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HomeMy WebLinkAboutBOH SIGN OFF •°�"r TOWN OF YARMOUTH s ,x- . ° HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: f g' .a9 - Building Site Location: , 'i Proposed Improvement: . kZ- r' 4 Y Applicant: �.- i‘ t2 - Tel. No.:J'd ZZ- / Address: ' K�' P�-1 /�' 10 '' �i �/ii Date Filed: / / ` ?_.Z **If you would like e-mail notification of sign off please provide e-mail address: Owner Name: I74 71 //Q]I©VI Owner Address: �2e‘/'./Z-• '.r%�r��6�1���f/ ��t' Owner Tel. No� � .... il P j 40 p/9., ./ ,----' i ( ' 7 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. I 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; „v.,, (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: V /.d — I S 4153ATE: PLEASE NOTE COMMENTS/CONDITIONS: "I)° AZ-ruir-e sc, ,,,„ --(-( (,, €,-, cs 1/1cf / <ewc,/C (,..,� ik.)e uu j r/ ,L± c_ s 7 f 4 - �"'L, l 3 ' ( , g 4 ((c> cy 1 1 i 'i _ 4,H yp s s; },i,',T���I4p N__!¢ .E$}Ex=x ,ii it iI„ �,h lax,�■e•• '.'444 ,,, x. 4S i 11 ==El1 g E:I iiig~ ;'40111111it r Q - II III 1Ei app. < - = III luul lx='��- =x• m All Eilisisle ■ee® ,�m _ = No INN i.i.11:11111,: ! ¢E:o-Olibbx°r IR yam.i' '';Eai ii IIIIIIr NI.,1 :E =e a1E10. A 1p l Z .1 I , :E' e¢ E Igo m 4 ■ I I-:-.1 ■■ 4 ■■ III ,ii mime R i morn d —¢, ti4 4� 0 ,�rirN S . 11I n x _ m x . '_ ' i11111110,1111 i, mi'l ¢ I T Im■■r 1 'i1 A = ..■r A.m naiii .:1 I low.: $1r" 111 — 411 I: rxfs■, ith ENE 1 3 ii O �Ex .... 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P 1 52'2.r z15 I g MIX FC2 d '1 Fri, la 1 1 141 I I i p _ --- _C__,. .. .__ --1.6 the bed of Rs/Ifflauledge thee plow era dram tosentek,a ca.mull orWI.. -, ..5.,a I YOUR PLAN STO PROTECT OBSCRIPTION, 1 DESIONED FOR, opeohlueono Ind a Mang,retitle en Men arab are made.boa.,.el the meal end ALLEN B.OSGOOD 8 X 28'PORCH oh 1 RALPH CROSSER-BUILDER .."'i ‘".."..."'"*".".‘ "" "n"*.h.**'*".""*."""*"'d*ay.The bar Moil nom the Vedener of en.end MI delleinnatee telor tot.at of,end RESIDENTIAL DESIGNER ADDITION AND VARIOUS ' SANDWICH,mA !any“nlftudien,MR dm for deafen end elte alines to'ea much deed*.YOUR , 1 i NO- R..... is rave..•••••••••••••••••••••00 ,, . 1 „, ••••••••••••••• ALTERATIONS H 1 I PLAN.STOadenh....Oefeed In hateable ler ea owl atone a..S fansinialc•hoe boa._j..:, 1.0 O.IPA...A MA 02N•11110.44.6.1 I ea In the oration a Ms oten to evdd aka.,the oar um net ,_ ea.tad la,woe,Mal O.°peed Cegoight 2020 -- • tig RNI I._vxouasl _ N .ate ..,.- N i ill ® - , - I n2mN� �1 7— ' A N� pXI - _g _ I12, •• • • xi rnx�,Nzl Z 1 o r z • ni rn' �m4G`I r, c R 5 `F �v } crer:❖rye Dt CAN m ;, —I11 —CAA ®� 'b ® ON �€� �� 4 ? 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