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HomeMy WebLinkAbout2022 Sign off Transmittal - Demo ceiling and instal new sheet rock 0s. Yak„,. TOWN OF YARMOUTH .:::441. e. HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: ( ' %S Rd y q riii00-4-j, 71--7 s s s Proposed Improvement: 1)e 0 , „ t �,6 (,,,S 41:lec r, k I tOi e(C/ Jine-4- rot LQt 1 t S Applicant: Div -k % 00-r 1^ctc) y Tel. No.: 7? '-340'0253'3 Address:2 2 e/.2,z r-els ,0,-1 y Dr-I've Date Filed: �/`06•2)-- **If you would like e-mail notification of ofsign off please provide e-mail address: Owner Name: 6 rg, of r�' cri- Owner Address: / 2 i.e. w i ,S A Ya V (/ho3 Owner Tel. No.:72 y;i?}/-l��'zi 0....1 T 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=1:-.17 _ _ (1.) Site Plan showing existing buildings, water line location, E = - 2 D and septic system location; MAY 1 8 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: i olio DATE: S a — �.)”' F PLEASE NOTE COMMENTS/CONDITIONS: 12L L (A)IS 7Wiit fornotii P-60-12. PIAV cs> ,grng).26 Delecrok, Storage U a 1111111=111111apaaarmaas 4r-\ 41X1516'xii' Family Room Bedroom; MAY I d 2022 HEALTH DEPT. -Ll J2,4_ ? r • ' .PY>,,--e-. , , f q° i • ‘ Den ( Sun tt " " _ _ ( 14 X12M___�. . Room j ---" i If it( 16'X12' C 1 A■■: `"--- t Kitchen Master 11 �- °--- '1 12'xlo' "'dY '---- - Bedroom JO 1 L:Livi,ng 1 12X1 � D�`- ----. epi --. ,---�� .> la° ....... '41 1/9 ) ....__ v .,-..... • : ,Room I , Bedre►om 19rX13r 56 tt , 12"X10' '( (i MAY 1 d'2022 HEALTH DEPT.