HomeMy WebLinkAbout2019 May 17 - Sign Off Transmittal, Floor Plans - Finish Basement oo}-7:1:
A_cTOWN OF YARMOUTH
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AtHEALTH DEPARTMENT
'':4t,�` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 6 ,)- --z-Al I A .0 1 .- l"
1'roposed,Improvement:
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Applicant: \ ) P c, , a \N1 u rt-,f Tel. No.: -` .,‘ _7 -S_ L I
Address: ‘-/? r-1:2)0 �,' fi (."),'.7.-- - ,,,A''': 1)' Date Filed: --1--477/
**/f you would like e-mail notification of sign off please provide e-mail address:
Owner Name: )) A --- J4 r' L. 0 S P< i
-779
Owner Address: i) 6 )----c_ -L- ' -- ;.-, G•. Owner Tel. No.: l t- �e/-7
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.) 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: • DATE: /i 7/1?
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FINISHED CONTOUR—O =ROPOSEb PLOT PLAN
APOVED' BQARD OF M LTH
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R 4( ONE4IRN,NC,RLS, RS
1340 ROUTE 134
EASTDENNIS, MASS.
DATES S /Z
SCALE: /'...... "O
JOB NO. 78:7:•_7 CLIENTt Z?Ot yrs/
DR. BY' .., .. SHEET./..... OF2.
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