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HomeMy WebLinkAbout2007 Oct 01 - Sign Off Transmittal, Plan - Enclose Breezeway�,,,.�.__,_- - � -,��.R�ta.,5.�,�, ,�°F�Y`��.o TOWN OF Y°ARMOUTH o � ,cj HEALTH DEPARTMENT N MATTA H ESE � ��`°"�"""°��c� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be compdeted by Applicant: Building Site Location: � W� ��"J Map No.: a� ILot No.: J�� I + Proposed Improvement: ���1052 �jR�C2�W,4,,/ "' S C �.S� � a�+h !'•s c� Applicant: �uiCJ J cJ,�JWt d✓1 Tel. No.: �d�"���S�.�Q' Address: ��C� ��� �J �, � +�c�+ S (� t�l,. Date Filed: /� � C) **Ifyou would like e-mail notification ofsign off,please provide e-mail address: Owner Name: �V�i� t\f'1 C)Ltl�JJ Owner Address: l� /(1aR`� � �a �i�qWSf�(� Owner Tel. No.: ��'023`?-lo�a(•, ........-�- --- -..._.._......... -� ---�--------- -------------------............._. _.....-- ---�-..............._.............._._.............._._.......---------...-----�--------------------�-----�---�-----------.................-----------�--__..----------.._......... 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 four (4) cop�es of plans, to include: (1.) Site Plan showing existing buildings, water liae location, and septic system location; s� (2.) Floor plan labeling ALL rooms within building � . (all ezisting and proposed)— q,. Note:Floor ptans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. .......................................:........................... ...................��-��-�- .....-......................................._.......... ................_.............................._.. -- -�--- -�-.........._..._.......-------............ -� .......�-�- -�- -.-�-- --------�� REVIEWED BY: DATE: ����/U �� PLEASE NOTE � r'�� '�" 4 � ti COMIV�NTS/CONDITIO S: , ' -� �w5� � � �� f•� Li'��c �� -t- t i�r� c u5-e t� • u,� � 1� k1 v�2 $' �'' a S'r � v� � � i �� � � . .� �� . �� r . . � _ . . C . . � � . . _ ��; � � . . .�."T ������ � � . � , � � � �,.�..� ��� _ ���' V� � � � � '! _ __ . : - ._1 �, Lu 4 ' . �� � _ �-- , a � £r t! '7 5 )f �z� �N�✓j.) ; �'S ' ' y � t' �t �•v'!''+ �l ��.'}�� � � �t . I . ' � ! � / � ��� �• 4 � � � l____ ...- ,. _� p N7�_� ,.£�. ;'? ' . � � �{�'� Z 'Q ' i;. � -- ---_.�.__. ... . . - � ��� � '- �,�S�� �,S' `� � �. �. , ! / :�y: ' � -,,. , ; ; ., � � � � ; ; � . � � � � . � � � � _ � � � � , �W; � � � ��5 t� i iX' 1 �: —�-' � . i ; _�, �a ; � � : . �' � �� � � ' � ! j ���. , r � � j i .,.� •�} -.r. ;.� �� f F. �«� � . � " � � _ � ...� ... t . ;� ; � � I •,►����U ��^as + � ; T j -,.�,�►.. .. , 3 ; � --- � -- . 3 � � ly,?U�It? ` . � } � -E � �. � � � �, .� . ____ �.�. _ � . _._ . . � � . , �� �� , - ► � _._ .� _ _ _ � _:., ,8 r., , c� �: , ,9 4 a� ,..�,, £,, ,,1 � , z • � .tt--�.�i � ---- _ _ � t � , � � � � � ' � - � �, � . ' 3 i :� -�'; N - . `�` � ; . �; � �. � �=- °,�; ;�c � — . �; � {� � � �. - � -� '-�.. R =� � �� � � � . - . �# �.. -� � ;� � � , � � ; . . . - ; � t ,,., ���_.._.., � ' . ' �---� ____ ; � - __--- -�. - -� �.�....� �� _,� ��� �.....� � ;� f �� � __",...-.w.,-. _...o_�.._....--., .._w_..e..+�... ..~�I�� ..« � {J, <��