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HomeMy WebLinkAbout2017 May 30 - Sign Off Transmittal, Plans - Addition - � , � " �o����o TOWN OF YARMOUTH �, _-_3� HEALTH DEPARTMENT o;� w,, ��''��=�`��1� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant.• Building Site Location: �� ���� �� «'�� C� � • �•��V�• l'�-t f4 • Proposed Improvement: (�j k- �`{ '���t �c'"t� ��- ��c�i--'�-F-(�OGn.�S> Applicant: �' �`t"`��1�"C. 1�. -�-{c7 l.i`,-'�l_..-'�'j Tel. No.: Sv�' ��' QJ ly cj Address: �"� 64t-`'��� GN • �G�J� i�, t�-t�- d�63� Date Filed: c�. '3l� a°f� **If you would like e-mai!notification of sign o,f�;please provide e-mail address: �• E`{O�-�� a-3 � Owner Name: � +� �''LC_.c►V CC�wc c�4�,';. ��-- Qwner Address: �� atlt�r-'�J � ���.,,�J C I�.C� !„_= Owner Tel.No.: �� � 6�f, 6�0�7 .::_....:.............:.........................................S.'..Y�:�'.''�._�................:...............:.............. . . . . .............................................:................................:..........................................................................:....................... 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: (1.) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all ezisting and proposed) — Note:Floor plans not required for decks,sheds, windows,roofang; (3.) If necessary, Title 5 application signed by licensed installer with fee. ....... ...........................................................................:.................... ......... .................................................. ....._... .................................................. ......... ........ ........................................ 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