BY: (� DATE: '�{ /�/j' �
PLEASE NOTE
COMMENTS/CONDITION : � �
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Yarmouth Health Department aTi_Dj V, 6�n015
AP ROVID
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Same Date
DONALD I. MEYER
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B.53ngDesigner
S. Y mouth, MA 04664
1508) 39M52%
DONALD I.-MyER°
Pro fessiowl BDesigner
PD. Boz 932
So.. Ya nn K MA OZ%4