HomeMy WebLinkAbout2022 Sign off Transmittal - Change garage door on home to french doors C\(\c-,-/v--ee--
,-,,,--1-4,4.4, "TOWN OF YARMOUTH
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c HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: - = Y LIC / C VA
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Proposed Improve ctic 0- 'C ���,;-e7 5°C�,. cc, 6. y��S. (1(k r\_ -Cie rA c_(,v G(�✓' .
91a C—c<<-a , —I i`E wl Ot (✓I. �1i1-'A S� G�•
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Applicant: PC( \ ( JGc.C(..* Tel. No.: -771(-3C3
Address: PQ &DV 7`41 \la( ,i off. , Y ),-(- i 1 l 14 O,Ct-7c Date Filed: 7/a'(! iC'a-c)-
**/fyou would like e-mail notification of sign off please provide e-mail address: page(C CIO S -7� (Z � a (1 00 , c c.,,4-1
Owner Name: -e- ie ,CGcn c'
Owner Address: "379 Ct)-e;� ed. Owner Tel. No.: 5O&- 3111- Cr&
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: 7^ 6
PLEASE NOTE
COMMENTS/CONDITIONS:
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