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2018 Jul 25 - Sign Off Transmittal Sheet, Plans - New 3 Bedroom Dwelling
at-.x./.14. TOWN OF YARMOUTH ' __ o. � � HEALTH DEPARTMENT 4<tu a PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 7 5 3/5 fele S �/ 4 gi-e, Proposed Improvement: 4 /,..... 0/fl( -� jl < ;sze-- ( 6/ /3 edT1x s_.0,-;,., J) \. Applicant: fUJ)/ SI/74-A_ Tel.No.: 77% -Z,0G V.3U v-- Address: 7 d/' (9b/f /?,/( //, -e V/0/1/,,.///(GC Date Filed: **Ifyou would like e-mail notification of sign off please provide e-mail address: 1 . Owner Name: 01--1 Dix j/ . Owner Address: ,l 2 OM e..,U// ,G/ ' - e---s-t-¢- Owner Tel.No.: 77c"'0l3� - RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Dete if ,. , +nnce to State and Town Regulations; i.e., Requirements For Se• age 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 I.// DATE: T,,2 _/�''/ PLEASE NOTE COMMENTS/CONDITIONS: 'um-i-t td4cc 4Go -,& C41- e'S S PeAr A . '? i C i /4641-Pit #:60/ /. / 4,-/fi/17 ,,, ..>fp,,, 5 ,,., , ,...„ -3, 9/;/4d, / 1 frii/f4V k/ /' 1 ro woo sueldu6lsepewoypooedeo 1892-964(809) Or woo'I!ew6Qn gdsuMegs tlW'1HOd131s19 9L o VNI LaSSVOOd 310H10 SH3ISIS 9[ ,, fan, a SN7K n� Aa ON11111SNO0'8 NOIS30 w y .i -�]/ n 1VI0H3WW0011VI1N30IS3H 30N301S3H HlIWS o m o g4111 t I I n AO O � NOIS30 3WOH WO1S(10 n g m E \I o ar•-..... e• , 8 \ .3¢sg r C .5E 66 I F i6 T tQ i4 ' 3 s sl $ ''H��z Bd y� 3 �3 B .a 111 el Ill @ ii $i ofd d iplg ;1 EN Ili �\ a._7 , 03 isili to 2111` 1!11 flii IIIIU ! '__-i% `� 0 dli . 1\ LA :11110 Z 6 \ / IIID O ._�/ ■�rte_ a N. "� /� ■■D- 1 MU� NM 0 _ Ell /.. 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