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HomeMy WebLinkAbout2011 Jan 03 - Sign Off Transmittal Sheet, Plan - Partial Finishing of Basement =� -� - � - s08. G� �B� 3 3 �G� o�'�--_'-r�r TOWN OF YARMOUTH � � � � � •- �-��c HEALTH DEPARTMENT , Q� � ' � '�����`�� � PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET '� � '� To be completed by Appdicant. � � Building Site Location: 4�� �����"�- �� ��/'iGtot,t FI,. ��f-,GL� �t,� OZIv�.�' , �'��'��~ ' Proposed Improvement: J=/A�/S i1 4 � ��t���7�I� ! �/�/���� t ��"p�A�it � y APPlicant: ���r�-r�� � C�/�.C� Tel.No.: ��6�B-���� Address: �a ���r� ��'� '�� % � Date Filed: � �C�- �d **Ifyou woudd dike e-mail notification ofsign ofj,please provide e-mail address: Owner Name: �c��yC�c? � r�c� .r Owner Address: ��"C Owner Tel.No.: ��rK�� �...........................................................................................................................................................:............................:..............................................................................................................:.......................................................... ,�-� RESIDENTIAL AND/OR COMMERCIAL BUILDING , HEALTH DEPARTMENT: D�termines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activiti,es. Please submit three (3) copies of plans, to includ�: (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, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. ......................................................................... . ......................... .........................................................................................:............................................................................................................................................................ REVIEWED BY: ' DATE: I •� PLEASE NOTE � COMMENTS/CONDITIONS: ,.�� ! 3�-Sc w,z �f�1��t -�' r�T T� h-c vS� � a. at� �-e�d Yu�+�` i . .. . . ......... . . .. . _.. . . . _ .. _. . � � `�, w �}tND9NIS Z�k38 � --� ' 4q v � M t. M )vi.1 �„� - V � �� M � ���j� � �� � � O\ .� �\ , � � �� `9' � qL x �� ,._.�.�..� �. --� � �q � �; X � , �� . � � � � � � � �$ � � 3 0 � .� �� � _ - � ��� � _ Z f � � � �: � Q � ' - � �.� o � �� �.,., ,�:�_,z,�.,�; � � 3 � +� � � _ � � �� /'� x � � �`� O � N � : k p 1� .� m o �F- V � '� FY � � . � ' �, � � L � � �- � � . °� u � � � a � v � V! � . 1,� � � � � � `� � � � � , v � ` � N M ti 4 . � � � ,1y� � �� �' �� aZ��'�! � g�2 sc�c � v �_._..__.�_. �+lty�t,N�� N � � � �-- — J — X 4 + � � � � �i �� - � v \N � �`� � � � � °V, �'= fi °� 'c I�, ., � � 2 a, � ���` � \ `�, �. c� w �' � � _ _� � �n : � Q � � � 1 1..a � `' c J " � - _`_' - _ ���� �• �- � .� _ � _ —____ � o � � — � � - _ � �� w � �� �. � � � , . � � • � � i i a � i � � � � O� � 0 � � Y � Q � �3 � � � � y � � � � � ' � � �� � '�o � � � o � � � z � � � x N . � ________. � � _ � 1 � � J : �--- ,�, �