HomeMy WebLinkAbout2019 Oct 09 - Sign Off Transmittal, Plan - Replace Landings/Steps = TOWN OF YARMOUTH
,� •c HEALTH DEPARTMENT
�$1 PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: AL,.).)
Proposed Improvement: ` :., \.\ ) Ls.N\ \c\<,- \
Applicant: ** \A=-)\�? N. ')v,,\A e t5 \--N( Tel. No.:)0`k"Y\* X 11
Address: `��`�t. v t.c L \; -;'y tt o -A Nty ) `vc•, U l._ vU
� Date Filed: \U 1�
**!f you would like e-mail notification of sign off please provide e-mail address:
Owner Name: \..\\\ ` \ , c n'R-)\\„�
Owner Address: \4 cfOwner Tel. No.:`)U'
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:
Note:Floor plans not required for decks,sheds, windows,roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: DATE.: /0
PLEASE NOTE
COMMENTS/CONDITION
1
9780
NAME Chr
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• 28 .Flicker Lane • .... ..le,...
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'STREET 28 dicker Lane •
Loth 101
VILLAGE West Yarmouth
SERVICE NO. 9780-f 3/( W ) 4
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• WORK MUST ' 0' ► TO ALL
TOWN BYLA : REGULATIONS
YARMOUT WATER DEPT DA E