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HomeMy WebLinkAbout2018 Oct 04 - Sign Off Transmittal, Plan - Renovation 2nd Floor Bath cs Yak TOWN OF YARMOUTH ti -Xi� c HEALTH DEPARTMENT • .-- PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 13 ekc k e jz.t G '.0(11 j o(AL Yax(MQ u-t h.) Proposed Improvement: 1Z eel o vat 6 J C cO ftIL Lorry 10,,. N o It Y u !'t cora L eiva.k.r. IsAtircor wovic ()tit. Applicant: 6 e09 G ZaV( f, Itte,. Tel.No.: 50P-J?g4-0al Address: 3, N o r t. k_ t ,f-L. LA t LYar IQ(,et k) Date Filed: 10/4 1 le **Ifyou would like e-mail notification of sign off,please provide e-mail address: Owner Name: ,0rGG 00LULL, el/ N cukct aryl Qti Owner Address: TO_ i f; Owner Tel. No.: ',Imp- Br-60J 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) ' ide, DATE: 1 71 PLEASE NOTE COMMENTS/CONDITIONS: TW 2446 81 1 /2" -- A Existing Existing I 81 1/2" AL 2nd Floor Bath replace existing tub in same location f , update existing sink and toilet in same location replace tile floor Proposed Yarmouth Health Department PPS 'VED// Date a 3 (3 G Ali 0 0 U 0) U O:3 Ur O O � O O aZ N O U �D w 1= w 2 N ..-finn.+ V! Q � (6 O Os N Z Z3 m ca o E o � � �q m Io Z DATE: io�i�2ois SCALE: !SHEET' Pg-7