HomeMy WebLinkAbout2007 Feb 07 - Sign Off Transmittal, Floor Plans - Finish Room in Basement with Half Bathroom triihw.,P-4,41-41,44r70, , a.7-7 ; ----mannww 4z,"?•?-44-.TV:,tr4v1.1
TOWN OF YARMOUTH
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4 64\
430tHEALTH DEPARTMENT
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MATTAHS
41/
) PERMIT APPLICATION SIGN( IF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: ai iilotiA(1111 116 Map No.: Lot No.:
Proposed Improvement: 74/1/ 11 a Room /yk SI j- ii 1— / 1" el 1.1-11
ChC71— -ro cfs, R •1 s,
Applicant: •Je pi le: a nd 17)1D Zee— Tel. No.: 5PcF-
Address: /17 A)0-*n Date Filed: ai- 7-07
**Ifyou would like e-mail notification of sign off please provide e-mail address:
Owner Name: ehn
Owner Address:Address: SII/OLP ,(1/) a koate____ Owner Tel,No.: 3 60?
(C) ‘50: P6 - (6g"1
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 four (4) copies of plans, to include:
(14 Site Plan showing existing building* 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
•thfee.
REVIEWED BY: 41,
DATE:
PLEASE NOTE
COMMENTS/CONDITIONS:
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FEB 0, 7 2007
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