HomeMy WebLinkAbout2017 Aug 18 - Sign Off Transmittal, Info - Replace Deck�-.-. ._ .. _. . �.,....,� -.�_- �,� �,� _ - _
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oY Ya� TOWN OF YARMOUTH
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���'`��-=�=�%��� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: ;
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Building Site Location: � / ��-GL"`w? �/� �
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Proposed Improvement: i��G-s�r,�c� O�d �-� �-�"�/��- -�-G�� ��� I
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Applicant: /�i� ,� ��'11��..,�.r Tel. No.:CS�a`�y� C��'�
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Address: ��--s- , �01�.- ` �,.,,.- / l-.r�.- ��" Pi+�'f''�T�ate Filed: �'�' /c'c �'' i
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**If you would like e-mail notification of sign off,please provide e-mail address: �
Owner Name: s�i ��r..�nt' -� ,�,�-- �c��. �-j1�.rb.--, �
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Owner Address: �,� c��j/P�v� ��/� �-'���/�`"�wner Tel.No.:L�c�� .,�%f� 7�//'
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RESIDENTIAL AND/OR COMMERCIAL BUILDING �
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:
(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: cG / � /,7
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PLEASE NOTE
COMMENTS/CONDITIONS:
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� LOT NOw : ADDRESS ; � 7 STEVENS STREET
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Ot�NERS NAt�iE : C H A M B E R L I y
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SEtaAGE PERMIT N0. : 96� � 03 NEW: REPAIR: �
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DATE ISSUEll : �'� 24 �9 6 DATE I1'�STALLED : S /t� S�
� I��STALLERS NAME : ELLIS BROTHERS CONST . C0 .
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I NSTALLATI OAI OF: /S�O sT 1�8 _ , ss'x y 'l��xh
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WATER TABLE : F INAL INSPECTI01� BY : /gl/�
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Di�AtJING aF INSTALLATION ON REVERSE S IDE :
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