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HomeMy WebLinkAbout2013 Nov 20 - Sign Off Transmittal Sheet, Floor Plans - New Home rof�"R� TOWN OF YARMOUTH s' ' ` `c HEALTH DEPARTMENT °��`- ,�s � �"•���% � PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: ��(�^l �A/ Jj��C,t'y � /-'f �t/t Proposed Ixnprovement: A/� u/ l-lUry/ L Applicant:� J � ._(.�C_ VYI/9l�S Tel.No.: `^/7�( q�Z- ZzZJ Address: �� Gt/�Q 7�,� S% y�7.tJ/Sr,yP y�jrq� �/1� Date Filed: s'lfyou would like e-mail notification ofsign o,/f;please pravide e-marl address: � Owner Name: S / C�JC �i d/�{t � Owner Address: � %//vi6t�L �-/l�v E Owner Tel.No.: ,��3-�,,.5�-�j��� .._..............._._......._�x.�.�TtX............._..._�1f_.............._................................................ ........................................._................._................... ......................................_............. RESIDENTIAL AND/OR CONIMERCIAL 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 egis�ing and proposed) — Note:Floor pdans not required for decks,sheds, windows, roofing; (3.) If necessary, Title S application signed by licensed installer with fee. _............._......................_............................................................................................................_........................................................................................................................................................................................................... ' REVIEWED BY:�.(r (j(,G//Xy�f DATE:_//- � %� PLEASE NOTE COM�NTS/CONDITIO S: ,�L_ � /� /' /'`� iS� a� C D�1 //�u � r47�T-/ 6 ���rM� o'li�'.L (J-q c�. . wr/� ^ �r /'v� --- --- -- __ _-- � :01 01 � 8 O O 461_611 O wo�� O �' C/) C CD —4 00 z m 00 Z7 z z C D cl) maw@-v�Doo C7 rMIL � � rnm zT ���rD� z r n: -� -� C.��_ CD CL CD -, 4 Or CD CD =3(/) T CD ■ ■ g.!R Q o CZ— L— 0 r C: �WCD o CD ' © m m -° - O X > (n rn : ai N (a co r. plm Cl) .a z oD =�D O n ti C --O O fi C O tD F 3 0 v j O wo�� O �' C/) C CD —4 00 z m 00 Z7 z z C D cl) CDM C7 rMIL CD zT ���rD� r CAI) CL CD n -, 4 Or CD CD =3(/) T CD ■ ■ CZ— CD O wo�� O �' C/) C CD —4 00 z m 00 o=C31� C) z D I L N Q r- 0 0 0 -p r Z 0 O = O m. o��� o m N o rn -� '3���_ �z r o m y CD jj OD • cn CD ml m COL 1 • �, , s sk r— o N N M D CD M m 0 o�0 CIm n zi "'NCfl Cn �4� O O 0 O •. N Q' p CQcn •• r CL0 .Q� o m >5�_ z O > .;oo Z= C--0 CD oo, '',. • COC. jj OD • cn CD CD 1 • �, , s sk 0 D CD • )�• .. .., ►... �,: �� ' •. •• �. I.1 Iii f CD '',. • COC. �� • • �/,- _'► CD OEM