HomeMy WebLinkAbout2022 Sign off Transmittal - Suite 3 - Use & Occupancy ,o.f:Y/toty47. TOWN OF YARMOUTH
HEALTH DEPARTMENT
1/4.,,; "' •-!/'.
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
t
Building Site Location: f - 3
Proposed Improvement: C) (gel tL
Applicant: 41 ,,1,14 S Tel. No.: -5-°55-- 7 7 -"C")
Address: ri A/0 r) 1-1,:& 01/ Date Filed: 5-
**If you would like e-mail notification of sign off please provide e-mail address:
Owner Name: 3C)c <
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Owner Address: Owner Tel. No.: 1 6(66 6
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: DATE: 3 / 4
PLEASE NOTE
COMMENTS/CONDITIONS:
$1 I I- e 3
118" 710" 7'8" 134"
AlliM111.1111111
Hardwood Floor
Z1- .
iL 484'11
B . - 1143'0"I o .- .- -
iN 199'8"I — 191'0"
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4'4"
r6 139'1r_
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l4'2"I 44'2"I II
74" 78" 78"
6
96'0I b
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68" 90" 84"
45'2"I 14'6"
inimillon 9'4"
Hardwood Floor
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14'11"I Int 13'6"I 12'10"
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1'8" 60" 8'4" 3'8"
BATHROOMS ' EGRESS STAIRS