HomeMy WebLinkAbout2014 Aug 01 - Sign Off Transmittal Sheet, Plan - Move Garage to New Location � �a. __,.. _ _:__ � .w,. .�._�� _.. _ . _ _—. � _ � - __ __
of��x,y TOWN OF YARMOUTH
y�' •.:�c HEALTH DEPARTMENT
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� '�•�••`' $ PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: �
Building Site Location: �� w"""�`' ��� �p� �r �".—�1��
4'posed Impmvement:�sv� �l S�� ���, 9Cr��-�ie d-o y�y_u.) �oC o��B^-� �
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Applicant: �d� , �otSS�5 � �76��- ��C— Te1.No.: �O� l �`ll�O �
Address:� 36 O�`O'��`�� C.t� g��5+� �� DateFiled: � ��
•*lfyou would like e-mar/notifrcation ofsign ojj;please prwide e-mail address: � �m ev�,� ' S C{/�� /`-��`���' � � �G�-- �
Owner Name: ��� �" ��-J�` C� ;; �� S
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Owner Address:s� re t�r (��"��s �awQ-- Owner Tel.No.� � L�
N�C�w�m � C7— d� 8� _........._.........
.._.................._..._..........................�.................................................. ................................................................................ .............._...............
RESIDENTIAL AND/OR CO�RCIAL 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;
li (2.) Floor plan labeling ALL rooms within building
� (all existing and proposed)—
Note:F[oor plans not required for decks,sheds, wendows, roofing; �
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
........._....._......._....................._................._....................................__....................................................................................................................................................................................... ...................................................._.......
REVIEWED BY: � I it7 // DATE: � ��
PLEASE NOTE
COMMENTS/CONDITIONS: .
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