HomeMy WebLinkAbout2019 Jul 31 - Sign Off Transmittal, Basement Sketch - Owner Removing Wall instead of Whelan 1
of , TOWN OF YARMOUTH
s, --:"‘. 7,0. � HEALTH DEPARTMENT
-.rpt- PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: / 1
Li
7 ivii4s
Building Site Location: ? s---/ lC /
t
Proposed Improvement: WALL et 7 G Q1 1 i r`'1 -',i�S '1 ffi/-1 ;�
C a 5-els 0 (rt "' f.'4 N^4 lam, va`�` IJ t, Qoc' v1/4)
Applicant: < Tel. No.:
Address: . . 3 C CAW)) -V�` E761( moi' A' Date Filed: 7" 3/ - / 7
if**!fyou would like e-mail notification of sign off please provide e-mail address:
Owner Name: , 7 t- 6 1 4F 6--i2
Owner Address: 3 0 � '" t7(�/14 Owner Tel. No.: 7 (-1- �'ce- Z6
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, 11
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. i
REVIEWED BY: � DATE:
-- : I -1
PLEASE NOTE
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