HomeMy WebLinkAbout2019 Jan 31 - Sign Off Transmittal, Floor Plans ov ,„ TOWN OF YARMOUTH
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•\I,''� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: .}0V/171A0 1��9 5 t >
Proposed Improvement: ' r t1 ; �E ;,s t f 7 !
Applicant: o,j ,r' 1 /�r,.� iy1 Tel. No.: ``z=`I 7
Address: /r,tri/!1'f i/.< '',i/r/ ,//r7 %("7- S Date Filed:
**Ifyou would like e-mail notification of sign off please provide e-mail address:
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Owner Name: / `; i ["r(I 1- r ci/1 t'
Owner Address: , / ; /;t/, I/ Owner Tel. No.: - <
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 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.
REVIEWED BY: = ' [/C lgDATE: �'"�/_- 9
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PLEASE NOTE
COMMENTS/CONDITIONS:
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