HomeMy WebLinkAbout2007 Sign off Tranmitall - Deck with Roof °F t TOWN OF YARMOUTH
o _ HEALTH DEPARTMENT
'••� MATTACM CSF
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: --- -1) 02 IN /71;4 /T-._ Map No.: Lot No.:
Proposed Improvement: ; f �'J �� �/ , v�� we
Applicant: /j ,,6 •�-� zleo - 4.6.„i7--- Tel. No.:.0r3
Address: /�r�, ,/%,.; jr r . Date Filed: /,;?//3i 7
**If you would like e-mail notification of sign off,please provide e-mail address:
Owner Name: "p�, /// ,),4
Owner Address:(--->Z29 o.ezt 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 four (4) 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: 13/6
PLEASE NOTE
COMMENTS/CONDITIONS: