HomeMy WebLinkAbout2019 May 01 - Sign Off Transmittal, Plan - New Deck ov Yqk TOWN OF YARMOUTH
4o; % HEALTH DEPARTMENT i
„i-. PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 11 4 CI, , ;s 4 s L.1&y
Proposed Improvement: we to c1'41‹. (o ii S T .044,;-, -z
Applicant: E0 L e r± /44 r i',) x Tel. No.: 5Q ' 7d7 4- e /
Address: t/b l it r:/5 '.0r s LI Ay Date Filed:
**If you would like e-mail notification ofsign off please provide e-mail address:
Owner Name: /4 11 /et-n C4 G ve Its'
Owner Address: 't/6 4 4, ,.$1-m#1-,s L'G y Owner Tel. No.: -6-04) 3i 4'-a 4 6 3
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.
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: JJ-)/c,
(L G 44
DATE: 5 7- 79
PLEASE NOTE i
COMMENTS/CONDITIONS:
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