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HomeMy WebLinkAbout2020 Feb 04 - Sign Off Transmtital, Floor Plan Sketches ovTOWN OF YARMOUTH ..,..*:',::::74 .9 HEALTH DEPARTMENT p ,,y PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 3 C caryi I 5(, wrs t yfrfrviput, ,M it 6067 EE Proposed Improvement: ,f r i,s i .d SCA ce Ott a n C of✓ clplci st Drct „, o bv61 be tA r'cyp r►i Applicant: $f`,, rt ac n CLtw1.c a �Lti Tel. No.: 50 g _50 ;� (0 , Address: 3G l ,ctr-i cc., tAIESt1./41,t4Ouitt, ivtIk O22.0 3 Date Filed: I/3.t/a 020 **If you would like e-mail notification of sign off,please provide e-mail address: . 4 Owner Name: ISIlanclari clt M of - 6.t.41 , � 0 .}� Owner Address: _ (€2"1 p� , II CS \//triO 1, ,41 J4 Owner Tel. No.:,gO% 5© c9/d O 2013 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 i REVIEWED BY: DATE: c fo2G .G PLEASE NOTE COMMENTS/CP.DITIONS: C4.-C- w‘c C� ' Li . ( t/'0 C/V1,n • r. wM F el \ ill 4 ..a. I :i. vs 1 0 vl el -7- 1 m",r'. S. Tn S .4. d U o J v li tie .I�,, cam'. i 441t ID0 CI, 0 2 _ )c-'. cr1 1 t 1._______________............. g L' f-ibati 1CO's 'teaire 1 4' v`ZM , ty 0 2 " � Q- tg k. I: rioDp7 o 6 otiop , I si.. 1 to 0 o 1--: i xr c.. i ,,� sic' �J N ..::leu p1�; ! r j `! 7.....; '� S 16/1► ' iT' c) �u1r t. 1 0, w t CSC L.L.- '1.1 ...\ Ailcs. • , II a . - ' s 0 MIS cite) eel9- tn� 1 ••A . � 3�3 `.-D. "-.6c160°"12111d S 3 w vZ d a,)wJ 9