HomeMy WebLinkAbout2017 Feb 17 - Sign Off Transmittal, Floor Plan - Renovations _ _ ..
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��'���,�.� TOWN OF YARMOUTH
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��`'' `��1�. . PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
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To be completed by Applicant:
Building Site Location: ��� ��7 M,t S`-T1( (.rr�N�
Proposed Improvement: �+vU+�2T� �+Q(�tv1 a,�q�Z�•.��-( a S'tMv�� -��µ.c�_(
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Applicant:-_�t� 6 �c'�'�'� Tel. No.:�7�-°270 - 3 3�9'
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Address: ,�� s f�t2�y99,t'� .�';' �(,,�,�"/�� ft�J,q a/-��(� Date Filed: 7
**Ifyou would like e-mail notification ofsign off,please prouide e-mail address: ��(/�f) C, �s'�-,/�,�'�J-Q��.�'Q y�
Qwner Name: ����� C� S{--�d�2�
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Owner Address: �� �S��iQ�1,�y�,_� ��_�(y��-�G� 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.
Please submit three (3) copies of plans, to include:
{l.) 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 neeessary, Title 5 application signed b� licensed installer
with fee. ..__ ,
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REVIEWED BY: DATE: �. / (
PLEASE NOTE � j
COMMENTS/CONDITIONS: ,
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