HomeMy WebLinkAbout2014 Jun 09 - Sign Off Transmittal Sheet, Plans - New Construction - 6 BR Dwelling � r ___ �__�__� �.���.,,,,,,,�..�_.��.
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{oF�,qR,y, TOWN OF YARMOUTH
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F "•<�•`� x PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 7Z �/�i i� rE�f/�2 .P� . G�/ yf;-Z���c v/ �i
ProposedImprovement �rNrr�:�rr�oN o� Rt-�>l�cE���E�� r ��u��L����G
Applicant: /�,lETT /r%�i s ro ,�� Tel. No.;!%i � ��� - � 7�6
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Address:_ ? s r`,-77f/r.2 �F"r�=�z S !�/. /%'I///�.�.v,F,,v,� �T Date Filed: � 5/� � �
*"Ifyou would like e-mar[notification ofsign off,please provide e-mail address:
OwrieiNalne: _/--��'/"rT ! -'isTdFi il�� o/ %f �Cisiof=,� Zo�2 �xFi�'J/�T F.+il7iLs i.ziJ T �'.
Owner Address: ; S' ��r r�rf,� i���Fiz S �.v. Owner Tel.No.�-i/ i,> ;_ i.�6' ��
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RESIDENTIAL AND/OR CODIl�IERCIAL BUILDING 7 I
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HEALTH DEPARI'MENT: Determines Compliance to State and Town Regulations; i.e., Requirements i
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 ezisting and proposed) - �
Note:Floor ptans not required for decks,sheds, wdndows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee. (
................................/.................................................................................................................................................................................................................................._............_...........
REVIEWED BY: �((.�(�Q�p DATE: �— 9��
PLEASE NOTE
COMMEN S/CONDITIONS: �/ / ,/
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