HomeMy WebLinkAbout2022 Sign off Transmittal - Enlarge existing deck RECEIVED
�'�►k TOWN OF YARMOUTH
HEALTH DEPARTMENT ?022
HEALTH DEPT.
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: 6 n.-1-1-0.„, (,,,oc J S.-f reed-
Proposed Improvement: till j& I LL > }� )Z y 'Z a`,
Applicant: AJ Lc ,-i Tel. No.: ) o
Address: S4erre 12o<<.f r��-.� VA P4 02 63' Date Filed: 7-7 -7oz z
**If you would like e-mail notification of sign off please provide e-mail address: ACL v. ` h L- ►Z e.r►'�,x�e I: •� i .7 ,
Owner Name: rY) S K c
Owner Address: 7 L• C. i- 0 .--, 0 1 rOwner 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: L....,_A4,411, DATE: C Z
PLEkSE NOTE
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