HomeMy WebLinkAbout2022 Sign off Transmittal - Season room addition with laundry of Yak TOWN OF YARMOUTH
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HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant.
Building Site Location: 0 -0 t-CNI`A, t'A \ ` C)C
Proposed Improvement: ,A- \0 l x Ito S� S� �� v‘ S�"�
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Applicant: 1/lO l� Tel. NoT?Li c i '116-C
Address: )A�2J) 'h-Q-C Date Filedl V2i \'Z1—
**If you would like e-mail notification of sign off,please provide e-mail address:
Owner Name: L>L— W` cyst_
Owner Address: 5Z ./1.4 Owner Tel. NoT) ! r ?10'
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;
M. 2 1 2022 (2.) Floor plan labeling ALL rooms within building
(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: 4 DATE: 7-01C _ Z L
/PLEASE NOTE
COMMENTS/CONDITIONS:
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