HomeMy WebLinkAbout2019 Jun 20 - Sign Off Transmittal, Plans - New 4 BR House (3 BR and 1 Office) „t 1,„.� TOWN OF YARMOUTH
otgtty HEALTH DEPARTMENT
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t , a PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 3 -7 12)r1 hot W 3,. NU 4,D W k t'l 6t i+. M
Proposed Improvement: Ni 1 N W 2 S VIACI 3 r'((YUO hIAY._ w1-
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three NOAA.vIAN1 . Ii4 I,,VV1Vt.+ Si 2-- .; ? x` S
Applicant: S\\ILO ( 1 4 ' OUT( 16A0-- Tel. No.: 50S- 60"-- II -i-
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Address: 2- 27 \3\\\I Pk c %tt V 4,.1 . Ufl1 I S 1 ffl i 0 2(, K Date Filed: ,(//4 { c I ! 1
**Ifyou would like e-mail notification ofsign off please provide e-mail address: C -- (..if Uk..0 ( 0111(0j j .
Owner Name: 5(k:°Y'1'1.L ' 7 ;� 4-i c,17 . 2-i' 1..1.,,
Owner Address: Owner Tel. No.: 1
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2 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.
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REVIEWED BY: , '�((/ C '' DATE: tar - /
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3. Contractor shall report any discrepencies to the Architect for
instruction.
4. All work to be executed in accordance with State and Local
codes and industry standard construction requiements.
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