HomeMy WebLinkAbout2018 Dec 18 - Sign Off Transmittal, Renovation Plans 1
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0t4, TOWN OF YARMOUTH
r( - . c HEALTH DEPARTMENT
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''' .`' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
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Building Site Location: `;T , ?Ai �
Proposed Improvement: ,-=> (r.r: t.")5rlaE' t 7lvr
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Applicant:—)1-0c,-1504T-
pplicant: ) -t1CJ 4 .,9M Iet Ce t4 -IL/ Tel. No.: Q'.,�-'78-Z.2-` S'
Address:7C, 4- ili -2,7 Date Filed:
*/fyouwould like e-mail notification ofsign off please provide e-mail address:
Owner Name: A.,�^-ee a 4 .\J500
Owner Address: i7 ,--6/6 6 / Owner Tel. No.:
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements 4-
For Septage Disposal and other Public Health Activities. .r--
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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.
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REVIEWED BY: / G DATE: / II
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`y PLEASE NOTE
COM ENTS/CONDITIONS:
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j OFFICE:
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JOHNSON, Mary Beth &James
#1 12.12.2018_pin
Renovation Plans
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