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Home My WebLink About2014 Jan 30 - Sign Off Transmittal, Plans (VOID) ,. . . oroF��e,y� TOWN OF YARMOUTH ° HEALTH DEPARTMENT s r '^��°� � PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: /a fe��ef' he� L��- Proposed Improvement: �,�,��( o��U� � �t /��USe w�-� a / �� c�G�a yfz , ! Applicant�o��.��4-, (��bkru Tel. No.: S� �wa 3�� Address: I��-�� 'c � � lx Date Filed:J-/S ,�U/�I ` s�`/fyou woald like e-marl notrftcadon of sign off,please provrde e-mail address: � ,r, c/ o h u� .c orv� Owner Name: �� r-��e��.e Owner Address: U3 c,a�� +�U nh� � Owne Tel.No.: SZ� �1�9 7� �b ;r.-y ......._......_......................_.._................__..........._...._........._............................................. ._............................................... .... ..................... ............................................................................................................................. ^° \ RESID IAL OR CO RCIAI.BUII.D G HEAL'fH DEPARTMENT: Dete in s Complian to State and Town Regulations; i.e.,Requirements For S ta e Disposal d other Public Health Activities. Please bmit thre (3) copies of plans, to include: (1.) Si lan sh ing existing buildings,water line location, � an s ' system location; :' (2.) FI or plan labeling ALL rooms within building `• (al existing and proposed)— � \� No :F/oor plans not required for decks,sheds, windows, roofing; , (3.) If ecessary, Title 5 application signed by licensed installer w' h fee. ..........._....._........__............_.........._............._................................. .....�...... ................................................................................................................................................................................................................_..........._........... /J i ��"� � // REVIEWED BY: �5,/��J�v�-( DATE: �^ � - ��l' PLEASE NOTE COMMENTS/CONDITIONS: .�. ;� 3 � < %� � � �o , h p / �� //l� Ul7 . �� !�r , 7� 6c� «�lii` z�` � � ,-//jC � ;� ," r� ^ . i y� r.:?' ��. - _ ____— _ __ ---------- -____ __ _ _ � I VN `N3J-vm3mal6Q'3 L GS xog 'O'd 99 L S'GSS'S66 :'1'130 W00'-IOV@SNSIS300-13W0 0-13 (N a inch SN'ElIS3Cl :aau8lsa0 "1d3oH1lV3F4 W `ulnoutzuA.IsaAk CoZ 9�J NVf ` aue'I poqjoqluoj Z i _ 0 N LLI Q Q N ILI ° 8 S �- m a°. ° w LLI R to J �7 ct) u' QL m IK LLL LuLU 3: O J W m II_ du), �- aV U LU A LU qb tea° �u a a �U NQ �LU w9 } 0 Q—i 111 Q V "1 .r '� w 4- U LIJ 111 Q t- i--- an ° 1 6a 8t� sus u L,-�o ooc nLU Xd 1u a� Al �a = L N ell V .._ r eei tt rri .9 r eA I0-176 I10-117 0 Q O LLL Lu Q�diJ d) lu m pp W 3 Q V wu Q d) LU J�o�o 2 J �7J�N�LL �L.0L �- pw~a Q- Q w _� 3 629 QOQu o? �w-ZNC' --j �,1� W Z m N 2r,WWG O Ld y o if 0uwj vohnHoff •� �U�� OOF—� Q k-'wOzS xFaF Q arao=v, Ln ,I-o++9Z� w � z o �"o �a 0 w 3 j T N — M N aO = co .N Ga � � w O Z �- hl p } (L N "O ujA� �t .— o c X x X X x � � 0 ti a = _ _s `N __ \N �N m N \N _ Vl x AN x x x x N IN s !L1 O a N C4 cn �sssss I0-176 I10-117 0 Q O LLL Lu Q�diJ d) lu m pp W 3 Q V wu Q d) LU J�o�o 2 J �7J�N�LL �L.0L �- pw~a Q- Q w _� 3 629 QOQu o? �w-ZNC' --j �,1� W Z m N 2r,WWG O Ld y o if 0uwj vohnHoff •� �U�� OOF—� Q k-'wOzS xFaF Q arao=v, Ln ,I-o++9Z� w � z o �"o �a 0 w 3 C o L aO = O .N Ga w O Z �- hl p } (L N "O �t .— o c ti VV4 `M3J-VM3FJa12ie'3 ILLS XOS 'O'd 99 l S'68S'S 66 :1130 IN00 "10 V@ SNE)IS31J0'13W0 0-13 W G 1AVCI 91, 9F I r 9 S N V■ S3 Cl :�au5lsa4 1--- ------- ni -IZ ------cel---� ( � 3 I I— i —I n�xn8 A 1 -I � lU --� m �T O E CD--- U _1% Ile -M -VW 941nouueA IsaM auz7 poqjqp3oj ZI OOMOD'kpjso� uToisnD:ajjp 1!1.. : 11 0 400�1 I U-1 W0:)'dONdANvkna 'NldVH:) SWHJ :aoj pa.redaJd O r .j -� u8-11{ ni -IZ ------cel---� u ii�E %W n f/0f* t"I I r i _ A 1 -I � lU --� m I 1 O E I IIS I ! 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