HomeMy WebLinkAbout2019 Apr 26 - Sign Off Transmittal, Plan - Deck { k� TOWN OF YARMOUTH
Sr HEALTH DEPARTMENT APR 2 6 2019
-' PERMIT APPLICATION SIGN OFF TRANSMITTAL SIII F DEPT.
To be completed by Applicant:
Building Site Location: L 'I'I 4 / U
Proposed ImI ovement od k7 / 3 ) Z F <:_ J.,
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Applicant: �.. - e . No.: - 13
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Address: .. :..+- .-.:,: __� - __ e Date Filed: ,
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**If you would like e-mail notification of sign off please provide e-mail address:
Owner Name: ' i ..
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Owner Address: " ,. 4',: , If , R v G . `�f Owner Tel. No.: id G
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RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements`''.. 1
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 existing and proposed)—
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: 1� - DATE: /- - - '-7
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