HomeMy WebLinkAbout2022 Sign off Transmittal - Remove and Replace Deck xi TOWN OF YARMOUTH MAY L 3 2022
���Y& ;� HEALTH DEPARTMENT HEALTH DEPT
‘.
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:'',l ,,
Building Site Location: `4 11* Carson son hiQLl
Proposed Improvement: Removal of Eg i Ski ng I?ec r 12 X 12 Deck Cvr1 ct
C3 uile laeu) I LI x 1.-a. I Dtck..
Applicant: Rom, CO n S+ru dip rl Tel.No.: -4.-÷4—2I Z,—40404-
Address: TO BOK Vpo 6e paeans, MA Q7,4407. Date Filed: 5/23/2.7..
**Ifyou would like e-mail notification of sign off please provide e-mail address:Seo_brc.t-.c,Pont, .oftvrlC.tielq
g r»a.;t. t ft,
Owner Name: Chris P tiv'so n
Owner Address: ILI A-Cors o n W l armoot'h O 4 Owner Tel. No.:6 0 -�-2.
—
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: i I DATE: `d\ Y ----
PLEASE
PLEA SE NOTE
COMMENTS/CONDITIONS
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