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2002 Jan 31 - Sign Off Transmittal, Certificate of Inspection, Floor Plan Sketches
-�:Y yc TOWN OF YARMOUTH wit,ta ,,ea.4...4,- ic2hii 44).4.21.6) }.o��� a BUILDING DEPARTMENT ig( +H a ,'6 MAT::. E,�,'xi BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF r � TRANSMITTIAL,SHEET Building Site Location: HpGr /1-- Map No: /4 --. / Lot No: 72 Proposed Improvement:, �LLzhi_ 1. A.+' -- _kx-, i if Applicant: i A.r ti,./49. ,, „ Address: //a, ��f0er 315 ff/o J Date Filed: f }�- Tel.No.: The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following 1 applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING - WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts;i.e.,If Lots)Border any Type of Wetlands,Streams,Ponds,Rivers,Oceans,Bogs,Bays,Marshland,Etc - HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations;i.e.,Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal - Safety,Property Protection;i.e.,Smoke Detectors,Sprinkler Systems,Etc. - REVIEWED BY: - 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: I 3. CONSERVATION: A i DATE: N/A: 7 «_' 4. HEALTH DEPARTMENT. i A DATE: 1, )*-°L N/A: INDUS . i/OR COMMERCIAL PERMITS 5. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: �. — i) 1 S d Mr�T OF:'elNCSc ii)e- ttel t`7ilt e red. (-700 12- 7-- a) (4,t.' C \ Raffia meNt�. Aetticti -- '3,) /vI,AT e� ,l� (OR P © ..: ,eG I C-� . .,- X #v p rte- jt' , . , , , —F Lt c -C RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: -_' White copy—Building Dept. - Yellow Copy—Health Dept. - Pink Copy-Engineering Dept. - Goldenrod-Fire Dept/Conservation i g all 44 z 2 - Y 2 o1 o '� y p.-- Qcr o E U she 4ei til ICJ v 4t V ;� 03 0. E i v in 43 WI 04 QS o „ „V Val $ a o a Z o Z o v � Ca h r 'C C � . ,., 'a -,. 0 . 4i v 4t CP z : I . u z Q • a. a 3 • Q 4 _ w. a U W h E • rco g t�t[3 a 0 ... O R. y G 0 aV1 v C the te) ccR V ; y?. .. a 3 cm i (} ch 4 U tC ..a E•. n sts r 1 fl ... C41 g. C 1 0 c� .. `a a a o ce o ¢ 0� ';111111'1,'I jI 1 ,� s. vs 0 g et w iq! ;,Iffi ''I Ilii o, o, t, a W .- 4 c; 4Z1 C4 CNI it t I Alli !I I,,, V „*!ii sp iI ��I I11r� ' I III Il I I��I D Nd I i- I I OLrG6r I I I lrif-` FA�Ni k�r4l Room Ra 10 X/j, J71" O/Y