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HomeMy WebLinkAbout2022 Sign off Transmittal - Kitchen Renovation .OV-.Y4k TOWN OF YARMOUTH -tr HEALTH DEPARTMENT .,--E,1 ,,,o- PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: S � Building Site Location: iS l'�v-�,,;,,,_ �;�c.�.J Sc).— � `-moi` Ulfw-oma 1-1--, Proposed Improvement: A 1 tCi.,c n eRer,0v,ficr-..._ . 5 (..,4J,...)5 f-v be- J'e fk,,„( 1 '1 CQcw- tit lip«.►,.. - . Applicant: Pc,,,- ;ek 0 u-e) k Tel. No.: Address: 3S 1 A ePQ,,,, \-. 0,,.,k 1-��w+n,S MA Date Filed: Q—a Z **If you would like e-mail notification of sign off please provide e-mail address: D L Crcitt +r7©,9(P%r.., I -co 4-\ Owner Name: - Ac,-}t• U0 ACL7h S Lir Owner Address: /S C.-0i>A-ctin 0,` ^'e/ Rc.k c3.4k AnNAL 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. RECEIVED Please submit three (3) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, jui t' and septic system location; HEALTH DEPT. (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: 0 p1 ` , D---` PLEASE NOTE COMMENTS/CONDITIONS: 6/23/22,11:16 AM ParcelSketch.ashx(1100x767) a,I t• (DSP}- /5 Capt Vv ;Gke,rScp-. K/4 CV) RECEIVED JUN ?ht''" HEALTH DEPT. 15 12 EAF BAS EAU BAS UBM BAS 1 of Levi^,_ro00-, CvoY — 22 22 26 �nGi Sf c.6" wo,�. 30 . 14 16 e.. �(f c,.ft`o-s S -70 1-4.,renGt.,k -- https://gis.vgsi.com/yarmouthma/ParcelSketch.ashx?pid=11151&bid=11606 1/1