HomeMy WebLinkAbout2019 Mar 22 - Sign Off Transmittal, Floor Plans - Finish Garage with Bathroom and Family Room of ,,� TOWN OF YARMOUTH
sri - HEALTH DEPARTMENT
'.,.44.1.0„,4".- PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 2 0 7 5/ g ./,/ / ,i�'` k' '
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Proposedimprovement: GTr .d' GYM ° i,t ' / le//7 '/ l!/Vi�'I i t
/ Gil
Applicant: IOWA. lti (&\1 Tel. No.: 5-0 (P)—. 901 Y
Address: � /-z-5-r- J,,---‘, \A (v).Q Date Filed:
*/fyou would like e-mail noti lcation of sign off please provide e-mail address: `"c 1f 103 0 C'C 141Ga5-t-, (e-f'
Owner Name: 5-01NA, I to i c 1t:
Owner Address: x67 5-1-Pct t v f t. i . \/'/CA IAA o -k , u?(P(v`'/Owner Tel. No.: 5T1. OP- -67 I7
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMLT: 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:
(l.) 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: .l-f.% ^iii-V. DATE: '-,2.. 2-. -7,9
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Yarmouth Health Department
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Name Date
GALLAGHER ENGINEERING JOB
4 Windsor Drive SHEET NO. OF
Foxboro, MA 02035 CALCULATED BY DATE
(508) 543-9894 CHECKED BY DATE
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