HomeMy WebLinkAbout2022 Sign off Transmittal - Rebuilding Front Deck .C1N TOWN OF YARMOUTH AUG 1 7 2022
HEALTH DEPARTMENT
.' HEALTH DEPT.
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: 2q 124e. )//wkG'dI -/ -
Proposed Improvement: ft ii/iy 4i"i1t'7 /9#4 Firov-T—
Applicant:
/0A/I/mt/1/ Tel. No.: cOg-7/3 " 5
Address: r)9 P44-- letemolArot+ Date Filed: g//-7/...2;—
**/fyou would like e-mail notification of sign off,please provide e-mail address:
Owner Name: fJ, /IrI1LI t/9Xc)
Owner Address: g/ ///1`f- ` ya,,2.44,44 4 Owner Tel. No.: cog '7/3 -7a441.5
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: 0}) /0\/ : DATE: v —0
PLEASE NOTE — la (9-'-
COMMENTS/CONDITIONS:
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