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HomeMy WebLinkAbout2017 Jul 03 - Sign Off Transmittal Sheet, Plans - Deck Extension . �_.�,_„�,.__ :, ,�,_-. �^ � _ . _ � �r�.� .� ry� � �� _ - . ,,. , � �. �, � . , .oYr'�a� ' TOWN OF YARMOUTH .�.--�� �� ,�--� HEALTH DEPARTMENT �:_ � ��_J"'I � �'�`4''� `'�J� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET +� �...�.,N�r . To be completed l�y Applicant: Building Site Location: r�7 �i�!/1�P6t/ /�U� L�l/T�� -�//1�i�'iDGr�'"'`� Proposed Improvement: �XTP���� T L%k/S�/JS' G�P�'� �x-r�.,,r'�h �� ��X 1a � Applicant: J / Tel.No.: �f'/p2�7--��� Address: f ����C�h T�/v'' /�� !J/eFD Date Filed: � / **If you would like e-maid notifacation of sign o,f,j;pdease provide e-mail address: /0 hP �r,►� C�n � Owner Name: i � � J0�? /� l � Owner Address:�� � ���J:! �U�2�n..�~y''�J✓ � �/�t�..,30wner Tel. No.:��/-.��.•����� U .................................................................................................................................................................................................................................................................................................................................................................. 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 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. .................................................................................:.....�.:....................:........................:..:..........:.....................................................................:.....................................,........................................................................................... REVIEWED BY: �� DATE: 7� /� ,, PLEASE NOTE COMMENTS/CONDITIONS: r � ,__..,�_w�. � � � � f.. �. ,l' ,`� C° -. Q 8 � � �� a A 1� !, ,._,. __--___._.r. .---..��..— �, W _._..�..:._..._ _ _, ��:� ►� � j � � �� ! +x p.�, � ��'` . � � ar ��. � � � � � �� �':� � � _..__. � 8 � � � � � � , _ �, ' ___. � -"j' ( �.� ; �..___._.... , � ; , - � .� ; i /' 1 � j' � � ; � `� �_'�,4 � i� �A _ '� -- 1 .� � � � ,,,� �. � �—�—__ t; � � ' "' f' I . ..._. . ., i i � � � � � !� ` � � � i '� ! ��u'-�---s_ % ''� i � i , . � � �_� � � ���� f � � � � - �� � :� : � � � ; t � � _-. � � .� : ._ _ �� ' ; �: 4 � � ; l�--- .ti � ; ,.� ; ; ;. - . � � � i �^ , ,,... � .- �.i : _.. _ � •—�— � � ,� .. ___ _ ... ._ ��I l , A.� t�' � j '`°�' ►'*)'� ��.' ' f ..._..... --�'-�' ( ��1 � � '`...Y �;�j � � i i �/'�� � � ��� �� � i f... : �`, 2 #�..i ! t �! "� �„ �,� � � -.�` � '"-,r ! ? y� `; `� '�,. �-..,..__. , � � .-Y-.� I v� � ; , `'� ,.,, ' � � �t� �� � ! � � � � �{ i � � 'd1�. ~iti,� t„e"_'t.�,� i f-'-�..._ �--;',. ,� ��`�'1 ; '`a � T,w `^p' �� �'�� i j � i i�._. __.._ -�'� i 1 � ;� I s ` �� I t i '� � � �� ��,1 t � ' ;--�� , r 4. ' � � � i ', . � ( �y.� j .i "{ i I . ,! J�(r ! . 1 . i .� ; r I I . ; � ' � ' ___._.__-��'� 1 _ ______.___.. f p� �.______------�—�_-_...— TI i f •r ' ' . i .1, e�"r � v,�„ , ,,, / ; , .��, . . : ,.:.y_ � 'it,!� "�:F � . i ��. �..� � i_.. ' i �,a.� �,� � �k `� � ` � . ! --_; ---- ____.._.._.�,�..�_....i ,,� + .^,___-_. -,,�r� .� ' 4 '�"� � 41, SAY - j-�rz,it - i76c. _f L.,I — 6.1 3 ve X,'. , �✓ ;'j' "0 id f n: 1+0 , f If i ww, LJ v1AU.. e' _ i I ,'fir t ��.- � / ���` T •. 4f. NIS _. j �� i? t"�{L+ �i'C§Jf `_�r ----- "r" — ,—",' �'. r•.,.�C s�(� -.` l: r' � C ia..l 1 � Cq� S 77 12 ,3— c Yarmouth Health Department PPV,ED ame Date nrTP Yiu. Mt 15 41 .r r i �i ' `Ft -:-,v s' n.,c c, ,.,y��'-' J •4i`,' f j '1✓ .!� ' 1 FJ- 1� 1.3•x'.. '' .71 .;r„ � � „� +- � �-'�•�-s�`�#��^���,as�,-��'-�- `fir-�i�k� � �. •��'- � �'-€� � s � n �f �,e ,`�� •�'•�-4� 3�: .z"-xS.x..':�,�` �'c�� } Sr .�''L�` ..',mac �'-ruE--,��.4 ,� �i � � -,.�`i �' ���F'`.y��ym3�0�'�,*�:�&`'i". '�� :� ti'�� Caq., '�-i- -a-: `� '4 }:'s''�--r-- .,amu.-•uyya+F�Yi'� � �"3" K'yXw, :�.�„ .£�- '�y.— �\ _ t Yarmouth Rtaftartlttt 4 z r g �yBea: g 1 I tiED ti 1 ` OV _ .. �.,.. :. .. ._... .. , .. ....: „ ,. ...... .... _ ... .. .,