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HomeMy WebLinkAbout2022 Sign off Transmittal - Finish Basement w/ Bathroom of Y��k TOWN OF YARMOUTH ;:*1 A HEALTH DEPARTMENT ''�• PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: 7 S ' Yk•-•-.1.0 rt A ©a() 7 Proposed Improvement: r n t S .,s th -" r < < 1<.-) A -71-\ ( a AA• 3 At& Applicant: P',.0 N • lei (-6 r-Jc Tel. No.: 5"0 f" '131 r`/S— Address: r e.l< .c • Vc, r m-e)t1lhf 1 r'f A ®')6'7.SDate Filed: t1 cy>> **/fyou would like e-mail notification of sign off,please provide e-mail address: Mr Q r-14 . welt- Owner Name: uv\ . M <<6N L r Owner Address: 7 r01P0'FhQor4-f NA Owner Tel. No.: -D t� ' .7 3 71 Ol-)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 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: (// DATE: / a Gj'�a • PLEASE NOTE COMMENTS/CONDITIONS: �] 3 ct J-e W1r �, i067— r� j-f Li C 4 5 (�P Cy ✓O _ ,--, -:-.: ,..::-''.:A• --.4. 1- „....r... 1 i- 1 4 =_____. ) it 1 T -› c--- ull-f UN I r- .- .-..„ T=.7 ......... -... _...c„. --c-_-, 1 ,..... _ . . -4- .7%. %.,.,. C. ) (1,-": V..,--r.,... r... --.C., ,...- I cs — 1 , ,....---(7-----, nr: . 4. (."1' CI )-11Vrci„i, (Ay ....1\ *, likx„......e., 4ti V ...0 ,..,.. — I • Ful•/- -...,..----- _.„ I —_---7.. I - E. .. ,___ cf" rt.• (..._,..-, . ____ .. . ck---..,- - - - -- - , -.0 1 . ; rk L., tA l'• I ' C -,..- 6.I') -4-- v‘ ,.,, 1,,,,i ----) ).-) 0 - , , m ,.....„ ......._— --P(' el 27ii-1,11 {) —, 414'. 1`") raIii C4t-..-...' .< t'''' , -3 ..,, t 1 -4- ,