HomeMy WebLinkAbout2022 Sign off Transmittal - Replace existing Deck TOWN OF YARMOUTH
HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: (/(/ _Bay riv-Th hd
Proposed Improvement: 1Zea �j�����-- �,)('it v9 'ick
4Applicant: Q 1 [� r,7l' c0, t,e, L 1 Tel. N .: G=� 'Z
Address: ' '."X•4117-_2‘1 `�5r \ '- ate Filed:22 02.
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**Ifyou would like e-mail notification of sign off,please provide e-mail address: 017(1 (1 6--c)51r— rl6_► 00/4.7
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Owner Name: 1)00 1�( (IL
Owner Address: cj Owner Tel. No.: 'd
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: (✓;
PLEASE NOTE
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° RE-BUILT/EXPANDED DECK FOR: 8I <•CgOTUIT BAY DESIGN.LLQ
BRENSTER ROAD
MASHPEE MA.02649
N m M , ,,, .� THE MARY MANNING TRUST PH.(666 2r,_„66
Ni g N -4.. 60 BRAY FARM RD. NORTH YARMOUTPORT, MA FA%(SO��s399aoz
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