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2007 Oct 10 - Sign Off Transmittal, Plans - Addition
.�.w. _. ,, . . . __ , n .r _ _ �- , ,., -, , : � '� �`` �, ,:v �,� - �o � TOWN OF YARMOUTH o _ , � _ ,�,, � HEALTH DEPARTMENT N MATTA M ESE�+�J �� � ���pNRAT[D��.�f� ^•. .. PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be compdeted by�plicant: Building Site Location: �Q ��J � �-I j 4�� ��--�t(� Map No.: Lot No.: Proposed Improvement: ��J � � ,,,j � F /1��`�► k � rJ £� �jy4.2, [ �... �c,�s.�c' G uj U P�,r+-, � i�r it�-� f,,,� ��'u s=o �-► , �1'a v Fty��e.. � �t .4 Qo v,,� �(� �'C l 9 � - • fj _ C�-f,�" Applicant: �..�,c ,i�c t� � I��LJ� S c 1 /�} Tel. No.: �� �`/�/= 7�b Z Address: �J� .�q � ��/�,J �' �R.�v �, . Date Filed: �Q � � G? **If you would like e-mail notification of sign off,please provide e-mail address: i Owner Name: � t�►.� (h�.; tf i �- S � Owner Address: �/� ' I ,� �t P���d' .,���f Owner Tel. No.: S"�� � �y- 7�[� Z. ..._.....----. ............_-.......... ...._.-----......._...--------�-------...--..........- -...........-----.._..---------_......._................ -�-----......................-------------._......._.......---.._----_..................._....._...--._.........._-------......_ RESIDENTIAL AND/OR COMMERCIAL BUILDING ` � , HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements � For Septage Disposal and other Public Health Act�ities. `: Please submit four (4) copies of plans, to include: � (l.) Site Plan showing ezisting buildings, water line location, ' and septic s�stem location; ' -..� (2.) Floor plan labeling.�LL 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 s with fee. � J`/ _ ""_"_/......'""_""""'"'_"_".....""""'""""'......""_' '"... __....... .."' ""_"'"""'""_'"""......."""""""""....."""""""'...." ""_""'...._""_"'...'"""'"""'........."""""""' �. . """""'"........"""""_"'.....'""""'""...'"""'.....:...""'........____""'........"""""""......""'_""""'"'""_"""........"""_""............."""' REVIEWED BY: DATE:_ l o��o/G �'1 ' . 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DI�A�iING OF INSTALLATION ON BEVERSE SIDE: ��� G � �M+s� � �'!►w«� �!� l� . �ah� � � 4�y, ����/ 3 « s�,e,,• 1t"3.., � • /¢'�t � ' _ � F,�o�-� �!� Q , � � , 1�1 �t�• s l�3��� ' . ... . . ,• • ��r_ 3S w � ' �� to �CS` -�� � rr � � � � . � � , � � � �_l � , . � � � , a • - — -- �� - 3v MARVIN HAYiN5(045 FRAME: 3'-0" X 4'-O�" LL MEDIA EXISTING WINDOWROOM TO REMAIN LU <,b< fs LU MARVIN NAVqN3645 FRAME: 5'-0" X 4'-0,6'" C, 0 LL- 0- SED OM 0L 43 LU O c)') m _.4 < P BATH w > 6 7'. T 7�y < vE OCT 1 0 2007 o o HEALTH DEPT, � o � DATE: A 142P