HomeMy WebLinkAbout2022 Sign off Transmittal - Deck TOWN OF YARMOUTH
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S HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: 9,8 Ccunpion 121c2.ct
Proposed Improvement:Add 1itX7to c'ear c4ef,JK
Applicant:Be n Q7iczj< Tel. No.50.3-322--0366
Address:i P vet- st.so Yos moo ft) MA o26g1 Date FiledS-,2 3-2
**If you would like e-mail notification of sign off please provide e-mail address: r3i;11t BerN Yahoo,corn
Owner Name:\N"leconefft-bosepk Car neS
Owner Address:2Z CaSnIDICA BcYarmootbport /1A 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) —
MAY Z 3 2022 Note: Floor plans not required for decks, sheds, windows, roofing;
HEALTH DEPT. (3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY:
DATE: 5---°1 V
PLEASE NOTE
COMMENTS/CONDITIONS:
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