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2021 Sign off Transmittal - Finish Basement
r Y44, TOWN OF YARMOUTH ° J : HEALTH DEPARTMENT �IH PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant. Building Site Location: /c / Proposed Improvement: ,; i< r c. w ' c v o r C 4-e C,()-e' gq. ( s pc Applicant: s - Tel. No.:` Address: ' ; ! ; , (-�. . y/r1 :LI /.-\ C 'Date Filed: **If you would like e-mail notification of sign off please provide e-mail address: i Owner Name: :�« Owner Address: '-1/ 1 Li 1,v", /i c;t ' - 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, L=:=. and septic system location; OCT 5 `1021 (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: CdDATE: 4,4 ' PLEASE NOTE COMMENTS/CONDITIONS: 1 L.� 1 \ 1Master Suite I5'X 126 I vaulted ceiling l i III - Maste 0 I. bath 4 . ..._ Living 0 In •,l llo°x 13° 1,11 cathedral ceiling Powpdem �r ll 12p ►i ,1) , 11p foyeru tli liiisolow t--Mr broom � l OCT 5 2021 110-8,1111, HEALTH DEPT, ni, 1 ' , Kitchen 116x89 [Lqi___I IN the - Town h ornes D ,.....,ros ,, f KINGS WAY I Falf at Yarmouth Port ni ly/E reakfast plan ti i16,4x !i° ,' vaulted ceiling r 4 ui t "lf. 'e imo , w `'i { , Garage T 7I. 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