HomeMy WebLinkAbout2022 Sign off Transmittal - Second Floor Addition SYR TOWN OF YARMOUTH
4 ;F. HEALTH DEPARTMENT
' '•CN PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 60 7 /cerfai _ S. Ya.rltil Ott
Proposed Improvement: 14 0 rtoC b u & 1-ecce d - ('naw, cekk v\ CP.wiare
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Applicant: Pc4-0.. jeA.c.ObC Tel. No.: 1 (-3533-68Sa
Address: Pio, fi 0x P/4( YartvtoteA t2ar(t rM PI- bio 7 Date Filed: fFl
**If you would like e-mail notification of sign off,please provide e-mail address: patj4 c 04,f 70 ay A-hop . C Ori -
Owner Name: y PO rczl� - V7
Owner Address: (07 fi 'd i` S• YanktOVA Owner Tel. No.: G t 7-"NB- 8368
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,
AUG 2 3 2022 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: �j S
PLEASE NOTE
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INFORMATION ON THIS PLAN WAS TAKING FROM A PLOT PLAN
PREPARED BY RONALD CADILAC LAND SURVEYOR, WEST YARMOUTH
MA.—DATED JUNE 9, 2017
ARCHITECTURAL SITE PLA
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1ST FLOOR LIVING SPACE 974 S.F. co CARBON MONOXIDE DETECTOR
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REVISIONS:
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