HomeMy WebLinkAbout2020 Apr 06 - Sign Off Transmittal, Plan Section - Screen in Existing Deck „t _. ,. ' i
oy- � TOWN OF YARMOUTH
,tatA o ,; HEALTH DEPARTMENT
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• ' .t`' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
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To be completed by Applicant:
Building Site Location: if JIA R SW SIJD •
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Proposed Improvement: -S-C /i tY/s'i�i'y D E 1
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Applicant: ?At t (�. AANER,- '` Tel. No.' 9W7 c>2c- ( /9 7
Address: ( ri`7i ./,?fA::> `. LI - Pit- -1- h/-.) r--2(7--'7 1:,`” Date Filed: 2-/2 ;-(
**If you would like e-mail notification of sign off,please provide e-mail address: ray'-AiifiL '\":-nrl k - !--''' �r x'719 I-- . '*----4'`'k
Owner Name: ,1;41,11:25' /I/c __Z '
Owner Address: 4--2/9 , kA/r)1); IA/fly Owner Tel. No.: - g 36 5 0 L2
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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.
1 1 T
REVIEWED BY: I r lI,i DATE: 41 I' i 202 v
PLEASE NOTE
COMMENTS/CONDITIONS:
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