HomeMy WebLinkAbout2022 Sign Off Transmittal - Inground Pool — Fool; 01%)J y
TOWN OF YARMOUTH
.�� HEALTH DEPARTMENT
VIS
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: 33 'I-4soti f- s4 --
Proposed Improvement: Pc.v L.
Applicant: O. Tel. No.: 77Y-t/7 0/C3
016V:1--
Address:
1 VfAddress: G/ /4irs4.?...,s /44,6 Date Filed: 7,2G-2Z.
**If you would like e-mail notification of sign off please provide e-mail address:
Owner Name: c y 5 -- 1,5�►r
Owner Address: AT 2 ®t74,so4.-4-- S 4,4— Owner Tel. No.: 7 Ti- x7-.77r
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,
REGEIV and septic system location;
(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: - Q DATE: 8'a -a
PLEASE NOTE
COMMENTS/CONDITIONS:
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12, 3