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HomeMy WebLinkAbout2018 Jun 25 - NOT CONSTRUCTED - Sign Off Transmittal, Floor Plans - Finish Basement A OW TOWN OF YARMOUTH •' V'e 13 , - - ,c HEALTH DEPARTMENT *te I I, w 1 ' ' - \,t4„ ,..t.t/. z ........„2,4_, PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET Z Ti be completed by Applicant: i I /2'-' \\/ i 1 i , <I .; ', 0 B ilding Site Location: ,,=-- /- / yi-c, I- ki ... ,... ..,1 , 9',,- ill ii ''''k If 1 / U) \ f Proposed Improvement: r , , i, ...,B _-._._ s ._.,, „(0..se 0,2 ei, /6/04 -io ),-,:e. L.,f., i (YJ ii Applicant: ---.3.9-,f 5 -),--, si 1:2 ' -'--'. Tel. No.: Address: '7 i ,,- I 4,,q :1--/1 01 2,231 -,„,,,,.. ii, '1, 0 t:,)Date ' ed: 6 19 tol'• **Ifyou would like e-mail notification of sign off please provide e-mail address: I Owner Name: _ 2 ,;, >- --,i1 i / i , ) , ,, II Owner Address: 1 I Cu -,/ „ALA /4:. I.Lie,f1 ,, '‘,1.4,v I\ I), 16.0wner Tel. Nov: •f---) ''.7 1.'-f( ? _. ...)! RESIDENTIAL AND/OR CO ' I RCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance a State and Town Regulations; i.e., Requirements < For Septage Disposal Please subm hree (3) copies of plans, to include: , d other Public Health Activities. Is . • (1.) Site an showing existing buildings, water line location, g 14 a , . septic system location; A (2.) oor plan labeling ALL rooms within building 4%-- (all existing and proposed) — 0 Note:Floor plans not required for decks,sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED B AfilliAhDATE: C ei,, C 8 — / / PLEASE NOTE COMM S/CONDITIONS: 1‘.-'- -.-- a(C C 4 C -- 1 or -1 i i . 1 i i i i i ..,- i . >--• j ,.,.. \.)...„ , . _ , . • . , ,... ---- . • < 1 1 -— I , , •• , •••_._, , ----,t. --1, • / -••,.4 . t I ei ...i_______----------- ; \ .........-- i ; 1 1 _ t k a , ,......---- \ 0 _....‘..A . . 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