HomeMy WebLinkAbout2017 Mar 27 - Sign Off Transmittal, Floor Plans - New Front Deck . � ,� TOWN OF YARMOUTH RECEIVED
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s! �-� HEALTH DEPARTMENT MAR ) 4 201� �'
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��y4''���%��'� PERMIT APPLICATION SIGN OFF TRANSMITTAL SH �L7�H DEpT '
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To be completed by Applicant: �
Building Site Location: �� ��' W�'" �cc►�..e� �W� ll N�+���� �r u. '
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Proposed Improvement: �v�.r:�d �¢,�n���c i,�,�,� o�,, �, 01i� Q�..��
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Applicant: Se�re�.��h ! � �� �� Tel. No.: �d� b g� ��$3 i
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Address: i�� ��i� ��Li�_� i-�7 � ��� r i.7 2�G o ( Date Filed: 3 �� �_��
**Ifyou would like�mail notification ofsign off,'please provide e-mail address:
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OwnerName: �'�r�.+�C�C <<n i5e�y
Owner Address: �� � - �/l i;�-�/L��--� r�/L,tu� �• ��. Owner Tel.No.:S�� 3�� o�!�O �
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RESIDENTIAL AND/OR COMMERCIAL BUILDING �
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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: �
(1.) Site Plan showing existing buildings, water line location, r
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; j
(3.) If necessary, Title 5 application signed by licensed installer �
with fee. �
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REVIEWED BY: DATE: � �a����
� PLEASE NOTE
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