HomeMy WebLinkAbout2018 Sign off Transmittal - Finish 2nd Floor for stroage oc:''1, TOWN OF YARMOUTH
HEALTH DEPARTMENT
���`� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: / /�z, Z ?,4 4/P )47/2/3,6- 1 b.,
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Proposeded Improvement: _(,d op/-/'oc ,¢�O -t-.v5-,11 -6'7f f1e-7/ A�,9/A.ilE' F/ e,,A2
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Applicant: /(.j,,��//rO'.* Tel. No.:-C-i-'?- 4."7-.0 /j/
Address: 7;1..C7fLP,is97,v7`s771;/1/1.0A/ Date Filed: // / *
**/fyou would like e-mail notification of sign off,please provide e-mail address:
Owner Name: /11/7 / /ct/e- -'/, ,,i•-5
Owner Address: y /,6 A' 'e A-2), �,r,?/ric/,%r,!e Ceyv).-L Owner Tel. No.:Pia -27,9-7,7,2-
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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:
(l.) 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. f
REVIEWED BY: 1P6-- DATE: l/b /t
PLEASE NOTE
COMMENTS/COND TIONS: j
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