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HomeMy WebLinkAbout2008 Jul 10 - Sign Off Transmittal Sheet, Plan - Basement Renovation , ..� . . �. _. ..., . .,_ . . . . . . . . .. . . . . .. _ . . ,r _"".���'fii•ar-;t'�",e R--. r-^�AS`-e� :F.w..l u _r °f�Y�''4� TOWN OF YARMOUTH 0� y HEALTH DEPARTMENT l"����N�,�+Z" �' PERMTl'APPLICATION SIGN OFF TRANSMITTAL SHEET To be eompleted byAppliamt: Building Site Location: { W�N C N�S �C � � V w� ���? �uUM p No.: L.ot No.: �GSP �'eLt? (PI� UVG.TIGN a¢�f' Pro sed Improvement: r �✓Q�� r �u �� aU2 �� Applicant: � �NOF S /?C 1//eV s G� � S TeL No.: � 9`�/, z� 7- � 7� � Address: �/�/ °� W//1/S L J l,✓ 6,+�/IY /Q /�. S, �����YUu ��ate Filed: 7 ,� ���� •*lfyou would like e-mail notifecafion ofsign o,J�;please pravide e-mail address: OwnerName: ��,• scr k � S�P�n � e :n C /�a r� � a ,� Owner Address: � � �F� s c< C� �' 'h �G �+ r � Owner Tel. No.:( ''�j�� 4 2.0-3 9 /�V l�G �� ,� , G� , ;�IY ia s � � � __._._ __._.. ___ _.... .......__.. ...__.. .._._......._..... ........ .....__ __ _ _ _. . ._......._.... ......... ..._.............. ......._._.........._.............._....._ ............. .................___..............__ RESIDENTIAL ANDlOR COMMERCIAL BUILDING � HEALTH DEPARTMENT: Deternvnes Compliance to State and Town Regulations; i.e., Requirements � For Septage Disposal and other Public Health Activities. Please submit four (4) 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 ; (ap existing and proposed)— Note:Floor plans not required for decks, skeds, windows, soofing� (3.) If necessary, Title 5 application signed by licensed installer , with fee. ! -_. _....... _... -- - __ ._ G -__.._..____ REVIEWEDBY: DATE: �/ l �� I � PLEA E NOTE ��_ COMIvIENTS/CONDITIONS: N� � ��,� � �� � �, AKs�� �� ( I?� Y 4 S a Z I I r r a dW `H1f10W�ld �l 1S�M 6ui�apowa.� o s� '/� 'd ��1S�H�NIM Z ��N�QIS ��I NOl�ld �� �ua�asng � � o ; � Q C +' \ d � U dl� L d � Ao qpq o „6,EZ � � O O i d _ _ d � � � � O O O � � U 4- L � � 3 3 T � +' � i-' � U1 d O a +' U . �1 � � U�i � £ i U £ " W L lf) � �. x o � a� o0 �'`� U � d st N c� ++ � 4 X i-' d � 3N � � 3 S � N � i UI +� O Z O +' ... � 3 �d �r,�adc+ � ,i� � � �(auwiy� � I ��� X � • � N ! ,I � 1.� z � d � O � > Q O� �- ; � �"' O � J_ J � a �, � a � � �^ c � f :: ��, d N E � v W d 3 LL' � d 0� � � `� ;, " Z O - - a �, i N o u°ii a -a „�,9 °�' L.� � i � ,£T Z LQ 4� d � O � ?� s � , Z � A� '� � °° W s � � � � o u >,� � W "� a.Y a oi, � m � � � � �' 'o +� � � W ca �' o £ � — 01 Q a Y U d d � .-. O sY +' � 4" O T U 3 � .� X 3 N }> � T � N N N d Ul 3 £ � +' X 3 +' 6 3 � � W N d N i N +' i�' z ; s � � 3 �