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HomeMy WebLinkAbout2022 Sign off Transmittal - Convert Garage into Family Room oi. TOWN OF YARMOUTH ..*; r HEALTH DEPARTMENT ? PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: j,'7 G.E. ( A v C Proposed Improvement: �v•, A \ PL i�l I r'U L._ 8 ' 1 �� ,PQr'♦ V t H '.1 RQ t y:v v w1 Applicant: / Tel. No.: c,Cr 22 I .' < Address: r% K ,,, 7U r Pic . J, �,rlic�..7l� Date Filed: z / ' 2 Z **If you would like e-mail notification of sign off please provide e-mail address: Owner Name: J/- kJ G l-i u y Owner Address: `:-( CI 7 e r ( i /yk Owner Tel. No.: 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: 4/1 r"—/ Z P EASE NOTE COMMENTS/CONDITIONS' L. C `•CV c2 ( �'1 rJ LI n � 'r? a Ni t r C :I ku of N l‘?:1 1. l.' :.?r %191 II I ('' . . - I 1:n , q-L , ,,. , 1 (t- ‹ kk,q 1)1 3 (3- 1 _I-- N p WA ,- lli(6 1" c1- s rn :1 1 9'1 4vim,, V V 4 (.`3 IT, ;., \(\t R :i (••,1 •\,....,,a `;r /..: It' ////A ..\/ ,0 ? i. N•.- - ii 5 1 i\ C I q