HomeMy WebLinkAbout2016 Oct 31 - Sign Off Transmittal, Floor Plan - 2 car garage with 2nd Floor� .. �__ : - .
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"'�- oF Ya,� TOWN OF YARMOUTH
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�''�� :�-'c HEALTH DEPARTMENT �
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' '�`r PE�ZMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: fsG� 1C��`t.ec�` S-F�r,�►e-�'- Srsc,-�� �/��,,,«,.4L,
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Proposed Improvement: � ��� �,Gf� y�,,;�:j� �..� �j�,.`� f
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Applicant: �-�-e 1.cn �. Ce t� Tel. No.: 77y-�/�,►.GlG 3
Address: (�/ gv�rre.r•«., �r;..� ,✓l�rS-��,�,,, .iy�;//s ri� �Fc' Date Filed: /G ' � �
**If you woudd like e-maid notification of sign ofJ;please provide e-mail address:�C�y�E e������,,�,(�s Jt c�». !
Owner Name: �"'r�- C,1.,,`,"�.n,�.� �� '3�'����2�����1�—�
OwnerAddress: ���.�►� -�-�r-*c#-- Sc.�,t{� v��r►�-sl� OwnerTel.No.: G/7:�13�5�– /,ZYj,
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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,
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 necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWED BY: �" DATE: /�r','3f /
PLEASE NOTE �
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