HomeMy WebLinkAbout2022 Sign off Transmittal - Convert Garage into living space .Y�,k� TOWN OF YARMOUTH
, � HEALTH DEPARTMENT
'�• `'• PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: QC 7I-Tel /1,5> QC<)
Proposed Improvement: ,/-�,9Ie �n %z _,7-Afro pro/'c �i
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Applicant: V 5e,Z7 ' Cc,7' Tel. No.59 �4 ,
Address: ,0 C"OFl I DFYJn/S7JX ROeu Date Filed: 3
**If you would like e-mail notification of sign off please provide e-mail address:
Owner Name: O,S��/f f ngTj i ..7 CCE/,16
Owner Address: C C,Wi1 J2. ,i'9S7F/2- Owner Tel. No, 3/Z"�-Sc�y
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
____
PLEASE NOTE
COMMENTS/CONDITIONS: I
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