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Home My WebLink About2017 Aug 08 - Sign Off Transmittal, Floor Plans - Repair Flood Damaged Basement -�,�__ ;,. _ �-- �n _ ._,�,...--.� ��_��,��., ., .� , x �--�f:�. .. .�� o4�'�q� TOWN OF YARMOUTH I' . �,, ,�,�, �� - � HEALTH DEPARTMENT o:..� _��-� ��"'�-.��=�%�� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant.• j ( Building Site Location: �__��R1� �I�i ... � Proposed Improvement: '�j��-�'�_ �� E I � � � i Applicant: ��'��}�. �. �'R�- Tel. No.: � , i / I Address: �j� �� IG.• Date Filed: ( **If you would like e-maid notification of sign off,please provide e-mail address: Owner Name:��,A � � �� ,�.. Owner Address: �j��j�� Q• Owner T'el.No.: �$��..-�l�° .� . .................................................................................................................................................................................................................................................................................................................................................................. . RESIDENTIAL AND/OR COMMERCIAL�UILDING 'HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septa.ge 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; t,,; � (2.) Floor plan labeling•ALL rooms within building � (all egisting and proposed) — R�.. . Note:Floor'plans nSt�required for decks,s�ie'ds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED'BY;... ...... ... ....... . ................................. ..... . ............................................................................. ............ � ........................................................ DATE: � �� _�� PLEASE NOTE �� COMMENTS/CONDITION • ��°�,._�` �.JCC� �� /'UC'/�^ �'� 1��cSe�u� --- { �� i ' � �� _ n � E � � __._—"_-- I � ' � � � _ I i _____— � I ( i` _ � 1 � s �� s I � 4 I i --- I — � - I - �1 �Z � . � � - - ; . . � . � � � � I • � � � Q _ � — _ „ � ;`-� o � _ �' � �.-;,� � Q ; = u.� . �n Q Z �� - � � �. �i � � --- - -�----- - --- : -- - � - - -- - � : � ---- � -- � _ � • i � ' f _ ; � . ; � ' � .: � � y� 1 5 � � � � � � � � �(�A� � � � � l �ti�� , c� �O� , � � � � � � ,� S21�� .L �� ` , � � � � � —� �„`� c�-, � � � � � _ ��i�yj M . � J �— v� 3�= � �.1��.. ; -� - O''�1.y � � � � — � �, � � — : _ �� i � � � �� I i � i i ,� ��s�� ► � � � � ;� ; ,_� � � � � _ _ . . . . _.. . . .._.. j ; � � �j ` �/� M - ct �` � _ � � �� r � � _ � -- � � � � . \ � � N � - -" �� l � � � � y��' ��/ N �� , r� - �.,. ��C�'�' � =� �� x � � � � �� ; - , � ,