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HomeMy WebLinkAbout2022 Sign off Transmittal - Merge 2 brm into 1 Master brm Yqits TOWN OF YARMOUTH c HEALTH DEPARTMENT ♦Ty.. t4 tet4 PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 7( gog— i�,!fs' A M Proposed Improvement: 6/266 a,,pqoatit � s • r. / - !'c A.! Applicant: I?ICflig fg/9 12/4k &{Al P " Tel. No.: 550 7 3gzc Address: o-O6 T 6.1 OZetitifrril ,n;j/j. Date Filed: **If you would like e-mail notification of sign off,please provide e-mail address: RI ' !)Qi,( Owner Name: /1(0134 3,qRl9/4 P,ou ,ij e y Da)Owner Address: la ,g0g, 0—L I v L. A). Owner Tel. No.: ' Or 3 '2'/ '( _...._w ( rnoifi) 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 JUN .1 2022 (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: AMANIO ...... .DATE: C �...e'•` 5—I1 __.._....._.�...... f PLEASE NOTE COMMENTS/CO TTIONS: /u5'I en frV- l� � ' m 0 LaVWG oo-A-1 -JUN 2 '120 HEALTH DEPT, i°y�T.jt/Yj"""" c P�yf3{ ¢ pj i}',yy g ¢`y g'$ HW J'f a s 'R3�l:..f pmpe y� j? ygj q j g `l JACO -+5AMtF4 Z "did#iNE 4"'f c a �f ST 80 i.,A)e . C-.�✓ l,i alr'� a F l Rte., ✓, / /1Etiovp76 cups*?N PArf' iT f 3 Cc fp�i O/ANNC 00it-I k .01 ! A)610 �v-40NIeo rrIe m 0 LaVWG oo-A-1 -JUN 2 '120 HEALTH DEPT, & - g HOS 4 I 44 lOv.A°; `yp PPOPW P; I' Ics i GRED t oo Xv