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Home My WebLink About2015 Jul 23 - Sign Off Transmittal Sheet, Floor Plans �� . _r_ oF�aR,� TOWN OF YARMOUTH �� -��0� HEALTH DEPARTMENT � •��,<.••' � PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant. Building Site Location: ��(' �i S►1 Ci L a n � PmposedImprovement: � �w �_'�j('� � T /oc�r Y12 G� p��1�� 5 /3��'�n 1.e n ��F/ODf� r'rM1 8—(��' Yh�i� 1�� 1 T��—=��C'� t �� .�� Applicant: ��M�.$ a 0'Mq rc. ^�C' Tel.No.: $�0�-�� I -d t)� Address: 3� �.c��Cro�Qj`i�P ��T�p�th �Y1asS 0�3(ODateFiled: � IS ■"IJ'yov would lrke e-mail notifrcation ofsigrr o�;please provide e-marl address:�q Q RQ W��I r ��`aI�ap•CJM Owner Name: SC O^� T �0/�-�G V' l C �Z- OwnerAddress: y��cf Sf �1/e.� �(�i�C�QPA�q�P.fOwnerTel.No.: S0� -�S? -700� oa3�9 RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. lease subm't three 3 co ies of lans to include: P � � ) P P + (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:Floor plans not required for decks,sheds, windows, roofmg; � (3.) If necessary, Title 5 application signed by licensed installer wit6 fee. REVIEWED BY: DATE: � � II PLEASE NOTE li COMMENTS/CONDITIONS: I �� ^ r � o u � � . . . �� N C� „ �'"� S � N F^ � J <. � u , !■■ � � '� 0} ..� . . � �.. y . . � 'e� .V . y�f. .. .. .. . . .� ✓ �Ani. i`'y, . . ._ . �� . . . .� . . . . � �� . . .. . � . t � . S . i • �: . . �.. . . ... .. � _ . . . - . "'^•E . . .. . . . �...� . . "" a -^,. o� G. � �' _ .. __ _. . �. -� � �: '� ! i� � � �..., � � � _ ., � � i✓�i l.�_ 4 �1 (((( �+. ..._ �Yi1._.. . ... . . . ■ � �_ ..�+.� i"^ � � � � _ � � � � � �q� � � � �:� � . �� 4�� A_ Y 6� � � � �T � � a . .. . . .._ .. _ . � .._ ;. __ � `�fi � , � `m" � . . . � : ' .}. . A . ._ . —.:. ..y .b� �-+ ...�.. � � �" � +G.. ^'S . . .. . . . � .. . . ✓ . . .. Y.i � . . . . . . �! . 4� . .. . "'..t *.�k`r _ � ��i,.� ,�:,, xj r-' � r,"f" ✓ i y.� ` � .�'a� , . .. .. � � ;�� 1 -.,� � � ' °' � . ; > �... _ � � � � .�� .1 1' � �a }n}� � r � � . ` . . .. . .. II.... . . � . . . . � � \� . l � j� �a� i � � .. h �q'j * � �-:i'. �� ( . .� �yt�J ^.,� , . .. �r� � .. Si.: . . � -' .� . . .. . . j}�. i l . . F d � . . . . . .. . . . .. . . �-�5 � . . . . . . . ._ ... �' r=-,.