HomeMy WebLinkAbout2020 Mar 05 - Kitchen, Bath Remodel 1
.0v:Y4 '. TOWN OF YARMOUTH
is, . HEALTH DEPARTMENT 1
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ti,s,,eta ' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
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To he completed by Applicant: 1
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Building Site Location: ' �E-� j
Proposed Improvement �c 'tL .- ,..\
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Applicant: ‘horlapi. Coe.,ATel. No.:
Address: \Ca ECa � L. '1,41,4-1",,,"1>1A. d‘lliS. Date Filed: 314\1/4
**If you would like e-mail notification of sign off please provide e-mail address:
Owner Name: ' ,..,. `t,� , \C V,
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Owner Address: leD b 0)( -) i\1Qwner Tel. No.: i 5Cto
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: DATE: 3 c c...1,40
- ' PLEASE NOTE.
COMMENTS/CONDITIONS:
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