HomeMy WebLinkAbout2017 Apr 19 - Sign Off Transmittal, Floor Plans - Finish Basement o� Yqk TOWN OF YARMOUTH
•Fo. o HEALTH DEPARTMENT
r PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 6 � y Vain/16A.I ( r„, La t/ Data43Proposed� Improvement: . • �. , ' .. � & A L- � . L /
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Applicant: anr) 1-14,1.06,k Tel. No.: "77(--0(p-44 /2
Address: CO( oU V1L W• Vatimailk MA-6 Z40-7. 3 Date Filed: 02 . ( ” ( I
**Ifyou would like e-mail notification of sign off,please provide e-mail address:1 d iY /Yl hoV 4 a/ 136- e t1y�
Owner Name:1 etyr/NO 7-,(a, ,k j(
Owner Address: l.L� /bug W. t/4 yiyl,tt,(k �( Owner Tel. No.: 7') y s3&gyp a
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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.) 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.
REVIEWED BY: '/ DATE: / / ? / l
PLEASE NOTE
COMMENTS/CONDITIONS: �,/
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