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Home My WebLink About2022 Sign off Transmittal - Partial finish of basement of-'mak TOWN OF YARMOUTH **"'1'%c HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: to 0 1 _.O/e Ave- .,k)• `7 rvvl ,P4oposed Improvement: LO() Ve / ()al/ n 1 ed Oe-c_4-ioc ©t lit S e.�lrl n r I N a Iii i I d J r'IP t1.1201 aid n a 44, a c_.e,n r o(VI 4I-So I A/c.o✓[lQ( a P_)(t om' }'i Y7.oM n Applicant: grneJ (2ZvrrtGA,1 Tel. No.(6:04.Ri 4P-?""!U Address: g (--I I95-E-inj Ave.. Ld gAnroijivi Date Filed: L " - **/fyou would like e-mail notification of sign off please provide e-mail address: A'\in e.C . c S P f I Ye • C.UM Owner Name: e U t Owner Address: 1E3 N► cOIe flVQ hA 94k4900-rh Owner Tel. No..07q)Yoe-Ci 3 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 APR 0 4 Z022 (all existing and proposed) — HEALTH DEPT. Note: Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. /1 � � U - REVIEWED BY: V' DATE: PLEASE NOTE COMMENT'CONDITION. . 2 (5 (L Sr- (`AC`''l; (J ,C cJ (1.) n�{, e `' �l ,, 1 +R`i 1 5 1'0r2M+�l V\ -- I I. n r nc 120ry" c n D Lire., `Pfacc.j.i 71 n i net eRWen Rtk)r), 177 r1/ 13Pth '1 .._ - o gl o 11;: . L ..... ,c,,.. i) 2.-• \ .g. UI3Il O ,e m c. F,lL. .. H r-: iL', • •. • . •- 114 ' ' g • iv • (k. • I ( . I ) \ .. -,. • Ce) 1) - . 13 ti • uM.ti vc" •i.:-:: I . . . . ..m . ....., • • -.4. . .10 .. elis.corsav(alip. : Cioscr . . 04,A e$41082c061 V J . ... - (20 ..r.,) .. --ci , n • -1,.. -. •- • v . • :-1-1 r,v, • ( tO 44 - cz- , ilb' 0 • ' 0 0) . • . '. ri i - - / - .. . • .T .,. ,a. • . ,› 17:-;) L.Ritfik' ' • rn -.1- 'bud . , ,,, 0.1 ,, k (;`, 'pill • • • 13 H ..-.. ::............_ . . . .