HomeMy WebLinkAbout2022 Sign off Transmittal - Partial finish basement with bathroom f t td t; 3 2022
TOWN OF YARMOUTH
HEALTH DEPARTMENT HEALTH DEPT
4
'''•< ,, PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 28 Bray Farm Road, Yarmouth Port, MA 02675
Proposed Improvement:Partial Finished Basement, Bathroom addition
Applicant:W.D. PRICE,Inc. Tel.No.:774.212.2942
Address: 161 Main Street,YarmouthPort,02675 Date Filed: Z) 3
**If you would like e-mail notification of sign off,please provide e-mail address:
Owner Name:Micheal and Ketti Ciamiello
218 LEWISTON CT
Owner Address: BRIARCLIFF MANOR, NY 10510 Owner Tel.No.:646.498.8058
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
ith fee.
REVIEWED BY: DATE: 7A:2`.
'LEASE NOTE
COMMENTS/CONDITIONS: