HomeMy WebLinkAboutBOH permit application sign - solar array off 9/9/13 TOWN OF YARMOUTH
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, ° HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
o be completed by Applicant: /14��f-(` e Sit eld
Building Site Location: 4na � ] tys- (r0 L..)p�( Kd , � �. vier /l/A
Proposed Improvement: iO /a. lVr� r
Applicant: �Q Gn� �d c( �►� ,L-f" Tel. No.: 3 - 0 T-
Address: ,29 I, 51- I- en ! `fez- • S- ,..1 i►,�otJt7�l AA ate Filed: q• 9• ) 3
**If you would like e-mail notification of sign off,please provide e-mail address: IQ r3 O(�(Ve C 01 1 C • (NA
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Owner Name: �:"'� �:—:.—e �(�-��L fr o0--e
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Owner Address: // 4 (n p l e 2 8' , 144,--0,..001. Owner Tel. No.:3' - 2.2 3
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:
PLEASE NOTE
COMMENTS/CONDITIONS: