HomeMy WebLinkAbout2021 Sign Off Transmittal - Deck & Bathroom Remodelt Y�r TOWN OF YARMOUTH
HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: p t�
Building Site Location: I l'N6 S -f -y!14%UT� �er Mfi
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Applicant: ``�� 4 o //h / 1/2 / L/1te/�,1 L n /� Tel. No.: S &,e-7/� %0 S
Address: r 3 � �% cLr) 01 S t Ul�/LG��� rr I `6 _ 0l15Q Date Filed:
"Ifyou would like e-mail notification ofsign off, pleaseprovide a -mail address:!/Jr1N/1 %1 K / L'P(,L '/ l01 \7-1/IUA t 1" '
Owner Name: ZQ—h 1M d1? -1 ZX160
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Owner Address: /QL�1 Qa Sf7 (�i� . , P wner Tel. No.:, ��3� ��5
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:
(L) Site Plan showing existing buildings, water line location,
and septic system location;
�- (2.) Floor plan labeling ALL rooms within building
J 4 207; (all existing ani
Note: Floor plans
FIEALTH rDEPT. (3.) If necessary, Ti
with fee.
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REVIEWED BY.
for decks, sheds, windows, roofing;
cation signed by licensed installer
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