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HomeMy WebLinkAbout2017 Sep 18 - Sign Off Transmittal Sheet; Floor Plan r_____�___._,T_T_�_ . -;-�-__ . : � T.,,e�.. .�.��—.P,�-r�... .�,�.�.� ..�--..� ..s.,,..._- . _ ,._ . _�,.,� ,� � � � ; . ; � ;; �,.ot ��,� T TOWN OF YARMOUTH �� ' ;� c :, HEALTH DEPARTMENT a:._� :.._ ,-� �\,,, �;�f'�' �t* ���- PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET ,� T�e completed by Applicant: Building Site Location: �3�.� �� ��� , �Jo��-��', ���c�r��.,�� h E. ! I� (;,�,�6 t.( Proposed Improvement: � -f- V � — �� T` �2. �� f5 ,� 1 c.c�2. v�� 4� Applicant: ���C a �1�C`pa`r�CU a Tel. No.: ��� �t��4 '���-t Address: �� ��Yr�?Qo:S c�, �.,Y\ }�.}Q.�� �U�C'Y'�du-��n �� t''�.��ate Filed;_�( �Q> Q f� **If you woudd like e-mail notification of sign o,f);please provide e-mail address: ,� , -:. . Owner Name: ��j��j �i�.,i*n ��,C.��\� �'�tJ��- I Owner Address:_ ��.� � �.� ,S��o��YY�ot.�-�!L� �� O,Z,�C'o 4 Owner Tel. No.: 50�'36�`�ot�� { .�. ................................. f .......................... ..... ................................................................................................................................ ................................................................................................. ...................... .. 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 thxee (3) copies of p.�ans, to include. � (1.) Si�e Pl�showing existing building9, water line location; - '� and septic system location; '� --� (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — y -Noter Floor plans not required for decks,sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. ............................................................................................................................................................................................................................................:.........................:...........................................................................:..................... � REVIEWED BY: DATE: 9 � 7 ,,—, PLEASE NOTE �. COMMENTS/CONDITIONS: � �r l.�cr c.� G'c�Py �� /�'�it � G'i ���O>%'E' �l�r.r9 %.r 5..2�J'�i Y�_ .5..L�nr� G'laP..-�/� Is / �. - � .. . � . . g i ' i ' • . .-- .... .. . . .. ...� . . . .. . . . . . .. . ..._ ...... .. 6 ....__. .. .___-_ � � � ' � �' � �i��� � `�.! v � � � � � i �J ��,.j ; � � aoa-� ��'�q � ,� h , moxv���, � � �ac�'p�� � � n - — ,-{� �iuii �__-.� -_____ ---- -- -- --__ -- � - � � �r---- , � �" � ;1 � ''� ��� d � ; � � � ; �.�� 4 � , ; - _-- , k � I � ; -�- , �I c� ; -� � �- � I ���+�.s� �, -� ; � � �D i.�- ; ;i :� a.-� i �... d ��. `���� �� � � ; � C�, , i j a �-� � -- ----__ _---------! � � L �I � � �wan� �o��,d � � � � _ _ z -� f � s� ____-- -�______� ,_ � �, ___ q�' i- � _} � f �''�n i O "� ; �___�_�___ � � R� - � ��� � j ��� � � � s `�'j d � � o � I - � � 3 � a � a � '� - � � z �� � ��8� �� Q `�- w �9� ___._______— i d � � L'� �.�� � ���.� ,a,; o , cr3 z � cv� � —r-- 3;_� i � � T �a� �-_--=-� f ; � ! �-- �� ��,�-�----- ; �°� j __ _---- - _ _ _ _ _; I_ �' � "� _. -- ------- --- �__----�___ � .�a�U�t,o�-� �rat U nc� i i --_ .� --� I �� � � � Is i � � p .�„p � � �� '+ G � __ � � � ___ � � _–___ i � Q � ___— � a �? � .� � s I '�s � � ��' �-- �,.� �° � ��s .�� ' � _�' 2 �----� :__� � . __. � ,��� , � ° � � mapr,�,,c� }��� S2le0 m v,;rn � I� � � � � �' �P r''°'� ' � 1�i,'� ii: i �::,'�i/ __ �.`_ 4� , .- __: _ ; - _...___ _..___ �___ i ,�;, .�;, � ;.i�.ii��i� ' --- ---- �...._ _ .. .. .... _. . ......_ _. - �'. -"r' "'� --_-- �� i �� ...__.. .... .....� ����J`}��