HomeMy WebLinkAbout2015 Feb 27 - Remove Bedroom; Make Closet _.�. ; � __ . _ _
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=04�'9R,� TOWN OF YARMOUTH � �
o� ' °-_�� HEALTH DEPARTMENT
Y '",_•<�� pERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Appdicant:
Building Site Locarion:/.� ��)��/a� � y/�,j,P��'/�"�
Proposed Improvement: ��lr"�r�if,�'.,` ����G�' ���/t/�
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Applicant: ,..,��,�-/� �/,e� Tel. No.:�V, v'2 5/I ���4�
Address:/4 �j�a�/,��� Date Filed: � �
•'I,fyou would like e-mail notification ofsign off,please provide e-mail address:
Owner Name:_.�.L�'/!�' f^'/�YS
Owner Address:l�/ ���i�'�CC/Gt�i�J��� � Owner Tel. No�,� ��� 610�
, ��.y.��
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RESIDENTIAL AND/OR CONIl1-IERCIAL 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 ezisting and proposed)—
Note:F[oor p[ans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application sigued by licensed installer
with fee.
.........................._................................................... ...... ..................................................................................................:............................................................................................................................................................_...........
REVIEWED BY: DATE: �, � O��— / S
PLEASE NOTE
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