Loading...
HomeMy WebLinkAbout2013 May 24 - Sign Off Transmittal, Floor Plans - Bathroom o� k, TOWN OF YARMOUTH �w• K c HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant.• ; EC I 1U/ I Building Site Location: / 3 C ,i/cE i AMAY 2 221 H Proposed Improvement: 3#41' D HEAL D 4. s (-E 3 (1 C � t .� —rio w►p e✓v dt vi c � /� Applicant: c-c Tel.No.: a Address: 1 3 44-re 4-- (24 & Date Filed: S/A• - 3 **Ifyou would like e-mail notification of sign off,please provide e-mail address: Owner Name: Owner Address: Owner Tel.No.: #-� 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. i REVIEWED BY: t DATE: I-^ 'Y ) 3 PLEASE NOTE COMMENTS/CONDITIONS: el ��-� tv'Cic,".-, 140("S<- • '''-''---S-,':',:,-/3Z-.7'..-,.:,•••.,,,i,-,-... oe".--,.--,-, .-- , S - -'''';''':.4-3:.:it?;t'--3';.-'•-.-.. ' .• , -' -7,-','''.3--''-,'-,:',,,".'-404*,,,,r,-:,'-'-',`"V:',_, ' ' - ' - " ' -..: !:.-,,,',,,--,-,-.f.7.'- '„„f:---,---;?;;I:,-,-"_,- *•-•••'-',.:-: ,,,,, • 1 . i54-il . - . -,:_:' •-':.•----,,-':•-•,,:•,'.... 17::? , ::':- _- ,... g 4044/ ,,N-ow ,.. .. . „ IMP aMPIIII 1111111111 (:) ' '1--:- 118 CA t‘8, 02 a u i cci.-:3 ill ks,\ * 144 o E , co r I?, 1 s- •rt 4'116)i " 13, • ' f‘,,v © :3 cc Eag '' i Cg a ix. 1..)c.f.).. i-1 -- lie a ILmar 4r4z._:?.., A ,,, 1...: ) - Cl- r inl ca J '''',1"..--1 C•%1 Uj CI . 1 b:if,j csj /T. ..._ +- -....„._ 4,-----;;•_, 1:ak 1 ....... 7 I 14 al 1 \\0 4. N • 1, 1_, , .... % . . ,. . ',.- .. --.....),, 0 . Vi ---J- --. 1.. Q '\ -.-.,Z -- i•s. N,,, - .:-::::.:1i..41• , Z P\ . • Pe) � yti✓ I ) , V / 0 (14 ftil 411 _1i rL1 od N W = < Q W i ' r hdI kki 41 „„_.___Ny \ V.. (N1 t's ck,. ‘il oist (...•-----..J o Nti 4\, tix N . T �� r -C-1\ ) -74 -3s'7 ' tr= . ii...„. -_-_,A v ) i ° / ,, f \.12r4\ o3