HomeMy WebLinkAbout2016 Oct 11 - Sign Off Transmittal, Floor Plan Sketches - Finish Basement o'.'Yap TOWN OF YARMOUTH ._
a. ., , ;c HEALTH DEPARTMENT
�� • PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 71 /2) fit//7/91
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Applicant: C /1 v" ilr"
AI I I. Tel. No.: 6 0(5r'-,36 -3/ Z 1
Address: (9 6 <"'y/ /'�i Pee,CI ,1 R - Date Filed:/0// /&
**If you would like e-mail notificationofsign off please prcp►ide e-mail address:
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Owner Name: illi)/ Rfrs 11' ,. ,A A' G0
Owner Address: 3? PA' Arte/4 /�.(� it) G Owner Tel. No.;j/8- 1/e- ?-.5-
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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.) Flom--plan labeling ALL rooms within building
(all existing andSroposedw - ..
Notes Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 51-pplication signed by licensed installer_..,
with fee.
REVIEWED BY: "j DATE: (C l! sm-
PLEASE NOTE -.-
COMMENTS/CONDITIONS:
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