HomeMy WebLinkAbout2019 May 30 - Sign Off Transmittal - 8x12 Deck TOWN OF YARMOUTH
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r y M t )y HEALTH DEPARTMENT
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tet`: PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 6 5 1, ,e WA/ A K
Proposed Improvement: .fid/S TA/CIA/6 J D/1/7 D 64‹ 6 X (2,,,
Applicant: 41,271-rh /#e--U' 'T l Tel. No.: s' 3 -360497
Address: 6. 7 "F `cEE/zx/ 4 V E• Date Filed: r- 70 '/7
**lfyou would like e-mail notification of sign off please provide e-mail address:
Owner Name: l t>/.yLG.I",rt. fricos C r
Owner Address: 6 7 i F�f i Cl ., d hf Owner Tel. No.:
RESIDENTIAL AND/ORCOMMERCIAL 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 fe
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REVIEWED BY: \P") f n DATE: j {
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PLEASE NOTE
COMMENTS/CONDITIONS: