HomeMy WebLinkAbout2022 Sign off Transmittal - Replace existing Deck TOWN OF YARMOUTH
A ° HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: 3 OPLL L 7-i j 1'J 5ot111/ `/AOrvOU 11-t
Proposed Improvement: !` r'i�L C L )E X/5-7--/1 v 6 i C' / 'Z
Applicant: PP f�'/e k/Re,L E_-,t/ 5 Tel. No.:6/7- 5 -V437
Address: S/ V/0L L 7 -A-LEN 2 . Date Filed: p
**Ifyou would like e-mail notification of sign off please provide e-mail address:! .. ; 1 E{
(' ... ice= j t't•: /1 t- ',- X -e
Owner Name: A a 1 L /
Owner Address: 39 V'/®L 6 T (t t.-' 12t . Owner Tel. No.:64 84,2 0437
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: ?)/1VV"'----"
DATE: 3 /7/
'`
PLEASE NOTE
COMMENTS/CONDITIONS:
•
-- w
�
� � c
W E-,
C ^ w W G•
TTS
• 4'zwq � S
coC •
Qf W � cg � a
� NO q toh
t o
qq - � Q
� � 1a '4 1c) ZaW � wcv''71 • u) Ac4 N W n. M
rh
-
V dcl ::
rn
44 003
O O � W >. w
Q
C w god 4
VD o
ci)
11 F=4> w
o
gg0' z
Iud) Y LLLLLL111
174.94'
oo
oo
W
p II
O
O 0
O
k
o (�
� JW •
P Q. N l<
SIC
�o7 w
Y• Z ,� rZ � a .s
c�
�vs s0 O 0 S w 'I
S Nu: