HomeMy WebLinkAbout2022 Sign off Transmittal - Enlarging Bedroom TOWN OF YARMOUTH MAR 2 2 2022
HEALTH DEPARTMENT
o", HEALTH DEPT.
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
- To he completed by Applicant:
Building Site Location: IV (U AUS RD t L0• 7 OW 0 V f 1/1.-
Proposed
Proposed Improvement: C(o c-T -1-c 6 N 1 a r J' N bed
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Applicant: (y tv <y (LS2 N [2, Tel. N : 4
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Address:
S--Address: ( t P kv Date Filed:Og-72' 22..
**If you would like e-mail notification of sign off please provide e-mail address: ik(\0 C_R.c C(�„ 5 ( ! V& &Mtr.CO M
Owner Name: (\.‘Ot;,,E-(2--e-a-) i t '—
Owner Address: Cfl N etc' t (2— Owner Tel. No.: S 5 (l) t? 7--
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 Iabeling 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: 23r DATE: .
PLEASE NOTE
COMMENTS/CONDITIONS: �-
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HEALTH DEPT.