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HomeMy WebLinkAbout2019 Sep 19 - Sign Off Transmittal, Plans - Addition, Going from 3 to 4 Bedrooms cs .at.YA TOWN OF YARMOUTH o`ecce HEALTH DEPARTMENT ''�=—N�`' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 3 Co v c V r --- ,, ,'v c Propose Improve nt: ' / o 0/ 2 1?-,o„0--,-C /.3` 7111 Qb - e--,0-4/.. syJv r r ��' ,ie �- ; ?�, ;,, 6r�t'd©1? �Co 47 -, c,14W �„ "ed,! 1' ;�Jf Applicant: � vi p/:s ? iliz r.. i// r (..,C Tel. No.: `o'G 3 . >'` /4"9 Address: ,..2' .. G /t-'or -ce,.., -� ,5i c- Date Filed: f'''-'""-/ 7.--1" I **If you would like e-mail notification of sign off please provide e-mail address: C� ',eu-rr/4 5 cstiJr 6, ,'` to.., Owner Name: 73.,y Co s �� Owner Address: Y (.; c'e- (/,`t 1--.-.1 is;L' 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. REVIEWED BY: t37lier------- DATE: ?//�/� PLEASE NOTE COMMENTS/CONDITIONS: _ 2 !� dk - ,,,et(�uuSe 5c, t 1� M v�-� J / Glc� Ft ,q O 17 a t v'cov nrt S-- P /S t't 13 e C(vO°'-,�, l cA.> et 6a cceS'ecCdrh- F ii {