HomeMy WebLinkAbout2019 Oct 09 - Sign Off Transmittal, Floor Plans - Bedroom over Garage 0t ky TOWN OF YARMOUTH
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s�'tHEALTH DEPARTMENT
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PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: , . w /. -----=
Promed Improvement: f��t,, �V�3` 60 0 ti Pik-- �� �.
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(CuggIZ.Y gooeti ; )i c:L b€ Fid,5 ff I NG- EZE(.:. c,PC.. -i-- l ti [.uia C."tinsE7)
Applicant: 7 4, ,L)A'cJ G rYik 5• / C • Tel. No. J _ ��'/i
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Address; * '% I. -() �f/k
**Ifyou would like e-mail notification ofsign off please provide e-mail address: ,,
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Owner Name: 1,4)fl y A9 �.- A 4 t/7,05, 1 0 ,
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Owner Address: /CA c ("A 'C l I A 4).''sVeil/t�t j ) - Owner Tel. No.7 'I- ,?7. /-(,'
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RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Complitin to State and Town Regulations; i.e., Requir4ments f
For Septage Disposal and other Public Health Activities. ,.,..
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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: "efDATE: /4Jt�'? /r 7
PLEASE NOTE
COMMENTS/CONDITIOIIS: /
3 -----"P 'V /.. - I/ °(:).N.--.1 .
fr e w tom,,,
/
Closet
Y" Petry ,
Half
Closet Master Batter
Bathroom Kitchen Garage
Laundry :-
' s
Living Room i,
MasterBedro4'-7" ^
Master
Den
Sunroomt' P#
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RECEIVED
OCT ()71,x?
HEALTH DEPT
.
/(7 5p P /A7
2nd Floor
1 Open
To Belo% Closet In
Close V Roolnkt.befiriehed
--V" Full Bathroom 2
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. . A i•("'-
Closet . Closet
____ ..- \, ' ,.,, in Co
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1
4,-
.' N, ,
Closet
,is' F--, %
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Bedroo r Sitting Room
BedroOma-/
25-3"
tr?
37
RECEIVED
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—a_-------- 13-9"
t
_ R
OCT 092019
HEALTH DEPT.