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HomeMy WebLinkAbout2022 Sign off Transmittal - Sun Room 0N-iY k,, TOWN OF YARMOUTH ;-7,4i1 A � HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: /c /61L- SOC .2 mcc '7'�j Proposed Improvement: 61_,i:(al v- /L/ Applicant: 4-0-Ar4T93?a_rx2i}--�j,li/6-j Tel. No.: 5-0P--20-/7,9 Address:ON/0Ct✓? Date Filed: 57/2/2-02._e__ **/fyou would like e-mail notification of sign off please provide e-mail address: Owner Name: 62.5_0 Owner Address: Pit r v? ( ke-r , Owner Tel. No.: w3-296-- J ) 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: .�._._ (l.) Site Plan showing existing buildings, water line location, and septic system location; MAY 1 z 2022 (2.) Floor plan labeling ALL rooms within building (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. REVIEWED BY: DATE: 5 PLEASE NOTE COMMENTS/CONDITIONS: r "'�„ ' , .. _ _ ,. - ,- • w Q Z 1 LL (--4.) o n s 0 CD CD x :, buil O W 1 O LJ c r,) f N 0 fl__ , 7-- U 0 cp Uj U Q z oo Q .r---1 oo �— _ I! c— e • — 1 0 - n 7- . (- --1 . iQ x , n z , Q Q -- LL C' LD 7--- y . 7- 1 . Lf) Q .,• . • . ,, . '411, IFY.: •- r;4". • ., ..„ .„ . ., .. e .., ... . . . •...., • ..all• . . . * . .. •' • 4., :i .4. 4 • • , . it':•, , .. .... • ', .. .. .. .t 4,, • . ,.. . ,. . it '.# 41t:e - • 1 . . < I . . • . . - - 4 • ... .. I. 1 IP ‹C . • I . .. .. ,.. • : . • ,› A . 4 . . . I. i4 1'• . * •I.; • , .. . . • :-. .. -- '.. • .• z. . i;,.... • . . , .. ..... • 04 0_. iV,. ,. . ,... ..,.. . ' - .. 19 i . _.,-,)1 . . V a '•: . . •, 1.4...44 •.: , : . , , ' t I . („) • " • .., ••.• pal >•••• , . • . ....,. i: .44.,., -. ... 1, ; ,,. :,.. 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' Cmdmpr Raid Pripet,Ad*** - Ridc Manse ovinsr 041111W11 Name • oformition* recttires for ally SOUlti Yannoulh MA 02994 07/29/13 Xge, MOO** WON Zip C—is —et Ode•----r-------- D.Britain Information (coot) sketch Of fleeme Disposal&Mint Pnnilde a view of tie eresaa disposal%stem,inchidine at tenet two pennons,*misionce iminiadca or bindimists,wadi a was within 100 feet.L. where pubic Wider supply anion;the building.Check ane albs boas below: • gi hndckeezh In the areibekne tj drwmoing sheched espeneely " W • . \I' N. . . - IIIII.W...-131' • ••-.--, N. Ell 29 54 . Ili . - !. • : ' v/if • I 3,- --,: in,: • . (..) f•\: CA 0 N...) C m CD • RI • • ,7_-_., ; H NJ l!.-J' - Ms.11/11) lib 6 0116616eumiaw 666/6 i kiliesdara ammo Olipoill Vim•Alp • ';,-.,,./.7.-,41,.•;a-,',:;V:,:i . , .t1".t:tta:CAVV,61 •' •-,:'OTSLe:7,,' l'.. ,V, ., -