Loading...
HomeMy WebLinkAbout2006 Jul 28 - Sign Off Transmittal - Deck A w,. . �S- �`,� —°=c � ' a ,'�. —���- x'-� ®— ?�,: —• Y 4 1P••• TOWN OF YARMOUTH rc. nor,Ivi HEALTH DEPARTMENT 3 G'' '* PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant ,. Building Site Location: Wr 1‘5. L o f//,0SS ,J Map No.: Lot No.: f / ., Proposed Improvement: , . ' .. gilli _ C 1 r eA/L ©� ho use M f!roY / //_ ' .07'4 © ,fir y/20cl Applicant: ail“ ///2/214 Tel. No.l526 77, 07 7/7 I Address: 15--- f L(/fit/'/l1' 5 'd. Date Filed: 7 "OG **If you would like e-mail notification of sign off,please provide e-mail address: Owner Name: S of pt lit J 12 : Owner Address: %S- 1(//��/9m S Ii3d W ,) ,/? 'd407er Tel. No.:,w j Zr427 7 { is RESIDENTIAL AND/OR COMMERCIAL BUILDING. HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements :x For Septage Disposal and other Public Health Activities. Please submit four(4) 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)— ,- 'I'Note:Floor plans not required for decks,sheds, windows, roofsnic = (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: DATE: 7/0) b-/O C PLEASE NOTE COMMEN /CONDITIONS: