HomeMy WebLinkAbout2022 Sign off Transmittal - Use & Occ, New Nail Salon (-)S C 4_
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7.� TOWN OF YARMOUTH
° HEALTH DEPARTMENT
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PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: j.31.3 / (?I !�n "/`°' SOH() 1 al tiil)-q)
Proposed Improvement: A/e uJ
Applicant: (CI rYl A/30c ATAL ,(n Tel. No.: 979: as' 4301
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Address: Date Filed:
**/f you would like e-mail notification of sign off please provide e-mail address:Tn rr, ncitme r i I c t1 ya hco.C 0 rY1
Owner Name:
Owner Address: 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.
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: 6/3) al
PLEASE NOTE
COMMENTS/CONDITIONS:
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v COMMONWEALTH OF MASSACHUSETTS
DIVISION OF PROFESSIONAL LICENSURE
B®A'D •F
COSMETOLOGY AND BARBERING
ISSUES THE FOLLOWING LICENSE
MANICURIST-TYPE 3 CC
TAM N NGUYEN
860 SANDWICH RD APT 15 rn°dagao V VD
PO BOX 205
SAGAMORE,MA 02561-0205 JUN 0 3 2021
3087617 09/15/2021 720755 `kHEALTH DEPT.
LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER
a-COMMONWEALTH OF MASSACHUSETTS
DIVISION OF PROFESSIONAL LICENSURE
BOARD OF
COSMETOLOGY AND BARBERING
ISSUES THE FOLLOWING LICENSE
MANICURIST-TYPE 3
UYEN T VO ELEgEO 1L_LD
860 SANDWICH RD
APT 15 PO BOX 205 w JUN 0 3 2021
SAGAMORE, MA 02561-0205
HEALTH DEPT. .
3087524 01/01/2022 779324
LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER