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HomeMy WebLinkAbout2020 Sign Off Transmittal - Remodel and Finish Basement TOWN OF YARMOUTH HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicants �f^,, Building Site Location: ( VUAwc' '` r \Iar v\ictiAn Ior AAA Proposed ImprovFm nt: il�vtil oa-e1 -(� i�:,� PCt� rn e � jr ( 'G i�U�w► .4 ./ baTk Applicant: �'li / //l /2/ /7/o(6),C5P/ Tel. No.: -1,7'74/- 33O 3.f' Address: ^,2 j (t`!�(7/ t r6.e (�f) / ,/( /A /r Date Filed: . L( '/5 **If you would like e-mail notification of sign off,please provide e-mail address: Owner Name: /M//j j!/ /a77/(:(0,i/-3 Owner Addres : 6)7( 71 ('/- ( (t(h Owner Tel. No.: 7 330 -3 •47/72/(7(4 -/ //e/-1 Le;.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. REVIEWED BY: 1/17A DATE: // / ;\ PLEASE NOTE COMMENTS/CONDITIONS: to v‘k 1' 3 ( S —e v —r c. )-t'^--771-173:_"~v N E to o0 cc ,� tc• X.‘ M _ Z 01 Q OVtW• . Z I— Q -- � N VI 1 ZI r.,43,n_iap = oF Nm >--d F- w s�3 �r . a I.. 00 oQ ¢ Q w -o 0 M.d ti (5CL th �—< O o O"V [n U 0 n N� O U � 141'-...0"O nI-0 Dcc a� p � O0 o� N Z `tea wUQW )- Qda rpNOigOH 38 g (/7 p) — } O._ ti T r- m La DiLo N W v) Q UO w • N >- -I aQ W Id W lY C W - - \ - Z 8 S O U) t�;�>_ �t --s-1.. n r a C7 0 o z z z a _�s s - ,.. -� o J as w !'� �" r /� . s e r a V ' ,.§ J Y ' N I .7.;t1. ;t 1.-m .. )1 1 O. I 2 /. ‘14.0/i'..Irmo*IV , y s,4 ON. 4 La : aOm`.Y . 14 -- - - o - le °�\ \ 54\ N rt \ r , Cr) s6 \ \ 7 \ s i. 11-1_ {\ \ \ V K r6 i 41 o OS V/+ \ \ \ ('� V J N ooh • U.a 630o ���00960 0 \ tui O @�00 z m I obi m• 4 j a' 03 O 1n11 ® W — o _Z ,wlIllIllIl • N p - v --- o OY > �Itll „_,..- to111i0 R VIII -n W N / ca � � �., y a D ami” o wm '\ O a� w rn 05 • t 1 Crmi �.i ,-„\P ‘-7 (y.-( cAcNN < L- co-ers t - 0 al A I H 4 it �p t m i, I I ,E de�sE bo To mN� o • d V p p 0 2 r O m %Z a+ rn O (�71 C ' u e s V • m > • j in 4.96.O1 { ...:c v H N • 4 e. O • N in 0 PI ♦ V -- N'i mm O i `1. Z,9100 • i 9 • 3 • c E Fn m O `:f C co 0 a v. • U N n U,v \ Oti Inri O • • • . o MV( R N • I O P • . I ..9,Z►, lb ' 16AL► I.6.11► 1 • bo • f H • • G.) Ci .0�ONy N p CO Ery .11 • • ;°-p 0 1 0 0 P © ro 1•92•• 1.9.Z► 4.£.Ol► • 4.9Z1. 1.9b10. • N RI -.9.ZZ - _______ ID v N E+ 10 y 0 D O N 4 o _ U Oq 11 i U i 40 IX b c 4 0.1 E :. m x:IA 173 0 VI to N m e •o 4-.. Zo `4 m m cn =meg y x� 4 0I z O C I 3 N O to• in .. OL I 4.9,11. ..,�.i. n M N • ♦ • 11.► oL uCV iv 'Y • y UCO♦ 0• C ,- • k. ti ► o b �4. Z,9► 0 • is 4-� V" 3 - V ` I. C w \ Y• C T �\ - u_O.%.4 i '1.11 • £>>3m m a O ci o + 4.0,E► 4.1.L► E N v an . 411 p y d t( N • m.- ,n H O V0 O • " ♦ , m i • N N .• , 4t ♦ i 1 • 0 C I • i7 N O • ',1.-* ♦ I 'V41'10'► ! I I I 1 / Al �.B,Z►/ 1 ..8,01.► \ 4.8 Ott► • I • -a V• N m O p @w • • .0O • c e. ---' \ • r,,, v ♦ EN ioG 1 .161. • ti }� pgg \` II • U a0 - � �.9,Lti ` 9� 1.CAt► 1.B,E► : .� 4:919'&► __..____ 0 RI v d u 4, • H -.1 M F