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HomeMy WebLinkAbout2019 Jan 31 - Sign Off Transmittal Sheet, Floor Plans I �t:YA dr TOWN OF YARMOUTH HEALTH DEPARTMENT 1('r`sem, /44 Z , PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 44 .r �', '/r' r,'; ' .c't Proposed Improvement: '(1/11(//, ( ;L ;LI + to/7 l Applicant: f I I (114/1/,-) (1C:_)" Tel. No.: f:J /Tie- `%'('t Address: ` 1/7/, i;'/ ,/t/ r-r f'!'t ii '' (7/ . Date Filed: **ifyou would like e-mail notification ofsign off please provide e-mail address: Owner Name: ,`'1/ L._ - (/ / S Owner Address: ."j -i 1 r/, . r: f. �__ f , .� l � 1 f Owner Tel. No.: 7,", /;',i, -_ t / 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: `t'' (..A:61,2(141,1, DATE: / 9/ PLEASE NOTE COMMENTS/CONDITIONS: II woo 6ulplingsoulpe6el MMM tau pooedeo@uoo6eI llewe 60LL 93f 809 Xe� L6017-9Z4-909 lei o 6ioa`oE xisnaep`iepsaupa y 9£930 b W`31n}o3 auel In��IUe41 E 4 s?Qa uejAeg pue T!' dE NJIS3Q. r 1r1 e Move Switches ..8-.Z e a R t 0 - , J m X V N A, 1 „� c c )7 10- mi,�m- I O �//��_ � / 1\ m - / X N L. _ X OS6481 Existing Kitchen C .37/£ 17-.8 . 7 woo'6u!pIin sou!pe6el MMM N 60LL jau•pooadeo@uoo6e!!!ewa 8Z4 805 Xe; L6017SZb 805 lel 6ioz'oE,tsenuer',SepsaupaM 9£9Z0 WI'1!u100 euei Inp ue41 el. sing ueIAex pue xFH :AG NJISHQ „9-.9 ---- A ., I e., i T ct . . , ._ Lc,,_ , _. w i.,,,u_ , _..., f, c„ -,......„ X(/) / 990Z / A 7 O , _ N V 9962 O -N au O CO n N C � co1 T O (p '1 LZXPEM V ii5 � � I 4- 3 m m _ gip 06X9El ♦O 1 Z 3 = — A CO AZ ---4-',,z N ' I 9m 0 _ bo g d „Z-,Z >'' to 6 �= „6 6-,5 - t T,,,-,2 o Yom �. = O , 0 __ -- - N - Sea esteO l(' _LJ__.� LEG �.� 3 d � _ z Z 9EXEEM 9ExE£M 8hXO8ry1� 9£XLEM -A / \ / . 1 o it— U) „9616 9-,06 ,'I 0- /7- wootuipp9souipe6el•mmm M}9u•po39de3@uoo6ej pewo 60LL -M -809 Xeb L604-8Zti-809 191 6zoz'oEdxenuer'.SapsaupaM 9E9Z0 VVj 'plop euel InpUe41 C6 Sula uejsex ptte )Ilia IH NDIOU 't h woo- bu!pp9sou!pe6e-1-mmm }au,poo9deo@)uoo6el !ewe 60LL-Mi-809 Xe1 L60ti-M7-809 lal 61oz `ofi fammp'AmpsaupaM 9E9Z0 VIN `3!n;oo aue-I Inb)lUe41 E 4 sing uei6ex pug TJH Iff N�ISdQ I M1 f