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HomeMy WebLinkAbout2019 Sign off Transmittal - New 4 Bdrm Home Jt: Ait,' y TOWN OF YARMOUTH r .°� AHEALTH DEPARTMENT it PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: „ , i , Building Site Location: (,),,,-7 V "‘,^,77-4 124 I .„-s.)\ ;1114/i'"?n 7f/ (t_.CT 7/1: Proposed Improvement: . d,( ! i,,,,,, 5 4 C4 �4/--(.9 11 ae ct"0) s. Applicant: (, 07i=r C4 f if"esTel. No.: `78`.--I2-2'" Address: IPG, Li (Yee e--,. 7 41 _' 4:14,...,... (vL T /4 Al o Z Co . q Date Filed: 21-46 - i j **lf you would like e-mail notification of sign off please provide e-mail address: C, "/6 _/`y G i 2: Al‘----- Owner /Owner Name: Owner Address: Owner Tel. No.: p RESIDENTIAL AND/OR COMMERCIAL BUILDING t 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: i r(—',-V1 rfr ' DATE: c "7- 7 i PLEASE NOTE CO MENTS/COND TIONS: /G` n y-//"�/ Az:;///4)////1 p r ,/?`i;/e"/ % /40( / - > re.0 7 5_.-/.4 l /i 5/ /,6e, *," j y,,-/• / `"G,y /`,7�/ >/r.�;t°)4y j 2. ,,�i,, /C,/ .- 7/-01- -I k7;4,/ra -IL ,w-di, t-0 Of- /' ``' / ''� t r / / I, r-_ 4' �,E, `/`'( L j // c-. ''/L �e P 5 e u�-3o4Sr-Z tt C` 23y 7),V-30 • l9 ..�T 1 Z iKiirc°-I pia° fLf�sef y�, .° •� qµ Q qt 4, y to' WWr nn 4 U y N r f a e'sY/J i C e7 Ai. d ,3 t.. f.P 4 • c�NJ �c,a'-• 1 . r ✓ Ni L n�` (�'sKGfil�� � £ � 2 � apt T'a, a. " z N 4-4 k G„ 4 /,o _�y „ r 2 t-tIN - A OF -- - i FRANK D. JCTAMBRIELLO f p' k' ..Ff T �. 18978 508.385 2266 ormcx/mx 7/4.353.6329 c r M - FAC"M*CftCAsr.XW PROFESSiO t 302 asivmr.w+.eD AFHUATE AMERMAM RSMUTE OF. DRUM, WA o2638 ARCHITECT$ °'-- ww .. . o ? _ \ I C rr3! 4a �f bPP,' �! Q 2. 6 : CLD IA14c- �, / diZ• 1 �" tr R V,,ll ar ESSI NG m a n� < kj I fjrc190}b a h! -/P SG 4G� 3G 9 rw3v ro r 9 a e02 4, Q �wNER 7� CH,19PAsK 0 Ill Ave ADDRESS bCC/ /V M®ciT/%nR W, N�nnOUT!'1 Meg _- SCALE / DESIGNS By DRAWN !w "d FRANK D. CIAMSRIELLO F.D.C. DATE a5A 111 REV. P 50A.395.22(+6 OFFiCFIFAX BOSTON 5(x.IE TY AWXRSL+w 774.353.6321 CELL OF ARCvttKTs CIS W FACIAM�COMCAST.NET RROFFSSIONAI REV. RD. 19m AFgEIATE AMERICAN 302 Sri ROAD INSTITUTE OF ABT - DFvvlc. Mn 026IN Ail !OW REV. } -✓-2. �aLdN DWG. NO. _ ®f "Will, wo —^- --- -I fiYp���© 114 o -D p ` 5-�� rv3o4�AI' -2 4G -v ilk - 7vefz6e V (p 0 .( — ?. v SER P_ c),00 t` POR N eo o I oP fN4 I, N , o ? _ \ I C rr3! 4a �f bPP,' �! Q 2. 6 : CLD IA14c- �, / diZ• 1 �" tr R V,,ll ar ESSI NG m a n� < kj I fjrc190}b a h! -/P SG 4G� 3G 9 rw3v ro r 9 a e02 4, Q �wNER 7� CH,19PAsK 0 Ill Ave ADDRESS bCC/ /V M®ciT/%nR W, N�nnOUT!'1 Meg _- SCALE / DESIGNS By DRAWN !w "d FRANK D. CIAMSRIELLO F.D.C. DATE a5A 111 REV. P 50A.395.22(+6 OFFiCFIFAX BOSTON 5(x.IE TY AWXRSL+w 774.353.6321 CELL OF ARCvttKTs CIS W FACIAM�COMCAST.NET RROFFSSIONAI REV. RD. 19m AFgEIATE AMERICAN 302 Sri ROAD INSTITUTE OF ABT - DFvvlc. Mn 026IN Ail !OW REV. } -✓-2. �aLdN DWG. NO. _ ®f "Will, wo —^- --- -I o ? _ \ I C rr3! 4a �f bPP,' �! Q 2. 6 : CLD IA14c- �, / diZ• 1 �" tr R V,,ll ar ESSI NG m a n� < kj I fjrc190}b a h! -/P SG 4G� 3G 9 rw3v ro r 9 a e02 4, Q �wNER 7� CH,19PAsK 0 Ill Ave ADDRESS bCC/ /V M®ciT/%nR W, N�nnOUT!'1 Meg _- SCALE / DESIGNS By DRAWN !w "d FRANK D. CIAMSRIELLO F.D.C. DATE a5A 111 REV. P 50A.395.22(+6 OFFiCFIFAX BOSTON 5(x.IE TY AWXRSL+w 774.353.6321 CELL OF ARCvttKTs CIS W FACIAM�COMCAST.NET RROFFSSIONAI REV. RD. 19m AFgEIATE AMERICAN 302 Sri ROAD INSTITUTE OF ABT - DFvvlc. Mn 026IN Ail !OW REV. } -✓-2. �aLdN DWG. NO. _ ®f "Will, wo —^- ---